Gastrointestinal/Hepatobiliary/Pancreatic Flashcards
(256 cards)
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
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
3
Q
Good empirical antibiotics used for periodontal pathogens?
A
Metronidazole, clavamox, clindamycin
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
5
Q
Difference in muscle layering of esophagus in dogs and cats?
A
Dogs - all striated muscle
cats - lower 1/3 is smooth muscle
6
Q
What breeds are predisposed to inflammatory myopathies, of which dysphagia can be a clinical sign?
A
Boxers and Newfoundlands
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
8
Q
Breeds predisposed to cricopharyngeal dysphagia?
A
Springer and Cocker Spaniels
9
Q
Levels of CK with focal or chronic myopathies?
A
Can range from normal to high
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.
11
Q
Most common cause of high grade esophagitis and stricture formation in dogs?
A
GE reflux under anesthesia
12
Q
Persistent right aortic arch are more common in which breeds?
A
GSD and Irish Setters
13
Q
Esophageal fibrosarcomas and osteosarcomas are common malignant tumors that result from malignant transformation from infection of what organism?
A
Spirocerca lupi
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
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
16
Q
Which short chain fatty acid is major source of energy for colonocytes?
A
Butyrate
17
Q
What contributes to gastric acid secretion?
A
Binding of histamine, gastrin, acetylcholine to parietal cells
18
Q
Causes for elevated gastrin other than gastrinoma?
A
Using PPIs, liver or renal dysfunction
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)
20
Q
NSAID- associated ulcers are found in which part of the stomach (generally)?
A
Antrum
21
Q
Atrophic gastritis has been associated with what breed?
A
Lundehund
22
Q
Gastric hypertrophy (especially in fundus) has been associated with what breed?
A
Basenji (they can also get an enteropathy as well)
23
Q
Atrophic gastritis in Lundehunds can precede development of what disease?
A
Gastric adenocarcinoma
24
Q
Gastric carcinomas commonly occur where?
A
Lesser curvature and pylorus
25
Major food source for small intestinal enterocytes is what?
Glutamine
26
How are cats more predisposed to lose cobalamin?
Lack transcobalamin 1 and lose cobalamin through enterohepatic recycling
27
Irish Setters are predisposed to developing what type of enteropathy?
Gluten-sensitive enteropathy
28
Breeds predisposed to PLE?
Basenji, Lundehund, Rottweiler, Soft-coated Wheaten Terrier, Yorkshire Terrier, and Chinese Shar-Pei
29
Why is a positive on occult blood test not always significant?
Can detect dietary meat proteins. Really only has significance if patient has been eating meat-free or hydrolyzed diet for 72h (according to Ettinger)
30
Most hydrolyzed diets can resolve type _ immune hypersensitivities, but type _ hypersensivities are still possible.
Type I, Type IV
31
Histopath consistent with true antibiotic responsive diarrhea?
Normal or subtle changes
32
Antibiotic course for antibiotic responsive diarrhea?
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
33
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.
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.
34
Canine GI adenocarcinomas metastasize generally to what organs?
Local lymph nodes and liver, carcinomatosis is also reported (can also go to testes, skin, other organs)
35
GISTs are known by their positive expression for which marker?
c-KIT (CD 117)
36
Paraneoplastic syndromes associated with leiomyosarcomas
Hypoglycemia (due to IGF-2), nephrogenic DI, erythrocytosis (due to production of EPO-like molecule)
37
Diagnosis of pseudo-obstruction requires histopathologic evaluation of what region?
Muscularis
38
Management of short bowel syndrome?
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
39
Normal distended colonic thickness in ultrasound is less than or equal to
2 mm
40
Main adverse effect of sulfasalazine is
KCS
41
"Alabama rot" (cutaneous and renal glomerular vasculopathy) has been found associated with what organism?
E coli
42
Most common GI large intestinal tumor in dogs? In cats?
Adenocarcinoma. Still adenocarcinoma.
43
Differences in metastasis rates in colonic adenocarcinomas in cats vs dogs?
Cats are more metastatic (dogs not so much so). Siamese cats over-represented
44
Colonic lymphoma in cats tend to be B or T cell?
B
45
Rectal lymphoma in dogs responds well to chemotherapy. T/F?
