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Clinical Medicine Master > SA GI (MR) > Flashcards

SA GI (MR) Flashcards

1
Q

GI Functions?

A 
Digestion 
Absorption 
Excretion 
Water balance 
Electrolyte and acid/base balance
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2
Q

Where does water absorption in the gut happen?

A

Small Intestine

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3
Q

What does LI do?

A

Form up feces Remove the rest of the water

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4
Q

TQ!!! Where is watery dxa from?

A

Small Intestine

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5
Q

What occurs in the GI?

A

Mechanical and Chemical Digestion Digestion& absorption – (•Carbs •Protein •Lipids •Vitamins) Fluid Balance Motility

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6
Q

Fluid Balance in GI: In healthy intestine how much of presented fluid does Jejumun absorb? Ileum? Colon?

A

• J-absorbs 50% • I- absorbs 75% of remaining half • C-absorbs 90% of remaining after ileum

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7
Q

Motility is what type of motion?

A

•Slow wave motion

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8
Q

TQ!!! What is the motion of the GI Controlled by? •Controlled by ANS + ENS, hormones

A

•Controlled by ANS + ENS, hormones

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9
Q

What are Segmental contractions?

A

Mixing not moving along

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10
Q

IF you give a promotility agent will you get dxa or constipation?

A

Constipation

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11
Q

With Reduced activity regarding Segmental contractions what will you see cx?

A

Dxa

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12
Q

What do Parastaltic contrations do?

A

Propel

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13
Q

With Reduced activity regarding Segmental contractions what will you see cx?

A

• Ileus

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14
Q

Fasted state is usually in what phase?

A

Quiescent Phase

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15
Q

What is Minor contractile activity? What phase?

A

•MMC migrating motor complexes – housekeeping Fasted

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16
Q

Dysphagia CX?

A

Abnormal Swallowing Halitosis Ptyalism Gagging and multiple swallowing attempts Abnormal prehension Weight loss Painful mouth Coughing – aspirating Hematemesis - vomit blood

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17
Q

What parts does it take to swallow?

A

Mouth tongue pharynx larynx UES Esophagus

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18
Q

Dysphagia Rule Outs?

A

Foreign bodies Ulceration Inflammation/Infection Uremia Feline Stomatits Glossitis Calicivirus, etc. Dental disease Fractures Sialoadenitis - inflamed salivary glands (Spiro Circa Lupi) Neuromuscular Dz Masses

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19
Q

Additional Dysphagia Ruleouts for Cat?

A

Eosinophilic granuloma Lymphocyitc/Plasmacytic gingivitis/pharyngitis

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20
Q

If you have a cat with oral ulcers, nasal, and ocular discharge is it most likely herpes or calici?

A

Calici like the mouth too

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21
Q

IF you have a cat with nasal and ocular discharge is is most likely herpes or calici?

A

Eye & nose = Herpes

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22
Q

What neuromuscular dzs can cause dysphagia?

A

Masticatory muscle myositis (MMM) Oropharyngeal dysphagia Cricopharyngeal achalasia and asynchrony Tetanus/Botulistm/Rabies - neuromuscular transmission Neurological dysfunction

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23
Q

What are the phases of Oropharyngeal dysphagia?

A

Oral phase Pharyngeal phase Cricopharyngeal phase

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24
Q

Paresis or paralysis of which Nerves can cause dysphagia? -

A

5 7 9 10 12

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25
Q

What types of Masses cause dysphagia?

A

Abscesss Neoplasia

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26
Q

What types of Neoplastic masses cause dysphagia?

A

Squamos Cell Carcinoma - Bad (Cats mostly) Malignant Melanoma – Bad FSA OSA Epulis (AA) Acanthomatous Amaloblastoma Plasmacytomas - usually benign

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27
Q

How should an animal be examined with mouth pain?

A

Complete PE - Pyrexia (can be systemic) Complete oral exam - specially teeth, under the tongue Palpate face and neck - Masses, FB, pain, SC emphysema Complete neurological exam Auscultation Thoracic Neck Observe animal eating if necessary

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28
Q

Do Blood work if? (2)

A

PE and CS indicate systemic involvement anesthesia is needed

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29
Q

Specific testing on cats?

