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VETM 522 > GI > Flashcards

GI Flashcards

1
Q

what is the most important part of a GI workup

A

history: ask about diet and presenting complaint

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2
Q

dysphagia is due to

A

oral cavity/laryngeal/upper esophageal disease

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3
Q

dysphagia C/S, ddx

A

trouble eating/grabbing food, difficult swallowing, exaggerated head movements, coughing/aspiration

ddx- severe dental disease, oral masses, neuro disease

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4
Q

vomiting vs regurg

A

vomiting- active process, nausea, GI material from stomach, indicates GI disease
regurg- passive, no nausea, GI material esophagus, indicates esophageal problem

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5
Q

sm vs lg bowel d+

A

SI- lg volume, melena, can have fat, v+, weight loss

LI- sm volume, tenesmus, mucous, fresh blood

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6
Q

ddx for anorexia in cats

A

pretty much anything, hepatic lipidosis, IBD

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7
Q

acute vs chronic GI

A

acute- self limiting, less diagnostics (unless GI urgency markers)

chronic- lasting more than 2-3wks, defined therapeutic trial/more diagnostics

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8
Q

differentials for GI

A

dysphagia/regurg- separate

anorexia, v+/d+, weight loss
primary vs secondary GI

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9
Q

therapeutic vs diagnostic tests

A

therapeutic trial- v+/d+ w no urgency markers, chronic w no progression or weight loss
diagnostics- chronic w/ progresion, dysphagia or regurg

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10
Q

GI urgency markers

A

unstable patients, weight loss, painful abdomen, low TP, effusion, prolonged anorexia, intractable vomiting

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11
Q

steps to therapeutic trial

A
  1. initial problem and urgency
  2. eliminate simple disease first (dewormer)
  3. eliminate dietary factors- diet trial
  4. treat symptoms
  5. hydration
  6. further workup if no resolution
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12
Q

GI tx (no urgency markers)

A

acute v+- MPO trial, GI diet, probiotics, antiemetic, deworm
acute d+- probiotics, GI diet +/- deworm, abx
chronic v+- elimination diet, deworm, probiotics
chronic d+- elimination diet, probiotics, fiber for lg bowel, abx

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13
Q

gi diet vs elimination diets

A

GI- highly digestible, low fat 1wk diet w transition

elimination- hypo diet to eliminate rxns 6-8wks

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14
Q

abx therapeutic trials

A

metro 8-12mg/kg q12 3-5d
tylosin 10-15mg/kg q12
fenben- 50mg/kg q24 5d

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15
Q

NPO for acute v+

A

NPO for 12h-> sm amount water q2h (if v+ do diagnostics)-> sm amount food 2-3d-> reintroduce diet 25% for 1-2d

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16
Q

other therapeutic trial meds

A

prebiotic, probiotics, anti-emetic, antacid, deworm, sucralfate (antacid and sucralfate probably don’t work)

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17
Q

when to use SQ or IV fluids

A

<5% under 25kg-> SQ
>5% or shocky-> IVF

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18
Q

normal swallowing stages

A

oral - prehension
pharyngeal- moving towards esophagus
cricopharyngeal- relaxation of upper esophageal sphincter

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19
Q

gastroesophageal reflux

A

reflux of gastric acid into esophagus. LES (striated and smooth muscle in dogs, smooth only in cats)

causes: LES incompetence, motility disorder, FB, v+, GERD

prolonged fasting >24h, anesthetic

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20
Q

esophagitis C/S, dx

A

anorexia, regurg, drooling, coughing, loud vocalization after eating, many are subclinical

dx- hx, C/S, TXR, can do contrast rads/scope

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21
Q

esophagitis tx

A

PPI- omeprazole 1mg/kg PO q12 for 2d then q24 7-10d, panto if IV

+/- cisapride, sucralfate
prognosis good

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22
Q

esophageal FB signalment, C/S

A

common in dogs, near LES< base of heart-> mucosal damage, ulcers, perf

acute regurg, gagging, hypersalivation, pain

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23
Q

esophageal FB dx, tx

A

dx- rads, scope
tx- scope to remove, push into stomach-> gastrotomy?

