RUSVM - SAM II Exam II
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Created by:
Brownbear86 on February 11, 2012
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Covers Disorders of: Mouth, Esophagus, Stomach, Intestines, Colon, Pancreas
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83 terms
Terms | Definitions |
|---|---|
 What are the normal spacing for the gingival sulcus in cats and dogs? | Cat - 0.5-1mm Dog - 1-3mm |
| What are the dental formulae for cats and dogs? | Cat - 2(I3/3 C1/1 P3/2 M1/1) = 30 Dog - 2(I3/3 C1/1 P4/4 M2/3) - 42 |
| For dogs, when do their incisors and canines erupt? | Deciduous incisors (4-6wks) Permanent incisors (12-16wks) Deciduous canines (3-5wks) Permanent canines (16-24wks) |
| For cats, when do their incisors and canines erupt? | Deciduous incisors (3-4wks) Permanent incisors (11-16wks) Deciduous canines (3-4wks) Permanent canines (16-20wks) |
| What's the rule of 4 and 9? | Every tooth ending in 04 is a canine and every tooth ending in 09 is the 1st molar |
| What's the mark of normal bite occlusion? | Upper incisors are rostral to lower incisors Lower canines are b/t upper canine and 3rd incisor |
| What neuromuscular DZ can lead to clinical sign of dysphagia? | Myasthenia gravis Myositis Cricopharyngeal achalasia Rabies, tetanus, botulism Idiopathic cranial nerve dysfxn |
| What is essential in performing a complete oral exam? | General Ax |
| What's the pathogenesis of periodontal DZ? | Combo of oral flora and host defenses and periodontal ligament loss Placque and inflammation |
| What are the stages of periodontal DZ and how much attachment is lost at each stage? | 0 - normal - 0% loss 1 - gingivitis - 0% loss 2 - early periodontitis - <25% loss 3 - moderate periodontitis - >25% loss 4 - severe periodontitis - >50% loss |
| What do the animals w/ periodontal DZ come into the clinic for (presenting complaint)? | Halitosis, dysphagia, ptylism |
| What painful oral condition in mature cats is idiopathic, but thought to be related to excessive host response to oral flora? | Lymphocytic-Plasmacytic Stomatitis |
| What do you see on physical exam and how do you Dx lymphocytic-plasmacytic stomatitis? | Gingivitis, bleeding, swelling, tartar, enlarged submandibular lnn. Dx by histopath of biopsy |
| How do you Tx lymphocytic-plasmacytic stomatitis? | Oral hygiene Extraction of all teeth (± except canines and incisors) Systemic abx |
| What does FORLs stand for, and what is it? | Feline Odontoclastic Resorptive Lesions is a progressive d/o teeth |
| What is a suspected etiology of FORLs? | Hypervitaminosis D |
| What's the pathogenesis of FORLs? | Begins w/ enamel resorption -> dentin resorption reaching pulp cavity Crown may fracture off leaving roots to become inflamed or roots may be resorbed too |
| How do you Dx FORLs? | Oral exam w/ rads, calculus may cover defects in teeth |
| What are some Tx options to FORLs? | Delay progression w/ sealing enamel defects Extraction once pulps is exposed Crown amputation if no gingival lesions and resorption below gumline |
| What are some crown abnormalities? | Enamel hypocalcification and hypoplasia (fever/inflammation prior to eruption) Enamel staining (tetracycline, silver from cage biting) Pulpititis Attrition (wearing of teeth) Trauma causing pulp exposure Cavities on occlusal surface Root abnormalities (resorption, ankylosis, fracture) |
| What is gingival hyperplasia, and how do you Tx it? | Benign overgrowth -> pseudopocket formation Tx - trim to create normal sulcus depth |
| How does glossitis develop? | Traumatic, infection, auto-immune, or 2˚ to vasculitis/uremia |
| What are some abnormalities of the jaw? | Craniomandibular osteopathy (developmental) Rubber jaw (HPT) Injury (fractures or TMJ luxation) Neoplasia |
| How do you Tx craniomandibular osteopathy? | Use anti-inflammatories til it resolves at maturity (11-13 months of age) |
| How does rubber jaw develop? | From hyperparathyroidism (HPT) or nutritional 2˚ HPT |
| What are some abnormalities of the lips? | Chelitis (auto-immune) EØ granuloma complex (EGC) - rodent ulcer Cleft lip - congenital |