A

FeLV/FIV MMM - 2M antibody titer

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30
Q

What is MMM?

A

Autoimmune disease against the masticatory muscles in cats.

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31
Q

Imaging Radiographs

A

Thorax Soft tissue neck - only need 1 view bc of spine +/- dental - close lil ones +/- skull - not the same of dental, may not be close enough

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32
Q

What is more appropriate for skull?

A

CT/MRI

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33
Q

Which is better for Bone, CT or MRI

A

CT

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34
Q

Which is better for Soft Tissue CT or MRI?

A

MRI

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35
Q

Which exams might you have to Sedate a cat for?

A

Oral Pharyngeal Laryngeal

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36
Q

Contrast (Barium Swallow) studies you can perform to evaluate the oral cavity?

A

Esophogram Fluoroscopy

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37
Q

What is fluoroscopy?

A

A 3D real-time radiograph (like a movie)

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38
Q

Parts of Esophagus?

A

Upper Esophageal Sphincter Esophagus Lower esophageal sphincter

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39
Q

What type of muscle is Lower Esophageal Sphincter?

A

Smooth

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40
Q

Striation of Dog Esophagus? Cat?

A

Dog = All striated Cat = Distal portion striated

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41
Q

Innervation to Espphagus?

A

Vagus Somatic & Autonomic

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42
Q

What type of peristalsis occurs in espphagus?

A

1º and 2º (left over) peristalsis

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43
Q

What is 1º peristalsis stimulated by?

A

Stretch

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44
Q

TQ!!! The MOST COMMON clinical manifestation of ESOPHAGEAL disease is?

A

REGURGITATION!!! Hx with Regurgitation? Chronicity Recent anesthesia - #1 Reason for regurg Foreign body ingestion/removal Dysphagia Halitosis Hypersalivation Weight loss - Can be severe +/- coughing & dyspnea +/-depression & anorexia

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45
Q

Why does anesthesia commonly cause regurgitation?

A

Lower sphincter is relaxed, acid can splash up into esophagus causing esophagitis (destroys mucosal surface)

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46
Q

What does esophagus do when it’s pissed?

A

Strictures!

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47
Q

How can you cause a cat esophagitis in a cat thru pilling?

A

Doxycycline very caustic

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48
Q

Is Regurgitation passive or active? Vomitting?

A

Regurg = passive Vom - Active

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49
Q

Is there Abdominal component/retching, bile, or Nausea with regurg? Vom?

A

R = NO V = Yes

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50
Q

Will food be digested with regurg? Vom?

A

R = May appear to be V = Maybe

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51
Q

What is Appetite like for regurg? Vom?

A

R = Usually ++ Vom = +/-

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52
Q

Which are you more likely to aspirate with, Regurg or Vom?

A

Regurgitation

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53
Q

Rule Outs for Regurgitation?

A

Megaesophagus/Esophageal weakness *Vascular Ring anomaly Esophageal Foreign Body Stricture, diverticula, fistulas - Pissed it off! Esophagitis Masses Hiatal Hernia GE Intussusception Lead Poisoning Canine Distemper

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54
Q

What is the vascular ring anomaly most often seen with regurgitation? Who gets it mostly? Where is it?

A

Persistent right aortic arch—most common GSD Cranial to heart

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55
Q

What are common causes of Esophagitis?

A

Post anesthesia GERD - Gastro Esophageal Reflux Dz Excessive acidity Lower Esophageal Sphincter Achalasia

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56
Q

Who gets Congenital Megaesophagus/Esophageal Weakness?

A

Any breed Danes Irish Setters Newfies GSD Shar Pei Labradors Dachshunds - can resolve at 6 months Rare in cats

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57
Q

Congenital Megaesophagus conditions?

A

***Vascular Ring Anomaly

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58
Q

Secondary acquired Megaesophagus/Esophageal Weakness causes?

