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ACVIM SAIM Specialty 2023 > Gastrointestinal/Hepatobiliary/Pancreatic > Flashcards

Gastrointestinal/Hepatobiliary/Pancreatic Flashcards

1
Q

Why can vegetarian diets lead to cobalamin deficiency?

A

Cobalamin is bound to animal dietary proteins - cannot be absorbed in this fashion and so needs to be further digested

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2
Q

Best clinical use of fecal alpha 1 protein?

A

To investigate GI loss for hypoalbuminemia. Must be collected under voluntary evacuation (NOT rectal) because the scraping of colonic wall can result in false positve

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3
Q

Good empirical antibiotics used for periodontal pathogens?

A

Metronidazole, clavamox, clindamycin

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4
Q

Normal lymph nodes should still be aspirated in cases of oral melanoma or squamous cell carcinoma. T/F?

A

True - tumors have very high metastatic rate

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5
Q

Difference in muscle layering of esophagus in dogs and cats?

A

Dogs - all striated muscle
cats - lower 1/3 is smooth muscle

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6
Q

What breeds are predisposed to inflammatory myopathies, of which dysphagia can be a clinical sign?

A

Boxers and Newfoundlands

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7
Q

Clinical signs associated with oropharyngeal dysphagia

A

Nasal regurgitation, transient apnea, gagging/retching associated with meals, dropping food while eating, swallow-related cough, recurrent aspiration

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8
Q

Breeds predisposed to cricopharyngeal dysphagia?

A

Springer and Cocker Spaniels

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9
Q

Levels of CK with focal or chronic myopathies?

A

Can range from normal to high

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10
Q

Benefits of swallow study in sternal vs lateral?

A

cervical esophageal transit is significantly delayed when dogs are in lateral recumbency. Swallow studies on dogs in sternal recumbency are significantly more likely to result in generation of primary peristaltic waves for both liquid and kibble boluses.

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11
Q

Most common cause of high grade esophagitis and stricture formation in dogs?

A

GE reflux under anesthesia

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12
Q

Persistent right aortic arch are more common in which breeds?

A

GSD and Irish Setters

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13
Q

Esophageal fibrosarcomas and osteosarcomas are common malignant tumors that result from malignant transformation from infection of what organism?

A

Spirocerca lupi

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14
Q

Congenital megaesophagus has been noted in which breeds?

A

Irish Setter, Great Dane, German Shepherd, Labrador Retriever,
Chinese Shar-Pei, Newfoundland, Miniature Schnauzer, and Fox Terrier breeds

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15
Q

Causes of gastro-esophageal reflux?

A

Things that weaken gastroesophageal barrier. Hiatal hernia, general anesthesia causing decreased lower esophageal tone, chronic vomiting (weakening tone), gastric atony

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16
Q

Which short chain fatty acid is major source of energy for colonocytes?

A

Butyrate

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17
Q

What contributes to gastric acid secretion?

A

Binding of histamine, gastrin, acetylcholine to parietal cells

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18
Q

Causes for elevated gastrin other than gastrinoma?

A

Using PPIs, liver or renal dysfunction

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19
Q

An upper GI obstruction will cause what pH change in the urine?

A

Aciduria (paradoxical; metabolic alkalosis from vomiting acid > H+ is exchanged for Na+ and H+ is excreted)

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20
Q

NSAID- associated ulcers are found in which part of the stomach (generally)?

A

Antrum

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21
Q

Atrophic gastritis has been associated with what breed?

A

Lundehund

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22
Q

Gastric hypertrophy (especially in fundus) has been associated with what breed?

A

Basenji (they can also get an enteropathy as well)

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23
Q

Atrophic gastritis in Lundehunds can precede development of what disease?

A

Gastric adenocarcinoma

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24
Q

Gastric carcinomas commonly occur where?

A

Lesser curvature and pylorus

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25
Q

Major food source for small intestinal enterocytes is what?

A

Glutamine

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26
Q

How are cats more predisposed to lose cobalamin?

A

Lack transcobalamin 1 and lose cobalamin through enterohepatic recycling

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27
Q

Irish Setters are predisposed to developing what type of enteropathy?

A

Gluten-sensitive enteropathy

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28
Q

Breeds predisposed to PLE?

A

Basenji, Lundehund, Rottweiler, Soft-coated Wheaten Terrier, Yorkshire Terrier, and Chinese Shar-Pei

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29
Q

Why is a positive on occult blood test not always significant?

A

Can detect dietary meat proteins. Really only has significance if patient has been eating meat-free or hydrolyzed diet for 72h (according to Ettinger)

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30
Q

Most hydrolyzed diets can resolve type _ immune hypersensitivities, but type _ hypersensivities are still possible.

A

Type I, Type IV

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31
Q

Histopath consistent with true antibiotic responsive diarrhea?

A

Normal or subtle changes

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32
Q

Antibiotic course for antibiotic responsive diarrhea?

A

4-6weeks initial therapy, but change after 2w if not working. Can stop to see persistent antibiotics are still required to manage disease as animals can “outgrow” antibiotics

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33
Q

Name three types of alimentary lymphoma that occur in cats and order from worse prognosis to best along with focal vs diffuse, T vs B vs both.

A

Large granular lymphoma - worse prognosis with MST of weeks to couple months with tx, generally focal, T cell ; intermediate/hi grade alimentary lymphoma - MST a little under year, generally focal, both; low grade alimentary lymphoma - MST 1-2 years, generally diffuse, T cell.

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34
Q

Canine GI adenocarcinomas metastasize generally to what organs?

