Diseases of the Digestive System

Card Set Information

Author:
sinopa
ID:
276290
Filename:
Diseases of the Digestive System
Updated:
2014-06-11 22:27:54
Tags:
clinical pathology cpp cal poly pomona
Folders:

Description:
spring 2014 clinical pathology with doctor wallace. lecture
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user sinopa on FreezingBlue Flashcards. What would you like to do?


  1. Diagnostics for abdominal disease
    • History - including diet
    • Physical exam
    • CBC and blood chemistries
    • Urinalysis
    • Spec cPL or Spec fPL
    • Microscopic fecal parasite examination
    • Abdominal Radiographs – 2 or 3 view
    • Parvovirus test if indicated
    • Abdominal Ultrasound
    • Fecal culture and sensitivity/fecal PCR tests
    • TLI//cobalamin (B12) and folate tests
    • Resting cortisol or ACTH stimulation test
    • Barium radiographs, upper GI endoscopy
    • +/-biopsy, colonoscopy
    • Exploratory laparotomy
  2. What is megaesophagus
    • diffuse dilation
    • lack of peristalsis
    • can be secondary to many diseases
    • found in large breed dogs
  3. symptoms of megaesophagus
    • regurgitation - distinguish from vomiting
    • idiopathic - most common
  4. treatment for megaesophagus
    • not treated well with medications
    • usually not reverisble
    • special diet
    • monitor for aspiration pneumonia
  5. signs of gastritis and gastric ulceration
    • Anorexia/hyporexia
    • Vomiting +/- blood
    • Dehydration
    • Cranial abdominal pain
    • Weight loss
    • Lethargy
    • Diarrhea +/- melena
  6. causes of gastritis and gastric ulceration
    • NSAID’s/corticosteroids
    • Inflammatory bowel disease (IBD)
    • Foreign bodies
    • Parasites/bacteria/viral
    • Pancreatitis
    • Toxicities
  7. treatment of gastritis and gastric ulceration
    • NPO (nothing per os)
    • IV fluids
    • Electrolytes - K+, NaCl
    • Antiemetics
    • Histamine (H2) receptor
    • antagonists – inhibit gastric acid secretion  
    • Antacids
    • Sucralfate – gastric protectorate
    • Antibiotics
  8. signs of gastric dilation and volvulus syndrome
    • Vomiting, dry heaves
    • Anxious
    • Abdominal pain
    • Collapse
    • Ptyalism (drooling)
    • Distended abdomen
    • Tachycardia/tachypnea
    • Weak pulses and pale mm
  9. causes of gastric dilation and volvulus syndrome
    • large breed dog
    • activity following a meal
    • genetic predisposition
  10. treatment of gastric dilation and volvulus syndrome
    • SURGICAL EMERGENCY
    • Treat shock – FLUIDS
    • Gastric decompression – orogastic
    • intubation or percutaneous gastrocentesis
    • Pain medication
    • CBC/blood chemistries
    • Electrolyte imbalances
    • Arrhythmias
    • Ventricular tachycardia
    • Sinus arrhythmia
    • Monitor for VPC’s after surgery
    • –SURGERY to derotate and gastropexy
  11. common causes of gastric neoplasia
    • lymphoma,
    • adenocarcinoma,
    • small cell lymphoma (cats)
  12. infrequent causes of gastric neoplasia
    • gastrinoma,
    • leiomyosarcoma,
    • plasma cell tumor,
    • mast cell tumor
  13. signs of gastric neoplasia
    • Vomiting
    • Weight loss – tumor cachexia
    • Obstruction
    • Older animals
  14. diagnosis of gastric neoplasia
    • endoscopy
    • biopsy
  15. signs of hemorrhagic gastroenteritis (HGE)
    • Sudden onset of diarrhea which quickly progresses to severe
    • bloody diarrhea
    • Vomiting
    • Hypovolemia
    • Marked hemoconcentration PCV > 60%
  16. etiology of hemorrhagic gastroenteritis (HGE)
    • idiopathic,
    • hypersensitivity reaction,
    • Clostridium
    • perfringens
  17. treatment of hemorrhagic gastroenteritis (HGE)
