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RUSVM Small Animal Medicine 2- A > GI Diseases > Flashcards

GI Diseases Flashcards

1
Q

Which of the following factors has not been implicated as an etiology of acute pancreatitis? A.Hypercalcemia B. Corticosteroids C. Trauma and surgery D. Hypertriglyceridemia E. Phenobarbitone in dogs F. L-aspariginase chemotherapy G. Septic shock H. Organophosphate in cats

A

B. Corticosteroids

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2
Q

What is the sensitivity of abdominal US in Dx acute pancreatitis in dogs? A. 5-15% B. 20-30% C. 55-70% D. 80-90%

A

55-70%

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3
Q

What statement regarding the accuracies (Sens & Spec)of pancreatic tests is correct? A. SPEC cPL >400 ng/mL is 90% specific B. The sensitivity of SNAP cPL is 87% for diagnosing mild or chronic pancreatitis C. Reduced GFR will cause false positive cPL D. cTLI is 80% sensitive for diagnosing spontaneous pancreatitis in dogs

A

A. SPEC cPL >400 ng/mL is 90% specific

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4
Q

Ultrasonographic changes of acute pancreatitis include all, except? A.Peripancreatic hyperechogenicity B. Pancreatic hyperechogenicity C. Duodenal corrugation D. Peritoneal anechoic fluid

A

B. Pancreatic hyperechogenicity

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5
Q

What is the most sensitive individual diagnostic test for acute pancreatitis in dogs? A. Abdominal radiograph B. Abdominal ultrasound C. Serum amylase activity D. Serum lipase activity E. cTLI F. cPL G Ultrasound guided FNA and cytology

A

F. cPL

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6
Q

A dog that has acute abdomen, elevated ALT and abnormal cPL (SNAP). Which is the correct statement/plan? A. You have made a diagnosis of acute pancreatitis as the cause of the acute abdomen B. Recommend and abdominal ultrasound C. Recommend abdominal contrast enhanced CT D. Additional assays like cTLI and urine Trypsin-alpha 1 protease inhibitor are indicated due to superior specificity

A

B. Recommend and abdominal ultrasound

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7
Q

What is the currently accepted diagnostic test in a dog with a high index of suspicion of pancreatitis? A. Amylase and lipase with cTLI B. Combination of abdominal US and cPL which is 84% sens and 75% specific C. Contrast enhanced abdominal CT D. Celiotomy with multiple biopsies

A

B. Combination of abdominal US and cPL which is 84% sens and 75% specific

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8
Q

Current EBM supports the diagnosis of specific therapy for acute pancreatitis. Which therapy in dogs is not specifically indicated? A. Crystalloid resuscitation B. Fentanyl CRI C. Broad spectrum antibiotics D. Maropitant, NK1 receptor antagonist

A

C. Broad spectrum antibiotics

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9
Q

Current feeding recommendations are enteral or PPN as soon as vomiting is under control or long-term dietary changes with dogs that have dyslipidemia. What diet should be fed? A. I/D B. Z/D C. Selected Protein D. Intestinal Low fat

A

D. Intestinal Low fat

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10
Q

What is the most common clinical sign in cats with pancreatitis? A. Vomiting and diarrhea B. Abdominal pain C. Anorexia and lethargy D. Icterus

A

C. Anorexia and lethargy

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11
Q

What is reported as an important prognosticators in cats that present with acute pancreatitis? A. BCS, overweight cats have more severe pancreatitis B. Age, older cats do poorly C. Hyperkalemia & hypoCa with hypothermia D. Left shift neutrophilia

A

C. Hyperkalemia & hypoCa with hypothermia

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12
Q

Which statement regarding pancreatitis is true? A.The most common form of pancreatitis in dogs is acute B. The most common form of pancreatitis in cats is acute C. The most common form of pancreatitis in dogs and cats is chronic, or chronic active D. Obesity is a predisposing factor for AP and is associated with worse pancreatitis in both dogs and cats E. High fat diets/dietary indiscretion can cause pancreatitis in both dogs and cats F. Vomiting and abdominal pain are hallmark clinical signs in both dogs and cats

A

C. The most common form of pancreatitis in dogs and cats is chronic, or chronic active

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13
Q

Which statement regarding the diagnostic accuracies of tests for pancreatitis in cats is correct? A. Radiography is highly sensitive and specific in pancreatitis B. Abdominal ultrasound is insensitive (23% agreement with necropsy), but fairly specific as in peripancreatic hyperechogenicity being diagnostic C. fTLI has a long half-life and a sensitivity of 80% fPL is extremely sens. in mild acute pancreatitis and chronic pancreatitis D. Serum amylase and lipase are at least 70-80% sensitive in the diagnosis of pancreatitis

