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Year 3 > GI > Flashcards

GI Flashcards

1
Q

What is intussusception?

A

The inversion of one portion of the intestine within another

like a collapsible telescope

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2
Q

What is the daily fluid volume entering the gut of a 20kg dog?

A

2700ml

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3
Q

Where does the fluid come from that enters the gut on a daily basis?

A 
Diet
Saliva
Gastric
Bile
Pancreatic
SI
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4
Q

The majority of fluid in a dog’s gut is absorbed where?

A

Jejunum

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5
Q

What things should you consider when a dog is brought in with D&V?

A 
Is intensive emergency treatment needed (fluids)?
Is there an underling non-enteric cause?
Is surgical management needed?
Is hospitalisation needed?
Is an infectious cause likely?
Is non-specific treatment sufficient?
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6
Q

What are the categories of acute GI disease?

A

Gastritis (stomach)
Enteritis (SI)
Colitis (colon)

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7
Q

Give some causes of acute gastritis

A 
Dietary indiscretions eg eating rubbish
Foreign material
Hairballs (bezoars) in cats
Certain drugs
Acute systemic disease
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8
Q

Describe acute enteritis

A

Acute onset of profuse diarrhoea, often associated with acute vomiting
Many causes, eg dietary indiscretions, enteric infection
Usually self-limiting

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9
Q

Describe acute colitis

A

Acute, frequent, small volume diarrhoea
Excessive straining (tenesmus)
Mucoid faeces
+/- fresh blood=haematochezia (blood not always in faeces but passed with it)
Common in dog, rare in cat
Causes: whipworms, rubbish ingestion, protozoa (Giardia, Cryptosporidia etc)

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10
Q

When should you reassess diarrhoea or vomiting after giving systemic treatment?

A

If signs persist for over 48 hours

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11
Q

What should you check on a clinical exam of a pet with D&V?

A

General body condition
Hydration status (PVC/TP, mm, skin tenting)
Oral and rectal examination (could be bones around back end, mouth ulcers)
Abdominal palpation

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12
Q

Which diagnostic tests should you carry out when investigating D&V?

A

Haematology
Serum biochemistry
Urinalysis
Faecal exam for parasites

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13
Q

SNAP tests can be used to test the faeces for what?

A

Giardia

Parvovirus

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14
Q

How can you test for Giardia in faeces?

A

SNAP test
Direct smears
Floatation

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15
Q

How can you measure TP?

A

Refractometer

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16
Q

What is contra-indicated in cases of gastroenteritis?

A

Corticosteroids and NSAIDs (damage GI mucosa -> ulceration. Also damage kidneys if hypovolaemic)

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17
Q

High corticosteroid use can lead to what?

A

Cushings disease (hyperadrenocorticism)

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18
Q

How can you maintain a pet with acute D&V’s hydration status?

A

Oral rehydration solutions

If vomiting water -> give parenteral fluids

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19
Q

When symptomatically treating D&V, compare restricting food intake with feeding through diarrhoea

A

Restricting GI intake
-Fast for at least 12 hours then feed frequently with small amounts of bland food eg chicken and rice

Feeding through diarrhoea

  • Speeds recovery
  • Reduces potential of sepsis
  • Not practical if there is concurrent vomiting
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20
Q

Give some examples of anti-emetics

A

Centrally-acting:

  • Metoclopramide
  • Chlorpromazine
  • Maropitant

Anti-cholinergics:
-Atropine

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21
Q

When should you use a gastric mucosal protectant?

A

Only if:
Vomiting persists
Ulceration is present
- H2-receptor antagonists eg ranitidine

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22
Q

How do absorbents/protectants work? (used to treat diarrhoea)
Give some examples

A 
'Protect' mucosa
Bind toxins 
Bind excess water 
-Activated charcoal
-Kaolin-pectin
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23
Q

Why are opioids used to treat diarrhoea?

