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JVIM 2018-2023 > GI Papers > Flashcards

GI Papers Flashcards

1
Q

How is bacterial alpha-diversity different in dogs with FRE?

A

Lower alpha diversity than normal dots

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2
Q

What does animal protein extrusion diet change do to the microbiome of dogs with FRE?

A

Increase microbiota richness

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3
Q

What bacteria are more likely to be found in FRE dog compared to healthy control?

A

Citrobacter, enterobacter

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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

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5
Q

What segment of the GI tract is more likely to have increased number of eosinophils in dogs with eosinophilic enteritis?

A

Duodenum

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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

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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

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8
Q

How are bile acids percentage different in dogs with CIE?

A

Less primary bile acids compared to healthy dogs

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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

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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

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11
Q

How many dogs is PLE life ending compared to IBD?

A

54.2% PLE, <20% IBD

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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

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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

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14
Q

What two parameters in dogs with CIE are associated with death?

A

BUN and CCEAI score

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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

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16
Q

What individual factors are not associated with death from CIE?

A

BCS, % weight loss, appetite, albumin, creatinine, cobalamin, folate

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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

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18
Q

How many cats with abnormal histopathology had no clinical signs of GI disease?

A

17 cats after 709 days

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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

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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

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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%

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22
Q

What layer of lesion is ultrasound best at predicting?

A

Mucosal lesion, low for submucosal and muscularis

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23
Q

How does Pro-Kolin paste affect acute diarrhea outcome?

A

Shorter duration of diarrhea (32h) and 1.6 times faster resolution

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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

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25
Q

What is the complication rate of e-tube placement in cats? (feline study)

A

35.8% complication, 14.5% dislodgement, 12.1% infection

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26
Q

What increases the odds ratio of e-tube site infection and to what degree?

A

Glucocorticoid or oncologic agent (3.91 OR)
Discharge at stoma site (159.8)

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27
Q

What is the outcome of botox injection and mechanical dilation and how long were these effects?

A

100% clients reported improvement, BW increased 20% regurgitation frequency decreased by 80%, lasts 40 days

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28
Q

What amino acids are lower in dogs with IBD? Which one correlates with CCECAI score?

A

Methionine, proline, serine, and tryptophan . Serine negatively correlated with CCECAI score

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29
Q

What SCFA are lower in dogs with CE?

A

Acetate and propionate

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30
Q

How do synbiotics affect clinical signs of dogs receiving antibiotics?

A

Decreases food intake derangements

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31
Q

What is the length of clinical effects of dogs receiving synbiotics?

A

> 9 weeks

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32
Q

What are three swallow study features of dogs with LES achalasia like syndrome and what is the frequency of these features?

A

Megaesophagus: 73.7%
Birdbeak 63.2%
Esophageal fluid line: 68.4%

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33
Q

In how many dogs were mucosal hemorrhagicic lesions identified by capsules endoscopy in the stomach and SI?

A

15/16 stomach, 12/14 SI
2 capsules did not leave stomach

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34
Q

How many cats with hiatal hernia had comorbidities (upper airway obstruction)?

A

77.4% upper airway obstruction

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35
Q

What is the most common type of hiatal hernia in cats and what percent of cats is this seen in?

A

85.7% type I hiatal hernia

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36
Q

What is the MST of cats with hiatal hernia? Which cats survived longer, medical or surgical?

A

MST 959, cats treated medically survived longer

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37
Q

OR of ulceration for dogs receiving prednisone

A

11.1

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38
Q

OR of ulceration for dogs recieving prednisone and aspirin

A

31.5

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39
Q

what is more effective at increasing gastric pH, famotidine q12h or CRI?

A

CRI, difference at all time periods (1, 2, and 3 days)

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40
Q

How does serum vitamin D binding protein differ between dogs with CIE and low 25OHD concentration vs normal 25OHD concentration?

A

No difference

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41
Q

In dogs with CIE with low serum 25OHD concentration, what other values are suspected to be higher or lower?

A

Higher CCECAI score and CRP, higher duodenal inflammatory lesions
Lower serum alpha-tocopherol, cholesterol, albumin

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42
Q

What markers can be used to differentiate between dogs with PLE needing steroids vs secondary immunosuppressants?

A

No markers

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43
Q

Median time albumin reached over 20 g/L in JVIM 2019 (Schmitz et al)?