A

B. Abdominal ultrasound is insensitive (23% agreement with necropsy), but fairly specific as in peripancreatic hyperechogenicity being diagnostic

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14
Q

Which is not a complication of chronic active pancreatitis in dogs? A. EPI B. Pseudocyst C. Pancreatic abscess D. Diabetes mellitus E. Pancreatic bladder

A

E. Pancreatic bladder

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15
Q

Bobby is referred to your clinic for further investigation of liver disease. He is weak, with non-specific signs of pain. Biochemistry shows, ALT (2 x TN), AST (4 x TN). What should you also test? A. Liver enzymes: ALKP, GGT, Abdominal US B. Muscle enzymes: CK, LDH; EMG and Toxo titres, 2M Ab assay

A

B. Muscle enzymes: CK, LDH; EMG and Toxo titres, 2M Ab assay

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16
Q

Maggie, a 6 year old, FS Shih tsu, visits your practice for a routine health screen. She has been diagnosed with idiopathic epilepsy and is on phenobarb. She is otherwise healthy. Biochemistry detects 10 x TN ALKP, 8 x TN ALT.Which is the correct statement? A. This is enzyme induction from phenobarbitone B. The liver enzymes are prognostic of phenobarb damage C. Recommend liver function testing and US/biopsy D. Immediately discontinue the phenobarb

A

C. Recommend liver function testing and US/biopsy

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17
Q

Mable, a 6 year old, FS Labrador retriever visits your practice for a routine health screen. She is otherwise healthy. Biochemistry detects 2 x TN ALT.What do you recommend to the owner? A. This is a mild increase, nothing to worry about as it does not indicate dysfunction B. Recheck in 3-5 days, ensure it decreases by 50% C. Start on SAMe, Ursodiol liver supplements D. Recommend liver function testing E. Recommend abdominal ultrasound

A

All but A! B. Recheck in 3-5 days, ensure it decreases by 50% C. Start on SAMe, Ursodiol liver supplements D. Recommend liver function testing E. Recommend abdominal ultrasound

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18
Q

“Silkworm”, a 2 year old overweight, MN, DSH is presented to your clinic for anorexia. Biochemistry tests detect 2 x TN ALKP.Which interpretation is correct? A. ALKP has many isoenzymes. This is not liver specific B. ALKP is liver specific for the cat and “Silkworm” has hepatic lipidosis C. Increased ALKP is not significant, due to the long half life and it is ‘too sensitive

A

B. ALKP is liver specific for the cat and “Silkworm” has hepatic lipidosis

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19
Q

“Quinn”, a 2 year, MN, Cockapoo in ICU is being treated for onion toxicity and has received a blood transfusion for anemia. He is now icteric.Which statement is correct regarding liver function? A. A bile acid stim. test is indicated to confirm liver dysfunction B. An abdominal US excluding EHBO is sufficient to confirm liver dysfunction C. There is no liver dysfunction, this is all pre-hepatic hemolysis

A

B. An abdominal US excluding EHBO is sufficient to confirm liver dysfunction

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20
Q

You are managing a 6 month old Yorkshire terrier with neurological signs, microcytosis and ammonium biurate crystalluria. How would you investigate for PSS? A. Ammonia tolerance test B. Bile acid stim C. Urea, Alb, Gluc D. Liver biopsy

A

B. Bile acid stim

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21
Q

Midge, a 4 year old Fox terrier has weight loss, mild hypoalbuminemia. There is microhepatica. How would confirm liver failure? A. Bile acid stim B. Ammonia tolerance test C. Low albumin, urea, gluc D. Prolonged PT/aPTT

A

B. Ammonia tolerance test

22
Q

Considering the risks and diagnostic value of each biopsy technique. Which biopsy method is the best option for dogs with non-infiltrative/neoplastic liver disease? A. FNA B. Menghini tru-cut C. Laparotomy/laparoscopy

A

C. Laparotomy/laparoscopy

23
Q

Which is not a short-term prognosticator in the case of biliary mucocoeles?

A. Hyperlactatemia

B. Hypotension

C. GB rupture

D. Anemia

A

C. GB rupture

24
Q

A 10 year old, MN, Golden retriever presents to your clinic with PuPd. Biochemistry detected a 4 x TN ALKP and mild hypoglycemia (BG 3.4 mmol/l, RI 3.5-5.5 mmol/l). Ultrasound detects the following lesion. What is your tentative diagnosis?