A

Local lymph nodes and liver, carcinomatosis is also reported (can also go to testes, skin, other organs)

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35
Q

GISTs are known by their positive expression for which marker?

A

c-KIT (CD 117)

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36
Q

Paraneoplastic syndromes associated with leiomyosarcomas

A

Hypoglycemia (due to IGF-2), nephrogenic DI, erythrocytosis (due to production of EPO-like molecule)

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37
Q

Diagnosis of pseudo-obstruction requires histopathologic evaluation of what region?

A

Muscularis

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38
Q

Management of short bowel syndrome?

A

Fat and fiber restricted diet; supplement vitamins, +/- antibiotics or probiotics if suspect SIBO (from ileocolic valve resection), cholestyramine for bile salt binding, +/- PPI for hypergastrinemia due to imbalance of GI hormones from massive resection

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39
Q

Normal distended colonic thickness in ultrasound is less than or equal to

A

2 mm

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40
Q

Main adverse effect of sulfasalazine is

A

KCS

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41
Q

“Alabama rot” (cutaneous and renal glomerular vasculopathy) has been found associated with what organism?

A

E coli

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42
Q

Most common GI large intestinal tumor in dogs? In cats?

A

Adenocarcinoma. Still adenocarcinoma.

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43
Q

Differences in metastasis rates in colonic adenocarcinomas in cats vs dogs?

A

Cats are more metastatic (dogs not so much so). Siamese cats over-represented

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44
Q

Colonic lymphoma in cats tend to be B or T cell?

A

B

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45
Q

Rectal lymphoma in dogs responds well to chemotherapy. T/F?

A

True

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46
Q

Most common intussusception is

A

ileo-colic

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47
Q

Two pathologic mechanisms of megacolon and their causes?

A

Hypertrophic - obstructive
Dilated - electrolyte abnormalities, neuromuscular, idiopathic

Hypertrophic can progress to dilated if not addressed

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48
Q

Perianal adenomas are more commonly found in intact/castrated males and intact/spayed females.

A

Intact males, spayed females (androgen driven, estrogen suppressed)

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49
Q

Negative prognosticators for AGASACA?

A

Large tumor size, evidence of mets

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50
Q

Breeds over-represented for portal vein hypoplasia/microvascular dysplasia?

A

Maltese dogs, and Cairn and Yorkshire Terriers (also Dobermans)

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51
Q

Progressive vacuolar hepatopathy is linked with which breed? What disease can this predispose to?

A

Scottish Terrier, hepatic carcinoma

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52
Q

Clinical signs of superficial necrolytic dermatitis from hepatic disease can be found where on the body in dogs but not in cats?

A

Paw pads

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53
Q

Low protein content in ascites secondary to liver disease localizes to what type of portal hypertension (i.e. pre-hepatic, etc)

A

Pre-hepatic, pre-sinusoidal, sometimes sinusoidal

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54
Q

Why can anorexic cats with hepatic lipidosis develop hepatic encephalopathy more easily than dogs can?

A

Lack arginine (essential for detoxification process in urea cycle)

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55
Q

Blood samples left at room temperature for ammonia will result in a false increase/decrease

A

Increase

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56
Q

Which clotting factors are not strictly produced by liver?

A

vWF and Factor 8

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57
Q

Normal common bile duct size in dogs? Cats?

A

The common bile duct
can measure up to 3 mm in diameter in normal dogs and up to 4 mm in diameter in normal cats

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58
Q

Acute hemolytic crisis can be a rare manifestation of what type of liver disease?

A

Copper storage disease

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59
Q

Copper accumulation due to a primary storage disease will have copper accumulate in which zone of liver?

A

Zone 3/centrilobular

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60
Q

Most common organism in feline bile infections?

A

E coli

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61
Q

Duration of antibiotic treatment in cats with bacterial cholangiohepatitis.

A

At least 6 weeks

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62
Q

Most effective treatment for Platynosomum Infections in cats?

A

Praziquantel

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63
Q

What large dog breed is over-represented in portal vein hypoplasia?

A

Doberman pinschers (~1/4 of cases)

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64
Q

What breed can have a false positive ammonia test?

A

Irish Wolfhound

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65
Q

Between PT and PTT, which is more frequently elevated in dogs with chronic liver disease (and PSS)?

A

PTT (acute liver cases more often PT)

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66
Q

Below what fraction % is considered normal for scintigraphy in terms of blood that bypasses the liver?

A

<15%

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67
Q

Next steps if hyperammonic animal does not have PSS (based on imaging, bile acids)?

A

Urine metabolic screen for urea cycle metabolic abnormalities

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68
Q

Why is fresh blood preferred for transfusions in dogs with hepatic encephalopathy?

A

Stored blood has higher ammonia content

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69
Q

Prognostic indicators for medical management in dogs with congenital PSS (if sx not pursued)?

A

Higher BUN or older age at diagnosis = better prognosis

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70
Q

Two critical differences
between surgical PSS management in cats (compared with dogs)?

A

Higher perioperative complication rate and worse long-term outcomes (generally due to neurologic signs) - seizures, blindness; 37-60% (neurologic sequelae) following suture ligation, 8-77% following ameroid constrictor placement, and in
1/5 cats and 3/9 cats following use of cellophane banding

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71
Q

Most dogs that receive interventional or surgical treatment for hepatic arteriovenous malformation still require medical management. T/F?

A

True - up to 75% still require (generally due to persistent acquired shunting)

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72
Q

Return of bile acids to normal after PSS attenuation is correlated
with long-term outcome. T/F?

A

False - use biochemical parameters/clinical signs/medication weaning

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73
Q

Recommended treatment for cats with feline hepatic lipidosis and resulting hepatic encephalopathy?