A

Slow the rate of transit
Anti-secretory
-Morphine/kaolin
-Loperamide

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24
Q

Give some pros and cons for using antibiotics to treat D&V

A

Cons:

  • ‘Upset’ the natural flora
  • Cause diarrhoea (eg antibiotic-associated colitis)
  • Promote resistance

Pros:

  • Flora is already ‘upset’
  • Risk of sepsis if mucosal barrier is compromised
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25
Q

What are the indications for antibiotics when treating D&V?

A

Haemorrhagic diarrhoea
Diarrhoea + pyrexia
Known infection (eg E.coli)

26
Q

What are probiotics?

A 
Live micro-organisms
Administered orally
Alter intestinal microflora
Beneficial effect on health
eg Lactobacilli, Bifidobacteria
27
Q

Give some examples of drugs used to induce vomiting (emetics)

A

Xylazine
Apomorphine

Only use if ingested object is smooth and was recently ingested

28
Q

Describe canine haemorrhagic enteritis (HGE)

A

Affects all ages, especially toy/miniature breeds
Unknown aetiology
Not inflammatory
Alters mucosal permeability or secretion

29
Q

What are the clinical signs of canine haemorrhagic enteritis (HGE)?

A 
Sudden onset of vomiting +/- blood
May precede diarrhoea by a few hours 
Severe bloody diarrhoea
Marked haemoconcentration (reduced serum but same no of RBCs -> increased blood viscosity and increased PCV: 60-80)
Depression
Shock
30
Q

How do you treat canine haemorrhagic enteritis (HGE)?

A

Prompt vigorous fluid therapy

  • IV balanced electrolyte solution
  • 80ml/kg/hr infused rapidly until PCV death
31
Q

What is dysphagia?

A

Difficulty/discomfort in swallowing

32
Q

Give some signs of oropharyngeal disease

A

Dysphagia
Drooling
Halitosis
Odynophagia (painful swallowing)

33
Q

Give some signs of dysphagia

A 
Difficulty lapping or forming a bolus
Excessive jaw or head motion 
Dropping food from mouth 
Drooling/foaming at mouth
Persistent, ineffective swallowing
Nasal discharge 
Gagging
Coughing
Reluctance to eat
Halitosis
Blood-tinged saliva
Failure to thrive
34
Q

Give the two types of causes of oropharyngeal dysphagia

A

Functional: abnormal neuromuscular activity
Morphological: structural abnormalities

35
Q

Give some causes of functional (neuromuscular) dysphagia

A

Myasthenia gravis (muscle weakness)
Cricopharyngeal chalasia/achalasia (relaxed upper oesophageal sphincter. Achalasia=failure to relax -> food cannot enter oesophagus)
Brainstem disease
Botulism

36
Q

Give some causes of morpholigical dysphagia

A 
Foreign bodies
Oropharyngeal trauma
Oropharyngeal inflammation
Neoplasia
Congenital/developmental
-eg cleft palate, malocclusion, cleft lip
37
Q

What is stomatitis?

A

Inflammation of oral mucosa

38
Q

What is glossitis?

A

Inflammation of tongue

39
Q

What is cheilitis?

A

Inflammation of lips

40
Q

Give some signs of oesophageal disease

A 
Regurgitation
Drooling saliva
Halitosis
Dysphagia
Odynophagia
41
Q

Give some secondary signs of oesophageal disease

A 
Malnutrition/dehydration
Anorexia/polyphagia
Aspiration pneumonia/tracheal compression
 -Cough
 -Dyspnoea
42
Q

What is regurgitation?

A

Passive event (unlike vomiting)
Undigested food covered by mucus/saliva
Neutral pH
Can occur immediately after eating or be delayed

43
Q

Why may an animal be drooling saliva?

A

Failure to swallow normal volume of saliva (pseudoptyalism)

Increased saliva production (ptyalism)

44
Q

What is the difference visually between the inside of a dogs and cats oesophagus?