True
46
Most common intussusception is
ileo-colic
47
Two pathologic mechanisms of megacolon and their causes?
Hypertrophic - obstructive
Dilated - electrolyte abnormalities, neuromuscular, idiopathic
Hypertrophic can progress to dilated if not addressed
48
Perianal adenomas are more commonly found in intact/castrated males and intact/spayed females.
Intact males, spayed females (androgen driven, estrogen suppressed)
49
Negative prognosticators for AGASACA?
Large tumor size, evidence of mets
50
Breeds over-represented for portal vein hypoplasia/microvascular dysplasia?
Maltese dogs, and Cairn and Yorkshire Terriers (also Dobermans)
51
Progressive vacuolar hepatopathy is linked with which breed? What disease can this predispose to?
Scottish Terrier, hepatic carcinoma
52
Clinical signs of superficial necrolytic dermatitis from hepatic disease can be found where on the body in dogs but not in cats?
Paw pads
53
Low protein content in ascites secondary to liver disease localizes to what type of portal hypertension (i.e. pre-hepatic, etc)
Pre-hepatic, pre-sinusoidal, sometimes sinusoidal
54
Why can anorexic cats with hepatic lipidosis develop hepatic encephalopathy more easily than dogs can?
Lack arginine (essential for detoxification process in urea cycle)
55
Blood samples left at room temperature for ammonia will result in a false increase/decrease
Increase
56
Which clotting factors are not strictly produced by liver?
vWF and Factor 8
57
Normal common bile duct size in dogs? Cats?
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
58
Acute hemolytic crisis can be a rare manifestation of what type of liver disease?
Copper storage disease
59
Copper accumulation due to a primary storage disease will have copper accumulate in which zone of liver?
Zone 3/centrilobular
60
Most common organism in feline bile infections?
E coli
61
Duration of antibiotic treatment in cats with bacterial cholangiohepatitis.
At least 6 weeks
62
Most effective treatment for Platynosomum Infections in cats?
Praziquantel
63
What large dog breed is over-represented in portal vein hypoplasia?
Doberman pinschers (~1/4 of cases)
64
What breed can have a false positive ammonia test?
Irish Wolfhound
65
Between PT and PTT, which is more frequently elevated in dogs with chronic liver disease (and PSS)?
PTT (acute liver cases more often PT)
66
Below what fraction % is considered normal for scintigraphy in terms of blood that bypasses the liver?
<15%
67
Next steps if hyperammonic animal does not have PSS (based on imaging, bile acids)?
Urine metabolic screen for urea cycle metabolic abnormalities
68
Why is fresh blood preferred for transfusions in dogs with hepatic encephalopathy?
Stored blood has higher ammonia content
69
Prognostic indicators for medical management in dogs with congenital PSS (if sx not pursued)?
Higher BUN or older age at diagnosis = better prognosis
70
Two critical differences
between surgical PSS management in cats (compared with dogs)?
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
71
Most dogs that receive interventional or surgical treatment for hepatic arteriovenous malformation still require medical management. T/F?
True - up to 75% still require (generally due to persistent acquired shunting)
72
Return of bile acids to normal after PSS attenuation is correlated
with long-term outcome. T/F?
False - use biochemical parameters/clinical signs/medication weaning
73
Recommended treatment for cats with feline hepatic lipidosis and resulting hepatic encephalopathy?
Not protein restricted diet but more frequent /small amount fed and address any underlying inflammatory disease (according to Ettinger)
74
Two feline breeds associated with hepatic amyloidosis? Differences in clinical presentation?
Siamese - present for hepatic disease
Abyssinian - generally present with CKD (renal medulla more primarily involved than glomeruli)
75
Mechanism of action of colchinine?
Inhibits microtubule polymerization by binding to its constitutive protein, tubulin
76
The risk of ALT elevation secondary to CCNU in dogs is highest with which breed?
Boxers
77
What has been associated with decreasing the incidence and severity of hepatopathies associated with CCNU?
Denamarin
78
Most common antibiotic associated with idiosyncratic hepatotoxicosis?
Sulfonamides
79
Course of clinical signs associated with amanita poisoning in dogs?
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
80
Different types of hepatic carcinomas in dogs and their risk for mets? Where do they met?
