Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Y4 SA - Endocrine > The approach to vomiting > Flashcards

The approach to vomiting Flashcards

1
Q

Primary vomiting is due to?

A

Underlying gastric disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Secondary vomiting is due to?

A

Non-GI disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

List the causes of focal primary gastric disease

A
  • Chronic gastritis
  • Gastric ulcers
  • Gastric retention disorders
  • Gastric neoplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

List the causes of diffuse primary gastric disease

A
  • Inflammatory bowel disease
  • Diffuse alimentary lymphoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What clinical sign usually predominates in secondary gastric disease?

A

Diarrhoea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

List some causes of secondary vomiting

A
  • Infections: distemper, lepto
  • Pyometra
  • Renal failure
  • Hepatic disease
  • Drugs
  • Hypoadrenocorticism
  • CNS disease
  • Motion sickness
  • Vestibular disease
  • Neoplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Chronic vomiting can occur secondary to which intestinal diseases?

A

Inflammatory bowel disease
Intestinal neoplasia
Small intestinal obstruction
Pancreatitis
Peritonitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Other than vomiting, list some other clinical signs of gastric disease

A

Haematemesis
Nausea/retching
Hypersalivation
Anorexia
Melaena
Bloating
Borborygmi
Weight loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the pathophysiology of gastric disease

A

Gastric outflow obstruction
Gastroparesis
Disruption of mucosal barrier

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How can the cause of chronic vomiting diagnosed?

A
  • Distinguish vomiting vs. regurgitation
  • Eliminate secondary causes: history, physical exam, laboratory analysis, imaging
  • Abdominal imaging
  • Gastroscopy / coeliotomy
  • Symptomatic therapy e.g. anti-emetic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the clinical exam for chronic vomiting cases

A
  • Oral examination: Ulcers
  • Abdominal palpation: Pain, Foreign body, intra-abdominal mass, distended stomach or bowel
  • Rectal exam, Diarrhoea, Melaena
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

On clinical pathology in chronic vomiting cases, what can electrolyte levels tell you?

A

Can tell you information regarding Addison’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

On clinical pathology in chronic vomiting cases, what can haematology tell you?

A

Inflammatory or not

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

On clinical pathology in chronic vomiting cases, what can the ACTH stimulation test tell you?

A

Basal cortisol – if low then do this test. If normal Addison’s can be ruled out

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

On clinical pathology in chronic vomiting cases, what can the bile acid stimulation test tell you?

A

Is the liver working as it should?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is radiography used in chronic vomiting cases? What can be diagnosed?

A

Survey abdominal radiograph
- Foreign body
- Abdominal mass
- Intestinal obstruction
- Peritonitis
- GDV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is ultrasound used in chronic vomiting cases? What can be diagnosed?

A

Foreign body
Ulcers
Thickening of gastric mucosa
Loss of layering (suggests infiltration)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

When is endoscopy/gastroscopy indicated in chronic vomiting cases?

A

If clinical or radiographic signs of gastric disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the causes of chronic gastritis?

A

Aetiology usually unknown
Sometimes generalised IBD
Various possible reasons
- Chronic gastric parasitism (eg. Physaloptera)
- Hairballs in cats?
- Spiral bacteria - Helicobacter
- Immune-mediated?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the most common clinical signs of chronic gastritis?

A

intermittent chronic vomiting (vague)
± periodic early morning vomit with bile
± poor appetite

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

How is chronic gastritis diagnosed?

A

Laboratory changes often non-specific
Imaging findings non specific
Gastroscopy and biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How is chronic gastritis treated?

A

Removal of aetiologic agent if known
Diet
- Multiple small meals
- Low fat diet
- ‘hypoallergenic’ diet
Acid blocker
Corticosteroids ?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

When does bilious vomiting occur?

A
  • Often occurs in dogs fed once daily (especially if fed in the morning)
  • Vomiting occurs overnight or in the morning
24
Q

How is bilious vomiting characterised?