A.Lymphoma

B.Hepatocellular carcinoma

C.Hemangiosarcoma

D.Biliary cystadenoma

A

B.Hepatocellular carcinoma

25
Q

A 9 year old Persian presents to your clinic with anorexia and icterus. The abdomen is painful and the liver enlarged. Ultrasound findings below. Biopsy confirms neutrophils periportal but not beyond the limiting plate. Dx?

A.Chronic lymphocytic cholangitis

B.Acute suppurative cholangitis

C.Hepatic lipidosis

D.Cholelith

A
26
Q

A doberman in Finland presents with weight loss, 2 x TN ALT, with abnormal BAS. You diagnose chronic hepatitis (CH) tentatively. What is the best course of action?

A.Start liver supportive care

B.Start prednisolone as Dobermans suffer from immune mediated CH

C.Biopsy the liver after a PT/aPTT screen

A

C.Biopsy the liver after a PT/aPTT screen

27
Q

Which is the parameter associated with the worst outcome (prognosticator) in CH

A.Normal liver enzymes

B.Copper conc. > 1500

C.Ascites with hypoalbuminemia

D.Prolonged PT/aPTT

A

D.Prolonged PT/aPTT

28
Q

Lady, a 6 year old Labrador has been under your care for CH for 2 months. Today she presents like this. What do you recommend as first line of treatment?

A.Drain all the fluid by adominocentesis

B.Spirinolactone at 2 mg/kg/d

C.Furosemide 2 mg/kg/d

D.Colloid like hetastarch

A

B.Spirinolactone at 2 mg/kg/d

29
Q

What is the mechanism of action of lactulose in resolving hepatic encephalopathy

A.Laxative

B.Purgative

C.Resolves dysbiosis

D.Ion trapping

E.Resolves alkalosis

A

D.Ion trapping

30
Q

Which is not a hepatotoxin?

A. Blue-green alge

B. Mouldy Corn

C. Braken Fern

D. Mushrooms

E. Day-lily

A

E. Day-lily

31
Q

Enteral nutrition for cats with HL should be supplemented with which essential amino acid (11) to assist mitochondrial fatty acid oxidation?

A.L-carnitine

B.Arginine

C.Taurine

D. Methionine

A

A.L-carnitine

32
Q

A 10 year old MN Pit Bull presents with shifting forelimb lameness and a history of regurgitation and odynophagia. On clinical examination you palpate enlarged mandibular salivary glands and firm thickening of the radial metaphyseal area. What is the most likely etiology?

A.Bronchoalveolar carcinoma

B.Panosteitis

C.Spirocercosis

D.Idiopathic sialoadenitis

A

C.Spirocercosis

33
Q

3 month old Shar pei. What is the diagnosis?

A.Esophageal FB

B.Spirocercosis

C.Vascular ring anomaly

D.Sliding hiatal hernia

A

D.Sliding hiatal hernia

34
Q

An otherwise healthy 4-year old border collie. PC: regurgitation. What is your diagnosis?

A.Vascular ring anomaly

B.Sliding hiatal hernia

C.Idiopathic megaesophagus

D.Esophageal FB

A

C.Idiopathic megaesophagus

35
Q

6 month old FS dachshund. Spayed 2 weeks prior. PC: BAR but regurgitating. Most likely Dx?

A.Idiopathic megaesophagus

B.Vascular ring anomaly

C.Esophageal FB

D.Esophageal stricture

A

D.Esophageal stricture

36
Q

In confirming Helicobacter spp. infection of the stomach mucosa. Which is the test with best sensitivity and the quickest turn-around time?

A.Endoscopic biopsy with histopathology

B.Endoscopic biopsy and urease test

C.Urea breath test

D.Endoscopy with cytobrush for cytology

A

D.Endoscopy with cytobrush for cytology

37
Q

A 12 week old Boston terrier presents to your clinic with the complaint of projectile vomiting. Based on the signalment what is the most likely diagnosis?

A.Gastric lymphoma

B.Gastric adenocarcinoma

C.Pithiosis

D.Antral pyloric stenosis

A

D.Antral pyloric stenosis

38
Q

A 1 year old male Labrador from Alabama has a history of projectile vomiting. You ultrasound the abdomen and find this abnormality at the pylorus cross-section. Considering the signalment and history, what is the tentative diagnosis?

