GI Papers Flashcards
1
Q
How is bacterial alpha-diversity different in dogs with FRE?
A
Lower alpha diversity than normal dots
2
Q
What does animal protein extrusion diet change do to the microbiome of dogs with FRE?
A
Increase microbiota richness
3
Q
What bacteria are more likely to be found in FRE dog compared to healthy control?
A
Citrobacter, enterobacter
4
Q
What stain is unable to detect degranulated eosinophils and what stain should be used instead?
A
H&E does not detect, Epx mAb (monoclonal antibody against eosinophil peroxidase) allows identification of degranulated eosinophils
5
Q
What segment of the GI tract is more likely to have increased number of eosinophils in dogs with eosinophilic enteritis?
A
Duodenum
6
Q
What location of the small intestine is ASBT expressed? What segment has the highest expression?
A
Ileum is the highest, expressed in ileum, cecum, colon
7
Q
How is the expression of ASBT in dogs with CIE different from healthy dogs? How is ASBT correlated with histopathologic inflammatory score?
A
Decreased expression in ileum, negatively correlates with histopath
8
Q
How are bile acids percentage different in dogs with CIE?
A
Less primary bile acids compared to healthy dogs
9
Q
How many dogs with AHDS, parvo, and healthy dogs are fecal PCR positive for netE and netF?
A
48.1% AHDS dogs, 0% parvo dogs, 12.1% healthy dogs
10
Q
How is netF and netE associated with outcome (hospitalization time, time to recovery, and lab variables) of dogs with ADHD?
A
No association
11
Q
How many dogs is PLE life ending compared to IBD?
A
54.2% PLE, <20% IBD
12
Q
What size biopsy forceps are ideal for feline GI biopsies and what are benefits of using this size forceps?
A
2.4 mm better than 1.8 mm, higher percent of adequate samples, indirectly decrease % of artifacts and increases evaluable villi
13
Q
What is the ideal dose of esomepraozle to increase gastric pH to 3 and 4?
A
No difference in 0.5 mg/kg IV q12h or 1 mg/kg IV q12h for 48 hours
14
Q
What two parameters in dogs with CIE are associated with death?
A
BUN and CCEAI score
15
Q
How is CCEAI score associated with death? What score and BUN level is associated with increased survival and for how much longer?
A
Each unit increase in CCEAI, hazard of death increased by 22.9%
CCEAI score less than 8: 256 days longer
BUN<7: 279 days longer
16
Q
What individual factors are not associated with death from CIE?
A
BCS, % weight loss, appetite, albumin, creatinine, cobalamin, folate
17
Q
How does administered oral famotidine to cats once per day vs twice per day differ?
A
Twice daily administration has a diminished effect on increased intragastric pH by 13 days of administration
18
Q
How many cats with abnormal histopathology had no clinical signs of GI disease?
A
17 cats after 709 days
19
Q
How is duodenal perfusion by contrast enhanced ultrasonography different in dogs with CIE compared to healthy dogs and compared to lymphoma?
A
Peak intensity higher in CIE compared to healthy dogs, no difference between CIE and lymphoma
20
Q
What should be performed alongside giardia IFA to mitigate difference in sensitivity and specificity in brands of testing?
A
Combine with ZnSO4 centrifugation. All tests have a similar sn and sp
21
Q
What is the PPV values and NPV of ultrasound to predict histologic lesions in cats with chronic enteropathy?
A
PPV: duodenum 82%, jejunum 91%, ileum 88.1%
NPV: 27.1%, jejunum 27.3%, ileum 40.4%
22
Q
What layer of lesion is ultrasound best at predicting?
A
Mucosal lesion, low for submucosal and muscularis
23
Q
How does Pro-Kolin paste affect acute diarrhea outcome?
A
Shorter duration of diarrhea (32h) and 1.6 times faster resolution
24
Q
In dog with chronic enteropathy, how are fecal unconjugated bile acids different and how long do you expect them to improve after treatment?
A
Lower in dogs with CE, should increase after 2-3 months of treatment
25
What is the complication rate of e-tube placement in cats? (feline study)
35.8% complication, 14.5% dislodgement, 12.1% infection
26
What increases the odds ratio of e-tube site infection and to what degree?
Glucocorticoid or oncologic agent (3.91 OR)
Discharge at stoma site (159.8)
27
What is the outcome of botox injection and mechanical dilation and how long were these effects?
100% clients reported improvement, BW increased 20% regurgitation frequency decreased by 80%, lasts 40 days
28
What amino acids are lower in dogs with IBD? Which one correlates with CCECAI score?