A
  • Vomitus often bile-stained fluid, not food
  • Presumably reflects abnormal inter-meal motility allowing bile-reflux into stomach
25
How is bilious vomiting diagnosed?
Rule out other causes of vomiting Treatment trial - When patient is not severely ill do this earlier on
26
How is bilious vomiting treated?
Feed more often, focussing on late meal You might add prokinetics (ranitidine or metocloperamide) - Sometimes only needed in the evening
27
Define gastric retention disorders
Retention of food for > 8 hours causing delayed vomiting of food
28
Why do gastric retention disorders occur?
Anatomical outflow obstruction Functional disorder
29
What are the causes of an anatomical outflow obstruction (...which causes gastric retention disorders)?
Pyloric stenosis Neoplasia, polyp CHPG = Chronic hypertrophic pylorogastropathy Foreign body - rubber ball, peach stone, conker, sock
30
Describe the main features of pyloric stenosis
Congenital in brachycephalic breeds Association with megaoesophagus in cats Treatment - pyloromyotomy / pyloroplasty
31
Describe the main features of Chronic hypertrophic pylorogastropathy
Idiopathic mucosal hypertrophy May cause outflow obstruction Most common in toy breeds May result from hypergastrinaemia ? Treatment - surgery
32
What are the causes of a functional outflow obstruction (...which causes gastric retention disorders)?
Primary motility disorder Inflammatory disease - Inflammatory bowel disease - Gastric ulcer
33
How can you treat the functional causes of gastric retention disorders?
Treat underlying inflammatory disease Prokinetics
34
Describe some prokinetic drugs used in function gastric retention disorders
1. Metoclopramide - Licensed products exist - Stimulate normal gastric peristalsis 2. Ranitidine - H2 antagonist plus prokinetic action 3. Erythromycin - Low dose stimulates motilin receptors
35
List the causes of haematemesis
- Generalised bleeding - Swallowed blood: Oropharyngeal, Nasal, Pulmonary - Severe gastritis - Gastric ulcer - Gastric neoplasia - Duodenal disease
36
List the clinical signs of gastric ulcers
Haematemesis Melaena Anaemia Weight loss Pain Peritonitis etc. if perforated
37
Which posture indicated abdominal pain?
The prayer posture
38
What is a peptic ulcer?
An ulcer in the stomach or duodenum
39
Which drugs can cause peptic ulcers?
NSAIDs Corticosteroids
40
List some other causes of peptic ulcers
- Head and spinal injuries, in combo with corticosteroids - Gastritis - Liver disease - Uraemia - Mastocytosis (excess number of mast cells gathering in the body's tissues) - Gastrinoma
41
Name the bacteria that can cause peptic ulcers
Spiral bacteria (Helicobacter)
42
Name the drugs used to treat gastric ulcers
Sucralfate Acid blockers – antacids, H2 antagonists, proton pump inhibitors
43
What is the action of H2 receptor antagonists, name some drug examples used in practice
Block stimulation of HCl secretion - Cimetidine - Ranitidine
44
What is the action of proton pump inhibitors, name some drug examples used in practice
Proton pump inhibitors completely block HCl secretion Omeprazole (Losec) Others (pantoprazole, esomeprazole, lansoprazole)
45
How can you prevent ulcers?
synthetic PGE misoprostol - antidote to overdose
46
Describe the triple therpay options for treating Helicobacter
Two antibiotics plus an acid blocker e.g. amoxicillin, metronidazole and omeprazole OR 3 antibiotics e.g. amoxicillin, metronidazole, clarithromycin
47
Which animals more common present with gastric neoplasia?
Middle-age/older male dogs > cats
48
Which gastric neoplasia are most commonly seen in dogs?
Adenocarcinoma (75%) Lymphoma Polyps Leiomyoma / leiomyosarcoma
49
Which gastric neoplasia are most commonly seen in cats?
Lymphoma Adenocarcinoma
50
Describe the effects of gastric adenocarcinomas
Infiltrate gastric wall -> Fibrosis / thickening and ulceration - Often lesser curvature / distal stomach - Metastasis to local LN and liver
51
Gastric adenocarcinomas have a predisposition to which breeds?
Belgian shepherds, Collies, Bull terriers
52
What clinical signs may lead you to suspect gastric adenocarcinoma?
Suspect in older animal with: - Chronic vomiting - Anorexia and weight loss - Haematemesis and melaena - Anaemia - Drooling saliva
53
How are gastric adenocarcinomas diagnosed?
Contrast radiography Endoscopic biopsy - often Full thickness biopsy
54
How are gastric adenocarcinomas treated?
Surgical resection
55
Describe the prognosis of gastric adenocarcinomas
grave/hopeless - Probably painful ‘leather-bottle’ stomach

Y4 SA - Endocrine (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions