Digestion & Metabolism 2: SA Esophageal & Swallowing Dz Flashcards

1
Q

esophagus STRUCTURE in…
CATS?
DOGS?

A

CAT esophagus = SMOOTH muscle in DISTAL esophagus SPIRALS, then some SKELETAL

DOG esophagus = TWO OBLIQUE LAYERS OF SKELETAL MUSCLE

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

what is this STRUCTURE in the esophagus? WHAT SPECIES

A

SPIRAL formation/SMOOTH MUSCLE, NORMAL finding in CAT ESOPHAGUS

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

ID SPECIES of this esophagus

A

DOG, smoother than cat

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

NORMALLY, esophagus on rads…

A

IS NOT VISIBLE because it’s SILHOUETTED BY OTHER SOFT TISSUE STRUCTURES

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

for DYSPHAGIA…

2 affected areas?

2 diagnostic tests?

A

affected areas?
1. ORAL CAVITY
2. SWALLOWING MECHANISM

diagnostic test?
1. ORAL EXAM
2. VIDEOFLUOROSCOPIC BARIUM SWALLOW

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

for REGURGITATION…

2 affected areas? which one is more common?

2 diagnostic tests?

A

2 affected areas?
1. ESOPHAGUS is MORE COMMON
2. STOMACH (with DISTENSION)

2 diagnostic tests?
1. CHEST LATERAL RADS
2. NECK LATERAL RADS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

if VOMITING…

affected area?

2 diagnostic tests?

A

affected area? = ABDOMEN

2 diagnostic tests?
1. ABDOMINAL RADS
2. ABDOMINAL US

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

what is the MOST IMPORTANT DIAGNOSTIC TEST for DIAGNOSING SWALLOWING DISORDERS?

A

VIDEO FLUOROSCOPIC BARIUM SWALLOW

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

___ ___ is the MOST COMMON esophageal disease in ____, but is VERY RARE in ___

A

GENERALIZED MEGAESOPHAGUS, DOGS

RARE in CATS

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

3 FORMS of megaesophagus?

3 common clinical signs?

2 diagnostic tests & done when WHAT clinical sign is present?

A

3 forms…
1. CONGENITAL
2. ACQUIRED IDIOPATHIC
3. ACQUIRED SECONDARY

3 common clinical signs?
1. REGURGITATION
2. WEIGHT LOSS
3. HYPERSALIVATION

2 diagnostic tests & done when WHAT clinical sign is present?
1. NECK rads
2. THORACIC rads
done when REGURGITATION is present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ID DZ

A

GENERALIZED MEGAESOPHAGUS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ID DZ

A

GENERALIZED MEGAESOPHAGUS

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

CONGENITAL megaesophagus…

RARELY reported in what species?

what AGE animals are predisposed?

what 3 BREEDS are predisposed?

diagnosis? (2, which one is MOST helpful?)

what disease do we need to RULE OUT?

A

RARELY in CATS

in YOUNG animals

3 DOG BREEDS…
1. MINI SCHNAUZER
2. WIREHAIRED FOX TERRIER
3. GERMAN SHEPHERD

diagnosis?
1. SURVEY rads of neck/thorax
2. VIDEO FLUOROSCOPIC BARIUM SWALLOW

we need to rule out VASCULAR RING ANOMALY (aorta wrapping around trachea/esophagus)

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

ACQUIRED SECONDARY MEGAESOPHAGUS…

what is the most COMMON cause of this?

what is the SECOND MOST COMMON CAUSE?

2 other common causes?

2 RARER causes?

A

most common = MYASTHENIA GRAVIS

SECOND most common = ADDISON’S DZ

2 other causes?
1. ESOPHAGITIS
2. OBSTRUCTION of esophagus

2 RARER?
1. NEUROLOGICAL
2. POLYMYOSITIS

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

diagnostic WORKUP for ACQUIRED SECONDARY MEGAESOPHAGUS (5, one is OPTIONAL)

A
  1. CBC/CHEM/UA
  2. THORACIC RADS
    –> do TRACHEAL WASH if EVIDENCE of ASPIRATION PNEUMONIA
  3. ACh receptor Ab TITER
  4. ACTH STIM TEST/BASELINE CORTISOL
  5. +/- ENDOSCOPY
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

____ _____ ____ is the MOST common form of ____esophagus in DOGS

A

ACQUIRED IDIOPATHIC MEGAESOPHAGUS, MEGA

17
Q

ACQUIRED IDIOPATHIC MEGAESOPHAGUS…

AGE/BREED of dog?

