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Gastrointestional Flashcards

(103 cards)

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1
Q

Main lymphatic duct is located where?

A

Thoracic duct

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2
Q

Reglan affects what part of the GI?

A

gastric motility (to empty stomach)

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3
Q

COX 1 enhances blood flow to what?

A

the gut

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4
Q

What does the spleen hug?

A

The stomach - left side

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5
Q

Common pancreatitis CBC changes

A

high WBCS (neuts) w/ left shift

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6
Q

inflammatory cascade of events - start with neuts/macrophages

A

neuts/macrophages attack bacteria
Activation releases cytokines
Cytokines signal to t-cells
T-cells signal macrophages and it begins again

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7
Q

Hepatic lipidosis prognosis

A

75%

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8
Q

RER calculation

A

70(k)^3/4

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9
Q

Maintenance fluid rate - dog

A

66ml/kg/day

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10
Q

parenteral nutritrion risks (3)

A
  • infection
  • fluid shifts (high osmolality)
  • refeeding syndrome including HYPERglycemia
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11
Q

A neurokinin receptor antagonist that affects substance P

A

cerenia

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12
Q

What does the liver do if it has not glycogen to convert to glucose?

A

Glucogenesis - create glucose from amino acids/pyruvic acid or glycerol

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13
Q

LPE characterized by what?

A

increase in lymphs and plasma cells overpopulating the mucosa of the GI

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14
Q

TPN must be administered via what? Why?

A

Central line, high osmolality (700)

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15
Q

Is it usually best to over feed or underfeed?

A

Underfeed - HYPER ailmentation leads to refeeding syndrome

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16
Q

Does Cerenia or Ondansetron affect GI motility?

A

Cerenia

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17
Q

Megaesophagus common disorder

A

myasthenia gravis

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18
Q

GIT water flow is ____ times that of blood volume or what % of body weight

A

1-2 x blood volume, 7% body weight

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19
Q

Treatment for IBD

A

steroids - calm down the attacking of the GI

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20
Q

Glucogenesis uses what for energy?

A

Amino Acids

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21
Q

How do you choose an enteral feeding tube?

A

Bypass the area of concern

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22
Q

Metoclopramide is a what type of drug

A

dopamine antagonist

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23
Q

Lymphangiectasia definition

A

Dilation of the lymph vessels

Lymph/anig/ectasia
Lymph/vessel/dilation

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24
Q

What percent dehydration should require IV fluids instead of SQ?