prognosis good, risk stricture

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24
Q

esophageal strictures

A

secondary to esophagitis (FB, reflux)

dx- esophagram w contrast, scope

tx- balloon dilation (3tx) can perforate

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25
Q

hiatal hernias

A

repeated protrusion of abd contents into thorax-> reduced LES tone

congenital- bulldogs, brachys
trauma induced

C/S- regurg, v+, repeated aspiration pneumonia
dx- rads, scope

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26
Q

hiatal hernia tx

A

medical- PPI, low fat diet, prokinetic
surgical- hernia reduction

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27
Q

PRAA

A

embryonic R aortic arch becomes aorta
GSD, greyhounds

regurg solid food, underdeveloped puppy, aspiration pneumonia

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28
Q

PRAA dx

A

contrast rads, fluoroscopy

tx- surgical correction

prognosis fair to poor

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29
Q

megaesophagus causes

A

congenital- schnauzer, GSD, great dane
acquired- idiopathic, chronic esophagitis, myasthenia gravis

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30
Q

megaesophagus C/S, dx

A

regurg, weight loss, cough/fever if acute
dx- TXR

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31
Q

megaesophagus tx

A

acute- abx to prevent aspiration

feed elevated, prevent weight loss, treat diseases for secondary

32
Q

secondary megaesophagus diseases

A

myasthenia gravis, lupus, addisons, hypothyroid

33
Q

acute gastritis/gastroenteritis

A

sudden gastric insult causing vomiting
C/S- v+, hematemesis, anorexia, d+
usually primary GI causes

34
Q

acute gastritis dx

A

clinical, hx- no urgency markers

tx with therapeutic trial

35
Q

chronic gastritis

A

chronic/intermittent or daily vomiting
cause rarely found-> likely dietary intolerance

tx- therapeutic trial (hypo diets)

36
Q

GI diagnostics for failed trial or urgency

A

AXR (FB), U/S (chronic), scope (biopsy), sx biopsy (full thickness), GI panel, fecal float

37
Q

helicobacter pylori

A

chronic v+ that doesnt respond, found in healthy and vomiting dogs, can respond to tx

38
Q

helicobacter dx,tx

A

scope w biopsy (bacteria seen on histopath)
urease test- not sensitive
tx- metro, amoxiciliin, famotidine

39
Q

delayed emptying/motility disorders

A

C/S- vomiting hrs after a meal, abd distension, bloating

causes- pyloric hypertrophic, neoplasia, pancreatitis, idiopathic, IBD

dx- scope, biopsies
tx- dietary low fat

40
Q

hairballs in cats

A

considered abnormal if frequent
vomiting hairballs-> delayed gastric emptying, neoplasia

41
Q

hairball tx

A
  1. special hairball diet
  2. dietary modification
  3. grooming
  4. small meals
  5. gastric lubricants
  6. prokinetics
42
Q

gastric ulcers

A

causes: decreased blood flow, hypersecretion of acid, NSAIDs, exercise-induced, addisons

C/S: v+, hematemesis, melena, pale MM, abd pain, shock

43
Q

gastric ulcers dx

A

CBC- regenerative anemia
chem panel- high BUN
rads, U/S, biopsies

44
Q

gastric ulcers tx

A

IVF, PPIs, sucralfate, anti-emetics, abx, opioids

45
Q

bilious vomiting syndrome

A

chronic intermittent vomiting early morning of bile
dx- clinical
tx- feed late, antacids

46
Q

HGE

A

acute hypersensitivity, hematochezia, acute dehydration.
c/s- dehydration, v+/d+, acute abdomen
hypovolemia, shock

tx- shock treatment , NPO, metro?

47
Q

canine parvovirus

A

fecal oral route, infect rapidly dividing cells
C/S- 4-7d post infection
acute v+/d+, depression, fever

dx- leukopenia, anemia, fecal Ag ELISA 10-12d after infection

48
Q

parvo tx

A

supportive care: fluids, nutritional support (NGT), albumin transfusions, opioids

49
Q

feline panleukopenia mortality?

