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Sys Path > Intestine 3 (Test 1) > Flashcards

Intestine 3 (Test 1) Flashcards

1
Q

What diarrhea causing pathogens results in intracellular infection and all life stages can be seen?

A

Coccidiosis

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2
Q

T or F

Coccidiosis cause cell lysis as part of lifecycle

A

TRUE

Loss of enterocytes

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3
Q

What type of diarrhea do you see with coccidiosis?

A

Loss of enterocytes:

  1. loss of absorptive surface area–>osmotic diarrhea
  2. Mucosal damage–> exudative diarrhea
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4
Q

When would you see coccidiosis in a calf?

A

Between 4-8 weeks

(has an 18 day pre-patent period)

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5
Q

What will you see grossly with Coccidiosis?

A

Small and/or large intestine segmentally dark red

hemorrhagic contents

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6
Q

What will you see microscopically with coccidiosis?

A

Segmental necrotizing enteritis

Villous atrophy

Crypt dropout

intracellular coccidial life stages

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7
Q

Cryptosporidiosis is an intracellular or extracellular protozoal parasite?

A

Extracellular

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8
Q

T or F

cryptosporidiosis attaches to apical surface of enterocytes (i.e. does not invade)

A

True

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9
Q

What is the result of cryptosporidiosis infection?

A

It attaches to the apical surface of enterocytes (does not invade)–>does not cause loss of enterocytes/severe mucosal damage

Marked villous atrophy/fusion

  • loss of absorptive surface area: (malabsorption) osmotic diarrhea
  • loss of microvilli membrane-bound digestive enzymes–>maldigestion

Compensatory crypt hyperplasia

Possible secretory component (large-volume diarrhea is common)-Cholera-like enterotoxin affecting cAMP levels

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10
Q

Who is most susceptible to cryptosporidiosis infecton?

A

Neonatal animals are most suceptible; adule animals likely immune but may shed oocytes

Most important in calves; sporadic in other ruminants

Can happen in horses

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11
Q

List 3 clinical signs for cryptosporidiosis

A

Large volume diarrhea

anorexia

depression

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12
Q

When do you see cryptosporidosis in calves?

A

Between 1-3 weeks

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13
Q

Cryptosporidiosis results in what?

A

Acute, distal small intestine (large intestine), osmotic (loss of absorptive surface area), secretory (inflammatory mediators) due to enterocyte damage

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14
Q

Crypto occurs along with what other pathogen infections sometimes?

A

Rota/coronavirus, ETEC

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15
Q

Giardiosis is most important in what species?

A

Young Dogs, cats

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16
Q

What type of diarrhea occurs as a result of giardiosis infection?

A

Results in diminished mucosal disaccharidase activity–>mucosal phase of digestion disrupted–>maldigestion

Some damage to microvilli–> malabsorption

Both of these mean Osmotic diarrhea

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17
Q

What will you see microscopically with giardiosis?

A

Usually none, but sometimes you may see mild crypt hyperplasia, villous atrophy, mononuclear cell infiltrates

-pyriform trophozoites associated with enterocyte surface

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18
Q

Giardiasis attacks what part of the GI?

A

Small intestine (chronic, intermittent)

Osmotic: maldigestion, malabsorption

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19
Q

The following describe what pathogen?

Calves

Intracellular

Destruction of enterocytes

Hemorrhagic diarrhea

A

coccidiosis

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20
Q

The following describe what pathogen?

Calves

Extracellular

Villous atrophy

Lamina propria Inflammation

Actue Diarrhea

A

Cryptosporidiosis

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21
Q

The following describe what pathogen?

Dogs

Extracellular

Disaccharidase inhibition

Damage to microvilli

Chronic, intermittent diarrhea

A

Giardiasis

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22
Q

Infiltrative disease cause what kind of diarrhea?

A

CHRONIC Diarrhea (accumulatio of cells in lamina propria)

2 Mechanisms:

Malabsorption: physical barrior + villous atrophy

Exudation: increased mucosal permeability due to: cellular infiltrate, inflammatory mediators (results in loss of water, electrolytes, often protein (PLE)

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23
Q

Infiltrating cells may be:

A

Inflammatory or Neoplastic

24
Q

what is a major consequence of infiltrative diseases?

A

Weight loss/Chronic Wasting

25
Q

What is most common casue of chronic diarrhea and vomiting in dogs?

A

Inflammatory Bowel disease (IBD)

26
Q

Describe the pathogensis of IBD?

A

Dysregulation of mucosal immune response leads to an imbalance between pro-inflammatory responses and down-regulatory responses-e.g. regulatory T-cells

27
Q

What are possible factors that play into IBD?

A

Multifactorial:

  • genetic predisposition
  • environmental-e.g. diet
  • immunologic-breach of mucosal barrier may influence initiation of IBD
  • Dysbiosis-Alteration in GI flora
28
Q

How do you diagnosis IBD?

A

It requires a Biopsy

Severity of clinical signs does not correlate well with severity of lesions

Forms: Lymphoplasmacytic, Eosinophilic

29
Q

What are the 3 classifications of IBD?