A

5% dehydration

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25
Three common signs of mega esophagus
- big esophagus - vomiting/regurge - esophagitis
26
In a normal state, glucose is used for ___ and protein for ____
Glucose - energy | Protein - growth
27
PLE can cause DIC - why?
Uses all the clotting factors to plug the holes, less protein
28
Four chemistry changes besides Amy/lip with panc
low calcium low albumin high BG high liver
29
You should avoid hyperailmentation in refeeding syndrome cases - why?
Need to re-feed slowly
30
The panc secreted digestive enzymes through the pancreatic duct into the what?
Duodenum
31
Name a serotonin antagonist antiemetic
ondansetron
32
Elemental diets should be used with what type of tube
J- tube - food should already be broken down by the time it reaches the jejunum
33
Three forms of IBD
LPE (lymphocytic plasmacytic enteritis) EE (eosinophilic) GE (granulomatous)
34
Refeeding syndrome is characterized by what three lab abnormalities?
Damn glucose scoops up everything: K+, Mg, Phos - Hypokalemia - hypomagnesaemia - hypophosphatemia
35
What is hyperailmentation?
total parenteral nutrition apparently
36
What happens when the panc releases the hormone glucagon?
The liver converts glycogen to glucose
37
Shock dose dogs
90ml/kg total
38
Cat vs. dog protein requirement
Cat 6g/100kcal | Dog 4g/100kcal
39
Why do 26% of panc cases develop icterus
panc inflames and blocks bile duct (rude)
40
With acute gastritis, patients should be fasted for how long before reintroducing a bland diet?
12 hours
41
When to increase protein in diet?
burns, sepsis
42
A lactate decrease by _____% in _____ hours is good prognostic indicator for GDV patients
50% in 12 hours
43
Elemental vs. polymeric diets
elemental are broken down already - polymeric require breakdown
44
EE is characterized by what?
Eosinophils overtaking the mucousa
45
Abdominocentesis will yield fluid when >__ml/kg of fluid is present?
>6ml/kg
46
GDVs with a lactate greater than _____ are associated with gastric necrosis
>6mmol/L
47
Glutamine and arginine are what?
essential amino acids
48
Approx what percent of hepatic blood flow comes from the GI tract?
80%
49
What type and kind of enteral feeding should be used with a jejunostomy tube?
CRI - elemental liquid | CRI to mimic slow moving from stomach
50
Two mega E treatment meds
- sucralfate | - famotidine
51
Effects of lymphagiectasia?
Lymph vessels dilate/leak or are obstructed --> loss of protein
52
What sided heart failure affects the GIT?
right sided
53
What's the gallbladder's job?
Store bile between meals/reabsorb water
54
What part of the SI is most permeable?
Duodenum
55
How do NSAID toxicities cause DIC?
GI bleeding uses up all of the coag factors
56
What side should you trocharize a GDV?
patient in Left lateral - trocharize right side (avoid the spleen)
57
Hypertonic saline dosing
4ml/kg over 2 min
58
Malfunction in the transmission of signals between the nerves and muscles ... what disorder?
myasthenia gravis
59
Patients in sever malnutrition (5 days) should get 60-90% of energy from what?
lipids
60
When to decrease protein in diet?
renal disease
61
Partial parenteral nutrition vs total percentages
Partial 40-60%
62
Where does the pancreas live?
Along the stomach and duodenum V shaped
63
GE characterized by what?
Macrophages taking over mucousa
64
Dolasetron can cause what
arrythmias
65
Colloid shock doses
10-20ml/kg
66
How much and what type of fluid should be used in a diagnostic peritoneal lavage?
10-20ml/kg of something isotonic
67
Why do some TPN avoid lipids?
pro-inflammatory and immunosuppressive
68
Shock dose cats
45-60ml/kg total
69
Replacement fluid calculation... how long do you replace over?
% dehydrated x body weight | replace 75% over 24 hours
70
CO2 enhances what?
mucosal healing
71
Body tries to plug big floppy vessel holes with what? leading to ________
plug w/ clotting factors, leading to DIC
72
E-tube diet type
thicker - less diarrhea
73
How often should open-abdomen bandages be changed?
3-4 times a day or when soiled
74
COX inhibitors regulate what?
renal function
75
Ace should be used cautiously in what breeds?
Sighthounds, giant breeds
76
COX inhibitors cause GI upset - HOW (2 things)?
blocks blood flow to the guts | blocks mucosal healing
77
Dogs vs. cats in RER use during malnutrition - where do they prefer to get calories?
Dogs - 90% dextrose | Cats - 60-90% lipids
78
VES daily rates - dogs vs cats
Dogs 20ml/kg/day | Cats 10-15ml/kg/day
79
Within 24 hours of no nutrition, what happens to the mucosal lining?
atrophy and increased permeability
80
LPE common in what breed
basenjis
81
hyperglycemia with PN or TPN can be managed how?
insulin CRI 0.5u/kg/day
82
Lymphatic system transports what?
transport of fatty acids, immune cells
83
How do NSAIDS cause GI ulcers?
Inhibit bicarb production (which balances GI acidity)
84
Approx 50% of cats with _____ have prolonged coags
hepatic lipidosis
85
Why does HYPERglycemia occur in refeeding syndrome cases?
Less efficient at converting glucose -->glycogen
86
Where does the breakdown of protein begin?
The stomach
87
The large intestines have no ______
villa or digestive glands
88
The liver destroys what?
old RBCs
89
The liver stores excess glucose in the form of what?
glycogen
90
J-tube benefits for panc
j-tube feeding does not stimulate pancreatic enzyme production
91
Parvo develop hypoglycemia - why?
Can't absorb any glucose
92
Phenothiazine antiemetics act on what? Two examples
CNS blocking dopamine Acepromazine Chlorpromazine
93
Maintenance fluid rate - cat
50-60ml/kg/day
94
RER adjustments for refeeding syndrome
1/4 to 1/3 RER and adjust up over 3-4 days
95
The liver metabolizes what 3 things?
Carbs, fat, protein
96
How does Panc cause petichia?
Loss of albumin -> loss of antithrombin -> uses up clotting factors
97
Antiemetics are better absorbed how?
Orally...
98
Refeeding syndrome - main issue
Low Lytes Insulin scoops up glucose AND LYTES - causing low phos, k, etc
99
RER adjustments for burn victims, cancer patients, head trauma and sepsis
1.1-1.5x RER
100
Since 80% of hepatic blood flow comes from the GIT - alterations in GIT can affect perfusion - including
mechanical ventilation, heart failure
101
Can TPN or PN be stopped suddenly?
NO - wean it off over several days
102
What is osmotic diarrhea?
Leaky GI - osmotic pressure pulls in fluid
103
Abdominal radiograph finding with panc:
loss of detail right cranial quadrant

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