A

Not protein restricted diet but more frequent /small amount fed and address any underlying inflammatory disease (according to Ettinger)

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74
Q

Two feline breeds associated with hepatic amyloidosis? Differences in clinical presentation?

A

Siamese - present for hepatic disease
Abyssinian - generally present with CKD (renal medulla more primarily involved than glomeruli)

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75
Q

Mechanism of action of colchinine?

A

Inhibits microtubule polymerization by binding to its constitutive protein, tubulin

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76
Q

The risk of ALT elevation secondary to CCNU in dogs is highest with which breed?

A

Boxers

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77
Q

What has been associated with decreasing the incidence and severity of hepatopathies associated with CCNU?

A

Denamarin

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78
Q

Most common antibiotic associated with idiosyncratic hepatotoxicosis?

A

Sulfonamides

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79
Q

Course of clinical signs associated with amanita poisoning in dogs?

A

Clinical signs of vomiting, bloody
diarrhea, and abdominal pain occur within 6 to 24 hours of ingestion, followed by severe hypoglycemia at 24
to 48 hours, caused by insulin release stimulated by alpha-amanitin. Finally, massive hepatic necrosis and
renal tubular necrosis develop after 36 to 84 hours

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80
Q

Different types of hepatic carcinomas in dogs and their risk for mets? Where do they met?

A

Massive (most common) - low risk
Diffuse and nodular - high risk
Met to regional LNs, peritoneum, lungs

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81
Q

Most common non-hematopoietic malignancy in cats?

A

Cholangiocarcinoma

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82
Q

Breeds that commonly develop gallstones?

A

Miniature schnauzers and miniature poodles

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83
Q

Emphysematous cholecystitis has been associated with what disease in the dog?

A

Diabetes mellitus

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84
Q

Antibiotics indicated for emphysematous cholecystitis?

A

FQ, metronidazole, chloramphenicol (reach bile, have anaerobic coverage)

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85
Q

Dog breed predispositions for gallbladder mucocele?

A

Shetland Sheepdog, Cocker spaniel, miniature schnauzer; Border Terrier (JVIM 2018), Affenpinscher, Bichon, Poms

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86
Q

Medical therapy for mucoceles has been successful with what concurrent disease?

A

Hypothyroidism

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87
Q

Dog breeds affected by pancreatic acinar atrophy leading to EPI

A

German Shepherd dogs, Rough-coated Collies, and Eurasians

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88
Q

Why is feeding low fat or high fiber diet in EPI discouraged?

A

Fat digestibility is impaired, so don’t want to restrict fat (ideally) or want to cause more problems with fat absorption (as with high fiber)

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89
Q

Alopecia in cats with hyperadrenocorticism vs exocrine pancreatic carcinoma can be differentiated in what way?

A

HAC cats have skin fragility. Biopsy results are very similar. Pancreatic carcinoma cats generally have ventrally distributed hair loss, with sometimes glossy appearing skin.

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90
Q

What was correlated with a longer duration of indwelling esophageal foreign body?

A

Severe esophagitis, need for feeding tube, major complications (JVECC 2019), NOT correlated with risk of death (JVIM 2017)…but JAVMA 2018 says that longer duration was so idk

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91
Q

Overall complication rate with esophageal foreign body removal?

A

About 22% - JVECC 2019

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92
Q

Which of the following was seen in the swallow study of normal dogs?
gastric reflux, esophageal retention, retrograde flow, bolus discohesion, all of the above

A

All of the above (JVIM 2017)

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93
Q

Gastric emptying times in healthy cats (tracked by scintigraphy or ultrasound) can be up to how long?

A

75% Gastric emptying time can be up to 5 hours (25% - 100 min) - JVIM 2017

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94
Q

Cats with gingivostomatitis also tended to have evidence of esophagitis. T/F?

A

True (JVIM 2017)

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95
Q

risk of stricture formation in survivors of esophageal foreign body removal?

A

2% (JVIM 2017)

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96
Q

Most common location of esophageal foreign body?

A

Distal esophagus - 49% of dogs (JVIM 2017)

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97
Q

What were minor and major complication rate in dogs/cats with B-tube?

A

58% minor; 17% major (JVIM 2018)

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98
Q

Characteristics of lower esophageal achalasia based on VFSS?

A

Megaesophagus (73%), baseline esophageal fluid line (68%), “bird-beak” (63%) ; latter two were exclusive to dogs with this disease JVIM 2019

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99
Q

Most common type of sliding hernia in cats?

A

Type 1 - 85% (JVIM 2019)

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100
Q

Complication rate associated with esophageal feeding tubes?

A

44% (JVIM 2019) - similar between dogs and cats

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101
Q

Brachycephaly was significantly associated with what variables on VFSS?

A

esophageal dysmotility, prolonged esophageal transit time, gastroesophageal reflux, and hiatal hernia (JVIM 2019)

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102
Q

Common bacterial agents associated with e-tube site infection in cats?

A

Enteroccoccus and E coli (JVIM 2019 - two papers)

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103
Q

What % of dogs improved after botulinum injection in dogs with lower esophageal achalasia?

A

100% (JVIM 2019)

104
Q

What % of healthy dogs had evidence of reflux detected based off of nuclear scintigraphy?

A

100% (12/12) - JVIM 2020

105
Q

Which of the following caused a delay in gastric emptying times in cats? Metoclopramide, erythromycin, exenatide

A

Exenatide (JVIM 2020)

106
Q

Complication and mortality rate associated with esophageal surgery in dogs and cats?