    • intense fluid therapy,
    • antibiotics,
    • antiemetics
  18. Causes of small intestinal diarrhea
    • Dietary indiscretion or changes
    • Dietary intolerance or hypersensitivity
    • Drugs and toxins
    • Malignancy
  19. Bacterial causes of small intestinal diarrhea
    • infectious vs. overgrowth
    • salmonella
    • campylobacter
    • E.coli
    • Shigella
    • Clostridium (exotoxin)
    • bacterial enteritis
  20. viral causes of small intestinal diarrhea
    • parvovirus
    • feline panleukopenia
    • coronavirus
    • canine distemper virus
  21. parasitic causes of small intestinal diarrhea
    • hookworms
    • ascarids
    • whipworms
    • Giardia
    • coccidia
  22. Metabolic causes of small intestinal diarrhea
    • addison's
    • liver disease
    • renal disese
    • pancreatic disease
    • malignancy
  23. causes of small intestinal diarrhea in young animals
    • dietary indescretion
    • foreign bodies
    • infectious
    • intussusception
  24. Principles of diarrhea treatment
    • Manage dehydration – deficits, maintenance and ongoing fluid losses
    • Evaluate electrolytes
    • K+ supplementation
    • Metabolic acidosis
    • Specific treatment for organisms
    • Organs system treatment
    • NPO
    • Bland diet 
  25. Dietary Intolerance
    • More common in cats
    • Idiosyncratic reactions to dietary ingredients or additives – colorings, preservatives, spices
    • Most are due to proteins - pet can become sensitive over time
  26. signs of dietary intolerance
    • diarrhea and vomiting may
    • be chronic or intermittent,
    • flatulence,
    • anorexia,
    • weight loss,
    • abdominal discomfort
  27. diagnosis of dietary intolerance
    • rule out other causes of symptoms
    • May require endoscopy with biopsy
  28. treatment of dietary intolerance
    • dietary change
    • novel protein indefinitely (albumin, globulin)
    • also known as lymphagiectasis
  29. Intestinal Lymphangectasia
    • Obstructive disorder of the lymphatic system of the gastrointestinal tract
    • Causes lymphatic hypertension and protein-losing enteropathy
    • Fluid flows into the intestine
  30. signs of intestinal lymphagectasia
    • diarrhea,
    • ascites,
    • SC edema,
    • weight loss,
    • flatulence,
    • vomiting,
    • dyspnea from pleural effusion
  31. diagnosis of intestinal lymphagectasia
    • rule out other causes of protein-losing enteropathy,
    • intestinal biopsy
  32. treatment of intestinal lymphangectasia
    • low fat diet with high quality protein,
    • supplement with fat soluble vitamins,
    • can try corticosteroids,
    • cobalamin if deficient,
    • antibiotics   
  33. Intestinal Obstruction
    • Partial or complete physical impedance to the flow of ingesta
    • Foreign bodies,
    • intussusception,
    • mesenteric torsion,
    • neoplasia
  34. signs of intestinal obstruction
    • Vomiting – hallmark sign
    • Anorexia,
    • lethargy,
    • malaise,
    • ptylaism,
    • diarrrhea,
    • melena
  35. Diagnosis of intestinal obstruction
    • Radiographs - gaseous accumulation cranial to obstruction
    • Contrast radiographs/ultrasound
  36. treatment of intestinal obstruction
    • Emergency surgery -
    • intestinal necrosis will occur with distention secondary to hypoxemia
    • Enterotomy or anastamosis
  37. Intusussception
    • Telescoping of the small intestine
    • Young animals, mainly dogs
    • Obstruction – partial or complete
  38. Signs of intusussception
    • Vomiting/diarrhea
    • Anorexia/weight loss
    • Depression/abdominal pain
    • May be able to palpate structure in abdomen
  39. diagnosis of intusussception
