Koster Test 1 Flashcards
1
Q
What is the common signalment for acute pancreatitis in dogs?
A
Small
Overweight
High fat diet
2
Q
What is the common signalment for acute pancreatitis in cats?
A
Underweight
Elderly
Malnourished
No high fat diet predisposition
3
Q
What is the cause of acute pancreatitis in cats?
A
Bacteria
Duodenal reflux
4
Q
A dog that is in the ‘prayer position’ most likely has what GI abnormality?
A
Acute pancreatitis
5
Q
When performing an ultrasound, what finding would make you lean towards pancreatitis?
A
Hyperechoic peripancreatic fat
Hypoechoic pancreas
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%)
7
Q
What is the best way to diagnose pancreatitis?
A
Combo of ultrasound and spec PLI
8
Q
What are the two prefered analgesics for acute pancreatitis?
A
Buprenorphine
Methadone
9
Q
What is the anti-emetic of choice for acute pancreatitis?
A
Cerenia (Maropitant)
10
Q
What is “triaditis” and what species is it associated with?
A
Associated with cats
Lymphocytic-plasmacytic enteritis, cholangitis, and pancreatitis
11
Q
What is the most accurate blood test for diagnosing pancreatitis in cats?
A
Feline Spec PL
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
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
14
Q
T/F: Acute pancreatitis is more common in cats than chronic pancreatitis
A
False
15
Q
What breeds are predisposed to chronic pancreatitis?
A
Cavalier King Charles Spaniel
English Cocker Spaniel
Boxers
Collies
16
Q
Why are Boxers resistant to end-stage disease associated with chronic pancreatitis?
A
They have a really high regenerative capacity
17
Q
Clinical signs associated with chronic pancreatitis?
A
Intermittent, low-grade clinical signs
Acute signs
Older, non-GSD dog with EPI
Diabetes millitus
18
Q
Why is the PLI test insensitive at diagnosing chronic pancreatitis?
A
Loss of pancreatic mass
28% sensitive
19
Q
What breed would benefit from corticosteroid therapy for chronic pancreatitis?
A
Cocker Spaniels
Cats
20
Q
What percent of pancreatic function loss is required for EPI?
A
80-90% loss of function
21
Q
What is the main cause of EPI in cats?
A
Chronic pancreatitis
22
Q
What is the most common cause of pancreatic acinar atrophy?
A
End stage autoimmune process (>90%)
23
Q
Pancreatic acinar atrophy is autosomal recessive in what breeds?
A
GSD
Rough collies
24
Q
Which test is very sensitive and specific for EPI?
A
TLI
25
What are the TLI cut off values for diagnosing EPI?
\<2.5 = EPI
2.5-5 = non-fasted or early EPI
26
How should you feed a patient with EPI?
Small amounts of food often
27
Tx for EPI?
Supplement enzymes
Frozen pancreas
28
What type of pancreatic neoplasia infiltrates surrounding organs and often results in icterus?
Adenocarcinoma
29
What pancreatic tumors do dogs get?
Lymphoma
Hemangiosarcoma
Adenocarcinoma
30
What pancreatic tumors do cats get?
Adenocarcinoma
31
What is the most common form of pancreatitis in dogs?
Acute on chronic
32
What is the most common form of pancreatitis in cats?
Chornic pancreatitis
33
What is a chronic complication of acute pancreatitis?
Pseudocyst
34
Which is not an end stage complication of chronic pancreatitis?
Pancreatic acinar atrophy (PAA)
Exocrine pancreatic insufficiency (EPI)
Diabetes mellitus (DM)
Pancreatic acinar atrophy
35
Which breed does not have inflammation associated with chronic liver disease?
GSD
36
What breeds get primary copper associated liver disease?
Bedlington terrier
Westies
Spaniels
Poodle
Dalmations
37
What breed gets secondary copper associated chronic hepatitis?
Dobermans
38
What drugs can cause drug induced chronic liver disease?