A

54% complication rate, 10% mortality (JAVMA 2016)

107
Q

On a study evaluating gastrointestinal motility and pH in dogs in hospital vs at home, what parameter was significantly prolonged in dogs at hospital?

A

Gastric emptying time (only parameter) - JAVMA 2017

108
Q

Overall mortality rate associated with esophageal foreign body removal?

A

~5% (JAVMA 2018, JVIM 2017)

109
Q

What were higher risk factors for esophageal perforation in foreign bodies?

A

Fish hook, longer time to presentation (JAVMA 2018)

110
Q

Dogs that received maropitant and metoclopramide were significantly less likely to have post-op clinical reflux than dogs that did not. T/F?

A

False - no effect. JAVMA 2019

111
Q

Median survival time of dogs with intestinal leiomyositis?

A

19 days with treatment (pro-kinetic, immunomodulatory) - JVIM 2016

112
Q

Neutrophilic IBD- especially with neutrophils near the mucosa, was associated with what pathogen in cats?

A

Campylobacter (JVIM 2016)

113
Q

Best method of handling endoscopic biopsy specimens (cucumber vs sponge vs free-floating)?

A

Free-floating (less artifact, wider specimens) - JVIM 2016

114
Q

Features associated with PLEs on histopath in dogs?

A

villous stunting, epithelial injury, crypt distension and lacteal dilation JVIM 2017

115
Q

What was occurrence of GE reflux in healthy cats undergoing anesthesia?

A

33% - JVIM 2017

116
Q

What % of dogs with inflammatory enteropathy were dietary responsive?

A

66% (JVIM 2017)

117
Q

Serum 3-BrY levels were more prevalent in food or steroid responsive enteropathies?

A

Steroid JVIM 2017

118
Q

positive anti-neutrophil cytoplasmic antibodies were significantly associated with food responsive or steroid responsive enteropathy?

A

food responsive (JVIM 2017)

119
Q

Dogs with IBD had what decreased numbers of which lymphocytes in blood stream compared to healthy dogs?

A

decreased percentages of TCRγδ+ T lymphocytes and CD21 positive B cells (JVIM 2017)

120
Q

Dogs with lower IBD tend to have lower abundance of what bacteria compared to healthy dogs (and is opposite of that found in humans)?

A

Fusobacteria (JVIM 2017 review)

121
Q

Which bacteria phylum tends to predominate in intestinal tracts of cats and dogs?

A

Firmicutes (JVIM 2017 review) [this includes clostridial and bacillus species]

122
Q

fecal calprotectin was higher in which of the following groups of disease? steroid responsive, food responsive, antibiotic responsive

A

Steroid responsive (JVIM 2018), SERUM calprotectin is not useful (JVIM 2018)

123
Q

Fecal transplant in parvo pups was associated with what?

A

faster resolution of diarrhea and shorter hospitalization time (JVIM 2018)

124
Q

Is serum citrulline a useful biomarker for enteropathy?

A

No (JVIM 2018)

125
Q

A relative increase in IL-1β may result in oclin expression (leading to inflammation) in which tissue?

A

Colonic mucosa (not duodenal) - JVIM 2018

126
Q

Serum concentrations of which amino acid was lower in dogs with PLE? How about with IBD?

A

Tryptophan (JVIM 2018); tryptophan, methionine, proline, serine (JVIM 2019)

127
Q

Cubulin mutations resulting in selective cobalamin malabsorption are present in which two breeds?

A

Beagles, Border collies (JVIM 2018)

128
Q

Which two spp of bacteria were more highly associated with feline small cell LSA than IBD?

A

Fusobacterium and Bacteroides spp (JVIM 2018)

129
Q

Name some medications that require acidic environment for absorption

A

antifungals- ketoconazole, itraconazole (not solution), voroconazole, pozaconazole; iron; mycophenolate; clopidogrel (consensus 2018)

130
Q

Which of the following has the most evidence for use of gastroprotectants?
- Coiled intrahepatic shunt dog
- IRIS Stage 3 CKD cat
- Critically ill septic dog
- Acute feline pancreatitis

A

Coiled IHPPS shunt (consensus 2018)

131
Q

apical sodium-dependent bile acid transporter (ASBT) expression increased or decreased in canine chronic enteropathy?

A

Decreased (JVIM 2018)

132
Q

What was the most prevalent adverse effect in using video endoscopy in dogs?

A

capsule retention. JVIM 2019 said happened in 2/19 dogs HOWEVER JVIM 2021 found that capsule retention was much higher - 15/39, with 13 of those oral administration (28 total received oral admin)

133
Q

What are the clinical pH goals in people to promote healing of gastric tissue injury?

A

pH>/= 3 for at least 75% of the time and >/= 4 for at least 67% of the time (JVIM 2019) - this is used to assess efficacy of gastroprotectants - famotidine CRI meets this criteria

134
Q

Do dogs with PLE/chronic enteropathy have lower 25-OHD levels? Did this correlate with outcome?

A

Yes, yes - JVIM 2019

135
Q

Which short chain fatty acids were decreased in chronic enteropathies compared to controls?

A

Acetate, propionate (not butyrate) - JVIM 2019

136
Q

GSDs with chronic enteropathy had lower levels of which two interleukins? (These are generally associated with Th2)

A

IL-13 and IL-33

137
Q

Presence of ultrasonographic lesions within the submucosal and muscularis was predictive of histologic disease in cats with GI disease. T/F?

A

False - only true for mucosal layer (JVIM 2019).
However ultrasound WAS predictive of histologic disease in general

138
Q

Major bile acids in the dog?

