GI: Clinical Essentials Flashcards
(107 cards)
1
Q
would small or large bowel diarrhea have increased frequency?
A
LARGE: markedly increased
2
Q
would small or large bowel diarrhea have more volume?
A
SMALL
3
Q
would small or large bowel diarrhea have fecal mucus?
A
large
4
Q
do whipworms (trichuris vulpis) cause small or large bowel diarrhea?
A
large bowel
asymptomatic to fresh blood streaked diarrhea to bloody, weight loss, dehydration, anemia, death
5
Q
do hookworms (ancylostoma caninum, etc) cause small or large bowel diarrhea?
A
small bowel
anemia, poor doer, melena, death
6
Q
do roundworms (toxocara canis) cause small or large bowel diarrhea?
A
small bowel
pot-bellied poor doer, V+ up worms, pulmonary disease, acute death
7
Q
are whipworms, hookworms, or roundworms zoonotic?
A
hookworms and roundworms are zoonotic
8
Q
does giardia cause small or large bowel diarrhea?
A
small bowel
9
Q
does tritrichomonas cause small or large bowel diarrhea?
A
large bowel
10
Q
what is in a minimum database?
A
CBC
chem panel
urinalysis
11
Q
are NSAID-induced ulcers a cause of primary or secondary GI disease?
A
primary GI disease
12
Q
are addison’s-induced ulcers a cause of primary or secondary GI disease?
A
secondary
12
Q
how would iron deficiency anemia appear on a CBC?
A
microcytic
hypochromic
often non-regenerative
13
Q
what 2 causes would be on your ddx list for a dog with diarrhea and eosinophilia
A
- parasites
- allergies
14
Q
what differential is on your list with a dog presenting with diarrhea, ascites, and a lymphopenia on CBC and hypocholesterolemia on chemistry?
A
hypoalbuminemia
15
Q
hypoalbuminemia is more common in cats/dogs?
A
dogs!! rare for a cat to have hypoalbuminemia
16
Q
what are 3 general causes for hypoalbuminemia?
A
- not making it: liver
- losing it: GI! PLE
- pissing it away: kidneys
17
Q
if you have hypoalbuminemia but increased globulins, what are you suspecting?
A
decreased globulins: GI
increased: liver, kidney
globulins are BIGGER than albumin and cannot get thru kidneys easily
18
Q
how would a pyloric obstruction present?
A
- hypochloremic: V+ HCl out
- metabolic alkalosis: hanging onto bicarb
19
Q
a BUN:Cr ratio of greater than ________ is consistent with a GI bleed
A
BUN:Cr > 30 is consistent with a GI bleed
20
Q
what are the 4 entries on the texas GI panel?
A
- cobalamin/B12
- folate (B6)
- tripsin-like immunoreactivity
- PLI
21
Q
where is folate absorbed?
A
proximal small intestine
22
Q
where is cobalamin/B12 absorbed?
A
DISTAL small intestine!!
23
Q
if your patient has a LOW cobalamin, where are you suspecting the issue is?
A
distal small intestine
24
what is the function of the esophagus?
swallow to stomach
regurgitation!!
25
what is the most common clinical sign of an issue with the esophagus?
regurgitation!
25
what is the function of the stomach? what clinical signs will you see with problems involving the stomach?
digestion with acid
signs: nausea and vomiting
26
what is the function of the small intestine? what clinical signs will you see with problems of the SI?
digestion, absorption
signs: diarrhea, vomiting
27
what is the function of the large intestine? what clinical signs will you see if there are problems with the large intestine?
motility, fluid
signs: diarrhea, constipation, vomiting
28
describe the noise level of vomiting vs regurgitation
vomiting: often noisy
regurgitation: may be a quiet process
28
you see a cat that is constipated, and you assume it is having compensatory vomiting. what part of the GI tract are you suspecting is contributing to this issue?
large intestine: functions with motility and fluid
29
what is GERD?
gastroesophageal reflux disease, aka heartburn in humans
problem with stomach and esophagus
30
what type of retching is present in vomiting? vs regurgitation?
vomiting: active always
regurgitation: usually no retching, is passive
31
is there bile present during vomiting or regurgitation?