A

***Myasthenia Gravis—systemic or focal esophageal Vascular Ring Anomaly Dysautonomia - RARE - ANS don’t work right Polymyopathy/myositis Polyneuropathy/neuritis SLE - Systemic Lupus Erythematosus Addison’s Toxic - Lead, OP, thallium Botulism Polyradiculoneuritis/Coonhound Familial canine dermatomyositis Familial reflex myoclonus Glycogen storage disease CNS disease Infection, neoplasia Hypothyroidism

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59
Q

What tumor like to occur in conjunction with Myasthenia Gravis and Megaesophagus?

A

Thymoma

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60
Q

Most common Esophageal masses?

A

Neoplasia - Esophageal or Extraesophageal Granulomas - Spirocerca lupi

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61
Q

What is Hiatal Hernia?

A

Stomach herniates thru diaphragm puts pressure on esophagus

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62
Q

What is Gastro-Esophageal intussusception?

A

stomach intussuscepts into esophagus

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63
Q

Diagnostic tests with Regurg?

A

Survey radiography Thoracic & Cervical Contrast radiography Fluoroscopy Endoscopy CBC/Chem?UA Fecal Neuromuscular Eval Brain CT/MRI CSF Analysis

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64
Q

Important to Evaluate Radiographs for?

A

Esophageal Dilation Air Displacement Foreign bodies Masses Pneumomediastinum Metastatic disease Aspiration pneumonia

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65
Q

Where on radiograph should you look for aspiration pneumonia?

A

Right Mainstem Broncus to RT middle lung lobe. Likely place for aspirated food to go

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66
Q

What two things like to happen together? Besties if you will?

A

Aspiration Pneumonia & Megaesophagus!

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67
Q

What will you likely see with Metastatic Dz?

A

Aspiration Pneumonia She said DING DING DING after this.

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68
Q

What is Pneumomediastinum a sign for? Where might it occur?

A

Fistulas Hole Between trachea and esophagus Hole Between Esophagus and mediasteinum

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69
Q

What should you be aware of with megaesophagus and Contrast radiography?

A

Aspiration always a risk

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70
Q

Why is barium + food better than just barium?

A

Esophagus works on Bolus

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71
Q

Fluoroscopy is a way to analyze what?

A

Function

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72
Q

Endoscopy is good because it allows? What therapeutic interventions can you perform with Endoscopy?

A

Direct visualization Assessment of severity of disease FB removal Balloon dilation

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73
Q

Why should you run CBC/CHEM/UA?

A

Allow for systemic evaluation

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74
Q

Fecal evaluation is checking for?

A

Spirocerca lupi

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75
Q

What Titers are you testing for to dx Myasthenia Gravis?

A

Acetylcoline antibody titers - Gold Standard

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76
Q

What test is for MMM?

A

2 n Ab Titer

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77
Q

What would Creatinine Kinase tell you in regards to regurgitation?

A

General Myositis or Myopathy

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78
Q

How would you Rule out Addisons?

A

ACTH stimulation test

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79
Q

Esophageal Dzs?

A

Neoplasia Strictures Diverticula

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80
Q

Parts of stomach?

A

Cardia Fundus Body Antrum

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81
Q

Nervous control of Stomach? Specifically?

A

Autonomic - Vagus and Ciliac plexus Enteric - Myenteric and submucosal plexus

82
Q

How does stuff get moved along in stomach?

A

Peristalsis and MMC

83
Q

What do Parietal cells do?

A

HCl - neuroendocrine stimulation of Gastrin Ach Histamine

84
Q

Chief cells release?

A

Pepsinogen

85
Q

Mucous cells release?

A

Bicarbonate

86
Q

Phases of secretion?

A

Cephalic Gastric

87
Q

What controls the Cephalic phase of secretion?

A

PNS - ACh

88
Q

What controls the Gastric Phase of secretion

A

Gastrin

89
Q

When you vomit what are you vomiting?

A

all the way down to SI HCl & HCO3- (more bicarb in SA)

90
Q

What acid/base balance do find in your normal small animal vomiter? Why?

A

Metabolic Acidosis - You start vomiting from your SI Lots of bicarb in intestines More bicarb than acid leaves

91
Q

What acid/base situation would a High GI Blockage create?

A

Hypochloremic Metabolic Alkalosis

92
Q

Why is there a lot more chance of aspiration with aspiration than vomiting?

A

In vomiting epiglottis is coordinated to protect trachea

93
Q

What is in control of Tightly coordinated reflex action of vomiting?

