Thrall chapter 47 small bowel

Question 1

1) What is the normal diameter of feline small bowel based on radiographic measurements?
a) <1.6x the minimal height of L5
b) <2x the minimal height of L2
c) <2x the height of the vertebral end plate of L2
d) Less than or equal to 12 mm

Answer 1

c,d

Question 2

2) What percentage of non- fasted cats have gas within approximately at least 25% of their small bowel?
a) 15%
b) 35%
c) 50%
d) 65%

Answer 2

d

Question 3

3) In young cats, an additional asymmetric hypoechoic submucosal layer is sometimes seen in the ileum and proximal jejunum ultrasonographically, what is this likely to represent?
a) Lymphoid follicles
b) Fibrosis
c) Myenteric plexus
d) Nerves and blood vessels

Answer 3

a

Question 4

4) What is the normal thickness of the jejunal wall in a 20-29.9kg normal dog?
a) Less than or equal to 4.1
b) Less than or equal to 4.4
c) Less than or equal to 4.6
d) Less than or equal to 4.2

Answer 4

4) B (pennick 3-3.8, bigger in larger dogs)

Question 5

5) What is the maximal thickness of the ileum in normal cats (mm)?
a) 3.59
b) 3.5
c) 3
d) 2.59

Answer 5

a

Question 6

6) What is the maximal normal jejunal lymph node diameter in cats?
a) 4mm
b) 4.5mm
c) 4.8mm (3.0-10)
d) 5mm (2.8-7.2)

Answer 6

d

Question 7

7) What is the most common cause of the gravel sign in older cats?
a) Ileal adenocarcinoma
b) Mechanical obstruction by a hairball
c) Duodenal adenocarcinoma
d) Megacolon

Answer 7

a

Question 8

8) A jejunal sersoa-serosa measurement above what amount on ultrasound should raise suspicion of a mechanical obstruction in dogs (lowest suspicious value)?
a) 1cm
b) 1.25cm
c) 1.3cm
d) 1.5cm

Answer 8

d

Question 9

9) Which of these is not a commonly seen in dogs with parvovirus ultrasonographically?
a) Normal jejunal lymph nodes
b) normal mucosal layer
c) indistinct jejunal wall layers
d) normal total wall thickness

Answer 9

9) B- the mucosa is often hyperechoic, and irregular esp in duodenum, often the mucosal layers in the duodenum and jejunum is thin.

Question 10

which ligament holds the cranial duodenal flexure in place?
a) pancreatoduodenal ligament
b) renoduodenal ligament
c) gastroduodenal ligament
d) hepatoduodenal ligament

Answer 10

D

Question 11

the initial portion of the ascending duodenum is held in place by what?
a) it is not held in place
b) duodenocolic ligament
c) duodenocaecal ligament
d) duodenoilial ligament

Answer 11

B

Question 12

what’s your diagnosis

Answer 12

pseudoulcers

Question 13

how much gas would you expect to find in the intestines of fasted dogs?
a) 30-60% of the small bowel content could be gas
b) 20-40% of the small bowel content could be gas
c) 30-50% of the small bowel content could be gas
d) 15-80% of the small bowel content could be gas

Answer 13

A

Question 14

JSAP (2024); 1-10. Which of the following variables has been shown to be associated with increased technical success of gastrointestinal ultrasound guided fine needle aspiration?

A: Loss of wall layering
B: Jejunal location
C: Experience of the ultrasonographer
D: Description of a mass

Answer 14

D

Question 15

What is the prevalence of hyperechogenicity of the pyloroduodenal junction in small breed dogs?

85.7%

90.2%

66.7%

43.5%

Answer 15

85.7%

Question 16

Investigation of scan delays for CT evaluation of inner wall layering and peak enhancement of the canine stomach and small intestines using a 20 second fixed-injection-duration and bolus tracking technique (VRU 2022) From this study by Siow, what was the recommend scan delay, post aortic tracking, to best detect inner wall-layering of the stomach and small intestines?

40s gastric, 10-15s small intestines

180s gastric, 20-25s small intestines

30s gastric, 30-40s small intestines

15s gastric, 30-40s small intestines

Answer 16

40s gastric, 10-15s small intestines

Question 17

Clinical features and outcomes of dogs with attempted medical management for discrete gastrointestinal foreign material: 68 cases (2018–2023) (2024). Which of the follwing is the most correct regarding medical management of gastrointestinal foreign bodies?

Linear foreign bodies were successfully medically managed 50% of the time

Gastric and intestinal dilation always resolved in patients with successful medical management, in contrast to a previous study

The degree of intestinal dilation was similar between cases where medical management was successful and not successful

Intestinal dilation was seen in all cases, regardless of foreign body location.

Answer 17

Gastric and intestinal dilation always resolved in patients with successful medical management, in contrast to a previous study

Question 18

what is the height of the duodenal papilla in healthy cats?
a) 4mm
b) 2.4 +/- 0.63-0.57
c) 3mm =+/- 0.57
d) 5mm

Answer 18

B. The dimensions of the DP were a mean ± SD width of 3.13 ± 0.68 mm and height of 2.47 ± 0.63 mm in the transverse section, and length of 3.98 ± 1.27 mm and height of 2.44 ± 0.57 mm in the longitudinal section. The DP was homogeneous, subjectively isoechoic to fat and had a round and oval shape in the transverse and longitudinal sections, respectively. There was no correlation between the DP measurements and the weight, age or sex of the cats. The animals that were fed a mixed diet had a longer DP than those fed dry food. (from 2022)

Question 19

which lymph nodes drain the ileum and jejunum in the dog?
a) jejunal, ileocolic
b) jejunal, colic
c) jejunal, ileocecal
d) jejunal, hepatic, colic

Answer 19

B. no ileocecal in the dog. the right colic is closest to the iccj in the dog

Question 20

when doing an upper GI contrast study, contrast should start to be visible in the jejunum by what time point?
a) 15mins
b) 30 mins
c) 1 hr
d) 2hrs

Answer 20

b, at least 30 mins

Question 21

a intestinal:L5 ratio of 1.95 has what probability of mechanical obstruction?
a) 40-50%
b) 66-78%
c) 86-90%
d) 77-80%

Answer 21

D.

ratio of 2.07= 86-90%

Question 22

Name the common neoplasias of the small intestines (4)

Answer 22

Adenocarcinoma, lymphosarcoma, mastocytoma, GIST, leiomyoma, leiomyosarcoma

Question 23

Name three mycotic infections that can cause intestinal mass lesions

Answer 23

Histoplasmosis, cryptococcosis, pythiosis

Question 24

True or false, non infectious intestinal granulomas are rare in dogs and cats

Answer 24

True

Question 25

Name two causes of calcification of the intestinal wall

Answer 25

Metastatic calcification from hypercalcaemia (inc heterobilzaria/ schistosomiasis, rat poisoning, vit d tox etc) primary renal disease

Question 26

Name two types of intestinal congenital anomaly

Answer 26

Duplication cyst and diverticulum

Question 27

What is the difference between a duplication cyst and a diverticulum of the intestine?

Answer 27

Diverticula are usually on the mesenteric side and diverticula on the antimesenteric side