vomiting may contain bile, usually none in regurgitation
32
when does vomiting occur after eating? what about regurgitation?
vomiting typically is a long time after eating (but can be soon), and regurgitation is typically soon after eating
33
what is the shape of vomitus in vomiting vs regurgitation?
vomiting: rarely tube-shaped
regurgitation: can be tube-shaped
34
is there white/clear mucus in vomiting vs regurgitation?
vomiting: rarely composed of just bile
regurgitation: often is just white frothy saliva
35
what is the frequency of vomiting vs regurgitation?
vomiting: rarely occurs >1-2x/day for >1-2 days
regurgitation: frequency can be >5x/day for weeks
36
would a vomiting patient attempt to re-ingest the ingesta afterwards?
RARELY, this is more of a regurgitation thing, which occurs often
37
you have a patient with a markedly increased frequency of defecation. is this large bowel or small bowel diarrhea?
large bowel
38
you have a patient who has increased fecal volume. are you suspecting small or large bowel diarrhea?
small bowel
39
you have a patient with fecal mucus present in their diarrhea. are you suspecting small or large bowel diarrhea?
large bowel
40
you have a patient with melena in their diarrhea. are you suspecting small or large bowel diarrhea?
small bowel
41
what is melena?
digested blood: often looks like coffee grounds
42
your patient presents with hematochezia. are you suspecting small or large bowel diarrhea?
large bowel; fresh blood means it didn't come from very far
43
what is tenesmus?
distressing urge to defecate or urinate, even when the bladder or rectum is empty
44
what is dyschezia?
difficulty or pain during defecation (bowel movements)
45
tenesmus, urgency, and dyschezia are signs associated with small or large bowel diarrhea?
large bowel
46
will vomiting accompany small or large bowel diarrhea?
small bowel
47
will weigh loss often accompany small or large bowel diarrhea?
small
48
what is steatorrhea?
excretion of abnormal quantities of fat with the feces owing to reduced absorption of fat by the intestine
49
is steatorrhea present in small or large bowel diarrhea?
small
50
what organs contribute to small bowel diarrhea? what are their functions?
gallbladder: lipid digestion
small intestine: digestion
pancreas enzymes: protein/carb digestion
51
what are the functions of the large intestines?
electrolyte transport
water absorption
mucus secretion
bacterial fermentation (fiber)
motility
52
what is colitis?
inflammation of the large intestine
53
what are the 3 types of anorexia?
primary anorexia
pseudoanorexia
secondary anorexia
54
what are causes of primary anorexia?
CNS disease
hypothalamus
anosmia (COVID)
trauma
mass, inflammation
neoplasia
55
what are causes of pseudoanorexia?
dental disease
oral cavity pain
musculoskeletal
change in routine
anxiety, depression
finicky, food addiction
bowl design
whisker fatigue
56
what are causes of secondary anorexia?
CKD
cholangitis
pancreatitis
respiratory
infection
DKA
57
PLI tests for
pancreatitis
58
TLI tests for
EPI: exocrine pancreatic insufficiency
59
a patient presents with GI signs: D+/V+. what is your pathway of ruling out signs?
primary vs secondary GI
60
what are differentials for primary GI signs?
parasites
infectious
idiopathic
anatomic
dietary
inflammation
neoplasia
61
what are your differentials for secondary GI (nonGI) signs?
endocrine: addisons, hyperthyroid
inflammation
pancreatitis
EPI
hepatopathy
renal
62
active retching, excessive salivation, and nausea are all consistent with __________
vomiting
63
hematemesis is defined as
vomiting of blood
64
NSAIDS is considered a primary/secondary GI cause of vomiting?
primary
65
what CBC finding would be consistent with hypoadrenocorticism in a vomiting dog?
lack of a stress leukogram
65
the passage of fresh blood with stool is called
hematochezia
66
along with fresh blood in the stool, what is most consistent with large bowel diarrhea?
