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22 fall: path > Test 2: 6 diarrhea > Flashcards

Test 2: 6 diarrhea Flashcards

1
Q

small intestine micro anatomy

A

Slender villi lined by “leaky” epithelial cells

Enterocyte microvilli increase absorptive surface area AND contain digestive enzymes

Crypts = regenerative epithelium

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2
Q

crypts in small intestine contain

A

regenerative epithelium (also secrete fluid via ANS
stimulation)

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3
Q

— are lymphatic ducts within each villus

A

lacteals

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4
Q

large intestine micro anatomy

A

no villi

main job absorb fluid
tight junction

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5
Q

Lymphangiectasia

A

lacteals which are lymphatic ducts in the villus of the intestine get blocked and become dilated

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6
Q

intestine, what kind of exudate

A

mucus- catarrhal

caused by endoparasitism &
proliferative enteritis (eg
Lawsonia)

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7
Q

what two viruses will cause hemorrhage in the intestine

A

(Salmonella, Clostridium

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8
Q

diphtheritic membranes are made of

A

Fibrin + Hemorrhage Neutrophils + Cell Debris

secondary to virulent pathogens that cause necrosis (salmonella and clostridium)

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9
Q

crypt abscesses in intestine is caused by —

A

parvovirus

will cause villi blunting, damage and fusion

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10
Q

what causes crypt hyperplasia in intestine

A

Lawsonia intracellularis

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11
Q

fibrosis in the intestine can lead to

A

Bowel stenosis→ Altered peristalsis→ abnormal microflora proliferation→ dysmotility!

Lymphangiectasia→ protein exudation/effusion!

Decreased digestion and absorption from loss of enterocytes→ Malabsorp/maldigest!

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12
Q

granulomatous inflammation have what cells

A

epithelioid macrophages and multi nucleated giant cells

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13
Q
A

Lymphangiectasia - dilated lymphatic ducts

caused increased hydrostatic pressure and protein losing enteropathy

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14
Q

Lymphangiectasia causes

A

Increased hydrostatic pressure or decreased lymphatic drainage) → Protein Losing Enteropathy

more fluid in the poop, fluid stays in poop instead of being absorbed and causes diarrhea

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15
Q

intestine

A

muscular hypertrophy due to
Altered peristalsis: parasites, IBD

Chronic obstruction (FB, intramural mass)

Idiopathic (enteric nervous system?)

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16
Q

muscular hypertrophy of the intestinal wall will predispose — and —

A

obstruction and rupture

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17
Q

what three things cause muscular hypertrophy of intestinal wall

A

Altered peristalsis: parasites, IBD

Chronic obstruction (FB, intramural mass)

Idiopathic (enteric nervous system?)

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18
Q

Enteritis

A

inflammation of small intestine

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19
Q

Ileitis

A

small intestine (just ileum)

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20
Q

Colitis

A

colon inflammation

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21
Q

Typhlitis

A

cecum (typhl- [G] blind)

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22
Q

Enterocolitis

A

small intestine and colon

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23
Q

Gastroenteritis

A

stomach and small intestine

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24
Q

Typhlocolitis

A

cecum and colon

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25
Q

Proctitis

A

rectum

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26
Q

— is the Secretion of abnormally fluid
feces accompanied by
◼ Increased volume of feces ◼ Increased frequency of
defecation

A

diarrhea

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27
Q

4 mechanisms of diarrhea

A
  1. Hypersecretion

2.Malabsorption/maldigestion

  1. Exudation/Effusion (passive)
    * Damaged or obstructed capillaries, lymphatics, necrosis/erosion/ulcer
  2. Deranged intestinal motility
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28
Q

how does diarrhea from hypersecretion work

A

bacteria will bind to membrane and secrete enterotoxins activate cAMP and cGMP that cause fluid secretion

will resolve quickly after bacteria is killed

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29
Q

why does fasting have no effect on hypersecretion diarrhea

A

bacteria linked to cells to cause increased fluid secretion

no function change

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30
Q

what will cause hypersecretion diarrhea

A

Enterotoxigenic E. coli (ETEC)

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31
Q

hypersecretion diarrhea will cause

A

dehydration and perineal staining

chyle in lacteals normal but excess watery fluid in GI

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32
Q

what will ETEC do to enterocytes

A

no damage or ulcers

will just trigger cAMP and cGMP to produce fluid causing hypersecretory diarrhea

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33
Q

4 causes of malabsorption

A

Microvillus damage/destruction

Absorptive enterocyte necrosis/loss

Crypt cell necrosis/loss

Crypt hyperplasia → Epith. attenuation ( enterocytes will be immature and not absorb as well)