A

Cholic acid and chenodeoxycholic acid

139
Q

An altered dysbiosis index may not resolve in dogs with steroid responsive enteropathy despite improvement in signs. T/F?

A

True JVIM 2019

140
Q

What bacteria is primarily responsible for changing primary bile acids into secondary bile acids?

A

Clostridium hiranonis

141
Q

Breeds associated with primary intestinal lymphangiectasia?

A

SCWT, Norwegian Lundehund, Yorkshire Terriers, Maltese, Shar-pei

142
Q

Was contrast enhanced ultrasonography helpful in differentiating LSA vs IBD in dogs? How for IBD vs normal dogs?

A

No (JVIM 2019). Yes for IBD JVIM 2021

143
Q

Dogs with C perfringens associated diarrhea had higher prevalence of which two toxin genes compared to parvo or healthy dogs?

A

Net E and Net F. Note that cpa gene prevalence was similar in all groups (meaning that C perfringens was similarly prevalent) - JVIM 2019

144
Q

Ki-67/CD3 ratio was increased or decreased in dogs with CIE?

A

Increased JVIM 2020

145
Q

What was accuracy of histology-guided mass spectrometry in differentiating small cell LSA and chronic enteropathy in cats?

A

89% (compare to 60% for clonality) - JVIM 2020

146
Q

Which two treatments were superior to IV pantoprazole in terms of achieving human pH standards in the first 72h of treatment?

A

Famotidine CRI, esomeprazole (JVIM 2020)

147
Q

Did histopath identify lesions at perforation site in perforations associated with lower endoscopy?

A

No - JVIM 2020

148
Q

Auto-antibodies against what were most useful discriminating dogs with IBD and healthy controls?

A

E coli ompC (this was the best one) and autoantibodies to polymorphonuclear leukocytes (APMNA) JVIM 2020

149
Q

Fusobacteria levels in microbiome were decreased even long-term (4 weeks to 2 months) following discontinuation of both metronidazole and tylosin, respectively. T/F?

A

True (JVIM 2020, 2019)

150
Q

Gastric thickness correlates with decreased albumin. T/F?

A

False JVIM 2020

151
Q

Oral esomeprazole was superior to dexlansopromezole and lansopromeprazole in healthy cats. T/F?

A

True JVIM 2020

152
Q

What percentage of dogs with E coli-associated granulomatous colitis had FQ-resistant profiles?

A

Around 63% or 15/24 (JVIM 2020)

153
Q

What % of large intestinal biopsies were classified as lymphoma with histopath alone?

A

1/44 (JVIM 2021)

154
Q

Why are fecal cultures not helpful for chronic enteropathy?

A

Did not distinguish between healthy and diseased and there is a high level of interlab variability. JVIM 2021

155
Q

What % of dogs chronically treated with NSAIDs had gastric erosions?

A

~83% (10 dogs)

156
Q

What % of dogs with CE were hypercoagulable?

A

17/38 (~44%). No difference between dogs with higher albumin concentration vs lower albumin (JVIM 2021)

157
Q

pSTAT3 correlates with CCECAI in both epithelial and crypt regions. T/F?

A

True (JVIM 2021)

158
Q

What % of dogs with PLE that had feeding tube placed within 5d of biopsy had positive outcome?

A

76% (16/21) - JVIM 2021

159
Q

Were concentrations of high mobility box 1 protein higher in IBD dogs vs normal dogs?

A

Yes (JVIM 2021)

160
Q

Was monoclonality of lymphocytes a foolproof way to distinguish IBD vs low grade T cell LSA in cats?

A

No - JVIM 2021. 100% of low grade T cell lymphoma had monomorphic T cell populations but 70% of LPE cases featured monoclonality (40%) or monoclonality on a polyclonal background (30%). However all LSA cases were CD3+ pSTAT3− and pSTAT5+.

161
Q

What ultrasound findings were more consistent with low grade T cell LSA cats?

A

rounded jejunal lymph node, and the presence of (albeit small volume) abdominal effusion - JVIM 2021

162
Q

What conditions were associated with canine gastroduodenal ulceration or erosion?

A

NSAID, glucocorticoids, GI neoplasia, GI mechanical disease (JVIM 2021)

163
Q

What % of rectal masses are epithelial neoplasms?

A

90% (most benign) - JAVMA 2017. No lesions were seen beyond colorectal junction

164
Q

A dog is treated for acute GI disease (diarrhea) at rDVM, but presents 1 day later with acute erythroderma. What is your treatment?

A

Drug withdrawal (metronidazole, antibiotic), anti-histamines, steroids (JAVMA 2017)

165
Q

Crude fiber generally under or over estimates total fiber?

A

Underestimates. Especially soluble fiber.

166
Q

Most common food allergens in dogs? Cats?

A

Dogs - beef, dairy, wheat
Cats - beef, dairy, fish

167
Q

Most common underlying diagnosis for chyloabdomen in dogs and cats?

A

Malignant neoplasia - (45% cats, 53% dogs with malignant neoplasia in general or 13% cats, 6% dogs with disseminated carcinomatosis).

Other etiologies - cardiac disease, lymphangiectasia, pancreatitis.

MST about a month (8d for neoplasia, 70d for non-neoplasia) - JAVMA 2018

168
Q

Dehiscence rate in full thickness large intestinal incisions?

A

10%(JAVMA 2019)

169
Q

Characteristics of pyloroduodenal polyp in cats?

A

Homogeneous echogenic nodule filling lumen, no change in wall layering; can still result in severe signs! (GI bleed, obstruction) - JFMS 2017

170
Q

Intussusceptions in cats <1 year generally associated with what?

