Gastric Diseases Flashcards
(86 cards)
1
Q
Which parts of the stomach expand to accomodate food?
A
Fundus and Body
2
Q
Which part of the stomach acts as the grinder?
A
Antrum
3
Q
The outermost layer of the stomach is the
A
serosa
4
Q
What 3 types of cells comprise the Gastric Glands
in the mucosa of the stomach?
A
Mucous neck cells
Parietal cells
Chief cells
5
Q
What 3 cell types are considered neuroendocrine cells and
are found in the mucosa of the stomach?
A
ECL cells
D cells
G cells
6
Q
This cells is responsible for secreting HCl and intrinsic factor
A
Parietal cells
7
Q
What is the function of parietal cells?
A
Kill microbes, activate pepsinogen, and bind Vit B12
8
Q
What do Chief Cells secrete?
A
Pepsinogen and Gastric Lipase
9
Q
What is the function of Chief Cells?
A
Protein and fat digestion
10
Q
What do Mucus-Neck Cells secrete?
A
Mucus and Bicarbonate
11
Q
What is the function of mucus-neck cells?
A
To protect the stomach epithelium from acid
12
Q
What do ECL Cells (Enterochromaffin Cells) secrete?
A
Histamine and Serotonin
13
Q
What is the function of ECL Cells (Enterochromaffin Cells)?
A
to stimulate gastric acid secretion
14
Q
What do D-cells secrete?
A
Somatostatin
15
Q
What is the function of D-cells?
A
To inhibit gastric acid secretion
16
Q
What do G-cells secrete?
A
Gastrin
17
Q
What is the function of G-cell secretion?
A
Stimulates gastric acid secretion
18
Q
Which substances are responsible for stimulating gastric acid secretion?
A
Gastrin and Histamine
19
Q
What substance is responsible for protein digestion?
A
Pepsinogen (secreted by chief cells)
20
Q
What substance is responsible for fat digestion?
A
Gastric lipase (secreted by chief cells)
21
Q
Which substance inhibits gastric acid secretion?
A
Somatostatin (secreted by D-cells)
22
Q
What substance is responsible for binding Vit. B12
allowing for its absorption?
A
Intrinsic factor (secreted by parietal cells)
23
Q
What substance is responsible for activating pepsinogen?
A
HCl (secreted by Parietal Cells)
24
Q
Meissner’s Plexus (nervous system component) is found
in which layer of the stomach?
A
Submucosa
25
Auerbach's (Myenteric) Plexus is
found in this layer of the stomach
Muscularis
26
The **H/K ATPase Pump** is found in **parietal cells**,
which are part of this layer of the stomach
Mucosa
27
On a CHEM panel the following changes are noted:
BUN elevated and disproportionally higher than Creatinine
What does this finding suggest?
Bleeding in upper GI tract
28
On a CHEM panel the following changes are noted:
Metabolic alkalosis with increased bicarb, but decreased chloride
What does this finding suggest?
Gastric outflow obstruction
29
Endoscopy is unhelpful for any disease
deeper than the _________ (layer of the stomach)
mucosa
30
\_\_\_\_\_\_\_ is the best way to evaluate for
inflammation, ulcers, FB, and mucosal neoplasia
Endoscopy
31
\_\_\_\_\_\_\_\_\_ are contraindicated in treatment of gastric foreign bodies
Antiemetics
32
Inflammation of the mucosa is known as
Gastritis
33
Dramatic gastric distension of the stomach is known as
Dilatation
34
When the stomach twists and moves on its axis
usually to the left of the fundus, it is known as
Volvulus
35
GDV results in compression of the \_\_\_\_\_\_\_\_
which results in impaired venous return to the heart
which can cause hypovolemic shock
CVC (Caudal Vena Cava)
36
What are the common sequela of GDV?
Gastric wall necrosis
Splenic torsion or avulsion
Endotoxic shock
DIC
37
What condition would you be concerned with
in a large breed barrel chested dog that
eats quickly and then plays immediately?
GDV
38
A great dane presents with acute non-productive retching
and painful abdominal distension. He is tachycardic and has weak pulses.
What is the first thing you do?
FLUIDS FIRST! (GDV)
Then Rads
39
In GDV, what type of radiograph is the most important for diagnosis?
RIGHT lateral
40
What do you expect to see on a right-lateral rad
in an animal with GDV?
"Popeye arm"
41
What are the steps (in order) in treating GDV?
FLUIDS
Decompression (orogastric tube)
Trocharization
SURGERY ASAP
42
The mortality rate in GDV is \_\_\_\_\_%
15 - 30% (higher end in gastric necrosis or splenectomy)
43
T/F:
In cases of food bloat, it is ok to leave it alone for 24 to 36 hours
TRUE (sx is not rarely required)
44
How are gastric ulcers confirmed?
Endoscopy
45
How are gastric ulcers treated?
Sucralfate, Proton Pump Inhibitors (Omeprazole), Pain meds
46
T/F:
An animal with gastric ulcers can present with
hematemesis, melena, anemia, and elevated BUN
true
47
T/F:
Helicobacter Gastritis can result in acute or chronic vomiting
TRUE
48
Where would you look for spiral
gram negative bacteria in the case of helicobacter gastritis?
In crypts and gastric glands
49
How is helicobacter gastritis treated?
Clarithromycin + Amoxicillin + Metronidazole
(resistance has been documented!!!)
50
A dog from a tropical location presents with chronic vomiting.