34
Q

microvillus damage or destruction will cause — grossly

A

Gross Lesions
– Dehydration
– Watery diarrhea & fecal staining

cells replaced in 3 days

will cause malabsorption diarrhea

35
Q

microvillus damage or destruction will cause — histo

A

– Loss of microvillus (brush) border
– Villus enterocyte degeneration/sloughing

will cause malabsorption diarrhea

36
Q

which Ecoli causes damage to microvilli and causes malabsorption diarrhea

A

Attaching and Effacing E. Coli (AEEC)

intimin

loss of disaccharidases & absorptive surface area

osmotic diarrhea

37
Q

AEEC has — that will destroy microvilli

A

intimin

Attaching and Effacing E. Coli (AEEC)

damage/destroy microvilli → Malabsorption/Maldigestion Diarrhea

38
Q

what zoonotic pathogen damage/destroy microvilli and causes Malabsorption/Maldigestion Diarrhea

A

Cryptosporidium (protozoal parasite)

colonizes & destroys microvilli → Enterocyte sloughing & villus blunting → +/- mild inflammation

39
Q

villus enterocyte necrosis and loss will cause

A

villus to contract (blunting)
villus fusion
decrease in absorptive SA
immature replacement cells
malabsoption and osmotic diarrhea

40
Q

enteric — will kill villus enterocytes

A

coronaviruses/rotaviruses

depending on species will attack more or less of the villi

41
Q

swine GI normal on bottom

A

Transmissible Gastroenteritis (TGE) in swine

enteric coronavirus cause severe villus blunting

42
Q

— are pathogens that kill crypt cells and cause malabsorption diarrhea

A

“Radiomimetic” viruses

Feline Panleukopenia virus

Canine Parvovirus

Bovine Viral Diarrhea Virus (BVD)

43
Q

feline panleukopenia virus will kill

A

bone marrow leukocytes & lymphocytes, crypt cells

cause severe immunosuppression and malabsorption diarrhea

44
Q

canine parvovirus will kill

A

lymphocytes and crypt cells

cause immunosuppression and malabsorption diarrhea

45
Q

pathogenesis of feline panleukopenia

A

will kill crypt cells
cause villi blunting and fusion
allows for opportunistic infection → Diphtheritic membranes & Septicemia
slow regeneration with immature enterocytes

kills off bone marrow leukocytes & lymphocytes

also has teratogenic effect and causes cerebellar hypoplasia in kittens

46
Q

clinical signs of K9 and Feline parvovirus

A

vomiting, malabsorptive
diarrhea, dehydration, sepsis

47
Q

lesions of K9/FE Parvoviruses

A
  1. Necrotizing Enteritis with crypt necrosis
  2. Peyers Patch Necrosis (punched out)
  3. Panleukopenia (Cats! All bone marrow lineages affected)
    Lymphopenia (cats AND dogs) → GALT depletion, thymic atrophy, lymph node atrophy→ Immunosuppression
  4. **Cerebellar hypoplasia- in utero teratogenic effect- see neuro!
48
Q

feline small intestin

A

punched out peyer’s patch

from feline panleukopenia virus (feline parvovirus)→ kills bone marrow leukocytes & lymphocytes and crypt cells

49
Q

histro of small intestine with feline panleukopenia

A

kill crypt leads to necrosis and villi blunting and fusion

50
Q

BVD in the intestine will cause

A

crypt necrosis

allows for secondary infection to cause Ulcers with diphtheritic membranes

51
Q

what causes this in pigs and horses

A

Lawsonia intracellularis

proliferative enteritis -

cause crypt hyperplasia → Malabsorption/Maldigestion Diarrhea

52
Q

what virulent pathogens will cause exudative/effusive diarrhea through increased capillary or epithelial permeability (damage or obstruction)

A

Salmonella (ZOONOTIC)

Clostridium perfringens

53
Q

clinical signs of K9 and Feline parvovirus

A

vomiting, malabsorptive
diarrhea,dehydration, sepsis

54
Q

what virulent pathogens will cause exudative/effusive diarrhea through Lymphatic obstruction → protein losing
enteropathy (PLE)

A

Granulomatous inflammation (Johne’s disease)

Neoplastic infiltrates (diffuse lymphoma = LSA)

55
Q

two ways to cause exudative/effusive diarrhea

A

Increased capillary or epithelial permeability
(damage or obstruction)

Lymphatic obstruction → protein losing enteropathy (PLE)

56
Q

exudative diarrhea leads to — membranes

A

diphtheritic- Fibrin, Hemorrhage, Neutrophils, Cell Debris

57
Q

Pathogen #1 that kill villus enterocytes AND damage the lamina propria

A

Salmonella spp.

cause malabsorption and exudative diarrhea

LPS/endotoxin- cause necrosis and hemorrhage of lamina propria and enterocytes

58
Q

Pathogen #2 that kill villus enterocytes AND damage the lamina propria

A

Clostridium perfringens & C. difficile (HORSES!)