A

13 days

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44
Q

What was the rate of complications in dogs and cats with E-tube placement? Risk of infection?
% needing surgical debridement?

A

44.4% complications
17.8% cats infection. 22.7% infected cats needed sx debridement
13.7% dogs. 35% of infected dogs needed sx debridement

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45
Q

How does fecal microbiome change with tylosin?

A

day 7 after tylosin decreased biodiversity
Primary UBA increased after day 21 and 63
Changes to not uniformly resolve after stopping tylosin

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46
Q

Odds of endoscopic mucosal lesion when recieving prednisone or prednisone + clopidogrel?

A

7 times higher compared to placebo

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47
Q

What drug is more likely to cause GI ulceration when given in combination with prednisone? Clopidogrel or aspirin?

A

Aspirin

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48
Q

What duodenal histopath markers correlate with CCECAI score?

A

Ki-67/CD3 ratio ion LP region of cryp is positively correlated with CCECAI in dogs with CE

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49
Q

How does metronidazole impact duration of acute diarrhea and fecal culture?

A

decreases fecal culture detection of C perfringens
Shortens diarrhea from 2.1 days from 3.6 days

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50
Q

How is procalcitonin associated with endotoxemia? How long does it take to increase, how long does it remain increase, and when does it normalize?

A

Increases with LPS injection
Increases by 2 hours
Remains increased for 12 hours
Back to normal at 48 hours

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51
Q

What cut off can be used for CCECAI score to predict diet responsive disease? what is the Sn and SP?

A

Cut off of 8
Sn 82.6%
Sp 88.9%

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52
Q

What is the sn, sp, and accuracy of clonality alone (out of context) for small cell lymphoma in cats?

A

Sn 85.7%
Sp 33.3%
Accuracy 61.5%

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53
Q

What marker can be used to aide in diagnosis of SCLSA in cats? Sn, Sp, and accuracy when compared to panel diagnosis?

A

Histology guided mass spectrometry
Sn 86.7%, Sp 91.7%, accuracy 88.9%

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54
Q

What drugs reach the target gastric pH within the first 72 hours of therapy?

A

Famotidine CRI and Esomeprazole

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55
Q

Is iatrogenic endoscopic perforation associated with severity of GI disease?

A

no

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56
Q

Survival rate of post iatrogenic perforation?

A

93%

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57
Q

What serum marker is associated with parvovirus? How is it associated with outcome?

A

Serum D-lactate higher in dogs with parvo
dogs hospitalized <4 days had lower D-lactate but not associated with survival

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58
Q

Difference in outcome of dogs with acute diarrhea treated with clavamox vs controls?

A

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

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59
Q

Best serum biomarker to detect IBD?

A

OmpC

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60
Q

Combination of OmpC with what other biomarker to differentiate between normal dogs and non-IBD GI disease?

A

OmpC + APMNA (autoantibodies against polymorphonuclear leukocytes)
Compared to controls: sn76-97% sp 93-99%
Compared to non-IBD: Sn 66-86% Sp 79-98%

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61
Q

Percent of normal dogs with reflux based on nuclear scintigraphy?

A

12/12 dogs, 5/12 had reflux to pharynx
none aspirated

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62
Q

How does exenatide impact gastric emptying?

A

delayed gastric emptying (GLP-1 agonist)

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63
Q

How many dogs with LPR had concurrent GI signs? what location of the GI tract is most severely affected?

A

52% have concurrent GI signs, esophagus and duodenum most severe effected
Remission or marked improvement when GI disease is treated

64
Q

How does metronidazole impact fecal microbiome and how long do these effects last?

A

Decreases Fusobacteria
Increases fecal lactate
Decreases secondary BAs (deoxycholic acid and lithocholic acid)
Minimum of 4 weeks

65
Q

How is albumin associated with gastric wall edema?

A

21.4% of dogs with hypoalbuminemia have gastric wall thickening
No correlation with severity of hypoalbuminemia

66
Q

What medication has been shown to be efficacious for B12 supplementation in cats other than cyanocobalamin? How is it administered?

A

hydroxocobalamin
IM q2 weeks x 4
q4 weeks thereafter

67
Q

out of esomeprazole, dexlansoprazole, and lansoprazole, which medication most effectively increased gastric pH?