A

Vomiting center DA, histamine, Ach Chemoreceptor trigger zone (CRTZ) - Responds to toxins/drugs Limited BBB Direct stimulation to vomiting center from, CRTZ, higher CNS, vestibular center, GI tract, abdominal organs or peritoneum

94
Q

You must differentiate between what situations with vomiting?

A

Acute vs. chronic Self limiting vs. life threatening systemic illness. GI vs. Non-GI causes

95
Q

Minimum database for Self limiting vomiting?

A

PCV/TS/FeLV/FIV Fecal Float and smear, therapeutic de-worming Parvovirus ELISA if puppy NPO for a day Monitor for worsening signs over next day - may have to proceed to further diagnostics I usually DO NOT give anti-emetics - hide important clinical signs

96
Q

Which drug should you NEVER give?

A

Centrine Anti-Ach Turns off gut - causes ileus! Bad for the dog! - CONSTIPATION! CX associated with Systemic Illness? Pyrexia Painful abdomen Masses Tympany Oral ulceration Icterus Ascites Wounds Melena Lethargy PU/PD Non-productive retching—GDV!

97
Q

What is the only way to tell if it is vomiting over regurgitating?

A

Retching!

98
Q

Continued vomiting, non-stable patient should do what diagnostic tests?

A

CBC/CHEM/UA Rule in/out many non-GI causes Fecal floatation and smear Let those results and your PE guide you to further dx

99
Q

What diagnostics would you do if you suspect GDV? Tx?

A

Radiography Blood work CBC/CHEM/UA/VBG Lactate initial vs post stabilization Emergency stabilization and surgery

100
Q

What is one of the VERY best ways you can decide whether you are doing the right tx?

A

Decreasing Lactate Levels

101
Q

TQ!!! Primary Gastrointestinal Vomiting Rule Out List?

A

Dietary indiscretion/Diet change Motility disorders Ulcers Allergy-food Neoplasia Inflammation/ IBD Intussusception/Hiatal hernia/GDV Infection - Bacterial, Viral, Ricketsial, Fungal/fungal-like Parasites Colitis Toxins/Drugs Foreign body/ outflow obstruction/Hairballs/Obstipation

102
Q

Life Threatening Signs with vomiting?

A

Life Threatening Signs? Unproductive vomiting, distended abdomen, shock/collapse

103
Q

What happens with GDV? Who?

A

Gastric Dilatation and Volvulus Air trapped, vessels obstructed, progressive Giant breed dogs predisposed

104
Q

TQ!!! Non- GI Vomiting Rule Out List?

A

Neoplasia i.e. MCT Renal disease/failure Hepatobiliary disease Peritonitis Pancreatitis Acid/Base disorders Hypoadrenocorticism Hyperthyroidism Sepsis DKA Hypercalcemia Pyometra Heartworm Drugs - NSAIDS, Anesthetics, Chemo, Opiods, ABX Toxins CNS disease/vestibular/abdominal epilepsy

105
Q

If you are pretty sure you have perforation/foreign body should you do barium study?

A

No go to sx, if you’re pretty sure you aren’t going to want barium in gut Hx Questions to ask with vomiting?

106
Q

What is the best test for Pancreatitis?

A

PLI

107
Q

Maldigestive dxa you might have ____Cobalamine?

A

Low

108
Q

What can bacteria make?

A

Folate Consistent with over growth of

109
Q

TLI stands for? What is it a test for?

A

Trypsin Light Immunoreactivity EPI ExoPancreatic Insufficiency

110
Q

Best way to find Foreign Body?

A

Fingers–>Palpate Xray Ultra Sound Contrast Radiography Do not use barium if suspect perforation

111
Q

Advantages of Endoscopy?

A

Non-invasive Visualize the mucosa biopsies - tiny

112
Q

What will youdo with EVERY exploratory?

A

Biopsy

113
Q

What is Physoloptera?

A

ONE worm will cause you to vomit till you die IH-grasshopper/cockroaches

114
Q

If they keep vomitting and you dont know why what will you eventually have to do?

A

Biopsies Blood work and Imaging First!

115
Q

Exocrine Pancreas Functions?

