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Path of digestive system (Castleman) Flashcards

1
Q

Pathologic dzs of oral cavity

Developmental dz

A
  • Developmental dz
    • cleft palate
    • prognathism
    • brachygnathism
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2
Q

Cleft palate

A
  • due to delayed development and fusion of lateral palatine arches
  • genetic or toxic etiology
    • plant tox
    • steroids during pregnancy
    • veratrum californicum in sheep
    • poison hemlock in pigs
  • Common complication
    • aspiration pneumonia
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3
Q

Brachynathia and Prognathia

A
  • Brachy (short); prognathia (long jaw)
  • Growth abnormalities various causes (usually unknown)
    • Genetic abnormalities
    • Calcium deficiency
    • Chondrodysplasia
  • Complications are species dependant
    • malocclusion
    • tooth growth and wear abnormalities
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4
Q

Inflammatory lesions

Oral cavity

A
  1. vesicular
  2. erosive/ulcerative
  3. proliferative
  4. other
    1. pseudomembranous
    2. granulomatous
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5
Q

Inflammatory dzs

Vesicular stomatitis/esophagitis

A
  • Large, fluid-filled lesions in mucosa
    • blood
    • neutraphils
  • Lesions are short lived, progress rapidly to erosions/ulcers
  • Causes
    • viral (usual)
    • thermal, toxic (rare)
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6
Q

When you see erosive stomatitits in cattle

A

Always have to consider Foot-in-mouth as a ddx

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7
Q

Inflammatory dzs of oral cavity

Erosive/Ulcerative Stomatitis

A
  • Causes
    • viral infection
      • calicivirus
      • BVD
      • bluetongue virus in sheep
    • Toxic dz
      • phenylbutazone
    • uremia
    • immune mediated disease
      • pemphigus vulgarus
      • SLE

*often also esophageal involvement

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8
Q

Inflammatory lesions of oral cavity

Proliferative stomatitis/esophagitis

A
  • Causes
    • parapox viruses
      • bovine papular stomatitis: calves
      • contagious ecthyma - sheep, goat
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9
Q

Inflammatory lesions of oral cavity

Necrotizing stomatitis

A
  • causes
    • bacterial
      • oral necrobacillosis/fusobacterium necrophorum
      • actinobacillus (wooden tongue, osteomyelitis)
    • infarctive
      • NSAIDS: obstructs small capillaries
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10
Q

Inflammatory lesions of the oral cavity

Granulomatous

Pseudomembranous

A
  • Granulomatous
    • cryptococcal stomatitis
  • Pseudomembranous
    • Simian immunodeficiency virus
    • then something about yeast and hyphae take over, I think
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11
Q

Vesicular oral lesions can be induced by all of the following except

  • A. Foot and Mouth Disease virus
  • B. Thermal injury
  • C. Vesicular stomatitis virus
  • D. Swine vesicular disease virus
  • E. Bovine papular stomatitis virus
A
  • E. Bovine papular stomatitis virus
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12
Q

Ulcerative oral lesions can be induced by

  • A. Chronic uremia
  • B. Calicivirus
  • C. Bovine virus diarrhea virus
  • D. Foot and mouth disease virus
  • E. All of the above
A
  • E. All of the above
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13
Q

Oral cavity

Neoplastic dzs dogs and cats

A
  • Periodontal fibromatous epulis
  • Acanthomatous ameloblastoma
  • Melanoma
  • Fibrosarcoma
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14
Q

Periodontal Fibromatous Epulis

Dogs

A
  • Age:
    • usually over 3 years of age
    • mean 8.5 years
  • Location
    • anywhere on the gingiva
  • Histological features
    • mesenchymal spindle to stellate cells (periodontal ligament)
    • odontogenic epithelium (cell rests of Malassez)
    • variable matrix with characteristics of bone, dentin or cementum
  • Behavior if untreated
    • expansile and non-invasive
    • excision is usually curative
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15
Q