A

Esomeprazole

68
Q

What is the effect of prophylactic administration of PPIs in combination with NSAID?

A

Increases dysbiosis index
Increases fecal calprotectin (marker of inflammation)
No change in serum LPS or plasma iohexol

69
Q

How does the microbiota differ in puppies vs adults? what age should be used as a cut off?

A

Increased abundance of C diff and decreased C hiranonisis
Less than 6 weeks of age

70
Q

What percent of dogs with E coli associated GC have fluoroquinolone resistance?

A

62.5%

71
Q

Prognosis of GC with antimicrobial treatment guided by C+S

A

80%

72
Q

What minimally invasive imaging technique can be used to assess small intestinal inflammation?

A

SPIES (Storz Professional Image Enhancement System) aka endoscopic narrow band imaging-like endoscopy

73
Q

What minimally invasive imaging technique can be used to assess colonic perfusion and inflammation?

A

contrast-enhanced ultrasound

74
Q

How does HCT, BCS, and TIBC correlate with MMA?
What does this indicate?

A

HCT and BSC negatively correlate with MMA
TICB is lower in cats with increased MMA
Functional iron deficiency

75
Q

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?

A

none

76
Q

How can diagnosis of small cell lymphoma be increased in cats only having an upper GI scope?

A

integrating IHC and clonality

77
Q

How does fecal culture differ in dogs with chronic diarrhea compared to normal dogs?

A

no significant difference

78
Q

How many dogs chronically treated with NSAIDs had GI erosions? Which NSAIDs cause lesions and how long for therapy?

A

83.3% of dogs had GI erosions
Meloxicam, carprofen, and firocoxib
6 months of therapy

79
Q

What percent of dogs with CIE are hypercoagulable based on TEG?

A

44.7%

80
Q

Does hypercoagulability in CIE correlate with albumin?

A

correlated with albumin if hypoalbuminemia (negative correlation with G value on TEG), but dogs with normal alb can still be hypercoagulable.

81
Q

How many dogs with AHDS survive to discharge?

A

96%
Antimicrobials not positively associated with survival (77% of dogs survived who received 2 antimicrobials)

82
Q

What treatment reduced signs of SIRS in dogs with AHDS?

A

rehydration
SIRS criteria may not be good marker for needed antimicrobials

83
Q

What marker is increased in ADHS index at time of presentation?

A

CRP

84
Q

Does it matter if omeprazole is enteric coated vs non-enteric coated?

A

no, enteric coated increases pH appropriately

85
Q

What TEG abnormalities are seen in CIE and PLE dogs?

A

Hypercoagulable (higher MA, longer CLT, lower LY30 and LY60)
Don’t need to be hypoalbuminemic

86
Q

In dogs with CIE, what serum markers are associated with MA?

A

albumin, 25OHD, plasma antithrombin, and fibrinogen

87
Q

In dogs with PLE, what percent had positive outcome vs negative within 5 days of GI biopsies?

A

76% positive outcome, 24% negative outcome.
Enteral feeding is associated with positive outcome, esp when combined with immunosuppressive

88
Q

What are three risk factor of incomplete capsule endoscopy study?

A

Simethicone or opioid administration, CE, capsule gastric transit time over 6 hours
More likely to have incomplete study if orally administered capsule

89
Q

What GI regions have best visibility and worst visibility with capsule endoscopy?

A

Poor to limited in stomach and colon
Adequate to good in small intestine

90
Q

What proportion of dogs had an incomplete capsule endoscopy study?

A

38%

91
Q

How is contrast enhanced ultrasound helpful in dogs with IBD?

A

time-intensity curves help differentiate IBD from healthy
No useful information for monitoring

92
Q

How did fecal microbiome change in dogs with an AHDS outbreak in Norway?

A

Decreased Firmicutes
Overgrowth of Providencia and C perfringens

93
Q

What two serum markers are positively correlated with clinical severity of pancreatitis?

A

cPLI and CRP
Can be used as biomarkers for clinical changes of dogs with acute pancreatitis

94
Q

What serum marker can be used to predict meloxicam induced gastric ulceration as well as gastroscopic score of lesion?

A

Serum gastrin

94
Q

How does CRP correlate with IBD and CCECAI score?