A

Digestive enzyme production - STORE INACTIVE FORM Bicarbonate production Neutralizes gastric acid Facilitates: Nutrient absorption Mucosal cell turnover Enzyme activation Inhibits Autodigestion via enzyme inhibitors Bacterial proliferation - SEVO

116
Q

Where are Zymogens are activated? How?

A

in the intestines Cleaved from inactive to active forms by enterokinases

117
Q

Defense mechanisms of exocrine pancreas?

A

Physical separation of zymogens Distance between the site of enterokinase release and zymogens Presence of enzyme inhibitors within the pancreas and within the circulation within acinar cells

118
Q

Who gets pancreatitis the most? Age Sex Breed

A

Middle – Old Females Yorkies Obese

119
Q

TQ!!! What HISTORY is the most helpful to dx Pancreatitis?

A

Hx of HIGH FAT MEAL!

120
Q

What parts of body does pancreatitis cause inflammation?

A

WHOLE BODY

121
Q

What causes the Inflammatory disease with Pancreatitis?

A

Activation of digestive enzymes within pancreas Maintained and exacerbated by inflammatory cytokines and free radical production Vascultitis and edema Multisystem involvement Mild to Severe

122
Q

What is Triaditis?

A

Pancreatitis Cholangiohepatitis Inflammatory Bowel Dz

123
Q

CX of Pancreatitis?

A

Depression Anorexia Vomiting Diarrhea Shock Abdominal pain +/- Icterus Prayer position Any or none

124
Q

Who can exibit VERY non-specific signs?

A

Cats even less specific

125
Q

Additionally, What can the results of pancreatitis lead to? (i.e. you digested your pancreas)?

A

Hepatic Lipidosis Diabetes mellitus Thromboembolism Toxoplasmosis - can go wild DIC

126
Q

What position is a sign of pancreatitis?

A

Prayer

127
Q

Acute Pancreatitis Bloodwork: Chemistry results?

A

Hysper or Hypoglycemia Hypocalcemia Elevated liver enzymes Esp ALP Bile duct obstruction Hypercholesterolemia/ Hypertriglyceridemia/ hyperlipidemia Bilirubinemia Renal or pre-renal azotemia Amylase and Lipase

128
Q

Acute Pancreatitis Bloodwork: CBC?

A

Hemoconcentration Anemia Thrombocytopenia Neutrophilia w/ left shift UA Bilirubinuria Hemoglobinuria Concentrated USG

129
Q

Dx of Acute Pancreatitis: Classic changes?

A

Clinical Signs History Blood work Cytology Imaging Advanced Testing

130
Q

What Cytology can you do to confirm dx acute pancreatitis?

A

DPL • DX peritoneal lavage

131
Q

What might you see on diagnostic imaging to suggest acute pancreatitis?

A

Ground-glass appearance = loss of cranial abdomen detail

132
Q

On Advanced testing what can you look for to confirm acute pancreatitis?

A

TLI - Trypsin-like immunoreactivity PLI - Pancreatic Lipase immunoreactivity—PLI

133
Q

Why is TLI helpful in dx of acute pancreatitis?

A

May elevate prior to amylase and lipase PLI more helpful than TLI, also it is species specific

134
Q

How sensitive/specific is PLI in Dogs? Cats? How is test run?

A

Dogs = 82% Cats = 100% Sensitive & Specific Snap test available (CPL)

135
Q

What is the Test of choice for Pancreatitis?

A

PLI

136
Q

If you suspect Pancreatitis should you confirm dx or tx the patient for pancreatitis before confirmation?

A

TX!!!

137
Q

What might you see on radiographs with pancreatitis

A

Loss of cranial abdominal detail

138
Q

What might you see on Abdominal Ultrasound with Pancreatitis?

A

Duedonum looks like bacon with ileus Decreased peristalsis Mixed pancreatic echogenicity Peripancreatic hyperechogenicity Cranial abdominal mass Free abdominal fluid - Ca+fat = soap

139
Q

Where does Parvo like to hit the intestines?

A

Crypts (Paneth and Stems)

140
Q

Where does Corona Virus hit the intestines?