Massive (most common) - low risk
Diffuse and nodular - high risk
Met to regional LNs, peritoneum, lungs
81
Most common non-hematopoietic malignancy in cats?
Cholangiocarcinoma
82
Breeds that commonly develop gallstones?
Miniature schnauzers and miniature poodles
83
Emphysematous cholecystitis has been associated with what disease in the dog?
Diabetes mellitus
84
Antibiotics indicated for emphysematous cholecystitis?
FQ, metronidazole, chloramphenicol (reach bile, have anaerobic coverage)
85
Dog breed predispositions for gallbladder mucocele?
Shetland Sheepdog, Cocker spaniel, miniature schnauzer; Border Terrier (JVIM 2018), Affenpinscher, Bichon, Poms
86
Medical therapy for mucoceles has been successful with what concurrent disease?
Hypothyroidism
87
Dog breeds affected by pancreatic acinar atrophy leading to EPI
German Shepherd dogs, Rough-coated Collies, and Eurasians
88
Why is feeding low fat or high fiber diet in EPI discouraged?
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)
89
Alopecia in cats with hyperadrenocorticism vs exocrine pancreatic carcinoma can be differentiated in what way?
HAC cats have skin fragility. Biopsy results are very similar. Pancreatic carcinoma cats generally have ventrally distributed hair loss, with sometimes glossy appearing skin.
90
What was correlated with a longer duration of indwelling esophageal foreign body?
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
91
Overall complication rate with esophageal foreign body removal?
About 22% - JVECC 2019
92
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
All of the above (JVIM 2017)
93
Gastric emptying times in healthy cats (tracked by scintigraphy or ultrasound) can be up to how long?
75% Gastric emptying time can be up to 5 hours (25% - 100 min) - JVIM 2017
94
Cats with gingivostomatitis also tended to have evidence of esophagitis. T/F?
True (JVIM 2017)
95
risk of stricture formation in survivors of esophageal foreign body removal?
2% (JVIM 2017)
96
Most common location of esophageal foreign body?
Distal esophagus - 49% of dogs (JVIM 2017)
97
What were minor and major complication rate in dogs/cats with B-tube?
58% minor; 17% major (JVIM 2018)
98
Characteristics of lower esophageal achalasia based on VFSS?
Megaesophagus (73%), baseline esophageal fluid line (68%), "bird-beak" (63%) ; latter two were exclusive to dogs with this disease JVIM 2019
99
Most common type of sliding hernia in cats?
Type 1 - 85% (JVIM 2019)
100
Complication rate associated with esophageal feeding tubes?
44% (JVIM 2019) - similar between dogs and cats
101
Brachycephaly was significantly associated with what variables on VFSS?
esophageal dysmotility, prolonged esophageal transit time, gastroesophageal reflux, and hiatal hernia (JVIM 2019)
102
Common bacterial agents associated with e-tube site infection in cats?
Enteroccoccus and E coli (JVIM 2019 - two papers)
103
What % of dogs improved after botulinum injection in dogs with lower esophageal achalasia?
100% (JVIM 2019)
104
What % of healthy dogs had evidence of reflux detected based off of nuclear scintigraphy?
100% (12/12) - JVIM 2020
105
Which of the following caused a delay in gastric emptying times in cats? Metoclopramide, erythromycin, exenatide
Exenatide (JVIM 2020)
106
Complication and mortality rate associated with esophageal surgery in dogs and cats?
54% complication rate, 10% mortality (JAVMA 2016)
107
On a study evaluating gastrointestinal motility and pH in dogs in hospital vs at home, what parameter was significantly prolonged in dogs at hospital?
Gastric emptying time (only parameter) - JAVMA 2017
108
Overall mortality rate associated with esophageal foreign body removal?
~5% (JAVMA 2018, JVIM 2017)
109
What were higher risk factors for esophageal perforation in foreign bodies?
Fish hook, longer time to presentation (JAVMA 2018)
110
Dogs that received maropitant and metoclopramide were significantly less likely to have post-op clinical reflux than dogs that did not. T/F?
False - no effect. JAVMA 2019
111
Median survival time of dogs with intestinal leiomyositis?