U/S and Endoscopy reveal a thickened gastric outflow tract
with pyogranulomatous inflammation. What is your primary ddx?
Gastric Pythiosis (P.Insidiosum)
51
What is the prognosis for a dog with Gastric Pythiosis (P.Insidiosum)?
VERY POOR!
Fatal in all dogs, MST- 26.5 days) :(
52
Toxocara canis and T. cati are this type of parasite
roundworms
53
How are Toxocara canis and T. cati diagnosed?
Visual or fecal
54
How are Toxocara canis and T. cati treated?
Fenbendazole or Pyrantel Pamoate
55
T/F:
Fecal float is the best way to dx Physalloptera infection
FALSE!
Difficult to see on fecal, may see on **endoscopy**
56
How is Physalloptera treated
Pyrantel Pamoate (2 doses, 2 weeks apart)
57
This parasite only infects cats and grows to be
about 1mm in length. They can be seen on
**biopsy, gastric juice evaluation, and in vomitus**
What is this parasite?
Ollulanus tricuspi
58
How is Ollulanus tricuspi treated?
Fenbendazole
59
T/F:
Acute vomiting is seen in cases of gastric esophageal reflux
FALSE!
CHRONIC vomiting
60
How is Gastric Esophageal Reflux treated?
PPI (Omeprazole) and Sucralfate
| (or tx the primary disease)
61
How is **inflammatory gastritis** diagnosed?
Endoscopy or Biopsy!
62
What is the most common type of inflammatory gastritis?
Lymphoplasmacytic
63
In a case of chronic vomiting, surgical biopsy was performed and
and infiltrate of inflammatory cells were found. If this is
inflammatory gastritis, what layers of the stomach will these
cells been seen in?
Mucosa and Lamina Propria
64
In a case of chronic vomiting, surgical biopsy was performed and
a marked infiltrate of **mononuclear** cells were seen
(lymphocytes and macrophages).
Thinning of the gastric mucosa and atrophy of the gastric glands
was also noted. What is your primary ddx?
Atrophic Gastritis
65
Atrophic Gastritis can progress to ACA
in this species of dog
Norwegian Lundehund
66
How is inflammatory gastritis treated?
Antacid, gastroprotectants
Diet trial
Empiric deworming (Fenbendazole and Pyrantel Pamoate)
Immunemodulators (Prednisone in dogs, Prednisolone in cats)
Cyclosporine
67
What is the most common clinical sign seen
in dogs with Hypertrophic Gastropathy?
Chronic vomiting, projectile, hours after eating
68
What is the signalment of a dog with Hypertrophic Gastropathy?
Older, small breed dogs, especially Lhasa Apso and Shih Tzu
69
What would you expect to see on biopsy diagnosis
of a dog with Hypertrophic Gastropathy?
Diffuse or focal hypertrophy of
the **mucosa and/or muscularis**
with inflammatory infiltrates
70
What hypergastrinemic conditions are associated with
Hypertrophic Gastropathy?
Decreased clearance from liver or renal disease
or
Gastrin secreting tumor
71
Hypertrophic Gastropathy is pronounced in the
\_\_\_\_\_\_\_ _______ region
pyloric outflow
72
How is Hypertrophic Gastropathy treated?
By treating the primary disease or
## Footnote
**surgical resection of the thickened tissue**
73
What breeds are predisposed to
Congenital Pyloric Stenosis and Hypertrophy?
Boxers, Boston Terriers, English Bulldogs, Siamese Cats
74
A boxer presents with vomiting several hours after a meal (delayed gastric emptying).
He is not gaining weight and is depressed and dehydrated.
Endoscopy reveals muscular thickening of the pyloric sphincter.
What is your primary ddx?
Congenital Pyloric Stenosis and Hypertrophy
75
How is congenital pyloric stenosis and hypertrophy treated?
Surgical correction
76
What are 2 acquired causes of pyloric stenosis and hypertrophy?
Inflammation
and Gastrinoma
77
What would you expect to see on endoscopy in an
animal with Gastrinoma?
Thickened gastric wall
Hypertrophy of Pylorus
Gastric ulceration
78
Describe the pathology of Gastrinoma
Tumor in the pancreas of APUD cells
stimulates hypersecretion of GASTRIN
79
How is Gastrinoma diagnosed?
Gastrin levels after withholding antacids for 48 hours
reveals
LOW pH of gastric juices + HIGH gastrin level
80
How is Gastrinoma treated?
Surgical removal of tumor (often mets at dx though)
PPIs (Omeprazole)
and OCTREOTIDE- inhibits gastrin
81
What is the prognosis of Gastrinoma?
Guarded to Poor
82
What are the 2 most common benign tumors of the stomach?
Leiomyoma
Adenomatous Polyps
83
What are the 2 most common malignant tumors of the stomach?
Adenocarcinoma (DOGS) - 70%
Lymphosarcoma (CATS)
84
Delayed gastric emptying motility disorders like
GERD or Bilious Vomiting Syndrome
are seen secondary to what 6 causes?
Inflammation
Infection
Obstruction
Electrolyte Disturbance
Opioids
**Surgery!**
85
How are Delayed gastric emptying motility disorders diagnosed?
Rads and contrast studies on a fasted patient
(takes longer than 8 hours to empty)
86
How are Delayed gastric emptying motility disorders treated?
**CISAPRIDE** (compounding pharmacies)
(Also: Metoclopramide, Erythromycin, Ranitidine, Low protein and fat diet)