A

Diet-Responsive

Antibiotic-responsive

Steroid/immunosuppressive- responsive

30
Q

In which species is diffuse alimentary lympoma most common?

A. Horses

B. goats

C. Dogs

D. Cats

A

D. CATS

31
Q

What breed is the poster child for IBD?

A

GERMAN shepherds

often purebred dogs

Classically produces small intestinal malabsorption syndrome with PLE, but can affect somach/large intestine as well

32
Q

What is often associated with feline IBD?

A

Triaditis syndrome (IBD, cholangiohepatitis, panceatitis)

33
Q

T or F

Diffuse eosinophilic enteritis often idiopathic.

A

True: may also be associated with food allergy, RULE out parasites

34
Q

Describe the alimentary lymphoma pathogenesis?

A

Diffuse or focal/multifocal proliferation of neoplastic lymphocyte/lymphoblasts–> distortion and expansion of mucosa–>transmural invasion–>extraintestinal lesions (esp. mesenteric lymph nodes)

Often accompanied by secondary inflammation

35
Q

What other intestinal neoplasms are there along with alimentary lymphoma?

A

Adenoma/adenocarcinoma

Leiomyoma/leiomyosarcoma

Mastocytoma

36
Q

What might you see clinically with Alimentary lymphoma?

A

Animal presenting with chronic small bowel diarrhea, weight loss, vomiting and palpably thickened loops of bowel

37
Q

What do you see? What is your top differential with this slide?

A

Infiltation of the mucosa, submucosa, and tunica muscularis with neoplastic lymphocytes, villi distortion/atrophy

Diffuse alimentary lymphoma

38
Q

What is Lymphangiectasia?

A

It is a disease of abnormal lymphatic transport (dilation of mucosal and submucosal lymphatics)-TRANSPORT phase of digestion interrupted

39
Q

What phase of digestion does lymphangiectasia disrupt?

A

TRANSPORT phase

40
Q

What is the most common cause of PLE (protein-losing enteropathy)?

A

Lymphangiectasia

41
Q

List three clincial signs of Lymphangiectasia:

A
  • Diarrhea
  • Steatorrhea
  • Hypoproteinemia +/- ascites
42
Q

Describe what you see:

What is your top differential diagnosis from this?

Hint: Hypoproteinemic dog

A

Dilated mesenteric lymphatic vessels

Lymphangiectasia

43
Q

What is primary lymphangiectasia? How can you get it?

A

Primary lymphangiectasia means there is no evidence of lymphatic vessel obstruction

  1. Congenital-developmental disorder
  2. Idiopathic (dogs)
44
Q

What is acquired/secondary lymphangiectasia? How can you get it secondarily?

A

Secondary: inflammatory or neoplastic distorts and obstructs mesenteric lymphatic drainage

  1. IBD
  2. Johne’s Disease
  3. Lymphoma

(Can be segmental or widespread)

45
Q

How do you get ascites with lymphangiectasia?

A

Lymphatic stagnation–>leakage of fluid, protein, lymphocytes into intestinal lumen

Results in the following:

  1. Lymphopenia
  2. Hypoproteinemia
  3. Hypocholesterolemia: also due to impaired absorption of lipid (steatorrhea)
46
Q

Is lymphangiectasia acute or chronic?

A

CHRONIC

47
Q

What type of diarrhea do you see with lymphangiectasia?

A

Osmotic (malabosorpative)

Exudative (inflammatory)-increased hydrostatic pressure (PLE, fluids lost)

48
Q

T or F

Small intestinal bacterial overgrowth (SIBO) is an overgrowth of normal enteric bacteria

A

TRUE

49
Q

T or F

SIBO presents itself almost always with the same clinical signs

A

FALSE, Sometimes you will see all of the clinical signs reported other times you won’t see anything

50
Q

What does SIBO result in?

A
  1. Decreased brush border enzyme activity
  2. Disturbance of intraluminal solubilization/digestion
  3. Bile Sale Deconjugation

The top 3 cause maldigestion–>osmotic diarrhea

  1. Toxin production–>stimulation of colonic secretion–>SECRETORY diarrhea
51
Q

What will you see microscopically with SIBO?

A

Usually little to none histologically

52
Q

What can cause SIBO?

A
  1. Increased entry of bacteria: reduced gastric acidity, gastrectomy, colonicjejunal fistula
  2. Abnormality of intestinal loops
  3. Reduced clearance of bacteria: motility disturbances, obstruction of intestine, immunodeficiency, cachexia
53
Q

Is there more than one form of SIBO?

A

YEP, Primary: idiopathic; antibiotic-responsive diarrhea (ARD)

Secondary to: IBD, EPI

54
Q

What are the secondary causes of SIBO?

A
  1. Decreased motility/partial obstruction: delayed intestinal transport–>decreased flushing of normal intestinal flora
  2. Secondary to mucosal lesions: IBD
  3. Lesions that result in maldigestion/malabsorption–>increased substrate

EPI can also be a cause

55
Q
A

Sys Path (17 decks)

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