Lecture 11: GI III- diarrhea, SI dz, intestinal neoplasia, rectal/anal dz

Question 1

What is purpose of intestinal villi

Answer 1

absorption

Question 2

what is purpose of intestinal crypts

Answer 2

proliferation

Question 3

what is fx of SI epithelium

Answer 3

nutrient absorption

Question 4

what is fx of colonic epithelium

Answer 4

absorb excess water

Question 5

t or f: cecum/colon has no villi but lots of goblet cells

Answer 5

true

Question 6

What tissue is this and identify 1-2

Answer 6

SI
1. Villi
2. Crypts

Question 7

What part of intestine is this

Answer 7

Cecum/colon

Question 8

What specialized enterocyte produces antimicrobial proteins

Answer 8

paneth cells

Question 9

if you have no tight junctions in intestines what is consequence

Answer 9

no control of absorption and enhanced permeability—> diarrhea and dehydration

Question 10

what is enteritis

Answer 10

inflammation of SI

Question 11

what is typhlitis

Answer 11

inflammation of cecum

Question 12

what is proctitis

Answer 12

inflammation of rectum

Question 13

what is the pathogenesis of hypersecretion causing diarrhea

Answer 13

stimulation of enhanced ion (Cl-) transport at level of crypts—> increased osmotic pressure in lumen—> influx water into lumen

Question 14

what mediates hypersecretion causing diarrhea

Answer 14

1. Inflammatory mediators- prostaglandins
2. Enterotoxins

Question 15

what is the pathogenesis of malabsorptive diarrhea

Answer 15

damage to villi—> villus atrophy—> decreased surface area for absorption—> +/- crypt hyperplasia—> +/- enhanced secretion

Question 16

what viruses can cause malabsroptive diarrhea

Answer 16

rotaviruses, coronaviruses

Question 17

what bacteria can cause malabsoprtive diarrhea

Answer 17

EPEC and EHEC

Question 18

what parasites can cause malabsorptive diarrhea

Answer 18

cryptosporidium parvum, coccidia

Question 19

altered motility can be seen __ and is __ or __ mediated

Answer 19

hypersecretion, prostaglandin or cAMP

Question 20

increased permeability component of enteritis can result from any __

Answer 20

epithelial damage/loss

Question 21

Inflammation will result in increase ___ dump fluid and protein into lamina propria and subsequent loss into intestinal lumen

Answer 21

vascular permeability

Question 22

Increased permeability is also associated with __

Answer 22

protein losing enteropathies (ex: IBD)

Question 23

Maldigestion can be secondary to __, linked with __

Answer 23

villus atrophy, malabsorption

Question 24

exocrine pancreas insufficiency is associated with what mechanism of diarrhea

Answer 24

Maldigestion

Question 25

what is the consequence of any type of diarrhea

Answer 25

Water loss-> dehydration—> hypovolemia—> inadequate tissue perfusion and hypovolemic shock

Question 26

what are some clinical signs of parvovirus

Answer 26

bloody diarrhea, vomiting, anorexia

Question 27

what are some gross signs of parvo

Answer 27

segmental hyperemia, fibrin deposition on serosa

Question 28

what is the pathogenesis of parvovirus

Answer 28

Cl- enters and damages crypts—> lack of replacement of absorptive enterocytes and loss of barrier function—> loss of fluids/bacterial translocation—> sepsis—> shock

Question 29

what are some microscopic findings of parvo

Answer 29

severe crypt necrosis

Question 30

what type of diarrhea does parvovirus cause

Answer 30

malabsoprtive diarrhea—> damages crypts so can’t regenerative villus tips

Question 31

what virus likely cause this

Answer 31

parvo

Question 32

Puppy with bloody diarrhea, anorexia, became septic and was euthanized. Histopath of intestines was performed and this was seen. What is likely cause and how do you know

Answer 32

Parvovirus- loss of crypts and secondary villus atrophy

Question 33

What are the microscopic findings of coronavirus in intestines

Answer 33

villus atrophy, but crypts intact

Question 34

What is the pathogenesis of enteritis caused by Pythian insidosum

Answer 34

dog ingest oomycete—> granulomatous enteritis—> obstruction

Question 35

chronic enteropathies associated with hypoproteinemia that lead to __

Answer 35

weight loss, diarrhea, edema, ascites

Question 36

what is the most common presentation of IBD

Answer 36

lymphoplasmocytic

Question 37

what is the cause of lymphoplasmacytic IBD

Answer 37

immune mediated

Question 38

what is cause of eosinophilic IBD

Answer 38

Food allergies vs parasite

Question 39

what breeds are predisposed to histiocytic/ulcerative/granulomatous IBD

Answer 39

boxers, French bulldogs

Question 40

What occurs during histiocytic ulcerative colitis

Answer 40

diffuse thickening/ulceration of colon due to influx of foamy histiocytes (macrophages) and contain PAS positive material

Question 41

Boxer presents with chronic diarrhea, and weight loss- these were findings what is most likely dx and how do you know

Answer 41

histiocytic ulcerative colitis- diffuse thickening of colonic, PAS +, lots of macrophages

Question 42

what is cause of histiocytic ulcerative colitis

Answer 42

Invasive E. Coli

Question 43

define lymphangiectasia

Answer 43

dilation of lymph vessels/lacteals

Question 44

what blood work findings are consistent with lymphagiestasia

Answer 44

lymphopenia, hypocholesterolemia, hypoalbuminemia

Question 45

what dx

Answer 45

Lymphangiectasia

Question 46

What neoplasia most likely

Answer 46

adenocarcinoma

Question 47

What dx

Answer 47

Intestinal lymphoma

Question 48

mass was very firm and following histo was taken- what are your top 3 differentials and what test should be done to find definitive dx

Answer 48

1. Gastrointestinal stromal tumors 2. Leiomyoma 3. Leiomyosarcoma Test: IHC

Question 49

What breed most commonly gets perinatal fistulas

Answer 49

GSD

Question 50

a perianal fistula forms a track between __ and __

Answer 50

perianal skin and rectum

Question 51

what is the benign perianal tumor

Answer 51

adenoma

Question 52

what is malignant perianal tumor and what is a bloodwork sign

Answer 52

Apocrine gland anal sac adenocarcinoma BW: hypercalcemia