Methionine, proline, serine, and tryptophan . Serine negatively correlated with CCECAI score
29
What SCFA are lower in dogs with CE?
Acetate and propionate
30
How do synbiotics affect clinical signs of dogs receiving antibiotics?
Decreases food intake derangements
31
What is the length of clinical effects of dogs receiving synbiotics?
>9 weeks
32
What are three swallow study features of dogs with LES achalasia like syndrome and what is the frequency of these features?
Megaesophagus: 73.7%
Birdbeak 63.2%
Esophageal fluid line: 68.4%
33
In how many dogs were mucosal hemorrhagicic lesions identified by capsules endoscopy in the stomach and SI?
15/16 stomach, 12/14 SI
2 capsules did not leave stomach
34
How many cats with hiatal hernia had comorbidities (upper airway obstruction)?
77.4% upper airway obstruction
35
What is the most common type of hiatal hernia in cats and what percent of cats is this seen in?
85.7% type I hiatal hernia
36
What is the MST of cats with hiatal hernia? Which cats survived longer, medical or surgical?
MST 959, cats treated medically survived longer
37
OR of ulceration for dogs receiving prednisone
11.1
38
OR of ulceration for dogs recieving prednisone and aspirin
31.5
39
what is more effective at increasing gastric pH, famotidine q12h or CRI?
CRI, difference at all time periods (1, 2, and 3 days)
40
How does serum vitamin D binding protein differ between dogs with CIE and low 25OHD concentration vs normal 25OHD concentration?
No difference
41
In dogs with CIE with low serum 25OHD concentration, what other values are suspected to be higher or lower?
Higher CCECAI score and CRP, higher duodenal inflammatory lesions
Lower serum alpha-tocopherol, cholesterol, albumin
42
What markers can be used to differentiate between dogs with PLE needing steroids vs secondary immunosuppressants?
No markers
43
Median time albumin reached over 20 g/L in JVIM 2019 (Schmitz et al)?
13 days
44
What was the rate of complications in dogs and cats with E-tube placement? Risk of infection?
% needing surgical debridement?
44.4% complications
17.8% cats infection. 22.7% infected cats needed sx debridement
13.7% dogs. 35% of infected dogs needed sx debridement
45
How does fecal microbiome change with tylosin?
day 7 after tylosin decreased biodiversity
Primary UBA increased after day 21 and 63
Changes to not uniformly resolve after stopping tylosin
46
Odds of endoscopic mucosal lesion when recieving prednisone or prednisone + clopidogrel?
7 times higher compared to placebo
47
What drug is more likely to cause GI ulceration when given in combination with prednisone? Clopidogrel or aspirin?
Aspirin
48
What duodenal histopath markers correlate with CCECAI score?
Ki-67/CD3 ratio ion LP region of cryp is positively correlated with CCECAI in dogs with CE
49
How does metronidazole impact duration of acute diarrhea and fecal culture?
decreases fecal culture detection of C perfringens
Shortens diarrhea from 2.1 days from 3.6 days
50
How is procalcitonin associated with endotoxemia? How long does it take to increase, how long does it remain increase, and when does it normalize?
Increases with LPS injection
Increases by 2 hours
Remains increased for 12 hours
Back to normal at 48 hours
51
What cut off can be used for CCECAI score to predict diet responsive disease? what is the Sn and SP?
Cut off of 8
Sn 82.6%
Sp 88.9%
52
What is the sn, sp, and accuracy of clonality alone (out of context) for small cell lymphoma in cats?
Sn 85.7%
Sp 33.3%
Accuracy 61.5%
53
What marker can be used to aide in diagnosis of SCLSA in cats? Sn, Sp, and accuracy when compared to panel diagnosis?
Histology guided mass spectrometry
Sn 86.7%, Sp 91.7%, accuracy 88.9%
54
What drugs reach the target gastric pH within the first 72 hours of therapy?
Famotidine CRI and Esomeprazole
55
Is iatrogenic endoscopic perforation associated with severity of GI disease?
no
56
Survival rate of post iatrogenic perforation?
93%
57
What serum marker is associated with parvovirus? How is it associated with outcome?
Serum D-lactate higher in dogs with parvo
dogs hospitalized <4 days had lower D-lactate but not associated with survival
58
Difference in outcome of dogs with acute diarrhea treated with clavamox vs controls?
No difference in disease recovery
No difference in fecal dysbiosis scores
Increased proportion of clavamox resistant E coli in GI tract, persistent for 3 weeks
59
Best serum biomarker to detect IBD?
