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SAM 2 > Koster Test 1 > Flashcards

Koster Test 1 Flashcards

1
Q

What is the common signalment for acute pancreatitis in dogs?

A

Small

Overweight

High fat diet

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2
Q

What is the common signalment for acute pancreatitis in cats?

A

Underweight

Elderly

Malnourished

No high fat diet predisposition

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3
Q

What is the cause of acute pancreatitis in cats?

A

Bacteria

Duodenal reflux

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4
Q

A dog that is in the ‘prayer position’ most likely has what GI abnormality?

A

Acute pancreatitis

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5
Q

When performing an ultrasound, what finding would make you lean towards pancreatitis?

A

Hyperechoic peripancreatic fat

Hypoechoic pancreas

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6
Q

Between the snap PLI and the spec PLI, which is more sensitive and which is more specific?

A

Snap PLI is more sensitive (91%)

Spec PLI is more specific (95%)

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7
Q

What is the best way to diagnose pancreatitis?

A

Combo of ultrasound and spec PLI

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8
Q

What are the two prefered analgesics for acute pancreatitis?

A

Buprenorphine

Methadone

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9
Q

What is the anti-emetic of choice for acute pancreatitis?

A

Cerenia (Maropitant)

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10
Q

What is “triaditis” and what species is it associated with?

A

Associated with cats

Lymphocytic-plasmacytic enteritis, cholangitis, and pancreatitis

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11
Q

What is the most accurate blood test for diagnosing pancreatitis in cats?

A

Feline Spec PL

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12
Q

Which of the following factors has not been implicated as an etiology of acute pancreatitis?

Hypercalcemia

Corticosteroids

Trauma and surgery

Hypertriglyceridemia

Phenobarbitone

Canine babesiosis

A

Corticosteroids

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13
Q

Ultrasonographic changes of acute pancreatitis include all, except

Peripancreatic hyperechogenicity

Pancreatic hyperechogenicity

Duodenal corrugation

Peritoneal anechoic fluid

A

Pancreatic hyperechogenicity

It is hypoechoic

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14
Q

T/F: Acute pancreatitis is more common in cats than chronic pancreatitis

A

False

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15
Q

What breeds are predisposed to chronic pancreatitis?

A

Cavalier King Charles Spaniel

English Cocker Spaniel

Boxers

Collies

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16
Q

Why are Boxers resistant to end-stage disease associated with chronic pancreatitis?

A

They have a really high regenerative capacity

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17
Q

Clinical signs associated with chronic pancreatitis?

A

Intermittent, low-grade clinical signs

Acute signs

Older, non-GSD dog with EPI

Diabetes millitus

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18
Q

Why is the PLI test insensitive at diagnosing chronic pancreatitis?

A

Loss of pancreatic mass

28% sensitive

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19
Q

What breed would benefit from corticosteroid therapy for chronic pancreatitis?

A

Cocker Spaniels

Cats

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20
Q

What percent of pancreatic function loss is required for EPI?

A

80-90% loss of function

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21
Q

What is the main cause of EPI in cats?

A

Chronic pancreatitis

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22
Q

What is the most common cause of pancreatic acinar atrophy?

A

End stage autoimmune process (>90%)

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23
Q

Pancreatic acinar atrophy is autosomal recessive in what breeds?

A

GSD

Rough collies

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24
Q

Which test is very sensitive and specific for EPI?

A

TLI

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25
Q

What are the TLI cut off values for diagnosing EPI?

A

<2.5 = EPI

2.5-5 = non-fasted or early EPI

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26
Q

How should you feed a patient with EPI?

A

Small amounts of food often

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27
Q

Tx for EPI?

A

Supplement enzymes

Frozen pancreas

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28
Q

What type of pancreatic neoplasia infiltrates surrounding organs and often results in icterus?

A

Adenocarcinoma

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29
Q

What pancreatic tumors do dogs get?

A

Lymphoma

Hemangiosarcoma

Adenocarcinoma

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30
Q

What pancreatic tumors do cats get?

A

Adenocarcinoma

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31
Q

What is the most common form of pancreatitis in dogs?

A

Acute on chronic

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32
Q

What is the most common form of pancreatitis in cats?

A

Chornic pancreatitis

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33
Q

What is a chronic complication of acute pancreatitis?

A

Pseudocyst

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34
Q

Which is not an end stage complication of chronic pancreatitis?

Pancreatic acinar atrophy (PAA)

Exocrine pancreatic insufficiency (EPI)

Diabetes mellitus (DM)

A

Pancreatic acinar atrophy

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35
Q

Which breed does not have inflammation associated with chronic liver disease?