2 Hx findings?

A

MIDDLE-AGED to OLDER
LARGE BREED DOGS

2 Hx findings?
1. REGURGITATION
2. COUGH

18
Q

PROKINETIC drugs…

used to treat WHAT dz?

2 EXAMPLES? are they good..?

A

MEGAESOPHAGUS

examples? THEY’RE NOT THE BEST bc they work on SMOOTH MUSCLE
1. METOCLOPRAMIDE
2. SILDENAFIL

19
Q

PROGNOSIS for MEGAESOPHAGUS…

for CONGENITAL? (2)

for ACQUIRED SECONDARY? (2)

for ACQUIRED IDIOPATHIC? (3)

A

CONGENITAL..
1. FAIR to GUARDED
2. about HALF SPONTANEOUSLY RECOVER if MANAGED THROUGH CLINICAL PERIODS

SECONDARY…
1. depends on UNDERLYING DZ
2. MYASTHENIA GRAVIS = 50-50 prognosis for survival

IDIOPATHIC…
1. GUARDED to POOR
2. RARELY spontaneously resolves
3. most dogs die from RECURRENT ASPIRATION PNEUMONIA

20
Q

TOP & BOTTOM finding?

A

TOP = MEGAESOPHAGUS

BOTTOM = AIR BRONCHOGRAM from ASPIRATION PNEUMONIA

21
Q

ESOPHAGEAL FOREIGN BODY…

we SHOULD NOT rule it out when the animal has been ____ for _____ weeks

diagnosis?

considered a MEDICAL ____ because…

A

SHOULD NOT rule it out when animal has been REGURGITATING for TWO WEEKS

diagnosis? = SURVEY NECK/THORACIC RADS

EMERGENCY because the LONGER IT REMAINS IN ESOPHAGUS, more likely for NECROSIS –> STRICTURE

22
Q

ID LESION

A

ESOPHAGEAL FB

23
Q

TREATMENT for ESOPHAGEAL FOREIGN BODIES via ENDOSCOPY?

A

ENDOSCOPY & REMOVAL if able, and if not PUSH INTO STOMACH

24
Q

ESOPHAGEAL Sx for FBs carries a ___ PROGNOSIS, and instead we should consider….

A

POOR, GASTROTOMY TUBE

25
Q

THREE DRUGS to be used for ESOPHAGEAL FB?

A
  1. ANTACIDS
  2. SUCRALFATE to prevent ESOPHAGITIS post-removal
  3. ANTI-INFLAMMATORIES/STEROIDS (prednisone)
26
Q

overall PROGNOSIS for ESOPHAGEAL FOREIGN BODIES is generally ___ but depends on the….

A

GOOD, SEVERITY OF ESOPHAGITIS

27
Q

what is the MOST COMMON cause of ESOPHAGITIS?

A

PROLONGED ANESTHESIA so that LES relaxes and GASTRIC ACID GETS UP INTO ESOPHAGUS

28
Q

DIAGNOSIS for ESOPHAGITIS is usually based on….

but we can ALSO use…

what is required for DEFINITIVE diagnosis?

A

usually based on CLINICAL SUSPICION

but we can use ENDOSCOPY occasionally

need BIOPSY for definitive

29
Q

ID LESION

A

ESOPHAGITIS

30
Q

ID LESION

A

ESOPHAGITIS w/ STREAKS OF INFLAMMATION

31
Q

TREATMENT of esophagitis…

2 drug combo?

2 other options?

A

drugs? = SUCRALFATE (slurry) + ANTACIDS

2 other options?
1. PROKINETICS = help INCREASE ESOPHAGEAL SPHINCTER TONE & INCREASE GASTRIC GASTRIC EMPTYING RATE

  1. feed LOW-FAT DIET
32
Q

PROGNOSIS for esophagitis in…
MILD cases?
SEVERE cases?

what is the MOST COMMON COMPLICATION?

what are 2 other POTENTIAL complications?

A

EXCELLENT for MILD CASES & do well w/ SUPPORTIVE THERAPY

GUARDED to POOR for SEVERE cases

most COMMON complication = ESOPHAGEAL STRICTURE

2 other complications?
1. ESOPHAGEAL PERFORATION
2. BACTERIAL SEPSIS