A

Indicator of clinical severity

95
Q

How can high-mobility group box 1 (HMGB1) be used as a marked of CIE?

A

higher in dogs with moderate to severe histopath grade compared to mild histopath grade

96
Q

What histopathologic patterns are more common with lymphoma vs IBD?

A

monomorphic lymphocytic population, in-depth mucosal infiltration, epithelial plaques and nests

97
Q

What is the sp of Ki-67 to differentiate SCLA from IBD?

A

> 95% in epithelium and lamina propria

98
Q

What percent of LPE cases were either monoclonal or monoclonal with a polyclonal background?

A

70%

99
Q

What biomarkers were consistent in all cats with small cell lymphoma? (either positive or negative)

A

CD3+, pSTAT5+, pSTAT3-

100
Q

what percent of small cell lymphoma cases were monoclonal?

A

86%

101
Q

What distribution of CD3+ cells are expected in small cell lymphoma compared to IBD, what percent of SCLA cases had this gradient?

A

apical to basal gradient of CD3+ lymphocytes in 41% of small cell lymphoma, 5% of LPE

102
Q

What clinical and ultrasonographic findings can be used to differentiate between small cell lymphoma from LPE in cats?

A

duration of clinical signs, male sex, polyphagia, rounded jejunal LN, ultrasound effusion

103
Q

What are 5 risk factors for gastric ulceration?

A

NSAID, glucocorticoid, GI neoplasia, GI mechanical disease, working dogs (OR 2.8)

104
Q

How much does once daily omeprazole increased food consumption in cats with CKD?

A

2.7%, not recommended for appetite stimulation

105
Q

what is the risk of dogs with an episode of AHD for developing chronic enteropathy later in life?

A

2.57

106
Q

How does high fiber diet impact fecal score in shelter dogs?

A

100% of dogs fed high fiber diet had fecal score <5 on day 9 compared to 55% of standard diet dogs

107
Q

Prevalence of esophageal varices in dogs?

A

0.012%

108
Q

What is the most common intra-abdominal cause of esophageal varacies?

A

portal hypertension

109
Q

How many dogs died secondary to esophageal varices or hemorrhage?

A

none

110
Q

What are three intrathoracic causes of esophageal varices?

A

Pulmonary, caval, or systemic hypertension (9/11 cases with thoracic eitiology)

111
Q

How many dogs with esophageal foreign bodies resolved without surgery? per JVIM 2022 (Barash et al)

A

93%

112
Q

what increases risk of esophageal erosions from esophageal FB?

A

distal entrapment and longer duration

113
Q

What percent of gastric bone foreign bodies were successful removed endoscopically?

A

91%

114
Q

How does azithromycin impact gastric emptying?

A

faster gastric emptying
No effect on antral motility

115
Q

What age of dog are helicobacter like organisms associated with?

A

Younger

116
Q

What factors (clinical, signalment, endoscopic findings) are associated with gastric lymphoid follicular hyperplasia?

A

Intact males, young age
Vomiting
Gastroscopic findings (discoloration, hemorrhage, ulcers)
helicobacter-like organism score on histopath

117
Q

What percentage of dogs with chronic GI signs had a resting cortisol of <2? How many remained low with repeat analysis?

A

28%
8 dogs on repeat analysis (10%)

118
Q

Prevalence of hypoadrenocorticism in dogs with chronic GI signs

A

0.3%

119
Q

How many dogs with pancreatic fluid accumulation had complication post FNA?

A

none

120
Q

% of dogs with pancreatic fluid accumulation managed medically vs surgically

A

7/15 surgically-46%
8/15 medically-53%

121
Q

outcome of medical vs surgical management of pancreatic fluid accumulation?

A

Surgical: 57% discharge, 43% euthanized
Medical: 87% discharged (7/8, 3/7 represented for surgery)

122
Q

How many brachycephalic dogs have reflux?

A

84%

123
Q

What increases sensitivity for diagnosing pancreatitis on ultrasound?

A

“suspicion of pancreatitis” or “increased lipase” in clinical history

124
Q

Correlation of lipase and ultrasound for pancreatitis?

A

weakly correlated

125
Q

What percent of dogs with acute pancreatitis had gastric wall changes? what segment are changes most common?

A

47%
Duodenum most common (majority had thickening and abnormal wall layers, some had corrugation)

126
Q

What is a clinical predictor of GI wall changes in dogs with pancreatitis?