Acanthomatous ameloblastoma

aka: Acanthomatous epulis

Dogs

A
  • Age
    • older than three years of age
    • mean 8.8 years
  • Location
    • anywhere on the gingiva
  • Histologic features
    • interconnecting, invasive sheets of odontogenic epithelium
  • Behavior if untreated
    • invasive into bone
    • no metastasis
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16
Q

Squamous Cell carcinoma

Dog

A
  • Age
    • mean: 8 yrs old
  • Location
    • Tonsil, gingiva, lip, tongue, palate, pharynx
  • Gross features
    • nodular, firm, oten ulcerated
  • Behavior if untreated
    • Tonsillar: metastasis to regional nodes early (98%) with frequent more distant metastasis (63%)
    • Others: locally invasive, lower percentage 5-10% metastasize
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17
Q

Squamous cell carcinoma

Cat

A
  • Most common oral tumor in the cat
  • Age
    • median: 12 yo
  • Location
    • tongue, and gingiva most common
  • Gros and histo features
    • same as dog
  • Behavior if untreated
    • locally invasive and mass producing
    • destructive to bone
    • 15% metastasis rate to local nodes (one study)
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18
Q

Oral malignant melanoma

A
  • age
    • mean: 11 yo
  • Location
    • Gingiva and lips most common
  • Behavior if untreated
    • 70% metastasize to regional lymph nodes
    • 67% to distant sites
      • lung, brain, eyes, liver, kidney
  • May be amelanotic
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19
Q

Fibrosarcoma

Dog

A
  • Age
    • mean: 7.2 years
  • Location
    • gingiva, hard/soft palate, lip, tongue
  • Behavior if untreated
    • local infiltration and tissue destruction
    • metastasis in 20% to local lymph nodes
    • 10-20% to lungs
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20
Q

Which of the following oral neoplasms in dogs has the greatest pobability of metastasis?

  • A. Tonsillar squamous cell carcinoma
  • B. Periodontal fibromatous epulis
  • C. Acanthomatous ameloblastoma
  • D. Squamous papilloma
  • E. Leiomyoma
A
  • A. Tonsillar squamous cell carcinoma
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21
Q

Which of the following oral neoplasms in dogs has the least probability of invasion and/or metastasis?

  • A. Melanoma
  • B. Periodontal fibromatous epulis
  • C. Acanthomatous ameloblastoma
  • D. Fibrosarcoma
  • E. Leiomyomasarcoma
A
  • B. Periodontal fibromatous epulis
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22
Q

Calf: Morphologic diagnosis

Most likely cause is trauma and infection by?

A
  • Stomatitis
  • Focal
  • Necrotizing
  • Chronic: deep, rounded edges
  • Likely cause: fusobacterum necrophorum
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23
Q

Cow: Morphologic diagnosis

Most likely cause?

A
  • esophagous, esophagitis
  • Multifocal: some spots are not affected
  • Ulcers and erosions
  • Most likely cause: BVD
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24
Q