A

mortality 50-90%

50
Q

giardia

A

acute d+, v+
young animals, shelter
dx ELISA, PCR, zinc sulfate floats

tx- fenbendazole 50mg/kg SID 5d, repeat 3wks

51
Q

describe fecal tests and what they detect

A

fecal float- parasites
fluorescent Ab- crypto
fecal PCR- bacteria, but interpret carefully (w C/S)

52
Q

chronic SI diseases

A

food allergy- hypo food trial
gluten sensitive enteropathy- irish setters, celiac
dietary intolerance- individual specific ingredient intolerance

53
Q

ARD/SIBO

A

dysbiosis-> malabsorption, d+
primary- GSD, igA deficiency
secondary- abnormal GIT, chronic enteropathy (IBD)
dx- sm bowel d+, v+, weight loss (r/o other causes)

54
Q

advanced GI dx

A

cobalamin- low w IBD and bacterial overgrowth
folate- increased w ARD/SIBO decreased- mucosal disease

55
Q

EPI causes

A

insufficient pancreatic enzymes
primary in dogs- genetic (GSD)
secondary- cats (chronic pancreatitis)

56
Q

EPI dx, tx

A

C/S- loose stool, increased appetite, weight loss
dx- low TLI
tx- supplement enzymes, cobalamin, high quality diet

57
Q

key words for IBD

A

chronic
immune
inflammation
progressive

58
Q

IBD definition

A

collective disorders w persistent or recurring GI signs, histo evidence of inflammation
chronic, immune mediated enteropathy

59
Q

IBD pathophys

A

structural (tight junction, mucosal barrier)
environmental (dysbiosis, dietary)
genetic (local immune dysfunction, loss of self tolerance)

60
Q

what does the microbiome do

A

metabolic- fermentation to provide energy for cells
trophic effect- protective, influence nutrient uptake
crosstalk- chemokines/cytokines, GALT

61
Q

IBD C/S

A

chronic v+/d+, borborygmi, abd discomfort, altered appetite, weight loss

62
Q

IBD workup

A

history-> bloodwork (CBC/chem/UA, cortisol)-> GI panel (folate cobalamin, TLI,PLI)-> imaging (thickening , layer changes)-> GI biopsy (sx or scope), targeted therapy (deworming, diet, pred, abx)

63
Q

pros/cons of GI biopsy

A

inflammation is present w many disease, including IBD
use WSAVA grading system and C/S

64
Q

most common IBD

A

lymphoplasmacytic IBD
other: eosinophilic

65
Q

IBD tx

A
  1. hypo diet, pred 2mg/kg/d
    cobalamin, probiotic, metro, tylosine
  2. add cyclosporine, new diet
  3. other immunosuppressive, injectables
66
Q

IBD prognosis?

A

good to guarded, success not guaranteed

67
Q

PLE/lymphangiectasia

A

marked dilation and dysfunction, more than IBD
leakage of lymph
primary idiopathic (most common), secondary (obstructive)

C/s- D+, weight loss, hyporexia, ascites

dx- panhypoproteinemia, hypocholesterolemia
r/o PLN, Gi biopsy

68
Q

lymphangectasia tx

A

fat restriction, pred, cobalamin supplementation

prognosis good to poor

69
Q

histiocytic ulcerative colitis

A

young boxers- e coli in macrophages
hx, C/S- severe chronic lg bowel d+, weight loss, hematochezia

70
Q

histiocytic ulcerative colitis dx, tx

A

colonic biopsy via scope
tx- enrofloxacin, 5-10mg/kg SID 4-8wks

relapse frequent, good prognosis

71
Q

constipation causes

A

pelvic fx, neuro disease, diet change, dehydration, CKD, idiopathic megacolon

72
Q

megacolon

A

C/S- cats w progressive dilation of colon, loss of smooth muscle function

dx- PE, rads
tx- enema if mild, deobstipation if severe

73
Q

chronic therapy for megacolon

A

weight loss if overweight
chronic laxatives (lactolose, restoralax)
low fat diet
prokinetics
sx- subtotal colectomy

74
Q

tritrichomonas fetus

A

chronic lg or sm bowel d+ in cats
shelter cats
dx- PCR (fecal)

tx- ronidazole

75
Q

anal gland abscess tx

A

sx (flush) amoxiclav for 5-7d

76
Q

perianal hernias cause, C/S, dx, tx

A

chronic straining, IBD
C/S- none, swelling, tenesmus, painful defecation
dx- rectal exam
tx- sx

77
Q

perianal fistula signalment, cause, ddx, dx, tx

A

chronic progressive immune disease older GSD
immune dysfunction
ddx: neoplasia, anal gland disease
dx- C/S, biopsies
tx- cyclosporine
good prognosis

VETM 522 (22 decks)

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