A

Idiopathic. If > 6, generally associated with LSA/IBD. JFMS 2019

171
Q

Lymphofollicular hyperplasia in cases with and without chronic gastritis were associated with what clinical sign and breed?

A

Inspiratory dyspnea, brachycephalic (JAVMA 2020)

172
Q

At least 7/10 surviving dogs with gastroesophageal intussusceptions had what persistent clinical sign following correction?

A

Regurgitation (managed with feedings) - JAVMA 2020

173
Q

What was constipation recurrence rate of cats that received subtotal colectomy for idiopathic megacolon? What was median time that this occurred?

A

32% (24/74) - generally occurred around 344d (~1 year). Median survival time not reached. JAVMA 2021 [overall saying that subtotal colectomy has good survival time and outcome]

174
Q

Risk factors for increased risk of constipation in cats?

A

Older, overweight, CKD, previous episodes of constipation (JFMS 2020)

175
Q

Of canned hydrolyzed, canned gastroenteric, dry hydrolyzed, dry gastroenteric - which had the highest likelihood of causing false positive fecal occult blood test?

A

Canned gastroenteric (JFMS 2020)

176
Q

Serum haptoglobin could differentiate between IBD and small cell LSA cats. T/F?

A

False -they were both higher than controls but not different in comparison to one another (JFMS 2021)

177
Q

Histopathologic disease can be found in duodenum, pancreas, and gallbladder in asymptomatic cats. T/F?

A

True - JVIM 2016. but only call triaditis if there is severe IBD with clinical signs

178
Q

PCR for Giardia was negative of what % of ones that were positive based on fecal or IFA in a study evaluating enteropathogens in dog parks?

A

41% of positives were negative on PCR (JVIM 2016)

179
Q

Administration of symbiotic decreases incidence of antibiotic associated diarrhea (clindamycin) in healthy research cats. T/F?

A

False. Decreased hyporexia and vomting butnot diarrhea. (JVIM 2017)

180
Q

What breed of dog can have increased MMA concentrations with normal cobalamin levels?

A

Border Collie (JVIM 2020 review)

181
Q

Normal puppies can have evidence of “dysbiosis” (increased Dysbiosis Index, increased abundance of C. difficile, decreased secondary bile acid concentrations, and decreased abundance of C. hiranonis) up to how many weeks of age?

A

5-6w (JVIM 2020)

182
Q

Indications of cellular deficiency for cobalamin?

A

Homocysteine, methylmalonic acid (JVIM 2020 review)

183
Q

Lack of AUS findings in liver or pancreas in a cat with GI signs reliably predicts lack of histo findings. T/F?

A

False - AUS insensitive but specific for liver, sensitive but not specific for pancreas findings (JFMS 2016)

184
Q

Top 2 concurrent conditions associated with hypocholesterolemia in cats?

A

GI (25%), hepatobiliary (19%) JFMS 2020

185
Q

Breeds most likely to have congenital shunt?

A

Havanese, Yorkshire Terrier, Maltese, Dandy Dinmont Terrier, Pug, Miniature Schnauzer, Standard Schnauzer, and Shi Tzu (in descending order of likelihood)

186
Q

5 reasons why lactulose helps in hepatic encephalopathy

A

(i) trapping of ammonium ions within the colon leading to decreased absorption of ammonia into the portal circulation; (ii) inhibition of ammonia production by colonic bacteria; (iii) stimulation of incorporation of ammonia within bacterial proteins; (iv) reduced intestinal transit times leading to decreased bacterial ammonia release; and (v) increased fecal excretion of nitrogenous compounds

187
Q

Prevalence of asymptomatic biliary sludge in dogs over 4 year?

A

57% (JVIM 2016)

188
Q

Best way to look for fluke eggs if you are concerned for fluke cholangitis in a cat?

A

Bile (JVIM 2016)

189
Q

Most common bacteria isolated in canine bacterial cholangitis?

A

E. coli, Enterococcus (JVIM 2016)

190
Q

Dogs with gallbladder mucoceles have serum leptins that were higher/lower/the same as control dogs.

A

Higher (JVIM 2017)

191
Q

Dogs with chronic hepatitis have endothelin-1 levels that were higher/lower/the same as control dogs.

A

Higher (JVIM 2017)

192
Q

Washout ratios of perflubutane microbubbles of < 37.1% was how sensitive and specific for diagnosis of chronic hepatitis in dogs?

A

100% sensitive, 85% specific (JVIM 2017)

193
Q

What was sensitivity of ALT to detect chronic hepatitis in a group of labradors?

A

71% (JVIM 2017)

194
Q

Organize PV/Ao ratio in the following from highest to lowest- EH-PSS, portal vein hypoplasia, normal dog, chronic hepatitis

A

CH, normal, PVPH, EHPSS (JVIm 2017)

195
Q

What was the sensitivity and specificity of an abnormal gall bladder ultrasound for positive bacterial culture in cats?

A

96% sensitive, 49% specific in cats
(In dogs - 81% sens in dogs, 31% specifics) JVIM 2017

196
Q

Anti-histone autoantibodies were detected in how many normal Dobermans compared to those with hepatitis?

A

None. But found in 92% of dogs in subclinical stage and 84.6% of dogs in clinical stage JVIM 2017

197
Q

What is the main producer of the ECM matrix in the pathogenesis of hepatic fibrosis?

A

Hepatic stellate cells (JVIM 2018 review)

198
Q

Most dogs have neutrophilic or lymphocytic cholangitis?

A

Neutrophlic (53/54) - JVIM 2018

199
Q

Gallbladder agenesis was most common in what breed of dog, and was associated with what condition?

