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VETM 522 > GI > Flashcards

GI Flashcards

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1
Q

what is the most important part of a GI workup

A

history: ask about diet and presenting complaint

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2
Q

dysphagia is due to

A

oral cavity/laryngeal/upper esophageal disease

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3
Q

dysphagia C/S, ddx

A

trouble eating/grabbing food, difficult swallowing, exaggerated head movements, coughing/aspiration

ddx- severe dental disease, oral masses, neuro disease

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4
Q

vomiting vs regurg

A

vomiting- active process, nausea, GI material from stomach, indicates GI disease
regurg- passive, no nausea, GI material esophagus, indicates esophageal problem

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5
Q

sm vs lg bowel d+

A

SI- lg volume, melena, can have fat, v+, weight loss

LI- sm volume, tenesmus, mucous, fresh blood

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6
Q

ddx for anorexia in cats

A

pretty much anything, hepatic lipidosis, IBD

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7
Q

acute vs chronic GI

A

acute- self limiting, less diagnostics (unless GI urgency markers)

chronic- lasting more than 2-3wks, defined therapeutic trial/more diagnostics

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8
Q

differentials for GI

A

dysphagia/regurg- separate

anorexia, v+/d+, weight loss
primary vs secondary GI

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9
Q

therapeutic vs diagnostic tests

A

therapeutic trial- v+/d+ w no urgency markers, chronic w no progression or weight loss
diagnostics- chronic w/ progresion, dysphagia or regurg

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10
Q

GI urgency markers

A

unstable patients, weight loss, painful abdomen, low TP, effusion, prolonged anorexia, intractable vomiting

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11
Q

steps to therapeutic trial

A
  1. initial problem and urgency
  2. eliminate simple disease first (dewormer)
  3. eliminate dietary factors- diet trial
  4. treat symptoms
  5. hydration
  6. further workup if no resolution
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12
Q

GI tx (no urgency markers)

A

acute v+- MPO trial, GI diet, probiotics, antiemetic, deworm
acute d+- probiotics, GI diet +/- deworm, abx
chronic v+- elimination diet, deworm, probiotics
chronic d+- elimination diet, probiotics, fiber for lg bowel, abx

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13
Q

gi diet vs elimination diets

A

GI- highly digestible, low fat 1wk diet w transition

elimination- hypo diet to eliminate rxns 6-8wks

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14
Q

abx therapeutic trials

A

metro 8-12mg/kg q12 3-5d
tylosin 10-15mg/kg q12
fenben- 50mg/kg q24 5d

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15
Q

NPO for acute v+

A

NPO for 12h-> sm amount water q2h (if v+ do diagnostics)-> sm amount food 2-3d-> reintroduce diet 25% for 1-2d

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16
Q

other therapeutic trial meds

A

prebiotic, probiotics, anti-emetic, antacid, deworm, sucralfate (antacid and sucralfate probably don’t work)

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17
Q

when to use SQ or IV fluids

A

<5% under 25kg-> SQ
>5% or shocky-> IVF

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18
Q

normal swallowing stages

A

oral - prehension
pharyngeal- moving towards esophagus
cricopharyngeal- relaxation of upper esophageal sphincter

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19
Q

gastroesophageal reflux

A

reflux of gastric acid into esophagus. LES (striated and smooth muscle in dogs, smooth only in cats)

causes: LES incompetence, motility disorder, FB, v+, GERD

prolonged fasting >24h, anesthetic

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20
Q

esophagitis C/S, dx

A

anorexia, regurg, drooling, coughing, loud vocalization after eating, many are subclinical

dx- hx, C/S, TXR, can do contrast rads/scope

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21
Q

esophagitis tx

A

PPI- omeprazole 1mg/kg PO q12 for 2d then q24 7-10d, panto if IV

+/- cisapride, sucralfate
prognosis good

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22
Q

esophageal FB signalment, C/S

A

common in dogs, near LES< base of heart-> mucosal damage, ulcers, perf

acute regurg, gagging, hypersalivation, pain

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23
Q

esophageal FB dx, tx

A

dx- rads, scope
tx- scope to remove, push into stomach-> gastrotomy?

