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Small Animal Medicine II > Diseases of the Stomach and Vomiting > Flashcards

Diseases of the Stomach and Vomiting Flashcards

1
Q

What are 4 main differences between vomiting and regurgitation?

A 
Regurgitation has no prodromal signs
Regurgitation is passive
Regurgitation is usually shortly after feeding
Undigested food (often sausage shaped)
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2
Q

What are 3 things you should consider from the history of the vomiting patient?

A

Recent dietary changes?
On any medication?
Recent anesthesia?

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3
Q

What are 2 questions you might ask about the quality of the vomit?

A

Blood or “coffee grains”?

Is it undigested/partially digested food?

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4
Q

T/F: Vomiting is a relfex.

A

True

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5
Q

Where is the vomiting center?

A

In the medulla

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6
Q

What do you see in the prodromal phase?

A

Hypersalivation

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7
Q

What are 4 possible ddx for acute gastritis?

A

Bad/rich food
FB
Toxins
Drugs

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8
Q

What are 3 possible ddx for chronic gastritis?

A

IBD (Lymphoplasmacytic)
Helicobacter
Physaloptera

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9
Q

What is a possible ddx for gastric outflow problems?

A

Idiopathic hypomotility

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10
Q

What are 3 possible ddx for infiltrative gastric dz?

A

IMB
Neoplasia
Pythiosis

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11
Q

What are your first 4 steps in approaching a vomiting patient?

A

Systemic evaluation
Fecal
Imaging
Therapy

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12
Q

What are 4 possible therapies for a vomiting patient?

A

Deworm
Drugs
Bland diet
Fluids (if indicated)

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13
Q

What diagnostic approach would you take with acute vomiting and not ill?

A

Non-specific rx

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14
Q

What diagnostic approach would you take with acute vomiting and an ill patient?

A

Non-specific rx and workup

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15
Q

What diagnostic approach would you take with a chronic (over 7 days) vomiting patient.

A

Non-specific rx
Treatment trials and work up (need to figure out wtf is going on)
Biopsy

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16
Q

What 4 things would you do if you have hematemesis?

A

Determine origin (GI vs Resp.)
Evaluate coagulation
MDB
Imaging

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17
Q

What is “chronic” vomiting?

A

More than 7 days of vomiting

NOTE: Relatively common in dogs and cats

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18
Q

What will you likely need to do for a definitive dx in a chronic vomiting case?

A

Biopsy

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19
Q

What 3 things can help you exclude systemic dz in a vomiting case?

A

Hx
Exam
Routine labs

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20
Q

What 3 systemic dz might be excluded if an eosinophilia is detected?

A

Allergies
IBD
Verminosis

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21
Q

If you have a hypochloremia on your biochemestry, what systemic dz can you exclude?

A

Stricture

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22
Q

What is NOT appropriate to do with a chonic vomiting dog?

A

Withhold food

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23
Q

When is a diet trial not appropriate?

A

In systemically unwell patients

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24
Q

Cats with ______ tend to vomit and a large percentage respond to diet moditication.

A

IBD

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25
Q

With a vomiting patient, what 3 general symptomatic therapies would you use?

A

Anti-emetics
Antacids/Gastroprotectants
Pro-kinetics

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26
Q

When is the use of anti-emetics contraindicated?

A

If a FB is suspected

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27
Q

What are the 3 most common anti-emetics that you would use with a vomiting patient?

A

Maropitant (central and peripheral)
Metoclopramide (central in dogs)
Ondansetron (central in cats, peripheral in dogs)

28
Q

What are the 3 most common anti-ulcer meds that you would use with a vomiting patient?

A

H2 receptor
Omeprazole
Sucralfate

29
Q

What is important to remember about Cimetidine?

A

It may interfere with the metabolism of other drugs

30
Q

What 2 things are important to remember about Ranitidine?