A

Chihuahua; ductal plate malformation (JVIM 2018)

200
Q

Sensitivity/specificity for u/s to detect GB rupture in dogs?

A

Sensitivity 56%, specificity 91.7% - JVIM 2018

201
Q

Breeds predisposed to Cu hepatopathy?

A

Labrador Retriever, Doberman, WHWT, Dalmatian, Bedlington- JVIM 2018

202
Q

microRNA-122 was what sens/spec for detecting liver disease?

A

sens 77%, spec 97% - JVIM 2018. Another JVIM 2019 confirmed this in chronic hepatitis labs (alongside microRNA 29a).

203
Q

Of the following: Clinical score, ascites, hypoAlb, hyperBili, prolonged coag time, dose and duration of tx; which were associated with remission with cyclosporine use for canine idiopathic chronic hepatitis?

A

None - JVIM 2019

204
Q

What values were associated with decreased survival in dogs with GBM?

A

Increased Cr and hyperphosphatemia JVIM 2019

205
Q

Mutation of which ATP7ases are associated with copper storage diseases in Dobermans? In Labs?

A

Dobermans - ATP7B mutations result in higher Cu

other breeds with copper tox do not necessarily have this mutation (such as Keeshond, Bedlington)

Labs - ATP7A mutations result in lower Cu (JVIM 2019) (labs can also have ATP7b mutation!)

206
Q

Granulomatous hepatitis is associated with which two pathogens?

A

Leptospirosis, Leishmaniasis (JVIM 2019 consensus)

207
Q

alpha-1 antitrypsin (AAT) deficiency is reported in which breeds as a metabolic cause for canine chronic hepatitis?

A

American and English Cocker Spaniels (JVIM 2019 consensus)

208
Q

What is best screening test currently available for early detection of chronic hepatitis (CH)?

A

Unexplained increase in ALT > 2 months (JVIM 2019 consensus)

209
Q

What is a complication that can occur in a dog with known chronic hepatitis and presents with presence of ascites, abdominal pain, and thrombocytopenia?

A

Portal vein thrombosis (2019 consensus)

210
Q

What parameters make a patient high risk for liver biopsy?

A

PT/PTT > 1.5× the upper limit of normal, platelets < 50 000/uL, fibrinogen concentration <100 μg/dL, and/or PCV < 30% (also BMBT > 5 min or vWF < 50%) (2019 consensus)

211
Q

Recommended # of liver biopsy sampling?

A

5 laparoscopic or surgical biopsies from at least 2 liver lobes should be obtained for histopathology (3), aerobic/anaerobic culture (1) and quantitative copper analysis (1) (2019 consensus)

212
Q

Can zinc and D-penicillamine be given together? Why or why not?

A

No- their benefits negate each other

213
Q

What hepatic histopath diagnosis is associated with shorter survival time?

A

Survival times with a diagnosis of cirrhosis or lobular dissecting hepatitis (LDH) are short (1-2 months). - Consensus 2019

214
Q

What is another agent that could be used for Cu chelation besides D-pen, Trientene, zinc?

A

Ammonium tetrathiomolybdate (JVIM 2019)

215
Q

Most common cause of death in cats with EHPSS correction?

A

Seizures (JVIM 2019) [4/6 deaths - total 34 cats]

216
Q

In dogs with acquired shunts, plasma aldosterone concentrations were higher in which groups (chronic hepatitis, portal vein hypoplasia, EHPSS, healthy)?

A

Chronic hepatitis and PVH (JVIM 2020) (meaning spirinolactone may not be helpful only for ascites alone?)

217
Q

What was the incidence of major hemorrhage in dogs that underwent ultrasounded guided liver biopsy?

A

42% (JVIM 2020) - but complication rate was very low

218
Q

Severely elevated bile acids can also be found in dogs with cirrhosis and cholangitis. T/F?

A

True (JVIM 2021)

219
Q

What is another ddx for gallbladder wall edema besides anaphylaxis?

A

Cardiac disease - JVIM 2021 (gallbladder wall thickening can be associated with dexmed - JVIM 2021)

220
Q

Plasma amino acid profiles in dogs with closed extrahepatic portosystemic shunts should also completely resolve 3 mo post surgery. T/F?

A

False - partially improved despite neurological improvement (JVIM 2021)

221
Q

Dogs with GB mucoceles tend to be hyper, hypo, or normocoag based on TEG?

A

Hyper (JVIM 2021)

222
Q

What CBC variable may accompany dogs with higher hepatic lead concentrations?

A

microcytosis JVIM 2021

223
Q

A dilated cystic duct was found to be associated with what in healthy cats?

A

Reflux of pancreatic juices (JVIM 2021)

224
Q

What % of cats survived to discharge for choledochal stenting for EHBO?

A

78% (18 cats) - JVIM 2021

225
Q

What % of dogs with choledocholiths were found to be symptomatic?

A

100% (JVIM 2021)

226
Q

What was sensitivity/specificity of serum lidocaine/monoethylglycylxylidide concentration to assess closure of EHPSS?

A

Sensitivity 96.2% and specificity 82.8% ((JVIM 2021)

227
Q

What was mortality rate in cholecystectomy in a dogs with biliary disease in elect vs non-elect procedures?

A

2% in elective group and 20% in non-elective group - JAVMA 2018

228
Q

Most common CBC abnormality in cats with EHPSS shunts?

A

Microcytosis - JFMS 2017

229
Q

Survival rate of cats with hepatic lipidosis and acute pancreatitis?

