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Alimentary > Vomiting/regurgitation > Flashcards

Vomiting/regurgitation Flashcards

1
Q

4 types of oesophageal disease

A

anatomic, obstruction, oesophagitis, or motlity disorder

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2
Q

4 anatomic oesophageal disease causes

A

vascular ring anomoly, circopharyngeal disease, hiatial hernia, or diverticulum

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3
Q

oesophageal diverticulum

A

pouch that protrudes outward from weak point in oesophagus

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4
Q

3 causes of obstructive oesophageal disease

A
  • mural (relating to wall) e.g. stricture
  • luminal e.g. foreign body
  • exraluminal e.g. mass
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5
Q

3 causes of oesophagitis

A
  • trauma
  • reflux
  • irritation
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6
Q

3 causes of oesophageal motility disease

A
  • megaoesophagus
  • neuropathy
  • myopathy
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7
Q

6 charachteristics of oesophageal disease

A
  • hypersalivation
  • dysphagia
  • odynophagia
  • anorexia
  • nasal discharge
  • coughing
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8
Q

dysphagia

A

difficulty swallowing

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9
Q

odynophagia

A

pain on eating

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10
Q

be aware when radiographing oeasophagus that

A

air in the oesophagus can look like megaoesophagus

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11
Q

causes of megaoesophagus

A
  • myathenia gravis
  • thymoma
  • hypoadrenocorticism
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12
Q

myathenia gravis

A

an autoimmune neuromuscular disease the weakens muscle

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13
Q

thymoma

A

tumour of the epithelial cells of the thymus, associated with myathenia gravis

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14
Q

3 treatments of oesophagitis

A
  • small meals high in protein and low in fat to minimise acid reflux
  • sucralfate liquid to protect mucosa
  • inhibit gastric acid secretion
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15
Q

complications of oesophagitis

A

if it heals by fibrosis a stricture can form

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16
Q

treatment of oesophageal foreign body

A

remove or if cant then push into stomach and remove surgically

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17
Q

6 1* GI causes of vomiting

A
  • dietary
  • infection
  • inflammatory disease
  • neoplasia
  • obstruction
  • motility disorders
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18
Q

3 acute causes of 1* GI vomiting

A
  • obstruction
  • dietary
  • infection
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19
Q

2 chronic causes of 1* GI vomiting

A
  • neoplasia

- inflammatory disease

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20
Q

3 dietary causes of 1* GI vomiting

A
  • intolerance
  • indiscretion 9eating crap that shouldnt be eaten)
  • hypersensitivity
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21
Q

3 inflammatory causes of 1* GI vomiting

A
  • gastritis
  • IBD
  • ulceration
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22
Q

6 2* metabolic causes of vomiting

A
  • uraemia
  • adrenocotical insufficiency
  • hepatic disease
  • pancreatitis
  • toxin ingestion
  • drugs
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23
Q

coffee ground appearance of vomiting indicates

A

blood

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24
Q

sucralfate contains

A

aluminium hydroxide and sucrose octasulfate

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25
Q

sucralfate actions

A

the aluminium hydroxide and sucrose octasulphate dissociate in acid and the sucrose octasulfate reacts with HCl to make a viscous sticky substance that binds to proteinaceous exudate found at ulcer sites

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26
Q

sucralfate uses

A

acts as a protective barrier to stomach ulcer site

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27
Q

ranitidine actions

A

H2 receptor antagonist, which acts as an antihistamine and inhibits gastric acid secretion

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28
Q

ranitidine uses

A

used in any sort of vomiting/regurgitation

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29
Q

omeprazole actions

A

protein pump inhibitor of parietal cell, irreversably stopping H+ secretion into stomach by binding to H+/K+ATPase

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30
Q

metoclopramide actions

A
  • para-aminobenzoic acid derivative with central and GI effects
  • antagonises D2-dopaminergic and 5-HTs receptors in chemoreceptor trigger zone stopping nausea and vomiting
  • peripheral cholinergic effects (parasympatheic effect)
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31
Q

metoclopramide uses

A

anti-emetic

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32
Q

ondansetron actions

A

5-HT3 serotonergic antagonist

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33
Q

ondansetron uses

A

strong anti-emetic, used in chemotherapy

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34
Q

macropitant actions

A
  • neurokinin-1 receptor antagonist

- central and peripheral effects

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35
Q

macropitant uses

A

anti-emetic, stops any kind of vomiting

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36
Q

gastric vomiting causes 3 things..