A

Heart rate

127
Q

How would you expect ileum to appear on endoscopy in a dogs with B12<200

A

Greater ileal damange associated with lower cobalamin
Friable, villous atrophy, crypt dilation, epithelial injury

128
Q

How does the microbiome differ in dogs with ARE based on 16S ribosomal RNA gene analysis?

A

no difference

129
Q

In brachycephalic dogs with sliding hiatal hernias, what may they be more likely to present with?

A

More likely to be respiratory distress
Radiographic aspiration pneumonia

130
Q

In dogs with EPI or CE, is oral or injectable B12 prefered?

A

no difference in either form

131
Q

What % of patients were appropriately prescribed PPIs?

A

27%

132
Q

Does mineral oil as lubricant to collect feces from a cat impact microbiome?

A

no

133
Q

Outcomes in dogs with PLE?

A

31% achieved sustained remission for 2 years
25% remission but relapsed within 2 years
44% never achieved remission

134
Q

Risk factor of PLE relapse?

A

Poor diet compliance (scavenging or changing recommended diet)

135
Q

What miRNA can be used to distinguish neoplasia from CIE?

A

Fecal: miR-451, 223, 217
Serum: miR-20b, miR: 148a-3p, MiR-652
Combining slightly improves performance

136
Q

Correlation of iMg with PTH and 25OHD in dogs with CIE?

A

iMg weakly positively correlated with 25OHD and iCa
iMg weakly negatively correlated with PTH

137
Q

what percent of dogs was GI angiodysplasia diagnosed in via capsule endoscopy?

A

5%, all missed with conventional endoscopy

138
Q

How many dogs with GI angiodysplasias had overt bleeding, hematochezia, and microcytic hypochromic anemia

A

80% overt GI bleeding
73% hematochezia
40% microcytic, hypochromic anemia

139
Q

How can DLA pancreatic lipase be used to monitor dogs with chronic pancreatitis?

A

Associated with flareups of acute pancreatitis (increased DLA is associated with emergency revisits)

140
Q

Sn and Sp for serum ACA concentration for CE?

A

86.7% sn, 24% sp

141
Q

Utility of “chronic enteropathy” panel-antibodies against OmpC, calprotectin, and gliadin-derived peptides

A

Poorly specific for CE, not recommended

142
Q

true or false, serum folate is associated with markers of CE?

A

false

143
Q

what two markers of CE on biochemistry panel is B12 associated with?

A

albumin, cholesterol

144
Q

do probiotics administered with prednisone protect against GI bleeding?

A

no

145
Q

What cytokines are altered in German Shepherds with chronic enteropathy?

A

Lower IL-13 and IL-33 expression in duodenal mucosa
Indicates that Th2 cytokines play a role in CE

146
Q

What can be used to increased sensitivity of detecting proprial mucosal lymphangiectasia in dogs with CIE?

A

lymphatic endothelial cell immunolabeling

147
Q

How does BCS impact lifespan in dogs?

A

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
Q

What breeds get hereditary cobalamin disorder?

A

Australian Shepherds, Beagle, Border Collies, and Giant schnauzers

149
Q

What mutation is associated with inherited B12 deficiency in beagles and border terriers and what mutation in Giant Schnauzers and Australian Shepherds?

A

CUBN: Border Collies and Beagles
AMN: Giant Schnauzers and Australian Shepherds

150
Q

Is oral supplementation effective for inherited cobalamin deficiency?

A

Yes, serum MMA in reference range
(1 mg once daily used for beagles)

151
Q

What form of feline diet had lowest amount of Mg?

A

Canned diet

152
Q

What amino acids in cat diets may impact immune function?

A

effect of ornithine and arginine
Number of phagocytic granulocytes decreased with decreasing amount of dietary ornithine and arginine

153
Q

What devices can be used for maintain low profile E tube?

A

single port J tube
dual port J tube has risk of aspiration

154
Q

how does high sensitivity cardiac troponin change in dogs eating a grain free diet when they are switched to a grain inclusive diet?

A

Decreased after diet change, suggests that subclinical disease improves with diet change

155
Q

What biochemical parameters are impacted by fasting?

A

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
Q
A

JVIM 2018-2023 (9 decks)

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