A

GSD

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36
Q

What breeds get primary copper associated liver disease?

A

Bedlington terrier

Westies

Spaniels

Poodle

Dalmations

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37
Q

What breed gets secondary copper associated chronic hepatitis?

A

Dobermans

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38
Q

What drugs can cause drug induced chronic liver disease?

A

Anticonvulsants

Carprofen (labradors)

Steroid hepatopathy

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39
Q

What are some infectious causes of chronic liver disease?

A

ICH

Leptospirosis (usually acute)

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40
Q

What is usually the cause of chronic cholangiohepatitis?

A

Enteric bacteria that ascend the biliary tract

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41
Q

What conditions could cause vacuolar hepatopathies?

A

DM

Cushings

Storage disease

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42
Q

What cells produce collagen in the liver?

A

Ito cells

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43
Q

What happens if all acinar zones are affected by fibrosis?

A

Causes bridging fibrosis -> tissue remodeling -> cirrhosis

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44
Q

What age dogs are most commonly get chronic hepatitis?

A

4-7 years old

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45
Q

What value on your biochem is your clue to early chronic hepatitis?

A

Increased ALT

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46
Q

What is the only chronic liver disease that you want to restrict protein for?

A

HE

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47
Q

When is abdominocentesis indicated for the treatment of chronic hepatitis?

A

If the fluid is causing tachypnea

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48
Q

What are the 3 causes of feline inflammatory liver disease?

A

Suppurative cholangitis

Lymphocytic cholangitis

Lymphocytic portal hepatitis (flukes)

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49
Q

What is the triad of diseases associated with feline inflammatory liver disease?

A

Hepatitis

Pancreatitis

IBD

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50
Q

What ultrasound changes will you see with feline cholangitis?

A

Hyperechoic liver

Thickened and hyperechoic gallbladder wall and common bile duct wall

Dilated CBD

Anechoic tortuous CBD

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51
Q

What disease appears similar to lymphocytic cholangitis?

A

FIP

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52
Q

What is the only way to diagnose lymphocytic cholangitis?

A

Histopath

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53
Q

Treatment for lymphocytic cholangitis?

A

Prednisolone

Chlorambucil

Methotrexate

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54
Q

What are the causes of EHBO?

A

Stricture

Intraluminal obstruction

Extrinsic compression

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55
Q

What is the most common cause of EHBO?

A

Pancreatitis

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56
Q

What is the cardinal sign of biliary tract obstruction?

A

Icterus

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57
Q

What is the best way to diagnose EHBO? What do you see?

A

Ultrasound

See distended GB, dilated tortuous bile duct, thickened GB wall

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58
Q

Definition: Inflammation of GB which could become necrotic

A

Cholecystitis

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59
Q

What breeds are mostly associated with biliary mucocele?

A

Shetland sheepdog (ABCB1 mutation)

Minature schnauzer

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60
Q

What endocrinopathy is associated with biliary mucocele? Why?

A

Cushings

Change of hydrophilic bile salts to hydrophobic bile salts

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61
Q

What are the two most common comorbid conditions associated with biliary mucocele?

A

Cushings

Hyperlipidemia

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62
Q

What is the difinitive diagnosis for biliary mucocele?

A

Abdominal ultrasound

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63
Q

What is the difinitive treatment for biliary mucocele?

A

Surgery

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64
Q

T/F: Gallbladder outcome influences the prognosis

A

False

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65
Q

T/F: The presence of hypotensive shock peri-operatively will influence the outcome

A

True

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66
Q

What primary neoplasia is found in the liver?

A

Hepatocellular carcinoma

Bile duct carcinoma

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67
Q

What 3 signs would lead you to believe an animal has oral disease?

A

Halitosis

Ptyalism

Prehension difficulty

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68
Q

What age group and breed is predisposed to feline orofacial pain syndrome?

A

Bermese 3-8 years old

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69
Q

Whats the underlying cause of pain in feline orofacial pain syndrome? Tx?

A

Trigeminal nerve neuralgia

Gabapentin or phenobarbitone

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70
Q

What is odynophagia?

A

Paine while eating

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71
Q

Is tonsillitis/pharyngitis most commonly a primary or secondary disease?

A

Secondary to upper respiratory diseases

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72
Q

What is the most common etiology of tonsillitis/pharyngitis?

A

Viral:

Feline herpes

Feline calici

Canine distemper

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73
Q

What neoplasms are associated with the pharynx?

A

SCC

Melanoma

Fibrosarcoma

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74
Q

What age group is predisposed to nasopharyngeal polyps?