Anticonvulsants
Carprofen (labradors)
Steroid hepatopathy
39
What are some infectious causes of chronic liver disease?
ICH
Leptospirosis (usually acute)
40
What is usually the cause of chronic cholangiohepatitis?
Enteric bacteria that ascend the biliary tract
41
What conditions could cause vacuolar hepatopathies?
DM
Cushings
Storage disease
42
What cells produce collagen in the liver?
Ito cells
43
What happens if all acinar zones are affected by fibrosis?
Causes bridging fibrosis -\> tissue remodeling -\> cirrhosis
44
What age dogs are most commonly get chronic hepatitis?
4-7 years old
45
What value on your biochem is your clue to early chronic hepatitis?
Increased ALT
46
What is the only chronic liver disease that you want to restrict protein for?
HE
47
When is abdominocentesis indicated for the treatment of chronic hepatitis?
If the fluid is causing tachypnea
48
What are the 3 causes of feline inflammatory liver disease?
Suppurative cholangitis
Lymphocytic cholangitis
Lymphocytic portal hepatitis (flukes)
49
What is the triad of diseases associated with feline inflammatory liver disease?
Hepatitis
Pancreatitis
IBD
50
What ultrasound changes will you see with feline cholangitis?
Hyperechoic liver
Thickened and hyperechoic gallbladder wall and common bile duct wall
Dilated CBD
Anechoic tortuous CBD
51
What disease appears similar to lymphocytic cholangitis?
FIP
52
What is the only way to diagnose lymphocytic cholangitis?
Histopath
53
Treatment for lymphocytic cholangitis?
Prednisolone
Chlorambucil
Methotrexate
54
What are the causes of EHBO?
Stricture
Intraluminal obstruction
Extrinsic compression
55
What is the most common cause of EHBO?
Pancreatitis
56
What is the cardinal sign of biliary tract obstruction?
Icterus
57
What is the best way to diagnose EHBO? What do you see?
Ultrasound
See distended GB, dilated tortuous bile duct, thickened GB wall
58
Definition: Inflammation of GB which could become necrotic
Cholecystitis
59
What breeds are mostly associated with biliary mucocele?
Shetland sheepdog (ABCB1 mutation)
Minature schnauzer
60
What endocrinopathy is associated with biliary mucocele? Why?
Cushings
Change of hydrophilic bile salts to hydrophobic bile salts
61
What are the two most common comorbid conditions associated with biliary mucocele?
Cushings
Hyperlipidemia
62
What is the difinitive diagnosis for biliary mucocele?
Abdominal ultrasound
63
What is the difinitive treatment for biliary mucocele?
Surgery
64
T/F: Gallbladder outcome influences the prognosis
False
65
T/F: The presence of hypotensive shock peri-operatively will influence the outcome
True
66
What primary neoplasia is found in the liver?
Hepatocellular carcinoma
Bile duct carcinoma
67
What 3 signs would lead you to believe an animal has oral disease?
Halitosis
Ptyalism
Prehension difficulty
68
What age group and breed is predisposed to feline orofacial pain syndrome?
Bermese 3-8 years old
69
Whats the underlying cause of pain in feline orofacial pain syndrome? Tx?
Trigeminal nerve neuralgia
Gabapentin or phenobarbitone
70
What is odynophagia?
Paine while eating
71
Is tonsillitis/pharyngitis most commonly a primary or secondary disease?
Secondary to upper respiratory diseases
72
What is the most common etiology of tonsillitis/pharyngitis?
Viral:
Feline herpes
Feline calici
Canine distemper
73
What neoplasms are associated with the pharynx?
SCC
Melanoma
Fibrosarcoma
74
What age group is predisposed to nasopharyngeal polyps?
Young cats
75
What is another DDx for tonsillitis/pharyngitis?
Feline orofacial pain syndroms
76
What abnormalities during the oral phase of swallowing would make you think there is something wrong?
Tilting or throwing the head back to swallow
Difficult prehending
Salivation
Food held in cheeks
77
What abnormalities in the pharyngeal phase of swallowing would make you think there is something wrong?