19 days with treatment (pro-kinetic, immunomodulatory) - JVIM 2016
112
Neutrophilic IBD- especially with neutrophils near the mucosa, was associated with what pathogen in cats?
Campylobacter (JVIM 2016)
113
Best method of handling endoscopic biopsy specimens (cucumber vs sponge vs free-floating)?
Free-floating (less artifact, wider specimens) - JVIM 2016
114
Features associated with PLEs on histopath in dogs?
villous stunting, epithelial injury, crypt distension and lacteal dilation JVIM 2017
115
What was occurrence of GE reflux in healthy cats undergoing anesthesia?
33% - JVIM 2017
116
What % of dogs with inflammatory enteropathy were dietary responsive?
66% (JVIM 2017)
117
Serum 3-BrY levels were more prevalent in food or steroid responsive enteropathies?
Steroid JVIM 2017
118
positive anti-neutrophil cytoplasmic antibodies were significantly associated with food responsive or steroid responsive enteropathy?
food responsive (JVIM 2017)
119
Dogs with IBD had what decreased numbers of which lymphocytes in blood stream compared to healthy dogs?
decreased percentages of TCRγδ+ T lymphocytes and CD21 positive B cells (JVIM 2017)
120
Dogs with lower IBD tend to have lower abundance of what bacteria compared to healthy dogs (and is opposite of that found in humans)?
Fusobacteria (JVIM 2017 review)
121
Which bacteria phylum tends to predominate in intestinal tracts of cats and dogs?
Firmicutes (JVIM 2017 review) [this includes clostridial and bacillus species]
122
fecal calprotectin was higher in which of the following groups of disease? steroid responsive, food responsive, antibiotic responsive
Steroid responsive (JVIM 2018), SERUM calprotectin is not useful (JVIM 2018)
123
Fecal transplant in parvo pups was associated with what?
faster resolution of diarrhea and shorter hospitalization time (JVIM 2018)
124
Is serum citrulline a useful biomarker for enteropathy?
No (JVIM 2018)
125
A relative increase in IL-1β may result in oclin expression (leading to inflammation) in which tissue?
Colonic mucosa (not duodenal) - JVIM 2018
126
Serum concentrations of which amino acid was lower in dogs with PLE? How about with IBD?
Tryptophan (JVIM 2018); tryptophan, methionine, proline, serine (JVIM 2019)
127
Cubulin mutations resulting in selective cobalamin malabsorption are present in which two breeds?
Beagles, Border collies (JVIM 2018)
128
Which two spp of bacteria were more highly associated with feline small cell LSA than IBD?
Fusobacterium and Bacteroides spp (JVIM 2018)
129
Name some medications that require acidic environment for absorption
antifungals- ketoconazole, itraconazole (not solution), voroconazole, pozaconazole; iron; mycophenolate; clopidogrel (consensus 2018)
130
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
Coiled IHPPS shunt (consensus 2018)
131
apical sodium-dependent bile acid transporter (ASBT) expression increased or decreased in canine chronic enteropathy?
Decreased (JVIM 2018)
132
What was the most prevalent adverse effect in using video endoscopy in dogs?
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
What are the clinical pH goals in people to promote healing of gastric tissue injury?
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
Do dogs with PLE/chronic enteropathy have lower 25-OHD levels? Did this correlate with outcome?
Yes, yes - JVIM 2019
135
Which short chain fatty acids were decreased in chronic enteropathies compared to controls?
Acetate, propionate (not butyrate) - JVIM 2019
136
GSDs with chronic enteropathy had lower levels of which two interleukins? (These are generally associated with Th2)
IL-13 and IL-33
137
Presence of ultrasonographic lesions within the submucosal and muscularis was predictive of histologic disease in cats with GI disease. T/F?
False - only true for mucosal layer (JVIM 2019).
However ultrasound WAS predictive of histologic disease in general
138
Major bile acids in the dog?
Cholic acid and chenodeoxycholic acid
139
An altered dysbiosis index may not resolve in dogs with steroid responsive enteropathy despite improvement in signs. T/F?
True JVIM 2019
140
What bacteria is primarily responsible for changing primary bile acids into secondary bile acids?
Clostridium hiranonis
141
Breeds associated with primary intestinal lymphangiectasia?