A

Young cats

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75
Q

What is another DDx for tonsillitis/pharyngitis?

A

Feline orofacial pain syndroms

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76
Q

What abnormalities during the oral phase of swallowing would make you think there is something wrong?

A

Tilting or throwing the head back to swallow

Difficult prehending

Salivation

Food held in cheeks

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77
Q

What abnormalities in the pharyngeal phase of swallowing would make you think there is something wrong?

A

Coughing

Retching

Gagging

Worse while drinking

Food goes back to the mouth/nose

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78
Q

What abnormalities in the Cricopharyngeal phase of swallowing would make you think there is something wrong?

A

Repeated effors to swallow

Coughing

Retching

Gagging

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79
Q

How would you diagnose oral dysphagia?

A

Inspection and imaging

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80
Q

How would you diagnose pharyngeal/cricopharyngeal dysphagia?

A

Fluoroscopy

81
Q

What value should you look at if you are concerned about myopathy/myositis?

82
Q

Clinical signs associated with liver disease?

A

HE

Weight loss

Vomiting/diarrhea

PUPD

Jaundice

Ascites

Coagulopathy

83
Q

What breeds are associated with liver disease?

A

Cockers

Labs

Dobis

Bedlingtons

84
Q

What are the blood indicators of liver damage?

A

Enzymes

Bilirubin

85
Q

What are the blood indicators of liver function?

A

Bile acids

Ammonia

Urea

Glucose

Albumin

Coagulation factors

86
Q

What are the intracellular markers of liver damage?

87
Q

Where does ALT and AST come from?

A

ALT = liver specific

AST = Liver, skeletal muscle, cardiac muscle

88
Q

T/F: ALT and AST have very long half lives

89
Q

Which has a longer half life? ALT or AST

A

ALT (56 hours)

AST is only 12 hours

90
Q

If AST > ALT, what value should you look at next?

91
Q

What condition will cause an increase in ALKP and GGT?

A

Cholestasis

92
Q

How does the half life of ALKP in dogs compare to cats?

A

77 hours in dogs

6 hours in cats

93
Q

Which is more specific? ALKP or GGT?

94
Q

Where do ALKP come from?

A

Intestines

Kidneys

Placenta

Liver

Bones - young, old, and neoplasia

Drugs - corticosteroids (not in cats) and phenobarbitone

Endocrinopathies

95
Q

Where does bilirubin come from?

A

Liberated from RBCs and transported to liver

96
Q

What causes pre hepatic jaundice?

A

Hemolysis (IMHA)

97
Q

What causes hepatic jaundice?

A

Liver disorder resulting in intrahepatic bile duct occlusion

98
Q

What causes post hepatic jaundice?

A

Obstruction of common bile duct and gallbladder (pancreatitis or EHBO)

99
Q

How do you diagnose prehepatic jaundice?

A

PCV (anemia)

100
Q

How do you diagnose post hepatic jaundice?

A

US

Pancreatic assessment

Increased cholesterol

Potential surgical emergency

101
Q

How do you diagnose hepatic jaundice?

A

Rule out pre/post hepatic causes

Consider biopsy

102
Q

What is the best test for liver function?

A

Ammonia tolerance test

103
Q

Severe increases in biled acids are most commonly seen with what condition?

A

Acquired or congenital shunts

104
Q

Mild increases in bile acids are seen with what conditions?

105
Q

How much of hepatic capacity must be lost before you see increased ammonia?

106
Q

What percent of hepatic function must be lost before you see hypoalbuminemia?

107
Q

T/F: Hypoalbuminemia is a negative prognostic indicator

108
Q

What type of liver biopsy is the gold standard for histopath analysis?

A

Laparoscopic and celiotomy

109
Q

What type of stain is used for cirrhosis and fibrosis?

A

Masson’s trichrome

110
Q

What type of stain is used for ceroid lipofuscin?

111
Q

What type of stain is used for copper?

A

Rubeanic acid/Rhodanine

112
Q

What type of stain is used for amyloid?

113
Q

What type of stain is used for iron?

A

Perl’s stain

114
Q

What conditions can cause a transudate ascites?

A

Hypoalbuminemia

PLN

PLE

Liver failure

Portal hypertension

115
Q

What are teh characteristics of a transudate?

A

Low protein (<2.5)

Low cells (<1000)

116
Q

What are the characteristics of a modified transudate?

A

Protein = 2.5-7.5

Cells = 1000-5000

117
Q

What conditions are associated with a modified transudate ascites?

A

RCHF

Neoplasia

Liver disease

118
Q

What are the characteristics of an exudate?