A
  • loss of hydrochloric acid
  • dehydration
  • decreased feed intake
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37
Q

loss of hydrochloric acid causes..

A
  • metabolic alkalosis

- hypochloraemia (low blood chloride)

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38
Q

dehydration causes..

A
  • low tissue perfusion

- metabolic acidosis which causes decreased Na+

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39
Q

insufficient food intake due to vomiting causes..

A

hypokalaemia (low potassium)

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40
Q

given to stabalise vomiting patient prior to surgery

A
  • i/v isotonic crystaloid or colloid fluids

- i/v potassium supplements

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41
Q

lower small intestinal obstruction vomiting causes

A
  • decreased pancreatic na+ and HCO3-
  • metabolic acidosis casusing low Na+
  • dehydration
  • decreased food intake
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42
Q

higher intestinal obstruction vomiting causes..

A

signs similar to gastric vomiting

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43
Q

anaemia types

A

regenerative and non-regenerative

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44
Q

antibiotic indication post surgery in GIT

A

small intestine and colon

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45
Q

number of bacteria in GIT

A

increases as you go down the GIT, and so do % of anaerobes

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46
Q

antibiotics to be used post small intestinal surgery

A

1 broard spectrum antibiotic that covers anaerobes

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47
Q

antibiotics to be used post colonic surgery

A

2 antibiotics, 1 with specific anaerobic cover

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48
Q

3 ways you can reduce contamination in GI surgery

A
  • pack area off with saline soaked swabs
  • use different instruments and gloves for contaminated part of surgery
  • lavage wound after closure
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49
Q

2 ways to reduce amount of poo in small intestine

A
  • feed a low residue diet

- starve for 12 - 24 hours pre surgery

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50
Q

strongest layer of stomach lining

A

sub mucosa

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51
Q

sub mucosa is the strongest layer in GIT because..

A

it has a high collagen content

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52
Q

day 1-4 post surgery in GIT wound (4)

A
  • clot formation
  • no change to strength
  • inflammation
  • possible wound debridement
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53
Q

day 3-14 post GIT surgery wound (1)

A

increase in wound strength

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54
Q

day 3-14 post GIT surgery wound (1)

A

increase in wound strength

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55
Q

day 14 of small intestinal wound

A

regained 75-80% original strength

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56
Q

day 14 of colonic wound

A

regained 50% original strength

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57
Q

hypoproteinemia

A

low blood protein

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58
Q

effect of hypoproteinemia on wound healing

A

negative effect

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59
Q

time after surgery have to wait before starting chemo/radiotherapy

A

3 weeks

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60
Q

effect of steroids on wound healing

A

negative

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61
Q

where cut for ex lap

A

from xiphisternum to pubis

in the male cut through the preputial muscle

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62
Q

where cut for ex lap

A

from xiphisternum to pubis

in the male cut through the preputial muscle

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63
Q

think when cutting through preputial muscle

A

large skin blood vessel near it that need to tie off

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64
Q

stomach blood vessels and surgery

A

you can tie a few off as the stomach has a large collateral blood supply

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65
Q

suturing of the stomach layers

A

do mucosa and submucosa together then muscularis and serosa together

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66
Q

3 things to think when cutting the intestine

A
  • make sure the section is empty of contents
  • clamp of section with atraumatic bowel clamps or fingers
  • cut along antimesenteric border
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67
Q

how to biopsy liver

A
  • clamp a triangle off and use a skin biopsy punch
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68
Q

3 things to promote GIT healing

A
  • feed soon after surgery
  • omentalise it
  • if its small intestine then you can tack healthy intestine to the wound
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69
Q

define intussuception

A

where a section of intestine has invaginated into the lumen of its adjoining intestine

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70
Q

intussuception on radiograph

A

intestine will be distended with gas

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71
Q

intussuception treatment

A

surgery - push the invaginated bit out. do not pull

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72
Q

prevention of intussuception reoccurance

A
  • enteroplication - sex neighbouring bits of intestine together to prevent movement. look for an underlying cause first though
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73
Q

5 stages of septic peritonitis

A
  • inflammatory cells enter the peritoneal cavity and release endotoxins and cytokines.
  • vasodilation and increased capillary permeability
  • diaphragmatic lymphatics blocked due to fibrosis
  • increased fluid and protein in peritoneal cavity
  • hypovolemia, decreased oncotic pressure and hypovolaemic shock
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74
Q

clinical signs of septic peritonitis show on..

