Gastroenterology

Question 1

Risk factors for acute pancreatitis ?

Answer 1

• dietary indiscrétion
• hypertriglyceridemia
• hypercalcemia
• drugs & toxins
• endocrinopathies (cush, diabète)
• breed predilection ( min schnauzer)
• advance âge (> 7 yo)
• overweight

Question 2

Name and role of a specific treatment of pancreatitis ?

Answer 2

Fuzapladib : leukocyte function-associated antigen type 1 activation inhibitor
JVIM sept 2023 : administration safe and favorable clinical response

Question 3

What campylobacters are supposed to be pathogenic (diarrhea)?

Answer 3

Campylobacter jejuni and coli

Question 4

How is absorbed alimentary folate?

Answer 4

Folate polyglutamate is deconjugated by folate deconjugase on the proximal small intestine and then absorbed via the folate carriers in the proximal intestine

Question 5

What is the goal of testing fecal alpha1-proteinase inhibitor?

Answer 5

To look for gastrointestinal albumin losses (same weight but not digested)

Question 6

What is the target of antibodies in masticatory muscle myositis in dogs ?

Answer 6

2M fibers (antibody positive or immune complexes on biopsy are diagnostic)

Question 7

What is craniomandibular osteopathy?

Answer 7

Woven bone proliferation of the mandibles and temporomandibular joints affecting small breed dogs

Question 8

What is the main difference in oesophageal musculature between dogs and cats?

Answer 8

One third of striated muscles of the oesophagus are replaced by smooth muscles in cats

Question 9

What are the four phases of swallowing?

Answer 9

Oral preparatory, oral, pharyngeal and oesophageal phases

Question 10

True or false: cervical oesophageal transit is significantly delayed in lateral recumbency vs sternal recumbency in dogs

Answer 10

True

Question 11

Name 2 main host pattern recognition receptor systems of the gastrointestinal tract

Answer 11

Toll-like receptors (TLR, transmembranaires) et Nucleotide-binding oligomerization domain (NOD1 et NOD2, intracellulaires)

Question 12

Name a gastric parasite of cats

Answer 12

Ollulanus tricuspis that can be transmitted via ingested vomitus

Question 13

Name a gastric parasite of dogs (and cats)

Answer 13

Physaloptera spp. that can be transmitted by intermediate and paratenic hosts (cockroaches, beetles, lizards…)

Question 14

What is the prognosis of gastric pythiosis (Pythium insidiosum)?

Answer 14

Poor (<25% of cure with medical therapy alone)

Question 15

What is the prokinetic effect of erythromycin?

Answer 15

Release of motilin

Question 16

What are the pacemaker cells of the small intestine ?

Answer 16

Interstitial cells of Cajal

Question 17

What are the three phases of fasted small intestinal cycle?

Answer 17

Quiescent phase, minor contractile activity phase and migrating myoelectric complexes (MMC, stimulated by motilin)

Question 18

What type of T cells is prevalent in the lamina propria of dogs ? And cats?

Answer 18

Dogs CD4 T cells
Cats CD8 T cells

Question 19

True or false: pathogenic bacteria induced differentiation to Th17 cells

Answer 19

True

Question 20

True or false: digestive viruses induce differentiation to Th1 cells

Answer 20

True

Question 21

True or false: digestive parasites induce differentiation to Th2 cells

Answer 21

True

Question 22

True or false: IBD is related to abnormal induced Th17 response

Answer 22

True

Question 23

What are large volume of stool, melena, steatorrhoea, absence of tenesmus or mucus or urgency suggestive of?

Answer 23

Small intestine diarrhea

Question 24

What is the point of fecal calprotectin assay?

Answer 24

Measure intestinal inflammation (neutrophil elastase activity)

Question 25

What are EPEC, ETEC and EHEC ?

Answer 25

Enteropathic E.coli, enterotoxigenic E.coli and enterohemorrhagic E.coli

Question 26

What type of E.coli is associated with granulomatous colitis?

Answer 26

AIEC (adherent invasive E.coli)

Question 27

What is salmon poisoning in dogs?

Answer 27

Ingestion of Neorickettsia helminthoeca in the fluke Nanophyetus salmincola of the salmon (high fever, GI troubles, polyadenomegaly and high mortality)

Question 28

What type of hypersensitivity reaction should not be possible with an hydrolyzed diet?

Answer 28

Type I (IgE) but type IV (delayed) should still be possible (not with annalergenic)

Question 29

True or false: LPE of Basenjis is severe and occurs with concomitant hyperglobulinemia

Answer 29

True

Question 30

Where are encountered more frequently adenoma and carcinoma of the GI tract in dogs ? And in cats ?

Answer 30

Dogs: Large intestine (then duodenum) Cats: Small intestine

Question 31

Where is the preferential localisation of smooth muscle tumors of the GI tract in dogs ? And in cats?

