Test 3. 2

Question 1

where to place feeding tube in neck

Answer 1

left side

Question 2

differences between dysphagia, regurg and vomiting

Answer 2

Question 3

three forms of megaesophagus

Answer 3

congenital
acquired idiopathic
acquired secondary

Question 4

Answer 4

megaesophagus
* tracheal stripe sign on bottom

Question 5

what are some breeds that get megaesophagus

Answer 5

young animals with history of regurg
* mini schnauzer
* wirehaired fox terrier
* german shepherd
* great dane
* newfi

Question 6

What might cause congential megaesophagus

Answer 6

• defect in afferent innervation- can’t sense distention
• motor fuction decreased
• Lower esophageal sphrincter not opening- achalasia

Question 7

what are some 2nd acquired causes of megaesophagus

Answer 7

myasthenia gravis
addisions, hypothyroid
esophagitis
FB

lead, botulism

Question 8

how to work up 2nd acquired megaesophagus

Answer 8

• blood work
• Xray
• acetylcholine receptor antibody titer: M. gravis
• ACTH stim: addisions
• ∓ endoscope: esophagitis, FB, cancer

Question 9

resting cortisol > 2

Answer 9

rule out addisions

Question 10

resting cortisol < 2

Answer 10

need to do ACTH to test for addisions

Question 11

idiopathic megaesophagus occurs in

Answer 11

middle age to older dogs
* large breeds: shepherd, golden, irish setter, great dane

Most common form in dogs

Question 12

how to treat megaesophagus

Answer 12

• feed upright- high calories, low fat (decrease acid)
• gastric feeding tube
• sucralfate- GERD
• anti-acid: omeperazole, famotidine
• prokinetic work on smooth muscle- dogs have skeletal muscle- so not helpful

Question 13

can you give prokinetic drugs for megaesophagus?

Answer 13

not helpful in dogs, cause they work on smooth muscle and the esophagus of a dog is all skeletal muscle

• may be helpful in cats, but megaesophagus is very rare in cats

Question 14

Answer 14

megaesophagus leading to aspiration pneumonia- air bronchogram on L lateral in R middle lobe over the heart

Question 15

why are esophageal FB emergencies

Answer 15

can cause pressure necrosis quickly
* need to remove either by endoscopy or pushed into stomach

Question 16

how to treat esophageal FB

Answer 16

• emergency- need to pull out or push into stomach
• gastrostomy tube if esophageal damage
• antacids, sucralfate
• anti-inflammatories may help reduce stricture formation- prednisione taper

Question 17

what can cause GERD

Answer 17

• persistant vomiting
• abnormal LES function: megaesophagus or hiatal hernia
• prolonged anesthesia

Question 18

what two drugs can cause esophagitis

Answer 18

doxy in cats
clindamycin

• if med gets stuck, recommend liquid or give water after

Question 19

how to treat esophagitis

Answer 19

sucralfate slurry
antacids
prokinetics
low fat diet
feeding tube
antibiotics where bacterial translocation possible

Question 20

the esophagus lies to the — of the trachea in the cervical portion. This is clinically relevant because esophagostomy tubes must always be placed in the

Answer 20

left

Question 21

The — esophagus contains skeletal muscle throughout its length, while the — esophagus contains skeletal muscle proximally and smooth muscle in the distal 1/2 to 1/3 of its length

Answer 21

dog

feline

Question 22

clinical signs for congential megaesophagus occur

Answer 22

at weaning- when switching to real food

Question 23

— is a proton pump inhibitor used for gastic acid suppression

Answer 23

omeperazole
pantoprazole

Question 24

— is a H2 blocker that is used for gastic acid suppression

Answer 24

famotidine

Question 25

prokinetics such as — will — tone of the LES

Answer 25

cisapride, metoclopramide

increase