A

day 3-5

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75
Q

mortality of septic peritonitis

A

50%

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76
Q

treatment of septic peritonitis 3 stages

A
  • stabalise patient and give antibiotics
  • surgery to find and correct leak, then lavage and drain cavity
  • intensive post op care
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77
Q

diagnosis of septic peritonitis

A

abdominocentesis showing neutrophils containing bacteria

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78
Q

define salivary mucocoeles

A

cyst of the salivary gland

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79
Q

cause of salivary mucocoeles

A

disruption of gland and duct anatomy causing saliva to leak into tissues

80
Q

most common gland for mucocoele formation

A

sublingual salivary gland

81
Q

salivary mucocoeles 3 clinical signs

A
  • painless swelling
  • difficulty eating
  • dyspnoea
82
Q

ranula

A

a mucocoele that is formed independently (away from) salivary gland

83
Q

treatment for salivary mucocoeles

A
  • complete surgical removal of the salivary chain

- avoid draining for tx as they will reoccur and you can introduce infection

84
Q

large foreing bodies lodge in 3 sites

A
  • thoracic inlet
  • heart base
  • caudal oesophagus
85
Q

dyspnoea

A

difficulty breathing

86
Q

diagnosing oesophageal foreign bodies radiograph

A
  • lateral cervical and thoracic views

- orthagonal view (90*) to confirm location

87
Q

3 layers of the oesophagus wall

A
  • mucosa
  • submucosa
  • muscularis
88
Q

oesophagus blood supply

A
  • arteries are segmented with few anastomising branches

- veins drain into the azygous and the jugular veins

89
Q

oesophagus lymphatics

A

drain to thoracic and abdominal lymph nodes

90
Q

cervical tissues are continuous with…

A

cranial mediastinum

91
Q

infection in the neck can travel to..

A

the chest causing septic mediastinitis

92
Q

ligamentum arteriosum

A

ligament connecting the aorta to the pulmonary artery

93
Q

persistent right aortic arch

A

the right aortic arch remains and so the ligamentum arteriosum forms a circle around the oesophagus and the trachea

94
Q

4 medical treatments for persistent right aortic arch

A
  • feed from a height
  • feed a slurry diet
  • remain upright for 20 mins post feeding
  • possible treatment needed for aspiration pneumonia
95
Q

4 treatments for aspiration pneumonia

A
  • antibiotics
  • O2
  • nebulised drugs (made into a mist)
  • coupage (hitting chest wall to break up crap)
96
Q

prognosis persistent right aortic arch

A
  • guarded as surgical tx does not fix oesophageal dilation or motility disturbances
97
Q

rumen holds

A

180-200 litres

98
Q

rumen pH

A

6.2-7

99
Q

volatile fatty acid produced at normal rumenal pH

A

acetate

100
Q

if cow eats starch or sugar

A

pH will drop

101
Q

3 VFAs produced if rumen pH drops

A
  • butyrate
  • propionate
  • lactate
102
Q

ruminal acidosis can cause.

A

ruminal stasis

103
Q

amount of saliva cow makes in a day

A

100-150 litres

104
Q

amount of bicarbinate in cow saliva per day

A

3.5kg

105
Q

function of bicarbinate in cow saliva

A

to maintain a neutral pH

106
Q

time a cow needs lying down per day

A

14 hours

107
Q

normal cause of ruminal acidosis

A

eating a large amount of concentrate (fermentable carbohydrate)

108
Q

12 acute ruminal acidosis clinical signs

A
  • dull
  • recumbent
  • uncoordinated
  • ataxia
  • blindness
  • anorexia
  • dehydration
  • laminitis
  • ruminal stasis
  • abdominal distension
  • increased pulse
  • sunken eyes
109
Q

acute ruminal acidosis prognosis

A

guarded

110
Q

4 treatments acute ruminal acidosis

A
  • i/v sodium bicarbonate slow over 30 minutes
  • i/v fluinds NaCl over 6-12 hours
  • oral magnesium hydroxide
  • rumenotomy/rumen lavage
111
Q