Answer 31

Dogs: jejunum and caecum Cats: small intestine

Question 32

Name causes of intestinal pseudo-obstruction

Answer 32

Leiomyositis, sclerosing enteropathy, alimentary lymphoma (cats)

Question 33

What is the short bowel syndrome ?

Answer 33

The consequences of the absence/resection of 66-85% of small intestine

Question 34

What part of the GI tract does irrigate the caudal mesenteric artery?

Answer 34

Rectum and descending colon with anastomosis to the middle coloc artery (cranial mesenteric artery)

Question 35

What part of the GI tract does irrigate the cranial mesenteric artery?

Answer 35

All the GI tract (with anastomosis to le the left colic artery for descending colon and rectum)

Question 36

Which nerves supply the colon ?

Answer 36

Pelvic nerve for the distal colon and vagus nerve for the proximal colon

Question 37

What nervous plexus is present in the submucosa of the large intestine?

Answer 37

The submucosal plexus (Meissner's plexus) with also interstitial cells of Cajal

Question 38

What nervous plexus is present in the muscularis of the large intestine?

Answer 38

Myenteric nerve plexus (Auerbach's plexus)

Question 39

How is absorber water in the (proximal) colon?

Answer 39

Passive diffusion thanks to active absorption of sodium

Question 40

What are the 3 major contractions of the large intestine?

Answer 40

Ascending: rhythmic phasic contraction (mixing and absorption) Transverse: retrograde giant contraction (antiperistaltis) Descending: Giant migrating contraction

Question 41

What does the sympathetic nervous system on the large intestine?

Answer 41

Restrict progression of the content and contracting the sphincters

Question 42

What might trigger the defecation reflex ?

Answer 42

Ingestion of a meal (gastrocolic reflex) or distension of the distal colon and rectum

Question 43

True or false: FIP can present as a pyogranulomatous mass at the ileocolic junction

Answer 43

True

Question 44

Where is found the highest concentration of giardia in dogs? And cats?

Answer 44

Dogs: duodenum Cats: ileum

Question 45

By what cecal inversion may be predisposed (dog)?

Answer 45

Trichuris infection

Question 46

What is the sympathetic innervation of the rectoanal apparatus?

Answer 46

Via the hypogastric nerve (L1-L4+L5) Inhibition of rectum and colon, stimulation of internal sphincter

Question 47

What is the parasympathetic innervation of the rectoanal apparatus?

Answer 47

Pelvic nerve(S1-S3) stimulates the colon and rectum

Question 48

What is the somatic innervation of the rectoanal apparatus?

Answer 48

Pudendal nerve, contraction of the external anal sphincter

Question 49

What is the rectosphincteric inhibition reflex?

Answer 49

Inhibition of the internal anal sphincter due to intrarectal increased pressure

Question 50

True or false: a higher expression of relaxin receptors has been found in the muscles of the pelvic diaphragm of dogs with perineal hernia?

Answer 50

True (synthesized in the prostate gland)

Question 51

What C. Perfringens enterotoxin genes are associated with AHDS ?

Answer 51

NetE and NetF

Question 52

How is absorbed cobalamin ?

Answer 52

B12 is released from dietary proteins by pepsin and HCL in the stomach. It is then bound to the R-protein and released from it by pancreatic proteases in the duodenum. It is then bound to the intrinsic factor and absorbed with it in the ileum.

Question 53

Who is more frequently affected by juvenile hyperplastic gingivitis ?

Answer 53

Young adult cats (+/- animals on drug: calcium channel blockers, cyclosporine, phenobarbital)

Question 54

What is the only autoantigen recognized in mucous membrane pemphigoid in cats ?

Answer 54

Laminine 5 (Dogs: Laminine 5, collagen XVII, integrin alpha6-beta4)

Question 55

What are the risk factors for oral squamous cell carcinoma in cats ?

Answer 55

Flea collars, canned tuna, canned cat food, exposure to tobacco smoke

Question 56

What is the most common cause of oesophageal stricture in dogs ?

Answer 56

GER during anesthesia

Question 57

What sign regarding the trachea is indicative of persistent right aortic arch in dogs on thoracic radiograph ?

Answer 57

Focal leftward deviation

Question 58

What tumor may arise from granulomas of Spirocerca lupi in dogs ?

Answer 58

Oesophageal fibrosarcoma and osteosarcoma

Question 59

Where in the stomach and by which cell is produced gastrin ?

Answer 59

By G cells in the pyloric antrum

Question 60

Where in the stomach and by which cell is produced HCl?

Answer 60

By parietal cells in the fundus

Question 61

What is the equivalent of Migrating Motor Complexes in cats ?

Answer 61

Migrating Spike complexes which are not initiated by motilin

Question 62

What are the two subunits of the cubam receptor of cobalamin ?