Coughing
Retching
Gagging
Worse while drinking
**Food goes back to the mouth/nose**
78
What abnormalities in the Cricopharyngeal phase of swallowing would make you think there is something wrong?
**Repeated effors to swallow**
Coughing
Retching
Gagging
79
How would you diagnose oral dysphagia?
Inspection and imaging
80
How would you diagnose pharyngeal/cricopharyngeal dysphagia?
Fluoroscopy
81
What value should you look at if you are concerned about myopathy/myositis?
CK levels
82
Clinical signs associated with liver disease?
HE
Weight loss
Vomiting/diarrhea
PUPD
Jaundice
Ascites
Coagulopathy
83
What breeds are associated with liver disease?
Cockers
Labs
Dobis
Bedlingtons
84
What are the blood indicators of liver damage?
Enzymes
Bilirubin
85
What are the blood indicators of liver function?
Bile acids
Ammonia
Urea
Glucose
Albumin
Coagulation factors
86
What are the intracellular markers of liver damage?
ALT
AST
87
Where does ALT and AST come from?
ALT = liver specific
AST = Liver, skeletal muscle, cardiac muscle
88
T/F: ALT and AST have very long half lives
False
89
Which has a longer half life? ALT or AST
ALT (56 hours)
AST is only 12 hours
90
If AST \> ALT, what value should you look at next?
CK
91
What condition will cause an increase in ALKP and GGT?
Cholestasis
92
How does the half life of ALKP in dogs compare to cats?
77 hours in dogs
6 hours in cats
93
Which is more specific? ALKP or GGT?
GGT
94
Where do ALKP come from?
_Intestines_
_Kidneys_
_Placenta_
Liver
Bones - young, old, and neoplasia
Drugs - corticosteroids (not in cats) and phenobarbitone
Endocrinopathies
95
Where does bilirubin come from?
Liberated from RBCs and transported to liver
96
What causes pre hepatic jaundice?
Hemolysis (IMHA)
97
What causes hepatic jaundice?
Liver disorder resulting in intrahepatic bile duct occlusion
98
What causes post hepatic jaundice?
Obstruction of common bile duct and gallbladder (pancreatitis or EHBO)
99
How do you diagnose prehepatic jaundice?
PCV (anemia)
100
How do you diagnose post hepatic jaundice?
US
Pancreatic assessment
Increased cholesterol
Potential surgical emergency
101
How do you diagnose hepatic jaundice?
Rule out pre/post hepatic causes
Consider biopsy
102
What is the best test for liver function?
Ammonia tolerance test
103
Severe increases in biled acids are most commonly seen with what condition?
Acquired or congenital shunts
104
Mild increases in bile acids are seen with what conditions?
HAC
DM
105
How much of hepatic capacity must be lost before you see increased ammonia?
\>70%
106
What percent of hepatic function must be lost before you see hypoalbuminemia?
≥67%
107
T/F: Hypoalbuminemia is a negative prognostic indicator
True
108
What type of liver biopsy is the gold standard for histopath analysis?
Laparoscopic and celiotomy
109
What type of stain is used for cirrhosis and fibrosis?
Masson's trichrome
110
What type of stain is used for ceroid lipofuscin?
PAS
111
What type of stain is used for copper?
Rubeanic acid/Rhodanine
112
What type of stain is used for amyloid?
Congo red
113
What type of stain is used for iron?
Perl's stain
114
What conditions can cause a transudate ascites?
Hypoalbuminemia
PLN
PLE
Liver failure
Portal hypertension
115
What are teh characteristics of a transudate?
Low protein (\<2.5)
Low cells (\<1000)
116
What are the characteristics of a modified transudate?
Protein = 2.5-7.5
Cells = 1000-5000
117
What conditions are associated with a modified transudate ascites?
RCHF
Neoplasia
Liver disease
118
What are the characteristics of an exudate?