SARA

A

sub acute ruminal acidosis

112
Q

define SARA

A

an ill defined herd syndrome

113
Q

8 SARA clinical signs

A
  • low milk fat
  • decreased milk yields
  • long term laminitis
  • increased herd culling rates
  • decreased appetite
  • liver abscesses
  • haemoptysis
  • epistaxis
114
Q

haemoptysis

A

coughing up blood due to bleeding in lungs

115
Q

how SARA causes haemoptysis

A

bacteria leaks through wall and sets up abscess in liver. abscess breaks of and forms septic thrombosis in vena cava, this can spread to lungs, eroding blood vessels and causing bleeding

116
Q

5 clinical signs ruminal bloat

A
  • distended abdomen on left
  • recumbent
  • distressed
  • dyspnoea (due to pressure on lungs#)
  • sudden death (due to pressure on lungs)
117
Q

bloat types

A

frothy and gaseous

118
Q

frothy bloat causes

A

foaming properties of soluble leaf proteins in

  • legumes
  • clovers
  • alfalfa
  • rich lush pasture
119
Q

frothy bloat treatment

A

sit in sternal if recumbent and give surfactant like

  • cooking oil
  • poloxalene
120
Q

causes of gaseous bloat

A
  • excessive carbohydrate intake

- oesophageal blockage

121
Q

treatment gaseous bloat

A

stomach tube or trocar

- put local anaesthetic in paralumbar fossa, cut a small hole and then screw in trocar to rumen. then remove the canula

122
Q

define traumatic reticula peritonitis

A

where metal ruptures through reticulum causing local or diffuse peritonitis, pericarditis, or liver abscess

123
Q

6 clinical signs traumatic reticulo peritonitis

A

vague

  • decreased milk yield
  • pyrexia
  • decreased ruminal movement
  • arching back
  • increased jugular pulse or corded jugular vein
  • splashing sounds over heart
124
Q

3 tests for cow abdominal pain

A
  • withers pinch
  • pole test
  • eric williams test
125
Q

pole test

A

put pole under chest behind legs and pull up, should grunt if painful

126
Q

eric williams test

A

hear a grunt before rumen reticulum cycle

127
Q

3 treatments traumatic reticulo peritonitis

A
  • raise animal up on front legs for a few days, give antibiotics and pain relief
  • rumenotomy to remove object
  • cull
128
Q

prevent traumatic reticulo peritonitis

A

magnet in rumen

129
Q

LDA usually occurs

A

6 weeks post calving

130
Q

LDA 4 clinical signs

A
  • reduced milk yield
  • increased blood and urine ketones
  • decreased body condition
  • reduced rumen contractions
131
Q

diagnosis LDA

A

listen for pings or tinkles (move gut with fist) over left side

132
Q

3 treatments for LDA

A
  • roll
  • omentopexy
  • right paramedian abomasopexy
133
Q

omentopexy

A

organ is sutured in place to greater omentum

134
Q

RDA causes 3 things

A
  • acute intestinal obstruction
  • reduced blood supply
  • necrosis
135
Q

3 RDA clinical signs

A
  • sick
  • dehydrated
  • painful
136
Q

caecal dilation rectal exam presentation

A
  • caecal apex palpable coming into pelvic inlet

- can twist forming volvulus

137
Q

3 caecal dilation treatment

A
  • medical fluids
  • high fibre diet
  • surgery if persists
138
Q

4 differential diagnosis for right side ping

A
  • RDA
  • gas in spiral colon
  • uterine tear at calving
  • ruptured abomasal ulcer
139
Q

horse canines

A

usually only seen in males

140
Q

wolf teeth are

A

vestigial premolar teeth

141
Q

temporomandibular joint allows

A

occlusal contact with all cheek teeth

142
Q

2 features of horse teeth

A
  • hypsodont

- irregular enamel ridges

143
Q

hypsodont

A

constantly emerging teeth

144
Q

irregular enamel ridges in horse teeth allows

A

increased grinding ability

145
Q

how teeth are examined on dental chart

A

clockwise starting at the horses top right

146
Q

equine teeth 05

A

wolf teeth

147
Q

horse teeth 01-03 on dental chart

A

incisors

148
Q

horse teeth 04

A

canines

149
Q

horse teeth 06-08

A

premolars

150
Q

horse teeth 09-11

A

molars

151
Q

significance of horse tooth 09

A

most commonly affected tooth

152
Q

angisognathism

A

maxillary arcade is wider than the mandibular arcade

153
Q

5 components of teeth

A
  • dentine
  • enamel
  • cementum
  • secondary dentine
  • pulp
154
Q

where is dentine

A

inside the bulk of the tooth

155
Q

pulp

A

blood and nerve supply of tooth, in horses ends 5-10mm from surface

156
Q

infundibulum

A

cup shaped dips made by enamel infolding on occlusal surface of tooth, usually filled with black decaying matter