SCWT, Norwegian Lundehund, Yorkshire Terriers, Maltese, Shar-pei
142
Was contrast enhanced ultrasonography helpful in differentiating LSA vs IBD in dogs? How for IBD vs normal dogs?
No (JVIM 2019). Yes for IBD JVIM 2021
143
Dogs with C perfringens associated diarrhea had higher prevalence of which two toxin genes compared to parvo or healthy dogs?
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
Ki-67/CD3 ratio was increased or decreased in dogs with CIE?
Increased JVIM 2020
145
What was accuracy of histology-guided mass spectrometry in differentiating small cell LSA and chronic enteropathy in cats?
89% (compare to 60% for clonality) - JVIM 2020
146
Which two treatments were superior to IV pantoprazole in terms of achieving human pH standards in the first 72h of treatment?
Famotidine CRI, esomeprazole (JVIM 2020)
147
Did histopath identify lesions at perforation site in perforations associated with lower endoscopy?
No - JVIM 2020
148
Auto-antibodies against what were most useful discriminating dogs with IBD and healthy controls?
E coli ompC (this was the best one) and autoantibodies to polymorphonuclear leukocytes (APMNA) JVIM 2020
149
Fusobacteria levels in microbiome were decreased even long-term (4 weeks to 2 months) following discontinuation of both metronidazole and tylosin, respectively. T/F?
True (JVIM 2020, 2019)
150
Gastric thickness correlates with decreased albumin. T/F?
False JVIM 2020
151
Oral esomeprazole was superior to dexlansopromezole and lansopromeprazole in healthy cats. T/F?
True JVIM 2020
152
What percentage of dogs with E coli-associated granulomatous colitis had FQ-resistant profiles?
Around 63% or 15/24 (JVIM 2020)
153
What % of large intestinal biopsies were classified as lymphoma with histopath alone?
1/44 (JVIM 2021)
154
Why are fecal cultures not helpful for chronic enteropathy?
Did not distinguish between healthy and diseased and there is a high level of interlab variability. JVIM 2021
155
What % of dogs chronically treated with NSAIDs had gastric erosions?
~83% (10 dogs)
156
What % of dogs with CE were hypercoagulable?
17/38 (~44%). No difference between dogs with higher albumin concentration vs lower albumin (JVIM 2021)
157
pSTAT3 correlates with CCECAI in both epithelial and crypt regions. T/F?
True (JVIM 2021)
158
What % of dogs with PLE that had feeding tube placed within 5d of biopsy had positive outcome?
76% (16/21) - JVIM 2021
159
Were concentrations of high mobility box 1 protein higher in IBD dogs vs normal dogs?
Yes (JVIM 2021)
160
Was monoclonality of lymphocytes a foolproof way to distinguish IBD vs low grade T cell LSA in cats?
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
What ultrasound findings were more consistent with low grade T cell LSA cats?
rounded jejunal lymph node, and the presence of (albeit small volume) abdominal effusion - JVIM 2021
162
What conditions were associated with canine gastroduodenal ulceration or erosion?
NSAID, glucocorticoids, GI neoplasia, GI mechanical disease (JVIM 2021)
163
What % of rectal masses are epithelial neoplasms?
90% (most benign) - JAVMA 2017. No lesions were seen beyond colorectal junction
164
A dog is treated for acute GI disease (diarrhea) at rDVM, but presents 1 day later with acute erythroderma. What is your treatment?
Drug withdrawal (metronidazole, antibiotic), anti-histamines, steroids (JAVMA 2017)
165
Crude fiber generally under or over estimates total fiber?
Underestimates. Especially soluble fiber.
166
Most common food allergens in dogs? Cats?
Dogs - beef, dairy, wheat
Cats - beef, dairy, fish
167
Most common underlying diagnosis for chyloabdomen in dogs and cats?
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
Dehiscence rate in full thickness large intestinal incisions?
10%(JAVMA 2019)
169
Characteristics of pyloroduodenal polyp in cats?
Homogeneous echogenic nodule filling lumen, no change in wall layering; can still result in severe signs! (GI bleed, obstruction) - JFMS 2017
170
Intussusceptions in cats <1 year generally associated with what?