Necrotizing to necro-hemorrhagic enterocolitis

exotoxins burn tissues and damage blood vessels

Mucosal necrosis with diphtheritic membranes
(can look similar to Salmonella)

59
Q

Pathogens/processes that cause Infiltrative disease→effusion/exudation

A

Lamina propria infiltration → increased hydrostatic pressure → prevents absorption (fluid, nutrients, lymph) → Lacteal dilation (lymphangiectasia)→ effusion

Granulomatous enterocolitis- Johne’s dz & Diffuse alimentary lymphoma (“LSA”)

60
Q

johne’s disease is caused by

A

Mycobacterium avium subsp. paratuberculosis

Acid-fast, facultative intracellular bacillus

  • Endemic in cattle herds (dairy>beef) →chronic diarrhea & emaciation
    via Protein-Losing Enteropathy (PLE)
61
Q

Johne’s disease is infiltrative and causes — kind of diarrhea

A

effusion/exudation

(Mycobacterium paratuberculosis)

Protein-Losing Enteropathy (PLE)

61
Q

Johne’s disease is infiltrative and causes — kind of diarrhea

A

effusion/exudation

(Mycobacterium paratuberculosis)

Protein-Losing Enteropathy (PLE)

62
Q

what does Johne’s disease lesions look like

A

Thickened “corrugated” mucosa
– Multifocal mucosal erosions
– Enlarged mesenteric lymph nodes

63
Q

Johne’s disease
causes

Diffuse —-Enterocolitis
(ileitis/typhlitis/colitis) → inflammation extends

Mesenteric —
→Villus blunting & fusion, lymphangiectasia

—- (PLE)
→ hypoproteinemia → emaciation

A

Granulomatous

lymphadenitis

Protein-Losing Enteropathy

64
Q

—- →decreased contact time with mucosa→ maldigestion/malabsorption →2°secretory or osmotic diarrhea

A

hypermotility

65
Q

—→ bacterial overgrowth→ toxic substance production or reduced fermentation →2°secretory or osmotic diarrhea

A

hypomotility

66
Q

causes of abnormal motility

A

Physical stimulus or obstruction: parasites

Muscular hypertrophy (IBD, Idiopathic)

Peritonitis

67
Q

what are some Physical stimulus or obstruction that lead to abnormal GI motility

A

Parasites, foreign bodies, strictures intraluminal or mural mass

  • eg lymphoma, adenocarcinoma, leio
68
Q

what causes GI muscular hypertrophy

A

IBD
idiopathic

69
Q

intestinal response to injury
—- : Catarrhal, hemorrhagic, diphtheritic membranes, blunting

A

acute

70
Q

intestinal response to injury
—- : fusion, crypt abscesses, crypt hyperplasia, epithelial attenuation

A

subacute

71
Q

intestinal response to injury
—- : fibrosis, granulomatous inflammation (nodular or diffuse), lymphangiectasia, muscular hypertrophy

A

chronic

72
Q

4 Basic Mechanisms of Diarrhea

A
  1. Hypersecretion: ETEC
  2. Malabsorption maldigestion
  3. Effusion/exudation
  4. Dysmotility
73
Q

what causes hypersecretion diarrhea

A

ETEC

74
Q

Malabsorption maldigestion by Microvillus damage is by

A

AEEC, Cryptosporidia

75
Q

Malabsorption maldigestion by Villus Enterocyte Necrosis is by

A

Enteric Coronaviruses

76
Q

Malabsorption maldigestion by Crypt Cell Necrosis

A

FE Panleukopenia (feline parvo),

BVD

77
Q

Malabsorption maldigestion by Crypt Hyperplasia

A

Lawsonia intracellularis

78
Q

Effusion/exudation diarrhea by Lam. propria necrosis→hemorrhage is by

A

Salmonella

Clostridium

79
Q

Effusion/exudation diarrhea by Lam propria infiltration→lymphangiectasia:

A

Johne’s dz (Mycobacterium avium paratuberculosis)

LSA

80
Q

Dysmotility diarrhea by Physical obstruction from parasites such as

A

ascarids

81
Q

Dysmotility from Muscular hypertrophy is by

A

IBD

idiopathic

22 fall: path (46 decks)

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