A

Dog=very smooth

Cat=has thin rings, a bit like a trachea

45
Q

Oesophageal disorders can be classified into which categories?

A

Motility (eg megaoesophagus)
Inflammation (oesophagitis)
Obstruction (foreign body eg stricture, neoplasia)
Miscellaneous (broncho-oesophageal fistula)

46
Q

What is megaoesophagus?

A

Oesophageal dilation with functional paralysis
Failure of progressive peristalsis
Can be primary/idiopathic or secondary

47
Q

How can you diagnose megaoesophagus?

A

Radiography +/- contrast

  • Uniformly dilated, gas and/or fluid-filled
  • Ventral displacement of trachea
  • Secondary aspiration pneumonia

Can also use fluoroscopy to assess oesophageal dysmotility

48
Q

Give some conditions that meagoesophagus may be secondary to

A

Myasthenia gravis
Distemper
Trauma
Oesophagitis

49
Q

How can you treat idiopathic megaoesophagus?

A

Feed from a height (Bailey chair, place food bowls on chairs)
Slurry, textured food, meatballs (easier way for food to get into stomach)
Bethanecol? (muscarinic agonist)
Metaclopramide? (antiemetic used to treat oesophageal problems, dopamine-receptor agonist)

50
Q

What is the prognosis for idiopathic megaoesophagus?

A

Guarded, will never return to normal function
Danger of aspiration pneumonia
Spontaneous recovery in some congenital cases

51
Q

Give some causes of oesophagitis

A

Ingestion of caustics and irritants
Foreign bodies
Acute and persistent vomiting
Gastric reflux

52
Q

Give some clinical signs of oesophagitis

A 
Anorexia
Dysphagia (difficulty swallowing)
Odynophagia (pain when swallowing)
Regurgitation
Hypersalivation
53
Q

How do you diagnose oesophagitis?

A

Clinical signs
Endoscopy
Response to empirical treatment?

54
Q

How do you treat oesophagitis?

A

General:
Rest the oesophagus: frequent small feeds, antibiotics, liquid antacids, local anaesthetics, gastrostomy tube feeding

Specific:
Sucralfate (used to treat gastric ulcers and reflex)
Antacids
Metoclopramide (antiemetic)

55
Q

What is a stricture?

What is the aetiology?

A

Narrowing of the oesophagus
Caused by fibrosis after ulceration of mucosa by:
-Foreign body
-Caustic (corrosive) material
-Severe oesophagitis
-Gastric reflux esp pooled secretions during GA
-Drug therapy eg doxycycline in cats

56
Q

How do you dilate an oesophageal stricture?

A

Bougienage (snowplow effect)

  • Increased risk of perforation
  • Longitudinal shear force

Balloon dilation

  • Radial stretch using a stationary force
  • Less risk of perforation as radial force is less traumatic
  • Can watch process with an endoscope
  • Inject steroid around the lesion to minimise recurrence
57
Q

How do you treat an oesophogeal foreign body?

A

Per-oral approach:

  • Flexible or rigid endoscope
  • Preferably pull foreign body to mouth, or push to stomach for gastrotomy (surgical removal from stomach)
  • Check for oesophageal tear

Surgical removal

  • Last resort
  • Essential if large laceration
58
Q

What should you do after removal of an oesophageal foreign body?

A

May be post-removal oesophagitis
Radiographs
PEG tube (stomach tube feeding)
Omeprazole (used to treat gastric reflex)
Sucralfate (used to treat gastric reflex and ulcers)

59
Q

What are the categories of acute V&D?

A

Non-fatal/self-limiting (parasites, diet) (just give advice, will get better by itself)
Secondary to extra-intestinal/systemic disease (eg liver/pancreatic disease)
Severe potentially life-threatening (eg enteric infection, HGE-hemorrhagic gastroenteritis, intestinal obstruction)

60
Q

What kind of drug is Maropitant?

A

Anti-emetic, centrally-acting

NK-1 receptor antagonist

Year 3 (28 decks)

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