Pathology of the Esophagus

A
  • Inflammatory disease
  • Megaesophagus
  • Impaction / obstruction
  • Neoplasia
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25
Esophageal inflammation
* Generally comparable to inflammation in the oral cavity due to infectious agents * Exceptions of note * reflux esophagitis
26
Esophageal impaction
* lots of dry, poorly masticated feed * Regurge, bloat, choke * pressure induced necrosis * esophageal damage
27
Esophageal neoplasms
* papillom * leiomyom/leiomyosarcoma * squamous cell carcinoma
28
Pathology of rumen/reticulum/omasum
* Infectious inflammatory diseases * Chemical ruminitis
29
Infectious rumenitis/omasitis/reticulitis
* Erosive/Ulcerative * Proliferative * Necrotizing * Other * Pseudomembranous * Granulomatous
30
Rumenitis Lactic Acidosis
* Carbohydrate overload * Lactic acid burn of mucosa * Acidosis * Chronic complications * scars * mycotic infection * bacterial infection---hepatitis
31
Pathology of Stomach/Abomasum
* Ulcers * Inflammatory dz * Rupture * Neoplasia
32
Ulcers Associated conditions
* Trauma, chemical injury * High acidity * Local ishemia * Helicobacter spp * Parasites * Neoplastic dz * mast cells and gastrin producing tumors
33
Gastritis/abomasitis causes
* Infectious * Clostridial * Fungal * mycotic, animals on abx have changed gastral flora * Parasitic * ostertagia ostertagie -- protein abomasopathy * Helicobacter spp * Toxic
34
Gastric/abomasal neoplasia
* Adenocarcinoma * Leiomyoma/Leiomyosarcoma/GIST * Lymphoma * cats: stomach * dogs: stomach * Squamous cell carcinoma-horse
35
Most likely cause
* Chronic, diffuse, hyperplastic abomasitis * also widely disseminated, multifocal * ostertagia ostertagia
36
Most likely etiologic diagnosis
* Acute multi-focal hemorrhagic and necrotizing omasitis * Mycotic omasitis
37
Most likely morphologic diagnosis?
* leiomyoma or gastrointestinal stromal tumor
38
GI obstruction/vascular obstruction
* Gastric/abomasal volvulus * Intestinal volvulus/torsion * Intestinal external herniation * Itenstinal internal herniation/entrapment * Intussusception * Intestinal stenosis/atresia * Intestinal stricture * Enteroliths and impactions
39
Gastric/abomasal volvulus
* Twist of stomach/intestine on self and mesentery * Consequences * obstruction of lumen * obstruction of vascular supply and hemorrhagic infarction
40
Predisposing factors Gastric Dilation and Volvulus in Dogs
* Initial gastric dilation * gas accumulation * dietary and feeding/exercise may influence * Volvulus that may be associated with * deep chested body configuration * relaxation/stretching of gastrohepatic ligament
41
Right displaced abomasum Predisposing Factors
1. Displacement of Abomasum (LDA and RDA) * Conditions during first 6 weeks of lactation * High production of volatile fatty acids with diet * GI stasis allowing abomasal stasis and gas accumulation and decrease in size of rumen * Deep body cavity 2. Unknown factors contribute to vovlulus following right sided displacement
42
def: Torsion def: Volvulus
* Torsion * twist around the long axis of the intestinal segment * Volvulus * twist in axis outside the long axis of the organ and involving the mesentery
43
Herniation/Vovulus dz examples
* Internal herniation through epiploic foramen * Mesenteric rents * Strangulating lipoma * Intussusception * Intussusceptum goes in Intussuscipiens
44
Intussusception Predisposing factors
* Enteritis/altered motility * Intestinal foreign body * Intestinal polyp/neoplasm
45
Stenosis and Atresia
* Stenosis * Membrane atresia * Cord atresia * Blind end atresia
46
Vascular Obstruction
* Thrombosis/thromboembolism/infarction * horses: secondary to strongilus vulgaris * Intestinal lymphangiectasia
47
* Intestinal linear foreign body obstruction
48
* Internal herniation of small intestine through epiploic foramen with infarction
49
* Mesenteric volvulus
50
DZ affecting intestinal Crypts
* Parvovirus replication * BVD * Rinderpest * Mycotoxin * Radiation
51
Dzs affecting Villar tip
* Rotavirus * Coronavirus replication * Cryptosporidium attach, replicate
52
Mechanisms of Diarrhea in Enterocolitis