A.Acquired antral pyloric hyperplasia

B.Congenital pyloric stenosis

C.Pythiosis

D.Intessusception

A

C.Pythiosis

39
Q

An otherwise healthy dog (5 year old, FS Bichon) is referred for chronic small bowel diarrhoea. After exclusion of parasites, biochemistry and hematology WNL, and above reference cTLI with no response to a food and drug trial you decide to biopsy. Ultrasound shows thickened ileal wall but normal layering. What is your biopsy technique of choice?

A.US guided FNA

B.US guided tru-cut

C.Celiotomy biopsy

D.Endoscopic biopsy

A

C.Celiotomy biopsy

40
Q

A 2 year old M(N) Bengal cat presents with a 14 day history of green, malodorous stool, with tenesmus and mucous in the stool. The cat is otherwise healthy with normal hematology and biochemistry. The previous vet treated with antibiotics and a bland diet, but there was no response. The most likely differential diagnosis is?

A.IBD

B.Lymphoma

C.Pancreatitis

D.T. foetus

E.Garbage syndrome

A

D.T. foetus

41
Q

The most important risk factor for the development of biliary mucoceles are?

A.Hyperlipidemia

B.Hypothyroidism

C.Diabetes mellitus

D.Pancreatitis

A

A.Hyperlipidemia

42
Q

Which is the classic feature of small bowel enteritis in contrast to large bowel enteritis?

A.Mucous

B.Tenesmus

C.Dyschezia

D.Hematochezia

E.Low volume

F.Hypocobalaminemia

A

F.Hypocobalaminemia

43
Q

In the case of PLE caused by IBD which therapy correct?

A.Sulfasalazine

B.Clopidegral

C.Metamucil

D. Sucralfate

A

B.Clopidegral

44
Q

A dog with chronic small bowel 2 week hypoallergenic food trial or 28 day metronidazole trial. What is not a diagnostic option?

A.Cobalamine concentration

B.cTLI

C.cPL

D.Endoscopic duodenal biopsy

E.Extend the food trial for one more month

A

E.Extend the food trial for one more month

45
Q

A cat presents with a history of weight loss and small bowel diarrhea. Fecal flotation was negative. CBC and clinic chemistry including [Alb] is WNL. Abdominal ultrasound reveals the following intestinal pattern at the level of the ilium. What is the next best diagnostic test?

A.Endoscopic biopsy

B.Celiotomy biopsy

C.Cobalamine concentration

D.Thoracic radiographs

A

B.Celiotomy biopsy

C.Cobalamine concentration

D.Thoracic radiographs

46
Q

This 1.5 year FS Yorkshire terrier presents with chronic diarrhea, severe hypoalbuminemia and hypocalcemia. What is the most likely diagnosis?

A.Chronic lymphoplasmocytic IBD

B.Lymphangiectasia

C.Ulcerative colitis

D.EPI

E.Chronic pancreatitis

A

B.Lymphangiectasia

47
Q

A 2 year old M(N) Bengal cat presents with a 14 day history of green, malodorous stool, with tenesmus and mucous in the stool. The cat is otherwise healthy with normal hematology and biochemistry. The previous vet treated with antibiotics and a bland diet, but there was no response. The most likely differential diagnosis is?

A.IBD

B.Lymphoma

C.Pancreatitis

D.T. foetus

E.Garbage syndrome

A

D.T. foetus

48
Q

You have diagnosed histiocytic ulcerative colitis in a 3 year Boxer. What is the indicated therapy?

A.Metronidazole

B.Enrofloxacin

C.Prednisilone

D.Amoxycillin-clavulonate

E.Azothioprine

F.Mycophenolate mofetil

A

B.Enrofloxacin

49
Q

A dog vocalizes when defecating, scoots and licks and bites at the perineal area. This condition is?

A.Tenesmus

B.Dyschezia

C.Colitis

D.Rectoanal disease

A

D.Rectoanal disease

50
Q

A 10 year old overweight Keeshond, presents with a history of recurring constipation. You detect hypercalcemia on blood tests.
Considering the signalment and presenting complaint, the most likely underlying etiology is?

A.Addison’s disease

B.Hypothyroidism

C.Chronic kidney disease

D.Hyperparathyroidism

A

D.Hyperparathyroidism

51
Q

A cat presents with severe constipation. The first line of Rx is?

A.Intravenous fluid therapy

B.Lubricant laxative

C.Osmotic laxative

D.Manual extraction

A

A.Intravenous fluid therapy

52
Q

A GSD has body odor and perineal microabcesses on inspection. What is the specific therapy (not supportive) for this dog?

A.Chlorhexidine wash

B.Cephalexin

C.Ciclosporin

D.Prednisolone

A

C.Ciclosporin

RUSVM Small Animal Medicine 2- A (8 decks)

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