157
Q

maxillary cheek teeth number of infundibulum

A

2

158
Q

number of infundibulum in incisor

A

1

159
Q

how you get linguinal edge points on mandibular arcade

A

decreased lateral movement of jaw. encouraged by foraging

160
Q

enamel overgrowth causes

A
  • the jaw to stop moving freely
  • causing oral pain
  • which causes quidding, weight loss, headshaking, and shear mouth
161
Q

shear mouth

A

where occlusal angle is over 15*

animal will eventually adapt to it

162
Q

treatment of shear mouth

A
  • remove sharp lingual or buccal points
  • ongoing treatment to correct
  • find underlying problem
163
Q

quidding

A

food dropping from mouth

164
Q

cheapest rasping blade

A

carbide chip blade

165
Q

blest blade for rasping

A

tungsten carbide blade

166
Q

4 types rasping handle

A
  • straight head long length
  • obtuse angle long length
  • angled offset with medium length
  • s float
167
Q

straight head long length rasping handle use

A

all lower and some upper cheek teeth

168
Q

obtuse angled head with long length rasping handle uses

A

caudal upper cheek teeth and curve of spee

169
Q

define curve of spee

A

curve in upper caudal cheek teeth

170
Q

s float rasping handle uses

A

smooth of 1st cheek teeth and 6th mavillary cheek teeth, bit seat, and angle of curve of spee

171
Q

angled offset head of medium length rasping handle use

A

upper 1st - 4th cheek teeth

172
Q

bit seat define

A

where edges of first upper and lower cheeck teeth are rounded so that it is not painful when skin gets trapped there when horse pulls on the bit

173
Q

blood vessle that may bleed during equine dentistry

A

palantine artery found inside upper arcade

174
Q

caps on equine teeth

A

retained deciduous teeth

175
Q

when equine caps are shed

A

2.5, 3, and 4 years

176
Q

equine caps cause 3 things

A
  • anorexia
  • poor performance
  • malocclusion
177
Q

equine caps removal

A

with forceps or screwdriver

178
Q

equine parrot mouth

A

rostral displacement of the maxillary arcade causing overgrowth of rostral and caudal teeth

179
Q

overgrown teeth can cause 4 things

A
  • diastema

- displaced/fractured/lost teeth

180
Q

wave mouth

A

multiple overgrown teeth

181
Q

effect of wave mouth on 2* dentine

A

as does not have complete contact with occlusal surface 2* dentine may not form leaving pulp exposed

182
Q

define infundibular caries

A

a cavity in the infundibulum

183
Q

infundibular caries can cause formation of

A

septic pulpitis

184
Q

treatment of excessive transverse ridges

A

dont remove them as ridging is normal, you can reduce the larger ones

185
Q

stages of peridontal disease

A
  • localised gingivitis and pocket formation
  • trapped debris stagnate and food is compressed widening pocket
  • alveolar bone is destroyed
  • bacteria enter the pulp cavity through the root canals
186
Q

define diastema

A

a gap between teeth, can be normal

187
Q

if food packs into the diastema

A
  • food will also pack into peridontal spaces
  • pressure of food compaction causes pain
  • bone becomes infected
188
Q

treatment of abnormal diastema

A
  • widen it
  • extraction
  • monitoring and removing food when necessary
189
Q

define apical tooth infections

A

infection in the root of tooth

190
Q

5 clinical signs apical tooth infection

A
  • asymmetrical jaw swelling
  • ventral discharge tract
  • quidding
  • halitosis
  • submandibular lymph node enlargement
191
Q

diagnosis of apical tooth infections

A

radiography showing; gas in bulging root area, root fragmentation, increased pulp volume, abnormal pulp morphology

192
Q

significance equine teeth 06, 07

A

can burst into nasal cavity as in maxillary bone

193
Q

significance equine teeth 08-11 apical tooth infection

A

in rostral and caudal sinuses so can cause sinusitis

194
Q

clinical sign of sinusitis

A

unilateral nasal discharge

195
Q

diagnosis sinusitis

A

imaging

196
Q

3 treatment of apical tooth infection

A
  • anitibiotics
  • removal
  • endodontic treatment

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