| What are some neuromsucular DZ of the mouth? | Masticatory myositis Auto-immune Idiopathic trigeminal neuritis (mandibular neuropraxia) |
| What are some pharyngeal DZ? | Retropharyngeal abscess Tonsillitis Tonsillar neoplasia Dysphagias |
| What are some different types of supragingival dental scalers? | Ultrasonic (most common) Rotary Sonic |
| What are the different phases of swallowing? | Oropharyngeal - form bolus and open UES Esophageal - 1˚ & 2˚ peristalsis Gastroesophageal - opening LES when bolus arrives |
| What are some DDx for esophageal DZ? | Esophageal obstruction (foreign body, vascular ring anomaly) Weakness (megaesophagus or esophagitis) |
| How do you Tx megaesophagus? | Bailey Chair High calorie diet in small, frequent meals Feeding tube |
| What's the Px of congenital megaesophagus? | Good b/c spontaneous recovery by 6 months Worse if have aspiration pneumonia |
| What is dysautonomia? | Idiopathic condition w/ loss of autonomic nerve fxn....none recover esophageal fxn |
| Esophagitis is caused by what? | Acid reflux, foreign body, caustic agents |
| What's a hiatal hernia? | A diaphragmatic abnormalitiy that allows part of the stomach to prolapse into the thoracic cavity |
| What are some causes of esophageal obstruction? | Vascular ring anomaly Foreign body Esophageal Cicatrix (stricture) |
| What are some DDx for vomiting? | 1˚ GI - obstructive or non-obstructive 2˚ GI - uremea, Addisons, liver failure, etc |
| What are some drugs used in stomach disorders? | Antiemetics Antacids Motility modifiers Anti-inflammatory and Anti-secretory Abx Anthelminthic |
| What are some antiemetics used to Tx stomach disorders? | Substance P inhibitor (Cerenia) 5HT antagonist (Odansetron) Dopamine receptor blocker (Metoclopramide) Antihistamine (Diphenhydramine) |
| What are some antacids used to Tx stomach disorders? | Oral antacids (Maalox) Sucralfate H2 blockers (Famotidine) H+ pump inhibitor (Omeprazole) Prostaglandin E (Misoprostol) |
| What's a special property of misoprostol? | It incr blood flow, prevents NSAID ulcers and is an antacids |
| What are some motility modifiers used to Tx stomach disorders? | Prolong transit time - Ioperamide and Diphenoxylate Shorten transit time - Metoclopramide, Cisapride, Erythromycin, Ranitidine |
| What are some anti-inflammatory and Anti-secretory drugs used to Tx stomach disorders? | Bismuth subsalicylate (pepto-bismol) Kaolin/Pectin (kaopectate) |
| What are some anthelmentics used to Tx stomach disorders? | Fenbendazole, Drontal plus |
| What's the etiology, signalment, clin signs, Dx, Tx of acute gastritits? | Etiology - ingestion of bad food, foreign body, toxin, drugs Signalment - dogs >>>>> cats Clin signs - vomit, anorexia Dx - Dx of exclusion Tx - supportive care, w/holding food, antiemetics |
| What's the etiology, signalment, clin signs, Dx, Tx, Px of hemorrhagic gastroenteritis (HGE)? | Et - unknown, but clostridial endotoxin suspected Sig - small breed dog C/S - profuse hematemesis and hematochezia w/ systemic signs Dx - PCV > 55% w/ normal prots Tx - aggressive fluid therapy w/ abx (ampicillin) Px - good |
| What's the etiology, signalment, clin signs, Dx, Tx, Px of chronic gastritis? | Et - IBD, helicobacter, physaloptera, ollulanus Sig - cats (Ollulanus), dogs (physaloptera) C/S - Chronic vomit and/or anorexia Dx - gastric biopsy and histopath Tx - deworm, hypoallergenic diet ± corticosteroids, amoxicillin Px - variable |
| What are the Sx lesions of gastric outflow obstruction? | Benign muscular hypertrophy (pyloric stenosis) Gastric antral mucosal hypertrophy Gastric foreign body GDV |
| What's the etiology, signalment, clin signs, Dx, Tx, Px of idiopathic gastric hypomotility? | Et - unknown...lack of emptying Sig - dogs C/S - vomit several hrs after eating Dx - Dx of exclusion Tx - prokinetics and low fiber diet Px - may respond well to medical therapy |
| What's the etiology, signalment, clin signs, Dx, Tx, Px of bilious vomiting syndrome? | Et - gastroduodenal reflux induced vomit Sig - dogs fed SID C/S - vomit once daily prior to feeding Dx - Dx of exclusion Tx - feed extra meal late in evening ± prokinetics Px - good |