    • radiographs
    • ultrasound
  40. treatment of intusussception
    surgery
  41. Inflammatory bowel disease (IBD)
    • Group of chronic diseases characterized by persistent GI signs
    • Aberrant host immune responses to gut microflora
  42. signs of IBD in dogs
    • chronic intermittent vomiting
    • diarrhea
    • weight loss
  43. signs of IBD in cats
    • anorexia
    • weight loss
    • vomiting
    • diarrhea
  44. causes of IBD
    • multifactorial,
    • infectious agents,
    • dietary agents,
    • genetic factors 
  45. definitive diagnosis of IBD
    intestinal biopsy
  46. treatment of IBD
    • diet change,
    • cobalamin if deficient,
    • fiber,
    • fish oil,
    • probiotics
  47. what is megacolon
    Persistent increased large bowel diameter with constipation, obstipation and low colonic motility
  48. Idiopathic megacolon
    • middle-aged to old cats,
    • manx breed
  49. acquired megacolon
    chronic constipation leads to irreversible changes to colonic motility
  50. diagnosis of megacolon
    • vomiting
    • anorexia
    • weight loss
    • radiographs
  51. treatment of megacolon
    • exercise
    • low-residue diet
    • stool softeners
    • cisapride (prokenetic GI drug)
    • warm water enemas
  52. Pancreatitis
    • Inflammation of the pancreas –
    • natural defenses fail and auto-digestion occurs when digestive enzymes activated within acinar cell
  53. Acute vs Chronic pancreatitis
    • -Acute – inflammation that occurs abruptly with little to no permanent pathological changes
    • -Chronic – continuing inflammation accompanied by
    • irreversible morphologic changes to the pancreas
  54. pancreatitis in dogs
    • Most common - middle-aged to old,
    • female,
    • Miniature Schnauzers,
    • Miniature Poodles,
    • Cocker Spaniels
  55. signs of pancreatits in dogs
    • lethargy,
    • depression,
    • anorexia,
    • vomiting,
    • abdominal pain,
    • diarrhea,
    • dehydration,
    • fever
  56. causes of pancreatitis in dogs
    • usually unknown,
    • associated with hyperlipoproteinemia/high fat treat or meal
  57. risk factors of pancreatitis in dogs
    • obesity,
    • diabetes,
    • Cushing’s,
    • chronic renal failure,
    • neoplasia
  58. definitive diagnosis of pancreatitis in dogs
    • specCPL test,
    • abdominal ultrasound to rule out
    • abscess,
    • cyst,
    • neoplasia
  59. treatment of pancreatitis in dogs
    • IV fluids with K+ if needed,
    • feed unless vomiting,
    • avoid high protein/high fat diets,
    • pain
    • medications,
    • antibiotics,
    • antiemetics
  60. cPL - Canine Specific Lipase
    fPL - Feline Specific Lipase
    • -In house (qualitative) and reference lab
    • (quantitative) tests SPECIFIC for pancreatic lipase
    • -Rules out non-specific sources of lipase,
    • solving the problem in diagnosing pancreatitis definitively
    • –much better test than the
    • traditional AMS/LPS
  61. pancreatitis in cats
    • most common in middle-aged to old
    • siamese breed
  62. signs of pancreatitis in cats
    • vague and non-specific,
    • lethargy,
    • depression,
    • anorexia,
    • weight loss,
    • icterus,
    • dehydration,
    • fever or hypothermia
  63. causes of pancreatitis in cats
    • unknown,
    • infectious agents (toxoplasmosis, FIP),
    • feline hepatobiliary syndrome,
    • intestinal inflammation 
  64. risk factors of pancreatitis in cats
    concurrent hepatic/gut inflammatory disease 
  65. diagnosis of pancreatitis in cats
    • same as in dogs
    • specCPL test,
    • abdominal ultrasound to rule out abscess,
    • cyst,
    • neoplasia
  66. treatment of pancreatitis in cats