Idiopathic. If > 6, generally associated with LSA/IBD. JFMS 2019
171
Lymphofollicular hyperplasia in cases with and without chronic gastritis were associated with what clinical sign and breed?
Inspiratory dyspnea, brachycephalic (JAVMA 2020)
172
At least 7/10 surviving dogs with gastroesophageal intussusceptions had what persistent clinical sign following correction?
Regurgitation (managed with feedings) - JAVMA 2020
173
What was constipation recurrence rate of cats that received subtotal colectomy for idiopathic megacolon? What was median time that this occurred?
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
Risk factors for increased risk of constipation in cats?
Older, overweight, CKD, previous episodes of constipation (JFMS 2020)
175
Of canned hydrolyzed, canned gastroenteric, dry hydrolyzed, dry gastroenteric - which had the highest likelihood of causing false positive fecal occult blood test?
Canned gastroenteric (JFMS 2020)
176
Serum haptoglobin could differentiate between IBD and small cell LSA cats. T/F?
False -they were both higher than controls but not different in comparison to one another (JFMS 2021)
177
Histopathologic disease can be found in duodenum, pancreas, and gallbladder in asymptomatic cats. T/F?
True - JVIM 2016. but only call triaditis if there is severe IBD with clinical signs
178
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?
41% of positives were negative on PCR (JVIM 2016)
179
Administration of symbiotic decreases incidence of antibiotic associated diarrhea (clindamycin) in healthy research cats. T/F?
False. Decreased hyporexia and vomting butnot diarrhea. (JVIM 2017)
180
What breed of dog can have increased MMA concentrations with normal cobalamin levels?
Border Collie (JVIM 2020 review)
181
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?
5-6w (JVIM 2020)
182
Indications of cellular deficiency for cobalamin?
Homocysteine, methylmalonic acid (JVIM 2020 review)
183
Lack of AUS findings in liver or pancreas in a cat with GI signs reliably predicts lack of histo findings. T/F?
False - AUS insensitive but specific for liver, sensitive but not specific for pancreas findings (JFMS 2016)
184
Top 2 concurrent conditions associated with hypocholesterolemia in cats?
GI (25%), hepatobiliary (19%) JFMS 2020
185
Breeds most likely to have congenital shunt?
Havanese, Yorkshire Terrier, Maltese, Dandy Dinmont Terrier, Pug, Miniature Schnauzer, Standard Schnauzer, and Shi Tzu (in descending order of likelihood)
186
5 reasons why lactulose helps in hepatic encephalopathy
(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
Prevalence of asymptomatic biliary sludge in dogs over 4 year?
57% (JVIM 2016)
188
Best way to look for fluke eggs if you are concerned for fluke cholangitis in a cat?
Bile (JVIM 2016)
189
Most common bacteria isolated in canine bacterial cholangitis?
E. coli, Enterococcus (JVIM 2016)
190
Dogs with gallbladder mucoceles have serum leptins that were higher/lower/the same as control dogs.
Higher (JVIM 2017)
191
Dogs with chronic hepatitis have endothelin-1 levels that were higher/lower/the same as control dogs.
Higher (JVIM 2017)
192
Washout ratios of perflubutane microbubbles of < 37.1% was how sensitive and specific for diagnosis of chronic hepatitis in dogs?
100% sensitive, 85% specific (JVIM 2017)
193
What was sensitivity of ALT to detect chronic hepatitis in a group of labradors?
71% (JVIM 2017)
194
Organize PV/Ao ratio in the following from highest to lowest- EH-PSS, portal vein hypoplasia, normal dog, chronic hepatitis
CH, normal, PVPH, EHPSS (JVIm 2017)
195
What was the sensitivity and specificity of an abnormal gall bladder ultrasound for positive bacterial culture in cats?
96% sensitive, 49% specific in cats
(In dogs - 81% sens in dogs, 31% specifics) JVIM 2017
196
Anti-histone autoantibodies were detected in how many normal Dobermans compared to those with hepatitis?
None. But found in 92% of dogs in subclinical stage and 84.6% of dogs in clinical stage JVIM 2017
197
What is the main producer of the ECM matrix in the pathogenesis of hepatic fibrosis?