OmpC
60
Combination of OmpC with what other biomarker to differentiate between normal dogs and non-IBD GI disease?
OmpC + APMNA (autoantibodies against polymorphonuclear leukocytes)
Compared to controls: sn76-97% sp 93-99%
Compared to non-IBD: Sn 66-86% Sp 79-98%
61
Percent of normal dogs with reflux based on nuclear scintigraphy?
12/12 dogs, 5/12 had reflux to pharynx
none aspirated
62
How does exenatide impact gastric emptying?
delayed gastric emptying (GLP-1 agonist)
63
How many dogs with LPR had concurrent GI signs? what location of the GI tract is most severely affected?
52% have concurrent GI signs, esophagus and duodenum most severe effected
Remission or marked improvement when GI disease is treated
64
How does metronidazole impact fecal microbiome and how long do these effects last?
Decreases Fusobacteria
Increases fecal lactate
Decreases secondary BAs (deoxycholic acid and lithocholic acid)
Minimum of 4 weeks
65
How is albumin associated with gastric wall edema?
21.4% of dogs with hypoalbuminemia have gastric wall thickening
No correlation with severity of hypoalbuminemia
66
What medication has been shown to be efficacious for B12 supplementation in cats other than cyanocobalamin? How is it administered?
hydroxocobalamin
IM q2 weeks x 4
q4 weeks thereafter
67
out of esomeprazole, dexlansoprazole, and lansoprazole, which medication most effectively increased gastric pH?
Esomeprazole
68
What is the effect of prophylactic administration of PPIs in combination with NSAID?
Increases dysbiosis index
Increases fecal calprotectin (marker of inflammation)
No change in serum LPS or plasma iohexol
69
How does the microbiota differ in puppies vs adults? what age should be used as a cut off?
Increased abundance of C diff and decreased C hiranonisis
Less than 6 weeks of age
70
What percent of dogs with E coli associated GC have fluoroquinolone resistance?
62.5%
71
Prognosis of GC with antimicrobial treatment guided by C+S
80%
72
What minimally invasive imaging technique can be used to assess small intestinal inflammation?
SPIES (Storz Professional Image Enhancement System) aka endoscopic narrow band imaging-like endoscopy
73
What minimally invasive imaging technique can be used to assess colonic perfusion and inflammation?
contrast-enhanced ultrasound
74
How does HCT, BCS, and TIBC correlate with MMA?
What does this indicate?
HCT and BSC negatively correlate with MMA
TICB is lower in cats with increased MMA
Functional iron deficiency
75
Based on 2-dimensional fluorescence difference gel electrophoresis and nanoflow liquid chromatography tandem mass spectrometry, what can be used as a biomarker for IBD vs SCL?
none
76
How can diagnosis of small cell lymphoma be increased in cats only having an upper GI scope?
integrating IHC and clonality
77
How does fecal culture differ in dogs with chronic diarrhea compared to normal dogs?
no significant difference
78
How many dogs chronically treated with NSAIDs had GI erosions? Which NSAIDs cause lesions and how long for therapy?
83.3% of dogs had GI erosions
Meloxicam, carprofen, and firocoxib
6 months of therapy
79
What percent of dogs with CIE are hypercoagulable based on TEG?
44.7%
80
Does hypercoagulability in CIE correlate with albumin?
correlated with albumin if hypoalbuminemia (negative correlation with G value on TEG), but dogs with normal alb can still be hypercoagulable.
81
How many dogs with AHDS survive to discharge?
96%
Antimicrobials not positively associated with survival (77% of dogs survived who received 2 antimicrobials)
82
What treatment reduced signs of SIRS in dogs with AHDS?
rehydration
SIRS criteria may not be good marker for needed antimicrobials
83
What marker is increased in ADHS index at time of presentation?
CRP
84
Does it matter if omeprazole is enteric coated vs non-enteric coated?
no, enteric coated increases pH appropriately
85
What TEG abnormalities are seen in CIE and PLE dogs?
Hypercoagulable (higher MA, longer CLT, lower LY30 and LY60)
Don't need to be hypoalbuminemic
86
In dogs with CIE, what serum markers are associated with MA?
albumin, 25OHD, plasma antithrombin, and fibrinogen
87
In dogs with PLE, what percent had positive outcome vs negative within 5 days of GI biopsies?
76% positive outcome, 24% negative outcome.
Enteral feeding is associated with positive outcome, esp when combined with immunosuppressive
88
What are three risk factor of incomplete capsule endoscopy study?