Answer 62

Amnionless (AMN) and cubilin (CUBN)

Question 63

What does recognize TLR-2 ?

Answer 63

LPS of gram- bacterias

Question 64

What does recognize TLR-5 ?

Answer 64

Flagellin

Question 65

What does recognize NOD2 ?

Answer 65

LPS

Question 66

What is the impact of depletion of Clostridium hiranonis in the digestive microbiome ?

Answer 66

Decreased secondary bile acids proportion in the colon

Question 67

What is the most sensitive test to detect Heterobilharzia Americana: fecal sedimentation or fecal PCR ?

Answer 67

Fecal PCR

Question 68

True or false: a progression from small cell intestinal lymphoma to large cell lymphoma has been reported in 10% of cats.

Answer 68

True

Question 69

True or false: in familial PLE/PLN of SCWT, the detection of Perinuclear antineutrophilic cytoplasmic autoantibodies (PANCA) allow for the detection of the syndrome 2 years before hypoalbuminemia

Answer 69

True

Question 70

What are the characteristics of the measurement of IgG anti gliadin and IgA anti transglutaminase 2 for the diagnosis of paroxysmal gluten-sensitive dyskinesia in Border Terrier ?

Answer 70

Highly specific but lack sensitivity

Question 71

What is the location of predilection of digestive adenomas/adenoK in dogs ? And in cats ?

Answer 71

Dogs: Large intestine then duodenum Cats: small intestine

Question 72

What do secrète enterochromaffin cells in the colon ?

Answer 72

Serotonin (5-HT) which stimulates the motility of the colon

Question 73

What form of Protothecosis is more frequent in dogs ? And in cats ?

Answer 73

Dogs: disseminated Cats: cutaneous

Question 74

How does the hepatocytes clear NH3 from portal blood ?

Answer 74

By conversion of NH3 in urea in periportal areas and conversion of glutamate in glutamine through hepatic sinusoides

Question 75

What other organ may also present cystic disease in Caroli's disease or Caroli's syndrom in dogs ?

Answer 75

The kidneys

Question 76

What are the main histologic abnormalities of congenital hepatic fibrosis ?

Answer 76

Periportal fibrosis and numerous small irregular bile ducts

Question 77

What is the half life of ALT in dogs and cats ?

Answer 77

Dogs: 40-61 hours Cats: 3.5 hours

Question 78

Name 3 causes of acute liver injury without increase in hepatocellular leakage enzymes due to inhibition of transcription.

Answer 78

Blue-green algae (Microcystis, Nodularia), Cycads and Aflatoxins

Question 79

What are the 3 most frequent etiologies of centrilobular necrosis in case of acute liver injury ?

Answer 79

Ischemic, toxic and viral

Question 80

Which Aflatoxin is the most hepatotoxic ?

Answer 80

B1 (vs B2, G1, G2)

Question 81

Who produces aflatoxins?

Answer 81

Aspergillus flavus and Aspergillus parasiticus

Question 82

In case of chronic cholangitis due to fluke infestation in cats, where are most concentrated the eggs ?

Answer 82

Bile (>feces)

Question 83

Name 2 risk factors for Domestic Cat Hepadnavirus viremia.

Answer 83

Retrovirus infection and increased ALT

Question 84

Which molecules are important for the function of the pancreatic lipase ?

Answer 84

Biliary acids and colipase

Question 85

What are the main pathophysiological processes of the development of pancreatitis in cats ?

Answer 85

- Autoactivation of trypsinogen or trypsinogen activation by cathepsin B, - Zymogens activation by thrombin, - Colocalisation of Zymogens and lysosomes - Enterokinases from portal blood or reflux Trypsinogen activation is the believed inciting event

Question 86

What are the main pathophysiological processes of the development of pancreatitis in cats ?

Answer 86

- Autoactivation of trypsinogen or trypsinogen activation by cathepsin B, - Zymogens activation by thrombin, - Colocalisation of Zymogens and lysosomes - Enterokinases from portal blood or reflux Trypsinogen activation is the believed inciting event

Question 87

Once incited, is pancreatic inflammation dependant on trypsin activation or NF-kappabeta pathway ?

Answer 87

NF-KAPPABETA pathway

Question 88

What is possibly the best biomarker (at least most specific) to detect persistent PSS after surgery?

Answer 88

Fasted NH3

Question 89

What does recognize NOD2?

Answer 89

Bacterias LPS

Question 90

What does recognize TLR-5 ?

Answer 90

Flagellin

Question 91

Which breeds with immerslund grasbeck have a mutation of the AMN gene?

Answer 91

Australian shepherd and Giant Schnauzer

Question 92

Which breeds with immerslund grasbeck have a mutation of the CUBN gene?

Answer 92

Beagle, Border Collie and Komondor