Hepatic stellate cells (JVIM 2018 review)
198
Most dogs have neutrophilic or lymphocytic cholangitis?
Neutrophlic (53/54) - JVIM 2018
199
Gallbladder agenesis was most common in what breed of dog, and was associated with what condition?
Chihuahua; ductal plate malformation (JVIM 2018)
200
Sensitivity/specificity for u/s to detect GB rupture in dogs?
Sensitivity 56%, specificity 91.7% - JVIM 2018
201
Breeds predisposed to Cu hepatopathy?
Labrador Retriever, Doberman, WHWT, Dalmatian, Bedlington- JVIM 2018
202
microRNA-122 was what sens/spec for detecting liver disease?
sens 77%, spec 97% - JVIM 2018. Another JVIM 2019 confirmed this in chronic hepatitis labs (alongside microRNA 29a).
203
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?
None - JVIM 2019
204
What values were associated with decreased survival in dogs with GBM?
Increased Cr and hyperphosphatemia JVIM 2019
205
Mutation of which ATP7ases are associated with copper storage diseases in Dobermans? In Labs?
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
Granulomatous hepatitis is associated with which two pathogens?
Leptospirosis, Leishmaniasis (JVIM 2019 consensus)
207
alpha-1 antitrypsin (AAT) deficiency is reported in which breeds as a metabolic cause for canine chronic hepatitis?
American and English Cocker Spaniels (JVIM 2019 consensus)
208
What is best screening test currently available for early detection of chronic hepatitis (CH)?
Unexplained increase in ALT > 2 months (JVIM 2019 consensus)
209
What is a complication that can occur in a dog with known chronic hepatitis and presents with presence of ascites, abdominal pain, and thrombocytopenia?
Portal vein thrombosis (2019 consensus)
210
What parameters make a patient high risk for liver biopsy?
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
Recommended # of liver biopsy sampling?
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
Can zinc and D-penicillamine be given together? Why or why not?
No- their benefits negate each other
213
What hepatic histopath diagnosis is associated with shorter survival time?
Survival times with a diagnosis of cirrhosis or lobular dissecting hepatitis (LDH) are short (1-2 months). - Consensus 2019
214
What is another agent that could be used for Cu chelation besides D-pen, Trientene, zinc?
Ammonium tetrathiomolybdate (JVIM 2019)
215
Most common cause of death in cats with EHPSS correction?
Seizures (JVIM 2019) [4/6 deaths - total 34 cats]
216
In dogs with acquired shunts, plasma aldosterone concentrations were higher in which groups (chronic hepatitis, portal vein hypoplasia, EHPSS, healthy)?
Chronic hepatitis and PVH (JVIM 2020) (meaning spirinolactone may not be helpful only for ascites alone?)
217
What was the incidence of major hemorrhage in dogs that underwent ultrasounded guided liver biopsy?
42% (JVIM 2020) - but complication rate was very low
218
Severely elevated bile acids can also be found in dogs with cirrhosis and cholangitis. T/F?
True (JVIM 2021)
219
What is another ddx for gallbladder wall edema besides anaphylaxis?
Cardiac disease - JVIM 2021 (gallbladder wall thickening can be associated with dexmed - JVIM 2021)
220
Plasma amino acid profiles in dogs with closed extrahepatic portosystemic shunts should also completely resolve 3 mo post surgery. T/F?
False - partially improved despite neurological improvement (JVIM 2021)
221
Dogs with GB mucoceles tend to be hyper, hypo, or normocoag based on TEG?
Hyper (JVIM 2021)
222
What CBC variable may accompany dogs with higher hepatic lead concentrations?
microcytosis JVIM 2021
223
A dilated cystic duct was found to be associated with what in healthy cats?
Reflux of pancreatic juices (JVIM 2021)
224
What % of cats survived to discharge for choledochal stenting for EHBO?
78% (18 cats) - JVIM 2021
225
What % of dogs with choledocholiths were found to be symptomatic?
100% (JVIM 2021)
226
What was sensitivity/specificity of serum lidocaine/monoethylglycylxylidide concentration to assess closure of EHPSS?
Sensitivity 96.2% and specificity 82.8% ((JVIM 2021)
227
What was mortality rate in cholecystectomy in a dogs with biliary disease in elect vs non-elect procedures?