Simethicone or opioid administration, CE, capsule gastric transit time over 6 hours
More likely to have incomplete study if orally administered capsule
89
What GI regions have best visibility and worst visibility with capsule endoscopy?
Poor to limited in stomach and colon
Adequate to good in small intestine
90
What proportion of dogs had an incomplete capsule endoscopy study?
38%
91
How is contrast enhanced ultrasound helpful in dogs with IBD?
time-intensity curves help differentiate IBD from healthy
No useful information for monitoring
92
How did fecal microbiome change in dogs with an AHDS outbreak in Norway?
Decreased Firmicutes
Overgrowth of Providencia and C perfringens
93
What two serum markers are positively correlated with clinical severity of pancreatitis?
cPLI and CRP
Can be used as biomarkers for clinical changes of dogs with acute pancreatitis
94
What serum marker can be used to predict meloxicam induced gastric ulceration as well as gastroscopic score of lesion?
Serum gastrin
94
How does CRP correlate with IBD and CCECAI score?
Indicator of clinical severity
95
How can high-mobility group box 1 (HMGB1) be used as a marked of CIE?
higher in dogs with moderate to severe histopath grade compared to mild histopath grade
96
What histopathologic patterns are more common with lymphoma vs IBD?
monomorphic lymphocytic population, in-depth mucosal infiltration, epithelial plaques and nests
97
What is the sp of Ki-67 to differentiate SCLA from IBD?
>95% in epithelium and lamina propria
98
What percent of LPE cases were either monoclonal or monoclonal with a polyclonal background?
70%
99
What biomarkers were consistent in all cats with small cell lymphoma? (either positive or negative)
CD3+, pSTAT5+, pSTAT3-
100
what percent of small cell lymphoma cases were monoclonal?
86%
101
What distribution of CD3+ cells are expected in small cell lymphoma compared to IBD, what percent of SCLA cases had this gradient?
apical to basal gradient of CD3+ lymphocytes in 41% of small cell lymphoma, 5% of LPE
102
What clinical and ultrasonographic findings can be used to differentiate between small cell lymphoma from LPE in cats?
duration of clinical signs, male sex, polyphagia, rounded jejunal LN, ultrasound effusion
103
What are 5 risk factors for gastric ulceration?
NSAID, glucocorticoid, GI neoplasia, GI mechanical disease, working dogs (OR 2.8)
104
How much does once daily omeprazole increased food consumption in cats with CKD?
2.7%, not recommended for appetite stimulation
105
what is the risk of dogs with an episode of AHD for developing chronic enteropathy later in life?
2.57
106
How does high fiber diet impact fecal score in shelter dogs?
100% of dogs fed high fiber diet had fecal score <5 on day 9 compared to 55% of standard diet dogs
107
Prevalence of esophageal varices in dogs?
0.012%
108
What is the most common intra-abdominal cause of esophageal varacies?
portal hypertension
109
How many dogs died secondary to esophageal varices or hemorrhage?
none
110
What are three intrathoracic causes of esophageal varices?
Pulmonary, caval, or systemic hypertension (9/11 cases with thoracic eitiology)
111
How many dogs with esophageal foreign bodies resolved without surgery? per JVIM 2022 (Barash et al)
93%
112
what increases risk of esophageal erosions from esophageal FB?
distal entrapment and longer duration
113
What percent of gastric bone foreign bodies were successful removed endoscopically?
91%
114
How does azithromycin impact gastric emptying?
faster gastric emptying
No effect on antral motility
115
What age of dog are helicobacter like organisms associated with?
Younger
116
What factors (clinical, signalment, endoscopic findings) are associated with gastric lymphoid follicular hyperplasia?
Intact males, young age
Vomiting
Gastroscopic findings (discoloration, hemorrhage, ulcers)
helicobacter-like organism score on histopath
117
What percentage of dogs with chronic GI signs had a resting cortisol of <2? How many remained low with repeat analysis?
28%
8 dogs on repeat analysis (10%)
118
Prevalence of hypoadrenocorticism in dogs with chronic GI signs
0.3%
119
How many dogs with pancreatic fluid accumulation had complication post FNA?
none
120
% of dogs with pancreatic fluid accumulation managed medically vs surgically
7/15 surgically-46%
8/15 medically-53%
121
outcome of medical vs surgical management of pancreatic fluid accumulation?
Surgical: 57% discharge, 43% euthanized
Medical: 87% discharged (7/8, 3/7 represented for surgery)
122
How many brachycephalic dogs have reflux?
