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VET 405: GI > GI Pathology > Flashcards

GI Pathology Flashcards

1
Q

plica

A

folds of the gut wall that include both mucosa + submucosa

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2
Q

villi

A

fingerlike projections of the gut wall that include mucosa only
- many enterocytes per villi

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3
Q

microvilli

A

fingerlike projections on the apical surface of each enterocyte –> brush border

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4
Q

function of plica, villi, and microvilli

A

increase surface area

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5
Q

crypts

A

intestinal glands; invaginations between each villi
- crypts should be 1/4 the height of a villi

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6
Q

differences in large intestine vs small intestine

A

large intestine - NO villi/microvilli

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7
Q

functions of the intestines

A
  1. absorption of nutrients
  2. excretion of waste
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8
Q

main GI disease processes

A
  1. inflammation
  2. degeneration
  3. growth disorders
  4. developmental disorders
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9
Q

timeline of inflammation

A

acute, chronic, chronic active

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10
Q

acute inflammation

A

fibrin, neutrophils, hyperemia, congestion

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11
Q

chronic inflammation

A

fibrosis, macrophages, giant cells, plasma cells, lymphocytes

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12
Q

chronic active inflammation

A

combination of acute and chronic features

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13
Q

what is fibrin

A

acute phase protein that leaks from vessels during inflammation

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14
Q

what is fibrosis

A

collagen scar tissue; takes weeks to form

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15
Q

what is intussuception

A

type of degenerative/necrotic disease process

telescoping of proximal intestine into distal intestine

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16
Q

intussuceptum

A

the (proximal) part of intestine that goes into the intussuscepiens

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17
Q

intussuceptiens

A

the (distal) part of intestine that receives the intussuceptum

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18
Q

what is fibrinous colitis

A

type of degenerative/necrotic disease process

common in horses
often caused by C. diff infection
formation of a fibrin pseudomembrane on the mucosal surface of the colon

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19
Q

main consequences of diarrhea

A
  1. acid/base imbalance
  2. electrolyte depletion
  3. dehydration
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20
Q

normal absorption/secretion in the small intestine

A

absorption: occurs in cells at the top of the villi

secretion: occurs in cells at the base of the villi/crypts

net ABSORPTION

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21
Q

mechanisms of diarrhea

A
  1. secretory
  2. malabsorptive
  3. effusive
  4. osmotic
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22
Q

secretory diarrhea

A

absorption: normal
secretion: increased

net SECRETION

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23
Q

causes of secretory diarrhea

A

bacterial endotoxins (cholera, E. coli) on surface of enterocytes
- causes cAMP stimulated Cl- secretion into lumen –> draws water into lumen

disease: colibacillosis

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24
Q

malabsorptive diarrhea

A

absorption: decreased
secretion: normal

net SECRETION

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25
Q

causes of malabsorptive diarrhea

A

villus atrophy

causes morphologic damage –> reduced crypt:villi ratio

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26
Q

effusive diarrhea

A

absorption: normal
secretion: increased

net FIBRINOUS SECRETION

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27
Q

causes of effusive diarrhea

A

anything that damages endothelium of vessels

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28
Q

osmotic diarrhea

A

retention of water in the gut lumen

29
Q

causes of osmotic diarrhea

A

magnesium sulfate
starch - can’t get broken down
high grain diet in ruminants

salts pull water into the lumen

30
Q

what is large intestine diarrhea

A

reduction in the ability of the colon to absorb solute and fluid presented by proximal bowel (osmotic)

31
Q

what are the mechanisms of large intestine diarrhea

A

same as small intestine:
1. secretory
2. malabsorptive
3. effusive
4. osmotic

32
Q

partial obstruction

A

allows the passage of gas, fluid, or diarrhea

33
Q

complete obstruction

A

does not allow the passage of gas or fluids; causes severe distention

34
Q

strangulated obstruction

A

compromised blood supply + lumen obstruction

35
Q

non-strangulated obstruction

A

lumen obstruction only - no compromised blood supply

36
Q

mechanical obstruction

A

obstruction from within the lumen

37
Q

functional obstruction

A

diffuse dysfunction of the intestine causing it to not be able to move contents forward