A

It has a pro-kinetic effect

IV use may cause hypotension

31
Q

What 4 things does endoscopy allow us to examine?

A

Esophagus
Sphincter
Stomach
Proximal duodenum

NOTE: Never leave without a biopsy souvenir

32
Q

After what other procedure should you perform endoscopy?

A

After US

33
Q

What is the underlying cause of chronic gastritis?

A

Cause is rarely identified

34
Q

How is chronic gastritis classified?

A

According to cellular infiltrate

35
Q

What is the most common type of chronic gastritis?

A

Lymphoplasmacytic

36
Q

What 2 things can you do to help manage lymphoplasmacytic chronic gastritis?

A

Diet modification

Immunosuppressant medication

37
Q

What bacteria is often identified in chronic gastritis?

A

Helicobacter

NOTE: In humans, is associated with gastric neoplasia

38
Q

What are 3 things you’ll see on biopsy to help diagnose Helicobacter?

A

Associated inflammation
Intracellular location
Epithelium changes

39
Q

What is the test of choice for diagnosing Helicobacter?

A

Cytobrush via endoscope

40
Q

What are 2 tests that you can do for Helicobacter other than the cytobrush?

A 
Biopsy
Urease test (CLOtest)
41
Q

Why is it not just enough to see Helicobacter to diagnose?

A

Because it could be normal

42
Q

Why is it not just enough to see Helicobacter to diagnose?

A

Because it could be normal

43
Q

What is the most common gastric tumor?

A

Adenocarcinoma

44
Q

What 3 dog breeds most commonly get adenocarcinoma?

A

Belgian sheperds
Collies
Staffies

45
Q

What is the clinical sign of adenocarcinoma?

A

Hematemesis

46
Q

How is adenocarcinoma diagnosed and confirmed?

A

Diagnosed :US

Confirmed: Biopsy

47
Q

Why do adenocarcinomas often have such a poor prognosis?

A

Because they are highly infiltrative and complete excision is difficult

48
Q

What is the most common type of GI neoplasia in cats?

A

GI lymphoma

49
Q

What is the best way to diagnose a GI neoplasia?

A

Surgical biopsy

NOTE: Take multiple

50
Q

What is a high grade lymphoma?

A

Rapidly dividing, lymphoblasts

51
Q

What is a low grade lymphoma?

A

Slowly dividing, lymphocytes

52
Q

Which grade lymphoma responds rapidly to chemo?

A

High grade because of rapidly dividing cells

53
Q

What do you need to confirm the grade of lymphoma?

A

Biopsy

54
Q

What is the outcome of chemo in a cat with high grade lymphoma?

A

50-70%, survival time of 6-10 months

55
Q

What is the outcome of chemo in a dog with high grade lymphoma?

A

Not good

56
Q

How do you treat a low grade lymphoma?

A

Low dose, long term chemo (prednisolone)

57
Q

What is the outcome of cats treated for low grade lymphoma?

A

68% complete remission

Mean survival 23 months

58
Q

What is delayed gastric outflow?

A

Food in stomach for >8hrs post-ingestion

59
Q

What is a clinical sign of delayed gastric outflow?

A

Projectile vomiting

60
Q

What are 3 causes of delayed gastric outflow?

A

Intramural dz
Extramural compression
FB

61
Q

What is the most common cause of outflow obstruction?

A

Pyloric stenosis

62
Q

What are the 2 types of pyloric stenosis?

A

Congenital pyloric stenosis
Adult antral pyloric hypertrophy

NOTE: Both are progressive

63
Q

Who most often has congenital pyloric stenosis?

A

Boxers

Boston Terriers

64
Q

What is involved in the congenital pylori stenosis?

A

Usually only muscle

65
Q

Who commonly gets adult antral pyloric hypertrophy?

A

Small breed dogs

66
Q

What is involved in adult antral pyloric hypertrophy?

A

Muscle and mucosa

Small Animal Medicine II (8 decks)

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