84%
123
What increases sensitivity for diagnosing pancreatitis on ultrasound?
"suspicion of pancreatitis" or "increased lipase" in clinical history
124
Correlation of lipase and ultrasound for pancreatitis?
weakly correlated
125
What percent of dogs with acute pancreatitis had gastric wall changes? what segment are changes most common?
47%
Duodenum most common (majority had thickening and abnormal wall layers, some had corrugation)
126
What is a clinical predictor of GI wall changes in dogs with pancreatitis?
Heart rate
127
How would you expect ileum to appear on endoscopy in a dogs with B12<200
Greater ileal damange associated with lower cobalamin
Friable, villous atrophy, crypt dilation, epithelial injury
128
How does the microbiome differ in dogs with ARE based on 16S ribosomal RNA gene analysis?
no difference
129
In brachycephalic dogs with sliding hiatal hernias, what may they be more likely to present with?
More likely to be respiratory distress
Radiographic aspiration pneumonia
130
In dogs with EPI or CE, is oral or injectable B12 prefered?
no difference in either form
131
What % of patients were appropriately prescribed PPIs?
27%
132
Does mineral oil as lubricant to collect feces from a cat impact microbiome?
no
133
Outcomes in dogs with PLE?
31% achieved sustained remission for 2 years
25% remission but relapsed within 2 years
44% never achieved remission
134
Risk factor of PLE relapse?
Poor diet compliance (scavenging or changing recommended diet)
135
What miRNA can be used to distinguish neoplasia from CIE?
Fecal: miR-451, 223, 217
Serum: miR-20b, miR: 148a-3p, MiR-652
Combining slightly improves performance
136
Correlation of iMg with PTH and 25OHD in dogs with CIE?
iMg weakly positively correlated with 25OHD and iCa
iMg weakly negatively correlated with PTH
137
what percent of dogs was GI angiodysplasia diagnosed in via capsule endoscopy?
5%, all missed with conventional endoscopy
138
How many dogs with GI angiodysplasias had overt bleeding, hematochezia, and microcytic hypochromic anemia
80% overt GI bleeding
73% hematochezia
40% microcytic, hypochromic anemia
139
How can DLA pancreatic lipase be used to monitor dogs with chronic pancreatitis?
Associated with flareups of acute pancreatitis (increased DLA is associated with emergency revisits)
140
Sn and Sp for serum ACA concentration for CE?
86.7% sn, 24% sp
141
Utility of "chronic enteropathy" panel-antibodies against OmpC, calprotectin, and gliadin-derived peptides
Poorly specific for CE, not recommended
142
true or false, serum folate is associated with markers of CE?
false
143
what two markers of CE on biochemistry panel is B12 associated with?
albumin, cholesterol
144
do probiotics administered with prednisone protect against GI bleeding?
no
145
What cytokines are altered in German Shepherds with chronic enteropathy?
Lower IL-13 and IL-33 expression in duodenal mucosa
Indicates that Th2 cytokines play a role in CE
146
What can be used to increased sensitivity of detecting proprial mucosal lymphangiectasia in dogs with CIE?
lymphatic endothelial cell immunolabeling
147
How does BCS impact lifespan in dogs?
all breeds, instantaneous risk of death higher than if normal BCS
Median life span shorter compared to normal weight dogs (most in yorkies, lesast in GDS)
148
What breeds get hereditary cobalamin disorder?
Australian Shepherds, Beagle, Border Collies, and Giant schnauzers
149
What mutation is associated with inherited B12 deficiency in beagles and border terriers and what mutation in Giant Schnauzers and Australian Shepherds?
CUBN: Border Collies and Beagles
AMN: Giant Schnauzers and Australian Shepherds
150
Is oral supplementation effective for inherited cobalamin deficiency?
Yes, serum MMA in reference range
(1 mg once daily used for beagles)
151
What form of feline diet had lowest amount of Mg?
Canned diet
152
What amino acids in cat diets may impact immune function?
effect of ornithine and arginine
Number of phagocytic granulocytes decreased with decreasing amount of dietary ornithine and arginine
153
What devices can be used for maintain low profile E tube?
single port J tube
dual port J tube has risk of aspiration
154
how does high sensitivity cardiac troponin change in dogs eating a grain free diet when they are switched to a grain inclusive diet?
Decreased after diet change, suggests that subclinical disease improves with diet change
155
What biochemical parameters are impacted by fasting?
TG, BUN, phosphorus, glu, and bilirubin increased postprandially
SDMA, creat, col, and alb are not
Not increased to a degree that would impact clinical decision making
156