prognosis good, risk stricture

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24
Q

esophageal strictures

A

secondary to esophagitis (FB, reflux)

dx- esophagram w contrast, scope

tx- balloon dilation (3tx) can perforate

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25
hiatal hernias
repeated protrusion of abd contents into thorax-> reduced LES tone congenital- bulldogs, brachys trauma induced C/S- regurg, v+, repeated aspiration pneumonia dx- rads, scope
26
hiatal hernia tx
medical- PPI, low fat diet, prokinetic surgical- hernia reduction
27
PRAA
embryonic R aortic arch becomes aorta GSD, greyhounds regurg solid food, underdeveloped puppy, aspiration pneumonia
28
PRAA dx
contrast rads, fluoroscopy tx- surgical correction prognosis fair to poor
29
megaesophagus causes
congenital- schnauzer, GSD, great dane acquired- idiopathic, chronic esophagitis, myasthenia gravis
30
megaesophagus C/S, dx
regurg, weight loss, cough/fever if acute dx- TXR
31
megaesophagus tx
acute- abx to prevent aspiration feed elevated, prevent weight loss, treat diseases for secondary
32
secondary megaesophagus diseases
myasthenia gravis, lupus, addisons, hypothyroid
33
acute gastritis/gastroenteritis
sudden gastric insult causing vomiting C/S- v+, hematemesis, anorexia, d+ usually primary GI causes
34
acute gastritis dx
clinical, hx- no urgency markers tx with therapeutic trial
35
chronic gastritis
chronic/intermittent or daily vomiting cause rarely found-> likely dietary intolerance tx- therapeutic trial (hypo diets)
36
GI diagnostics for failed trial or urgency
AXR (FB), U/S (chronic), scope (biopsy), sx biopsy (full thickness), GI panel, fecal float
37
helicobacter pylori
chronic v+ that doesnt respond, found in healthy and vomiting dogs, can respond to tx
38
helicobacter dx,tx
scope w biopsy (bacteria seen on histopath) urease test- not sensitive tx- metro, amoxiciliin, famotidine
39
delayed emptying/motility disorders
C/S- vomiting hrs after a meal, abd distension, bloating causes- pyloric hypertrophic, neoplasia, pancreatitis, idiopathic, IBD dx- scope, biopsies tx- dietary low fat
40
hairballs in cats
considered abnormal if frequent vomiting hairballs-> delayed gastric emptying, neoplasia
41
hairball tx
1. special hairball diet 2. dietary modification 3. grooming 4. small meals 5. gastric lubricants 6. prokinetics
42
gastric ulcers
causes: decreased blood flow, hypersecretion of acid, NSAIDs, exercise-induced, addisons C/S: v+, hematemesis, melena, pale MM, abd pain, shock
43
gastric ulcers dx
CBC- regenerative anemia chem panel- high BUN rads, U/S, biopsies
44
gastric ulcers tx
IVF, PPIs, sucralfate, anti-emetics, abx, opioids
45
bilious vomiting syndrome
chronic intermittent vomiting early morning of bile dx- clinical tx- feed late, antacids
46
HGE
acute hypersensitivity, hematochezia, acute dehydration. c/s- dehydration, v+/d+, acute abdomen hypovolemia, shock tx- shock treatment , NPO, metro?
47
canine parvovirus
fecal oral route, infect rapidly dividing cells C/S- 4-7d post infection acute v+/d+, depression, fever dx- leukopenia, anemia, fecal Ag ELISA 10-12d after infection
48
parvo tx
supportive care: fluids, nutritional support (NGT), albumin transfusions, opioids
49
feline panleukopenia mortality?
mortality 50-90%
50
giardia
acute d+, v+ young animals, shelter dx ELISA, PCR, zinc sulfate floats tx- fenbendazole 50mg/kg SID 5d, repeat 3wks
51
describe fecal tests and what they detect
fecal float- parasites fluorescent Ab- crypto fecal PCR- bacteria, but interpret carefully (w C/S)