Hight protein (\>3)
High cells (\>5000)
119
What can cause a non septic exudate ascites?
FIP
120
What can cause a septic exudate ascites?
GI perforation
121
How can you differentiate non septic from septic exudate?
Non septic = neutrophils without bacteria
Septic = neutrophils with intracellular bacteria
122
T/F: ALKP is liver specific in the cat
True
123
Diagnosis of acute liver disease?
Biochem - elevated liver enzymes
Coagulopathies - PT/aPTT
Ultrasound - hypoechogenic liver, hepatomegaly
124
What liver condition do you want to restrict protein?
HE
125
What are some causes of acute liver disease?
Toxins - acetaminophen, carprofen, diazepam, aflatoxin
Metabolix - lipidosis
Infectious - ICH
Hypoxia - vascular injury
126
What can you use to treat acetaminophen?
Cimetidine
N-acetylcysteine
SAMe
Ascorbic acid
not ketoconazole
127
Effects of carprofen?
Bridgine necrosis
Acute renal injury
128
Effect of oral diazepam in cats?
Centrilobular necrosis
Hypoglycemia
Coagulopathy
Icterus
ARF
129
Tx for aflatoxins?
Plasma
Vitamin K
130
T/F: Liver enzymes will be elevated with Aflatoxins
False
Often in the normal range
131
Effect of xylitol?
Hypoglycemia due to insulin release
Marked elevated liver enzymes
Panlobular necrosis
Icterus
Bleeding
132
What plants can cause acute hepatic injury?
Cycads
Mushrooms
Chinaberry
133
What is the most important liver disease in cats?
Hepatic lipidosis
134
What type of diet should you feed a cat with hepatic lipidosis?
High protein
135
Enzyme levels in a cat with hepatic lipidosis?
ALP increased
Normal or mild increase in ALT and GGT
136
What do you see in puppies with ICH if they survive?
Corneal edema and uveitis
"Blue Eye"
137
What sign in cats is seen with HE?
Salivation
138
What amino acid should be given to cats with HL?
L-carnitine
139
How does lactulose resolve HE?
Ion trapping
140
On chest rads, what area will a mass due to spirocerca lupi show up in?
Caudodorsal
141
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?
Barium
142
What do you do if you are doing a contrast study and the animal aspirates the contrast?
Broad sepctrum antibiotics for 14 days
143
What dog breeds get congenital idiopathic megaesophagus?
Collie
GSD
Mini Schnauzer
144
What is the prognosticator of acquired idiopathic megaesophagus?
Aspiration pneumonia
145
What is the leading cause of idiopathic megaesophagus?
Myasthenia gravis
146
Tx for myasthenia gravis?
Pyridostigmine
147
What breeds are associated with congenital vascular ring anomalies?
GSD
Irish setters
Boston terriers
Persian
Siamese
148
What drug should be avoided if an animal has ME?
Metoclopramide
149
What is the most common cause of esophageal strictures?
Long GA when dog placed in dorsal recumbency
150
What is the treatment for esophageal strictures?
Balloon dilatation
151
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?
H2 blockers (ranitidine/famotidine)
Proton pump inhibitors (omeprazole)
152
What are some possible causes of acute gastritis?
Bad food/rich food
FB
Toxins
Drugs
153
What are some possible causes of chronic gastritis?
IBD
Helicobacter
Physaloptera
154
What are some possible causes of gastric ulceration?
Shock
Drugs
Gastrinoma/MCT
Helicobacter
IBD
Local tumor
Pythiosis
155
What are some possible causes of infiltrative gastric disease?
IBD
Neoplasia
Pythiosis
156
What is a possible cause of gastric outflow problems?
Idiopathic hypomotility
157
What is the best test for a difinitive dx of chronic vomiting?
Biopsy
158
What is the most common cellular infiltrate associated with chronic gastritis?
Lymphoplasmacytic
159
What is the test of choce for helicobacter?
Cytobrush via endoscope
160
What is the therapy of choice for gastric helicobacter?