1. Maldigestion/Malabsorption - Osmotic * epithelial surface area loss via villous atrophy and other mechanisms 2. Secretory mechanisms - Cl- Secretion * Many infectious agents act at the level of the intestinal crypts 3. Increased permeability * Mucosal epithelial damage * Inc vascular permeability
53
Morphologic classification of enterocolitis according to Exudate
* Necrotizing (gross and microscopic) * Fibrinonectic * Proliferative * Granulomatous
54
ecrotizing Enterocolitis Resulting in Villous atrophy
* viral * protozoal
55
Known causes of infectious diarrheal dz in calves with villous atrophy
* Bovine corona virus * Bovine rotavirus * Cryptosporidia sp. * Bovine enteric calicivirus * Bovine norovirus * Bovine enteric syncitial virus * rotavirus grp B * Bovine parvovirus * Astrovirus * Some E. Coli
56
Parvovirus can also cause
lymphoid atrophy
57
BVD can also cause
Acute multifocal erosive enteritis with necrosis of Peyer's patches
58
Which of the following infectious agents induces villous atrophy? * A. Rotavirus * B. Coronavirus * C. Cryptosporidia sp. * D. Parvovirus * E. All of the above
* E. All of the above
59
Which of the following infectious agents induces necrosis of crypt epithelial cells? * A. Rotavirus * B. Coronavirus * C. Cryptosporidia sp. * D. Parvovirus
* D. Parvovirus
60
Enteric salmonellosis
* classic disease resulting in fibrinonectroic lesions and fibrin casts
61
Pathogenic mechanisms Salmonella Not exam question
* Attach to M-cells, enterocytes and goblet cells * Survive in phagosome * neutralize NO through SPI-2 * Toxins inducing necrosis * Enterotoxin * Verotoxin * Endotoxin * Upregulate chloride ion secretion via PGE2
62
Salmonella Pathogenesis
* Forms 1. Peracute septicemia: sudden death * Vasculitis, thrombosis * common in rodents and pigs * diamond skin lesions 2. Acute enteric salmonellosis * Enterocolitis: fibrinonecrotic lesions * Septicemia: hepatocellular necrosis, lymphadenomegally, **splenomegally**, fibrinous cholecystitis 3. Chronic enteric salmonellosis * Enterocolitis * Thrombosis * Rectal strictures in pigs
63
DDX for fibrinonectrotic intestinal lesions
* **salmonellosis** * enterotoxigenic E. coli - calves * clostridium difficile - horses, other sp. * lawsonia intracellularis - classic in pigs * brachyspira hyodysenteriae and anaerobes - swine dysentary
64
Hemorrhagic Enterocolitis Causes
* Clostridial perfringens type C and other clostridia * Shigellosis in primates * Lawsonia intracellularis in pigs * Coccidiosis * Eimeria bovis in colon- calves, lambs and rabbits
65
Hyperplastic Enterocolitis Causes
* Lawsonia intracellularis - proliferative ileitis in a pig * Coccidiosis
66
Granulomatous Enterocolitis Causes
* Mycobacterial infection * Histoplasmosis, other deep mycoses * Less well defined entities * granulomatous enteritis in horses \*Johne's dz classic example * Chronic diffuse granulomatous enteritis and lymphangitis
67
Which of the following infectious agents most commonly induces fibrinonecrotic enterocolitis? **test question** * A. Rotavirus * B. Salmonella sp. * C. Cryptosporidia sp. * D. Mycobacteria sp. * E. Lawsonia intracellularis
* B. Salmonella sp
68
Which of the following infectious agents most commonly induces proliferative enteritis? * A. Rotavirus * B. Salmonella sp. * C. Cryptosporidia sp. * D. Mycobacteria sp. * E. Lawsonia intracellularis
* E. Lawsonia intracellularis
69
Intestinal Neoplasia
* Lymphoma * Epithelial tumors * adenoma * adenocarcinoma * Leiomyoma/Leiomyosarcoma/GIST * Carcinoid
70
Intestinal adenocarcinoma Dog
* Age * mean: 9 yo * More common in males * Location * colon/rectum \> 55% * Small intestine \< 45% * Gross features * plaque like or ulceratied * may be partially polypoid in colon/rectum * small intestine: almost always annular and constricted * Behavior if untreated * spread to local nodes and implant throughout peritoneum and liver
71
Intestinal Adenocarcinoma Cat
* Age * mean: 11 yo * More common in males * Siamese cats may be more susceptible * Location * small intestine (90%) * Gross features * small intestine: almost always annular and constrictive/obstructive * Behavior if undetected * usually spread to local nodes and implant throughout peritoneum by time noted clinically

3rd path test (4 decks)

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