A

Hight protein (>3)

High cells (>5000)

119
Q

What can cause a non septic exudate ascites?

120
Q

What can cause a septic exudate ascites?

A

GI perforation

121
Q

How can you differentiate non septic from septic exudate?

A

Non septic = neutrophils without bacteria

Septic = neutrophils with intracellular bacteria

122
Q

T/F: ALKP is liver specific in the cat

123
Q

Diagnosis of acute liver disease?

A

Biochem - elevated liver enzymes

Coagulopathies - PT/aPTT

Ultrasound - hypoechogenic liver, hepatomegaly

124
Q

What liver condition do you want to restrict protein?

125
Q

What are some causes of acute liver disease?

A

Toxins - acetaminophen, carprofen, diazepam, aflatoxin

Metabolix - lipidosis

Infectious - ICH

Hypoxia - vascular injury

126
Q

What can you use to treat acetaminophen?

A

Cimetidine

N-acetylcysteine

SAMe

Ascorbic acid

not ketoconazole

127
Q

Effects of carprofen?

A

Bridgine necrosis

Acute renal injury

128
Q

Effect of oral diazepam in cats?

A

Centrilobular necrosis

Hypoglycemia

Coagulopathy

Icterus

ARF

129
Q

Tx for aflatoxins?

A

Plasma

Vitamin K

130
Q

T/F: Liver enzymes will be elevated with Aflatoxins

A

False

Often in the normal range

131
Q

Effect of xylitol?

A

Hypoglycemia due to insulin release

Marked elevated liver enzymes

Panlobular necrosis

Icterus

Bleeding

132
Q

What plants can cause acute hepatic injury?

A

Cycads

Mushrooms

Chinaberry

133
Q

What is the most important liver disease in cats?

A

Hepatic lipidosis

134
Q

What type of diet should you feed a cat with hepatic lipidosis?

A

High protein

135
Q

Enzyme levels in a cat with hepatic lipidosis?

A

ALP increased

Normal or mild increase in ALT and GGT

136
Q

What do you see in puppies with ICH if they survive?

A

Corneal edema and uveitis

“Blue Eye”

137
Q

What sign in cats is seen with HE?

A

Salivation

138
Q

What amino acid should be given to cats with HL?

A

L-carnitine

139
Q

How does lactulose resolve HE?

A

Ion trapping

140
Q

On chest rads, what area will a mass due to spirocerca lupi show up in?

A

Caudodorsal

141
Q

If you want to do contrast radiography on a dog that you suspect has an esophageal fistula or aspiration pneumonia, what contrast medium should you avoid?

142
Q

What do you do if you are doing a contrast study and the animal aspirates the contrast?

A

Broad sepctrum antibiotics for 14 days

143
Q

What dog breeds get congenital idiopathic megaesophagus?

A

Collie

GSD

Mini Schnauzer

144
Q

What is the prognosticator of acquired idiopathic megaesophagus?

A

Aspiration pneumonia

145
Q

What is the leading cause of idiopathic megaesophagus?

A

Myasthenia gravis

146
Q

Tx for myasthenia gravis?

A

Pyridostigmine

147
Q

What breeds are associated with congenital vascular ring anomalies?

A

GSD

Irish setters

Boston terriers

Persian

Siamese

148
Q

What drug should be avoided if an animal has ME?

A

Metoclopramide

149
Q

What is the most common cause of esophageal strictures?

A

Long GA when dog placed in dorsal recumbency

150
Q

What is the treatment for esophageal strictures?

A

Balloon dilatation

151
Q

When dealing with an esophageal FB, if you decide to push it into the stomach, what drugs should not be used for post-op care?

A

H2 blockers (ranitidine/famotidine)

Proton pump inhibitors (omeprazole)

152
Q

What are some possible causes of acute gastritis?

A

Bad food/rich food

FB

Toxins

Drugs

153
Q

What are some possible causes of chronic gastritis?

A

IBD

Helicobacter

Physaloptera

154
Q

What are some possible causes of gastric ulceration?

A

Shock

Drugs

Gastrinoma/MCT

Helicobacter

IBD

Local tumor

Pythiosis

155
Q

What are some possible causes of infiltrative gastric disease?

A

IBD

Neoplasia

Pythiosis

156
Q

What is a possible cause of gastric outflow problems?

A

Idiopathic hypomotility

157
Q

What is the best test for a difinitive dx of chronic vomiting?

158
Q

What is the most common cellular infiltrate associated with chronic gastritis?

A

Lymphoplasmacytic

159
Q

What is the test of choce for helicobacter?

A

Cytobrush via endoscope

160
Q

What is the therapy of choice for gastric helicobacter?