A

20% (JFMS 2018 review)

230
Q

Serum cholesterol and TG were not different between controls and cats with hepatic lipidosis. T/F?

A

True (JFMS 2019) - but lipoprotein profiles were different [Low density were higher; high density were lower in hepatic lipidosis]

231
Q

Incidence of non-lethal bleeding complications in cats that underwent hepatic FNA?

A

16.7% (43% had minor bleeding, 56% had major bleeding) - JFMS 2019

232
Q

Spectroscopic-spectrometric analysis of hepatic biopsy specimens commonly overestimated the concentration obtained by digital image analysis of rhodanine-stained sections in dogs. T/F?

A

False. They under-estimated. JAVMA 2021

233
Q

Congenital peritoneopericardial diaphragmatic hernia or congenital central diaphragmatic hernia were commonly correlated with what other liver abnormality?

A

Ductal plate malformation (JAVMA 2021)

234
Q

Primary copper hepatopathy was associated with what gene mutation in some cats?

A

ATP7B (JFMS 2020)

235
Q

Increase in what biochemical liver parameter was associated with higher likelihood of hypocoagulability in cats with cholestatic disease?

A

ALP (JFMS 2021)

236
Q

What % of cat liver biopsy specimens were above the Cu reference interval?

A

31% (JFMS2021) - showing that the Cu reference range for cats may need to be altered

237
Q

specfPL and DGGRlipase performed similarly in diagnosing cats with pancreatitis confirmed with standardized evaluation of histopath. T/F?

A

True - both were NOT sensitive, but 100% specific JVIM 2016

238
Q

Elevated cPLI can be found in both acute pancreatitis and pancreatic neoplasms in dogs. T/F?

A

True- JVIM 2020

239
Q

Which marker was associated with mortality in dogs with acute pancreatitis?
ADMA, CRP, bands, CAPS [ canine acute pancreatitis severity]

A

ADMA - JVIM 2020

240
Q

Significant DGGR-hyperlipasemia is frequent in critically ill dogs and generally not associated with pancreatitis. T/F?

A

True - only 17% of dogs with elevated numbers had acute pancreatitis - JVIM 2020

241
Q

Most common sign associated with feline EPI?

A

weight loss (91%) - JVIM 2016

242
Q

What vitamins were still low in dogs with EPI despite enzyme replacement therapy?

A

Vitamin A, E (JVIM 2018)

243
Q

Gastric wall layer thickening/edema can occur in dogs with acute pancreatitis, even up to loss of wall layering. T/F?

A

True - JVIM 2019

244
Q

What were 4 independent risk factors for death associated with canine acute pancreatitis?

A

presence of systemic inflammatory response syndrome, coagulation disorders, increased creatinine and ionized hypocalcemia. JVIM 2019

245
Q

Most dogs with acute pancreatitis had normal triglycerides and cholesterol levels but different serum lipoprotein profiles. T/F?

A

True - JVIM 2020 Dogs with pancreatitis had higher low-density lipoprotein fractions and lower triglyceride-rich lipoprotein and high-density lipoprotein fractions than healthy dogs

246
Q

SpecFPL is more likely to have a false negative than a false positive. T/F?

A

True (this is opposite of dogs) - JVIM 2020

247
Q

What was survival rate of dogs that had EHBO from pancreatitis? Was there a difference in median bile duct dilatation or bilirubin in survivors vs nonsurvivors?

A

79%, no - JVIM 2020

248
Q

Of antithrombin, CRP, IL-6, and TNF-α - which was correlated with nonsurvivors vs survivors in canine pancreatitis?

A

Lower antithrombin activity (and higher CAP score) was correlated with nonsurvivors JVIM 2020. Other variables listed are significantly higher in acute pancreatitis compared to healthy dogs

249
Q

What type of test for pancreatitis is Precision PSL?

A

DGGR lipase assay - not specific for pancreatic lipase

250
Q

In 2018 study, what was the level of agreement between SNAP cPL, Spec cPL, VetScan cPL Rapid Test, and Precision PSL Assays in assessing for clinical pancreatitis?

A

Good to excellent agreement between all tests (JVIM 2018)

251
Q

what % of grey zone specfPLs had a normal snapFPL?

A

75% (JFMS 2019) - however, overall snap and spec fPL had very good agreement (97.5%) when snap fPL was negative. 90% agreement when snap was positive.

252
Q

Which would be detected first for evidence of pancreatitis - cPLI or AUS?

A

cPLI JAVMA 2021. so a dog with severely elevated cPLI but AUS normal may develop AUS signs later

253
Q

Which of the following is not a precipitating factor for hepatic encephalopathy?
- Hyponatremia and hypokalemia
- Acidosis
- Diuretic
- Azotemia

A

Acidosis (alkalosis is though)

254
Q

Sensitivity of CT or AUS to detect nonperforated ulcer compared to radiograph?

A

Around 2/3 compared to like 30% or so. If perforated, sensitivity is much better (like 70s for rads, 80s for AUS, and 90s for CT) - JSAP 2017

255
Q

What was sensitivity and specificity of ultrasound to detect canine acute pancreatitis using one ultrasonographic variable (pancreatic enlargement, echogenicity, or altered mesenteric echogenicity) vs including all 3?

A

Se/Sp - 89,43 compared to 43/92 (JVIM2020). Aka cannot use aus alone

256
Q

CKD cats on once daily omeprazole had what improvement over cats without omeprazole.

A

2.7% increase in food consumption, but no change in body weight or appetite score - ultimately the difference - albeit significant statistically - was negligible JVIM 2021

ACVIM SAIM Specialty 2023 (12 decks)

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