2% in elective group and 20% in non-elective group - JAVMA 2018
228
Most common CBC abnormality in cats with EHPSS shunts?
Microcytosis - JFMS 2017
229
Survival rate of cats with hepatic lipidosis and acute pancreatitis?
20% (JFMS 2018 review)
230
Serum cholesterol and TG were not different between controls and cats with hepatic lipidosis. T/F?
True (JFMS 2019) - but lipoprotein profiles were different [Low density were higher; high density were lower in hepatic lipidosis]
231
Incidence of non-lethal bleeding complications in cats that underwent hepatic FNA?
16.7% (43% had minor bleeding, 56% had major bleeding) - JFMS 2019
232
Spectroscopic-spectrometric analysis of hepatic biopsy specimens commonly overestimated the concentration obtained by digital image analysis of rhodanine-stained sections in dogs. T/F?
False. They under-estimated. JAVMA 2021
233
Congenital peritoneopericardial diaphragmatic hernia or congenital central diaphragmatic hernia were commonly correlated with what other liver abnormality?
Ductal plate malformation (JAVMA 2021)
234
Primary copper hepatopathy was associated with what gene mutation in some cats?
ATP7B (JFMS 2020)
235
Increase in what biochemical liver parameter was associated with higher likelihood of hypocoagulability in cats with cholestatic disease?
ALP (JFMS 2021)
236
What % of cat liver biopsy specimens were above the Cu reference interval?
31% (JFMS2021) - showing that the Cu reference range for cats may need to be altered
237
specfPL and DGGRlipase performed similarly in diagnosing cats with pancreatitis confirmed with standardized evaluation of histopath. T/F?
True - both were NOT sensitive, but 100% specific JVIM 2016
238
Elevated cPLI can be found in both acute pancreatitis and pancreatic neoplasms in dogs. T/F?
True- JVIM 2020
239
Which marker was associated with mortality in dogs with acute pancreatitis?
ADMA, CRP, bands, CAPS [ canine acute pancreatitis severity]
ADMA - JVIM 2020
240
Significant DGGR-hyperlipasemia is frequent in critically ill dogs and generally not associated with pancreatitis. T/F?
True - only 17% of dogs with elevated numbers had acute pancreatitis - JVIM 2020
241
Most common sign associated with feline EPI?
weight loss (91%) - JVIM 2016
242
What vitamins were still low in dogs with EPI despite enzyme replacement therapy?
Vitamin A, E (JVIM 2018)
243
Gastric wall layer thickening/edema can occur in dogs with acute pancreatitis, even up to loss of wall layering. T/F?
True - JVIM 2019
244
What were 4 independent risk factors for death associated with canine acute pancreatitis?
presence of systemic inflammatory response syndrome, coagulation disorders, increased creatinine and ionized hypocalcemia. JVIM 2019
245
Most dogs with acute pancreatitis had normal triglycerides and cholesterol levels but different serum lipoprotein profiles. T/F?
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
SpecFPL is more likely to have a false negative than a false positive. T/F?
True (this is opposite of dogs) - JVIM 2020
247
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?
79%, no - JVIM 2020
248
Of antithrombin, CRP, IL-6, and TNF-α - which was correlated with nonsurvivors vs survivors in canine pancreatitis?
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
What type of test for pancreatitis is Precision PSL?
DGGR lipase assay - not specific for pancreatic lipase
250
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?
Good to excellent agreement between all tests (JVIM 2018)
251
what % of grey zone specfPLs had a normal snapFPL?
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
Which would be detected first for evidence of pancreatitis - cPLI or AUS?
cPLI JAVMA 2021. so a dog with severely elevated cPLI but AUS normal may develop AUS signs later
253
Which of the following is not a precipitating factor for hepatic encephalopathy?
- Hyponatremia and hypokalemia
- Acidosis
- Diuretic
- Azotemia
Acidosis (alkalosis is though)
254
Sensitivity of CT or AUS to detect nonperforated ulcer compared to radiograph?
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
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?
Se/Sp - 89,43 compared to 43/92 (JVIM2020). Aka cannot use aus alone
256
CKD cats on once daily omeprazole had what improvement over cats without omeprazole.
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