38
Q

proximal obstruction

A

stomach or small intestine

more common in small animals

39
Q

distal obstruction

A

ascending/descending colon

more common in large animals

40
Q

simple obstructions in small animals

A

foreign bodies

41
Q

simple obstructions in large animals

A

food/sand impactions

42
Q

strangulated obstructions in small animals

A

GDV

43
Q

strangulated obstructions in large animals

A

strangulated lipomas, epiploic foramen entrapment, large colon volvulus

44
Q

non-strangulated infarctions

A

obstruction of blood supply without luminal obstruction

SA: thromboembolic events
LA: parasitic migrations (strongyles) causing cranial mesenteric arteritis

45
Q

mechanism of obstruction –> necrosis

A

intestinal obstruction –> distention –> decreased perfusion to mucosa/serosa/muscularis

46
Q

causes of distention

A

gas: aerophagia & bacterial overgrowth –> increased production

fluid: normal secretions, decreased absorption ability

47
Q

is the small or large intestine more sensitive to pressure necrosis

A

small intestine b/c it has villi –> takes longer to regenerate

48
Q

what layer of the intestinal wall is most sensitive to pressure necrosis

A

seromuscular layer

prone to neutrophilic infiltrate and mesothelial cell loss

49
Q

hemorrhagic strangulating obstructions

A

veins: compressed
arteries: not compressed

arteries continue pumping blood in –> compressed veins prevent blood from leaving

causes congestion & ischemia

50
Q

examples of hemorrhagic strangulating obstructions

A

intussusceptions
partially strangulated hernias

51
Q

ischemic strangulating obstructions

A

veins: compressed
arteries: compressed

complete lack of blood supply causes rapid degeneration of mucosa

52
Q

examples of ischemic strangulating obstructions

A

large colon volvulus

53
Q

what part of the intestinal wall is most prone to ischemic injury

A

villi

already hypoxic under normal conditions due to exchange of arteries and veins as they travel up villi

has a high energy requirement to power Na/K ATPases

54
Q

mechanism of ischemic injury in villi

A

hypoxia –> loss of oxidative phosphorylation –> failure of ATPases –> anaerobic glycolysis –> cell dies and detaches from basement membrane

55
Q

what can be used as an indicator of tissue perfusion

A

lactate (produced by anaerobic glycolysis)

serum lactate in SA
compare serum and fluid lactate in LA

56
Q

gruenhagen’s space

A

space that forms as epithelium begins to pull away from basement membrane

cells eventually slough off and can break all the way down to crypts

57
Q

ischemia

A

oxygen deprived cell death

58
Q

ischemia-reperfusion injury

A

local and systemic inflammatory response that occurs once blood flow is restored following an ischemic event

causes toxins that built up to be released all at once

59
Q

what toxin is generated during ischemia

A

superoxide

60
Q

superoxide

A

reactive metabolite that is generated during ischemia

targets cell membranes –> activates arachidonic acid pathway –> produces pro-inflammatory cytokines

61
Q

effect of NSAIDs on arachidonic acid pathway

A

blocks COX pathways

decreases PGE nad TXE production

62
Q

effect of corticosteroids on arachidonic acid pathway

A

blocks phospholipase A2

decreases all cytokine production

63
Q

epithelial restitution

A

the reformation of the mucosal barrier:
- tight junctions
- apical membrane
- mucous layer

64
Q

when does epithelial restitution occur

A

immediately after acute injury (18-24 hrs)

65
Q

is epithelial restitution faster in the small intestine or colon

A

colon (no villi)

66
Q

steps of epithelial restitution

A
  1. crypt cells proliferate and replace lost cells
  2. villi contract to decrease surface area that needs to be restored
  3. epithelial cells migrate to seal the basement membrane
  4. tight junctions and intracellular spaces close
67
Q

what is the number 1 prognostic indicator that a colicking horse needs to go to surgery

A

persistent pain after time/meds

68
Q

colic qualifications for surgical repair

A

usually small intestine or strangulated lesions
1. persistent pain
2. enteroliths
3. strangulated lesions
4. exploratory laparotomy

69
Q

non surgical colics

A

usually large intestine or non-strangulated lesions

medical management - fluids, electrolytes

VET 405: GI (19 decks)

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