tenesmus
67
Along with blood in the feces, what would most motivate you to submit a fecal culture for Salmonella
raw food diet
68
The passage of digested blood (“coffee grounds”) in stool is called
melena
69
Besides "coffee grounds" in the stool, what is most consistent with Small Bowel Diarrhea
vomiting
69
Both Whipworms & Hookworms cause anemia, which one of these is most likely to cause melena
hookworms
70
An elevation in which cell type on the CBC is most consistent with intestinal parasitism
eosinophils
70
Along with weight loss, what is most consistent with Small Bowel Diarrhea
large volume
71
An owner is confused by the fact that their dog, Stone, is eating “a ton” but losing weight; you explain that this is consistent with the role of the small intestines in digestion & absorption of nutrients. What other organ/tissue is critical for the appropriate digestion of nutrients
pancreas
72
The pancreas is critical for the absorption of which of the following in the distal small intestine
cobalamin
73
Young German Shepherds appear to be susceptible to a number of GI problems, including Exocrine Pancreatic Insufficiency (EPI). The best test for EPI is to measure
trypsin-like immunoreactivity
73
Are hookworms zoonotic
yes
74
what could result in a patient appearing to have a distended abdomen?
organomegaly
ascites
tumor or mass
fat
75
You have “mad skills” when it comes to Physical Exam and you palpate a “fluid wave”. What fluid types can be found in the abdomen of dogs or cats
transudate
modified transudate
exudate
blood
76
Which MDB abnormalities are most consistent with a protein-losing enteropathy
hypoalbuminemia and hypoglobulinemia
77
what causes a transudate
hypoalbuminemia
78
Which cell line from the CBC do the lymphatics transport
lymphocytes
79
Which Breed appears to be predisposed to developing Lymphangiectasia
Yorkshire terriers
80
Which end-product of digestion do lymphatics transport
cholesterol
81
what are some of the most prevalent diseases of older cats?
CKD
hyperthyroidism
diabetes mellitus
82
what is the LEAST likely differential for polyphagia and weight loss in older cats?
hypothyroidism (cats dont get this)
83
what would be primary GI rule outs for V+/D+ in older cats?
IBD
alimentary T cell lymphoma
84
We rarely know the reason a cat gets constipated, but we do know that the drug of choice for moving a cat’s colon is
cisapride
85
similar to dogs, the small bowel GI parasites you would consider on your rule-out list include
giardia
cryptosporidium
hookworms
86
Kittens with a large parasite burden often appear to have a “big belly”. What feline viral disease may manifest itself as fluid in the belly of a kitten
FIP
86
Alpo was dewormed with both Fenbendazole and Metronidazole (standard dewormers) prior to adoption, but this did not have any impact on his diarrhea. You would interpret this failure of therapy to mean
- diarrhea not due to GI parasites
- diarrhea not due to parasites susceptible to standard dewormers
- diarrhea due to parasites resistant to standard dewormers
86
Alpo (a cat) presents for diarrhea. on physical examination reveals no abnormalities except some inflammation around the anus. Otherwise, normal body weight and no vomiting. This presentation is most consistent with
large bowel diarrhea
87
do the skin and GI tract share any common cause of disease?
yes, both can suffer from allergies
88
if your patient was allergic to something in her food, what cell line would you expect might be elevated on their CBC
eosinophils
89
what can be considered a “food responsive” problem (i.e. a condition that can be successfully treated with a change in what the pet is fed)
- food intolerance
- food allergy
- food intoxication
90
is CKD a primary or secondary GI cause of V+?
secondary GI
91
yowling/vocalization during litter box trips could accompany many problems in cats. what could these problems be?
- large bowel D+
- lower urinary tract disease
- constipation
91
can constipation cause clinical signs of V+ and decreased appetite?
yes, there is colonic input to the emetic center
92
what would be the top priority and initial therapy for addressing a vomiting, anorexic, CKD, constipated cat?
fluids
93
Chronic diarrhea & weight-loss are most consistent with disease of the
small intestines
94
what parameter would help you specifically identify the location of disease in the GI tract?
cobalamin
95
In a 14 yr old cat (geriatric) presenting for chronic diarrhea & weight-loss, the top Primary GI rule-outs would be
1. IBD
2. lymphoma
96
96
In a 14 yr old cat (geriatric) presenting for chronic diarrhea & weight-loss, but not responding to treatment, the reason might be
- owner compliance
- comorbidities
- wrong diagnosis