52
chronic SI diseases
food allergy- hypo food trial gluten sensitive enteropathy- irish setters, celiac dietary intolerance- individual specific ingredient intolerance
53
ARD/SIBO
dysbiosis-> malabsorption, d+ primary- GSD, igA deficiency secondary- abnormal GIT, chronic enteropathy (IBD) dx- sm bowel d+, v+, weight loss (r/o other causes)
54
advanced GI dx
cobalamin- low w IBD and bacterial overgrowth folate- increased w ARD/SIBO decreased- mucosal disease
55
EPI causes
insufficient pancreatic enzymes primary in dogs- genetic (GSD) secondary- cats (chronic pancreatitis)
56
EPI dx, tx
C/S- loose stool, increased appetite, weight loss dx- low TLI tx- supplement enzymes, cobalamin, high quality diet
57
key words for IBD
chronic immune inflammation progressive
58
IBD definition
collective disorders w persistent or recurring GI signs, histo evidence of inflammation chronic, immune mediated enteropathy
59
IBD pathophys
structural (tight junction, mucosal barrier) environmental (dysbiosis, dietary) genetic (local immune dysfunction, loss of self tolerance)
60
what does the microbiome do
metabolic- fermentation to provide energy for cells trophic effect- protective, influence nutrient uptake crosstalk- chemokines/cytokines, GALT
61
IBD C/S
chronic v+/d+, borborygmi, abd discomfort, altered appetite, weight loss
62
IBD workup
history-> bloodwork (CBC/chem/UA, cortisol)-> GI panel (folate cobalamin, TLI,PLI)-> imaging (thickening , layer changes)-> GI biopsy (sx or scope), targeted therapy (deworming, diet, pred, abx)
63
pros/cons of GI biopsy
inflammation is present w many disease, including IBD use WSAVA grading system and C/S
64
most common IBD
lymphoplasmacytic IBD other: eosinophilic
65
IBD tx
1. hypo diet, pred 2mg/kg/d cobalamin, probiotic, metro, tylosine 2. add cyclosporine, new diet 3. other immunosuppressive, injectables
66
IBD prognosis?
good to guarded, success not guaranteed
67
PLE/lymphangiectasia
marked dilation and dysfunction, more than IBD leakage of lymph primary idiopathic (most common), secondary (obstructive) C/s- D+, weight loss, hyporexia, ascites dx- panhypoproteinemia, hypocholesterolemia r/o PLN, Gi biopsy
68
lymphangectasia tx
fat restriction, pred, cobalamin supplementation prognosis good to poor
69
histiocytic ulcerative colitis
young boxers- e coli in macrophages hx, C/S- severe chronic lg bowel d+, weight loss, hematochezia
70
histiocytic ulcerative colitis dx, tx
colonic biopsy via scope tx- enrofloxacin, 5-10mg/kg SID 4-8wks relapse frequent, good prognosis
71
constipation causes
pelvic fx, neuro disease, diet change, dehydration, CKD, idiopathic megacolon
72
megacolon
C/S- cats w progressive dilation of colon, loss of smooth muscle function dx- PE, rads tx- enema if mild, deobstipation if severe
73
chronic therapy for megacolon
weight loss if overweight chronic laxatives (lactolose, restoralax) low fat diet prokinetics sx- subtotal colectomy
74
tritrichomonas fetus
chronic lg or sm bowel d+ in cats shelter cats dx- PCR (fecal) tx- ronidazole
75
anal gland abscess tx
sx (flush) amoxiclav for 5-7d
76
perianal hernias cause, C/S, dx, tx
chronic straining, IBD C/S- none, swelling, tenesmus, painful defecation dx- rectal exam tx- sx
77
perianal fistula signalment, cause, ddx, dx, tx
chronic progressive immune disease older GSD immune dysfunction ddx: neoplasia, anal gland disease dx- C/S, biopsies tx- cyclosporine good prognosis

VETM 522 (22 decks)

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