A

Villus

141
Q

How much of the small intestines are Duodenum? feature?

A

10% length Major and minor papilla (dogs)

142
Q

Villi, microvilli, mucosal folds Increase the surface area by how many times?

A

600X Crypt/villus unit

143
Q

Which part is the Majority of SI?

A

Jejunum

144
Q

Where in SI is Ileum?

A

Last 12 inches

145
Q

What are the SI reasons the dxa occura?

A

decreased surface area & decreased function = no where for water to go = dxa! Luminal disturbances Villous atrophy Enterocyte dysfunction Microvillar membrane damage Brush border membrane disease Mucosal barrier disruption Hypersensitivity Mucosal inflammation Neoplasia Nutrient delivery blockade

146
Q

Why do we give Lactulose?

A

Constipated Cats PSS Dogs

147
Q

What are the mechanisms of dxa? (2)

A

Osmotic Secretory Describe Osmotic Dxa? Decreasee solute absorption - water goes with it Diet - unabsorbed nutrients in lumen

148
Q

Osmotic dxa is often caused by?

A

Medicines Decreased solute absorption

149
Q

Who gets secretory dxa?

A

Horses the most

150
Q

What causes secretory dxa?

A

Hyper-secretion of ions Toxins - Bacterial or chemical Intestinal inflammation Rare in small animals

151
Q

What does administration of DSS cause?

A

Secretory Dxa

152
Q

Dysmotility types?

A 
Primary (rare)  
Hypermotility (rare)   Hypomotility/ileus   
Secondary  
Exudative  
Mixed
153
Q

What type of dysmotility is the most common?

A

Secondary

154
Q

What are the causes of secondary dysmotility?

A

Drugs Hyperthyroidism
Exterotoxigenic
Hypomotility (more common)
Peristalsis vs Segmental

155
Q

What dysmotility is more common, hyper or hypomotility?

A

HYPO

156
Q

What causes exudative dysmotility?

A

Increased permeability
Damage to mucosal barrier
Leakage of blood proteins

157
Q

Clinical manifestation of intestinal dz is? (2)

A

Either Dxa or Constipation

158
Q

What must you evaluate History and PE to determine?

A

Chronic vs. acute chronic intermittent
Self-limiting potentially fatal systemic disease.
Small intestinal vs. Large intestinal or Diffuse

159
Q

Can you lose enough fluid from dxa to die?

A

YES!

160
Q

TQ!!! What is the most important thing to determine with small animals regarding DXA?

A

Small Intestinal vs Large Intenstinal

161
Q

Causes of Acute enteritis?

A

Dietary Parasitic Infectious Intussusception Hypoadrenocorticism

162
Q

Dietary Causes of Acute enteritis?

A

Dietary - Allergies/changes/ Indescretion

163
Q

Parasitic Causes of Acute enteritis?

A

Helmiths

Protozoa (Giardia, Tritrichomonas, Coccidia)

164
Q

Infectious Dz Causes of Acute enteritis?

A 
Parvo
Corona  
FeLV/FIV  
Bacterial overgrowth  
Rickettsia
165
Q

Causes of Chronic Enteritis?

A 
Same as Acute  
Neoplasia   
Fungal infections 
Pythiosis, histoplasma   
Lymphangectasia   
Breed Specific Enteropathies  
Systemic Dzs  
Malabsorptive Dzs & Maldigestive Dzs
166
Q

What fungal infections cause chronic enteritis?

A

Pythiosis

Histoplasma

167
Q

What breeds are prone enteropathies causing chronic enteritis?

A

Basenji
Wheaten
Shar Pei
Yorkies

168
Q

Systemic diseases causing chronic enteritis?

A 
Pancreatitis   
Hyperthyroidsm   
Hepatic disease  
Renal Dz  
Parasites  
Antibiotic Responsive Enteropathies
169
Q

What is Lymphangectasia?

A

Dialation of the lacteals don’t absorb things as well

170
Q

What Malabsorptive diseases cause chronic enteritis?

A

ABE/SIBO - Antibiotic Resistant Enteropathies Dietary IBD

171
Q

What Maldigestive diseases cause chronic enteritis?

A

ExoPancreatic Insufficiencies - TLI test

172
Q

Causes of LARGE INTESTINAL Dxa?