Metronidazole
Amoxicillin
Famotidine
+/- Bismuth
161
What breeds most commonly get adenocarcinoma of the stomach?
Belgian shepherds
Collies
Staffies
162
What is the most common neoplasia found in the canine stomach? Feline?
Canine = adenocarcinoma
Feline = lymphoma
163
What cells are associated with high grade lymphoma?
Lymphoblasts
164
What cells are associated with low grade lymphoma?
Lymphocytes
165
What breeds are associated with congenital pyloric stenosis?
Boxers
Bostons
166
What are some systemic causes of acute diarrhea?
Acute pancreatitis
Liver disease
Renal disease
Addison's
Sepsis
Shock
167
What clinical signs are associated with hemorrhagic gastroenteritis?
Acute, severe bloody diarrhea
Vommiting
Elevated hematocrit
Normal WBC
No fever
168
What are the suspected causes of hemorrhagic enteritis?
Type 1 hypersensitivity reaction
C. perfringens enterotoxemia
169
What breeds are most susceptible to parvo?
Rotties
Dobis
GSD
(brown eyebrows)
170
How many days after parvo vaccine can you get a false positive?
14
171
What is the definitive diagnosis for parvo?
Demonstrate CPV-2 virus in the feces
172
What usually correlates with the severity of parvo?
Degree of neutropenia
173
What is the pain med of choice for parvo?
Buprenorphine
174
What are some differentials for feline parvo/panleuk?
Corona
FIV
FeLV
FIP
175
What are some extra intestinal causes of chronic diarrhea?
Pancreatic disease
Hypoadrenocorticism
Liver disease
Renal disease
Hyperthyroidism
176
What are some intestinal causes of chronic diarrhea?
Parasitic disease
Infectious disease
Food responsive diarrhea
Intestinal neoplasia
Idiopathic inflammatory bowel disease
Antibiotic responsive diarrhea
177
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
Blood work and UA
Fecal parasitology and bacteriology
Diagnostic imaging
Diet trial
Antibiotic trial
GI biopsies
178
BARF diets are associated with what bacteria?
Salmonella
179
How can you distinguish clostridium and parvo?
Clostridium has a neutrophilia
180
What breeds are associated with B12 deficiency?
Mini Schnauzer
Border collie
Sharpei
181
Under what circumstances would you use antibiotics to treat diarrhea?
Hemorrhagic
Pyrexia
Inflammatory leukogram
182
What breeds are predisposed to idiopathic IBD?
Lundehund
Weaten terrier
183
What breed is associated with lymphocytic plasmacytic enteritis?
Goldens
184
What breeds are associated with eosinophilic enteritis?
Rotties
Cavalier king charles
185
What breed is associated with granulomatous IBD?
Boxers
186
What are the negative prognostic factors of idiopathic IBD?
Hypoalbuminemia
Hypocobalaminemia
Small bowel and older dog
187
What is the main treatment for IBD?
Prednisolone
188
When would you use ciclosporin for IBD?
If there is no response to steroids after 3 weeks
189
What breeds are associated with intestinal lymphangectasia?
Yorkies
Rotties
190
What is a common complication of PLE?
Hypercoagulability
give asprin
191
What breeds are associated with histiocytic ulcerative colitis?
Boxers \<2yr old
Mastiffs
French bulldogs
192
What drug do you use to treat histiocytic ulcerative colitis?
Enrofloxacin
193
What is the gold standard test for tritrichomonas?
Fecal PCR
194
What is the DOC for treating chronic colitis?
Sulfasalazine
195
What is the main side effect of sulfasalazine?
KCS
196
What are the causes of constipation?
Dietary and environmental
Painful conditions preventing defecation or positioning
Obstruction preventing fecal flow
Neurologic disease
Meetabolic and endocrine diseases
Drug induced
197
What is the tx for perianal fistula?
Ciclosporin
198
If client cant afford ciclosporin, what would you use? What is the main side effect?
Ketoconazole
Hepatotoxic
199