    • same as in dogs
    • IV fluids with K+ if needed,
    • feed unless vomiting,
    • avoid high protein/high fat diets,
    • pain
    • medications,
    • antibiotics,
    • antiemetics
  67. exocrine pancreatic insufficiency
    • Inadequate amounts of pancreatic digestive
    • enzymes leading to the incomplete digestion of food
  68. signs of exocrine pancreatic insufficiency
    • weight loss with good appetite,
    • chronic loose stools or diarrhea,
    • “cow patty” feces,
    • large fecal volumes,
    • steatorrhea (fat in stool),
    • flatulence,
    • borborygmi
  69. diagnosis of exocrine pancreatic insufficiency
    • trypsin-like immunoreactivity,
    • test of choice – will be reduced,
    • cobalamin and folate often run as a panel with TLI test
  70. treatment of exocrine pancreatic insufficiency
    • supplement with pancreatic enzyme replacement,
    • cobalamin injections,
    • initially may need antibiotics for SIBO (small intestinal bacterial overgrowth)
  71. Causes of exocrine pancreatic insufficiency
    • Pancreatic acinar atrophy in dogs
    • –Juvenile Pancreatic Atrophy
    • –High prevalence in German shepherds
    • Chronic pancreatitis in dogs and cats
    • –usually idiopathic and can lead to DM
    • Pancreatic duct obstruction in dogs and cats
    • –Pancreatic adenocarcinoma
    • –May cause acute inflammation before maldigestion and weight loss occurs
  72. TLI (serum) (EPI)
    • Trypsinogen is secreted in enzyme-rich pancreatic secretions
    • Converted to trypsin in the intestine
    • Small amount escapes into the blood
    • This is measured to determine pancreatic
    • activity
  73. Cobalamin (EPI)
    • -Cobalamin (B12) enters the stomach via ingested foods
    • -Cobalamin enters the intestine and binds to intrinsic factor (IF) that is secreted by pancreatic cells (dogs and cats) and gastric mucosa (dogs)
    • -Required for RBC synthesis
  74. Decreased Cobalamin (EPI)
    • EPI, SIBO, 
    • -can be severe in the cat due to malabsoption
    • -can be due to decreased absorption in the ileum due to disease
  75. Folate (EPI)
    • B vitamin linked to cobalamin metabolism
    • Present in food
    • Produced by enteric bacteria
  76. Increased Folate (EPI)
    • Bacterial overgrowth
    • Low intestinal pH – EPI – decreased HCO3 secretion
    • High dietary intake
  77. decreased folate (EPI)
    • small intestinal disease
    • dietary deficiency
  78. Other Biochemical Findings of Exocrine Pancreatic Insufficiency
    • Azotemia (pre-renal and renal)
    • Increased liver enzymes (ALT, AST, AP)
    • Hyperbilirubinemia
    • Lipemia
    • Hyperglycemia
    • Hypoproteinemia
    • Hypocalcemia
    • Metabolic acidosis
    • Variable alterations (usually decreased) in sodium, potassium and chloride
  79. Causes of Hypercholesterolemia
    • Acute pancreatitis
    • Cholestasis (obstructive)
    • Diabetes mellitus
    • Hyperadrenocorticism
    • Hypercholesterolemia in Briards
    • Idiopathic hyperlipidemia of miniature schnauzers
  80. Known, single Causes of Hyperlidemia (TGs)
    • Increased triglyceride production:
    • By hepatocytes
    • –Equine hyperlipemia or hyperlipidemia
    • By enterocytes
    • –Postprandial hyperlipidemia
    • Decreased lipolysis or intravascular rocessing of lipoproteins
    • –Hypothyroidism
    • –Nephrotic syndrome
  81. Other, unknown or multiple mechanisms
    • Acute pancreatitis
    • Diabetes mellitus
    • High lipid diet
    • Hyperadrenocorticism or excess lucocorticoids
    • Hyperlipidemia in a Brittany spaniel
    • Idiopathic hyperlipidemia of miniature schnauzers

What would you like to do?

Home > Flashcards > Print Preview