A 
Dietary   
Fiber Responsive   
Parasites - Giardia, whips   
Bacteria Clostridium   
Histiocytic ulcerative colitis 
Fungal 
IBD  
Neoplasia   
FeLV/FIV
173
Q

Describe Histocytic Ulcerative Colitis?
Who is prone?
How to cure?

A

Antibiotic Responsive Enteropathy (ARE)
Prone - Boxers, Frenchies
Cure - Enrofloxin

174
Q

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: What is the volume of Small Bowel vs Large Bowel Dxa?

A

Small = A LOT MORE Large = normal to Increased

175
Q

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Mucus?

A

Small: not so much Large: YES - Frequent

176
Q

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Melena?

A

Small: Maybe Large: Nope

177
Q

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Hematochezia?

A

Small: Nope

178
Q

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Steatorrhea?

A

Small: Yes Large: Nope

179
Q

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Undigested Food?

A

Small: Maybe Large: Nope

180
Q

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Color?

A

Small: variable Large: usually normal - already digested

181
Q

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Defecation Urgency?

A

Small: Rare Large: Usually

182
Q

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Defecation Tenesmus?

A

Small: Nope Large: Frequent

183
Q

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Defecation Frequency?

A

Small 3 X Normal Large: > 3X Normal

184
Q

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Defecation Dyschezia (painful)?

A

Small: Nope Large: Yes

185
Q

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: weight loss?

A

Small: Usually Large: Rare

186
Q

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Flatulence?

A

Small: Can be Large? Absent

187
Q

TQ!!! Differentiating Small Bowel vs. Large bowel diarrhea: Halitosis?

A

Small: Yes Large: Nope

188
Q

History taking for Dxa?

A 
Indoor/outdoor   
Vaccination and deworming status  
Access to garbage    
Travel history   
Previous episodes   
Drugs   
Diet/changes   
Duration   
Severity   
Progression   
Response to previous therapy
189
Q

Complete Physical exam for DXA do you have to do a rectal?

What else?

A

OMG YES!!!
Oral exams - Esp. under the tongue
Abdominal Palpation
Hydration status

190
Q

What can you find on Careful abdominal palpation?

A 
Thickened bowel loops   
Masses  
Effusions  
Pain  
Hydration status
191
Q

May have to observe defecation attempts: what will you look for?

A

Dyschezia
Tenesmus - urge to go w/ empty bowel
Evaluate feces

192
Q

Fecal Evaluation for?

A

Color Consistency Odor +/- malabsorption Blood Steatorrhea +/- malabsorption

193
Q

TQ!!! Fecal Tests to Run on Dxa Patients?

A 
Fecal floatation  
Cytology  +/- Parvo - puppy < 6 mo with dxa or vom   +/- 
Culture - salmonella in horses
SA not that common   
alpha-protease inhibitor - PLE
194
Q

What should you run for fecal float?

A

Sheather’s Zinc sulfate or Giardia Ag

Baermann - larval lung worm

195
Q

What Cytology should you run on fecal for dxa?

A

Direct smear – histoplasmosis
Rectal scraping Blood work for Dxa?
Min DB - CBC/CHEM/UA/VBG /FeLV/FIV/Parvo

196
Q

Additional Diagnostics for Dxa?

A 
Abdominal Radiographs 
Contrast Radiography Barium    
Abdominal Ultrasound
FNA/BX    
GI panel 
PLI
TLI
Cobalamin
Folate
197
Q

What will Cobalamin levels be with malabsorpitve diseases?

A

LOW

198
Q

What will Folate levels be with intestinal bacterial overgrowth?

A

HIGH

199
Q

Endoscopy Advantages?

A

Minimally Invasive
Can initiate some therapies sooner
Limited for most of the SI anatomically - Dog into Duad,
Cats into Jej Mucosal Biopsy )(Bx)

200
Q

Surgery needed to?

Pros & Cons

A 
Bx of more sites   
Full thickness bx   
Evaluate all abdominal organs    
Potential for correction – obstructions   
Risk of dehiscence   
Longer recovery time    
More expensive

Clinical Medicine Master (17 decks)

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