A

Metronidazole

Amoxicillin

Famotidine

+/- Bismuth

161
Q

What breeds most commonly get adenocarcinoma of the stomach?

A

Belgian shepherds

Collies

Staffies

162
Q

What is the most common neoplasia found in the canine stomach? Feline?

A

Canine = adenocarcinoma

Feline = lymphoma

163
Q

What cells are associated with high grade lymphoma?

A

Lymphoblasts

164
Q

What cells are associated with low grade lymphoma?

A

Lymphocytes

165
Q

What breeds are associated with congenital pyloric stenosis?

A

Boxers

Bostons

166
Q

What are some systemic causes of acute diarrhea?

A

Acute pancreatitis

Liver disease

Renal disease

Addison’s

Sepsis

Shock

167
Q

What clinical signs are associated with hemorrhagic gastroenteritis?

A

Acute, severe bloody diarrhea

Vommiting

Elevated hematocrit

Normal WBC

No fever

168
Q

What are the suspected causes of hemorrhagic enteritis?

A

Type 1 hypersensitivity reaction

C. perfringens enterotoxemia

169
Q

What breeds are most susceptible to parvo?

A

Rotties

Dobis

GSD

(brown eyebrows)

170
Q

How many days after parvo vaccine can you get a false positive?

171
Q

What is the definitive diagnosis for parvo?

A

Demonstrate CPV-2 virus in the feces

172
Q

What usually correlates with the severity of parvo?

A

Degree of neutropenia

173
Q

What is the pain med of choice for parvo?

A

Buprenorphine

174
Q

What are some differentials for feline parvo/panleuk?

A

Corona

FIV

FeLV

FIP

175
Q

What are some extra intestinal causes of chronic diarrhea?

A

Pancreatic disease

Hypoadrenocorticism

Liver disease

Renal disease

Hyperthyroidism

176
Q

What are some intestinal causes of chronic diarrhea?

A

Parasitic disease

Infectious disease

Food responsive diarrhea

Intestinal neoplasia

Idiopathic inflammatory bowel disease

Antibiotic responsive diarrhea

177
Q

List these in the order you should perform them when investigating chronic diarrhea:

Fecal parasitology and bacteriology

Diet trial

GI biopsies

Blood work and UA

Diagnostic imaging

Antibiotic trial

A

Blood work and UA

Fecal parasitology and bacteriology

Diagnostic imaging

Diet trial

Antibiotic trial

GI biopsies

178
Q

BARF diets are associated with what bacteria?

A

Salmonella

179
Q

How can you distinguish clostridium and parvo?

A

Clostridium has a neutrophilia

180
Q

What breeds are associated with B12 deficiency?

A

Mini Schnauzer

Border collie

Sharpei

181
Q

Under what circumstances would you use antibiotics to treat diarrhea?

A

Hemorrhagic

Pyrexia

Inflammatory leukogram

182
Q

What breeds are predisposed to idiopathic IBD?

A

Lundehund

Weaten terrier

183
Q

What breed is associated with lymphocytic plasmacytic enteritis?

184
Q

What breeds are associated with eosinophilic enteritis?

A

Rotties

Cavalier king charles

185
Q

What breed is associated with granulomatous IBD?

186
Q

What are the negative prognostic factors of idiopathic IBD?

A

Hypoalbuminemia

Hypocobalaminemia

Small bowel and older dog

187
Q

What is the main treatment for IBD?

A

Prednisolone

188
Q

When would you use ciclosporin for IBD?

A

If there is no response to steroids after 3 weeks

189
Q

What breeds are associated with intestinal lymphangectasia?

A

Yorkies

Rotties

190
Q

What is a common complication of PLE?

A

Hypercoagulability

give asprin

191
Q

What breeds are associated with histiocytic ulcerative colitis?

A

Boxers <2yr old

Mastiffs

French bulldogs

192
Q

What drug do you use to treat histiocytic ulcerative colitis?

A

Enrofloxacin

193
Q

What is the gold standard test for tritrichomonas?

194
Q

What is the DOC for treating chronic colitis?

A

Sulfasalazine

195
Q

What is the main side effect of sulfasalazine?

196
Q

What are the causes of constipation?

A

Dietary and environmental

Painful conditions preventing defecation or positioning

Obstruction preventing fecal flow

Neurologic disease

Meetabolic and endocrine diseases

Drug induced

197
Q

What is the tx for perianal fistula?

A

Ciclosporin

198
Q

If client cant afford ciclosporin, what would you use? What is the main side effect?

A

Ketoconazole

Hepatotoxic

SAM 2 (6 decks)

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