Lecture 3 1/30/25

Question 1

What is halitosis?

Answer 1

bad breath

Question 2

Where does halitosis typically localize to?

Answer 2

mouth/oral cavity

Question 3

What is dysphagia?

Answer 3

difficulty in eating

Question 4

Which areas can be affected to cause dysphagia?

Answer 4

-prehension
-chewing
-swallowing

Question 5

What are the characteristics of gagging?

Answer 5

-pharyngeal sign/localizes to pharynx
-stimulated by mechanical irritation of posterior palate or pharynx

Question 6

What are the characteristics of ptyalism?

Answer 6

-drooling
-increased saliva production by one or more salivary glands
-normal finding in some breeds

Question 7

What is retching?

Answer 7

unproductive vomiting

Question 8

What are the characteristics of regurgitating?

Answer 8

-passive expulsion of food, fluid, and/or material
-localized to esophagus
-absence of nausea and bile
-any volume can be produced

Question 9

What are the characteristics of vomiting?

Answer 9

-active expulsion of ingesta from the stomach and potentially duodenum
-localized to stomach and small intestine
-nausea common; seen as lip smacking and/or salivation
-bile may or may not be present
-any volume can be produced

Question 10

Which questions help to identify regurgitation vs. vomiting?

Answer 10

-is there abdominal press?
-is there warning?
-is there bile in the expelled material?
–with vomiting, the answer to each question is “yes”

Question 11

What is hematemesis?

Answer 11

vomiting blood

Question 12

Where does hematemesis localize to?

Answer 12

upper GI

Question 13

What is hematochezia?

Answer 13

frank-red blood in the stool

Question 14

Which areas of the body can be diseased when hematochezia is present?

Answer 14

-anal sacs
-rectum
-large intestine

Question 15

How does the presence of stool combined with hematochezia help to further localize the issue?

Answer 15

-blood independent of defecation indicates anal sac disease
-blood combined with otherwise normal stools indicates rectal disease
-blood combined with diarrhea indicates large intestinal disease

Question 16

What is melena?

Answer 16

black, tarry feces; digested blood

Question 17

What can cause melena?

Answer 17

-upper GI blood loss
-swallowing of blood

Question 18

What are the characteristics of hemorrhagic diarrhea?

Answer 18

-large volume of diarrhea and blood
-suggests lost of mucosal barrier
-seen with some small intestinal disease

Question 19

What are the classifications for diarrhea?

Answer 19

-small bowel
-large bowel
-mixed bowel

Question 20

What are the clinical signs associated with small bowel diarrhea?

Answer 20

-weight loss
-possible polyphagia
-increased volume
-normal frequency
-melena
-slight mucous
-possible vomiting
-no straining

Question 21

What are the clinical signs associated with large bowel diarrhea?

Answer 21

-no weight loss
-no polyphagia
-straining
-increased or normal frequency
-decreased or normal volume
-hematochezia
-lots of mucous
-no vomiting

Question 22

What is eructation?

Answer 22

burping/expulsion of gas from oral cavity

Question 23

What is flatulence?

Answer 23

expulsion of gas from the anorectal canal

Question 24

What is borborygmus?

Answer 24

rumbling noise of gas as it is propagated through the GI tract

Question 25

What condition is associated with detecting borborygmus in the thorax?

Answer 25

diaphragmatic hernia

Question 26

What are the descriptive terms for changes in appetite?

Answer 26

-dysorexia: changes in appetite -anorexia: no appetite -hyporexia: decreased appetite -polyphagia: increased appetite

Question 27

What is acute abdomen?

Answer 27

sudden onset of severe abdominal pain that often requires surgical intervention

Question 28

What are the steps to developing a differential list and prioritizing diagnostic tests?

Answer 28

-decide whether the clinical signs are caused by primary GI disease or are secondary to non-GI illness -localize the signs -determine duration of clinical signs -classify the severity of clinical signs

Question 29

What are the key components of a targeted GI history?

Answer 29

-diet/changes in diet -exposure to foreign material -medications and supplements -deworming/preventatives -environment -stool quality

Question 30

What are the key features of a physical exam when assessing for GI disease?

Answer 30

-body weight/body condition score -hydration -oral exam -palpation of cervical area -thoracic auscultation -abdominal palpation -assessment for peripheral edema -rectal palpation

Question 31

What needs to be included in the summary of each problem on the problem list?

Answer 31

-frequency -severity -duration

Question 32

What are the different descriptors for frequency?

Answer 32

-occasional: 1-2 times per month -intermittent: 1+ times per week -persistent: no normal periods

Question 33

What are the different descriptors for severity?

Answer 33

-mild: systemically well; only showing clinical signs related to the problem -severe: unwell; showing more systemic signs in addition to the noted problem

Question 34

What are the descriptors for duration?

Answer 34

-acute: < 7 to 14 days -chronic: > or = 3 weeks

Question 35

How is the problem list ordered?

Answer 35

-start with the most serious historical or physical exam finding -make sure to include owner's chief complaint -move problems with finite differentials up the list

Question 36

What is secondary GI disease?

Answer 36

GI disease that results from disease of other organ systems or from systemic disease

Question 37

What is primary GI disease?

Answer 37

disease of the oropharynx, esophagus, stomach, small intestine, large intestine, and/or rectum

Question 38

Which diagnostics are used to rule out significant metabolic disease?

Answer 38

-CBC -chem -UA -PLI -endocrine testing --baseline cortisol for dogs, T4 for cats

Question 39

Which fecal tests are important when working up GI disease?

Answer 39

-fecal flotation -giardia testing -fecal cultures -direct fecal smears

Question 40

Which patients always have an indication for abdominal radiographs?

Answer 40

acutely vomiting animals

Question 41

What can be diagnosed using abdominal radiographs?

Answer 41

-intestinal obstruction/foreign body -GDV -abdominal mass -decreased serosal detail

Question 42

What can be diagnosed using abdominal ultrasound?

Answer 42

-free fluid in abdomen -obstruction -focal masses -pancreatic abnormalities -non-GI disease in abdomen -intestinal wall thickening -lymphadenopathy