| What's the etiology, signalment, clin signs, Dx, Tx, Prevention, Px of GI ulcer/erosion? | Et - variable Sig - dogs > cats C/S - vomit ± blood ± anemia/hypoproteinemia Dx - Contrast rads, US, endoscopic (most sensitive and specific w/ biopsy) Tx - symptomatic Prev - misoprostol to prevent NSAID ulcer Px - variable, but usu good if can be controlled |
| What's the etiology, signalment, clin signs, Dx, Tx, Px of infiltrative gastric neoplasia? | Et - various cancers Sig - older animals C/S - often asymptomatic until advanced Dx - Fe-deficiency, rads, FNA, endoscope Tx - chemo (LSA), Sx (others) Px - 18 months w/ chemo for LSA |
| What's the etiology, signalment, clin signs, Dx, Tx, Px of pythiosis? | Et - fungal Sig - dogs C/S - skin and GI infection Dx - biopsy Tx - Sx resection and systemic antifungals (itraconazole) Px - often poor if have dirty margins |
| What are the usu clin signs of intestinal DZ? | Vomit, diarrhea |
| What are some DDx for acute diarrhea? | Diet, infectious, obstruction, non-GI |
| What are some DDx for chronic diarrhea? | Small bowel - maldigestive, malabsorptive Large bowel - parasite, bact, food intolerance, IBD, IBS, neoplasia, pythiosis |
| What are the different types of fecal exams you can perform for chronic diarrhea? | Fecal float - helminths, flukes, protozoa NaCl prep - motility evaluation of protozoa Cytology - clostridia (safety pin), campylobacter (seagull), fungi, inflammatory cells ELISA - giardia, crypto, parvo Toxin analysis - C. perfringens toxin Culture - salmonella, campy, clostr, yersinia, E. coli, trichomonas PCR |
| Ultrasound imaging of the intestinal tract is good for what? | Pancreatitis, intussusceptions, free fluid, lymphadenopathy, thick walls, abnormal layering |
| What do serum Vit B concentrations tell us when looking at intestinal disorders? | Folate can be incr d/t incr bact production Decr in folate and cobalamine d/t decr absorption or abnormal bact population |
| What's the etiology, signalment, clin signs, Dx, Tx, Px of acute diarrhea? | Et - inflammatory, parasite, infection, obstructive, non-GI Sig - young animals C/S - diarrhea/vomit, dehydration, fever, anorexia, depression, ab pain Dx -CBC, biochem, UA, rads, fecal, emerg panel, etc Tx - sympatomatic, abx, albon, fordiflor, small bland meals Px - excellent, but at risk of sepsis if emaciated |
| What's involved in an emergency panel? | PCV, TSP, blood glucose, BUN/azostick |
| What's the etiology, signalment, clin signs, Dx, Tx of maldigestive (EPI) chronic diarrhea? | Et - pancreatic acinar atrophy Sig - dogs (GSD) 1-5 yrs C/S - weight loss w/ good appetite and chronic diarrhea Dx - TLI is low in affected dogs Tx - pancreatic enz supplement, low fat diet |
| What are some DDx of malabsorptive chronic diarrhea? | IBD, CARF, parasites, infectious, abx responsive enteropathy, neoplasia, pythiosis, histoplasma, lymphangiectasia, intussusception |
| What's the etiology, signalment, clin signs, Dx, Tx, Px of IBD | Et - idiopathic Sig - dogs/cats C/S - stomach (vomit), SI (diarrhea, weight loss, vomit), LI signs, ascites Dx -Dx of elimination Tx - immunosuppression w/ pred and azathioprine Px - guarded |
| What's the etiology, signalment, clin signs, Dx, Tx, Px of abx responsive enteropathy? | Et - syndrom where prox SI has higher than normal bact count -> impaired motility, mucosal DZ Sig - cat/dog C/S - diarrhea ± weight loss ± vomit Dx - response to therapy...Vit B levels Tx - tetracycline, tyosin, amoxicillin Px - good |
| What's the etiology, signalment, Dx, Tx, Px of dietary responsive enteropathy (food responsive diarrhea)? | Et - abnormal response to diet proteins Sig - dog/cat Dx - response to therapy Tx - unique diet, hypoallergnic diet Px -good |
| What's the etiology, signalment, clin signs, Dx, Tx, Px of intestinal lymphangiectasia? | Et - lymphatic obstruction Sig - dogs C/S - diarrhea, ascites, prot-losing enteropathy Dx - endoscope, histopath Tx - ultra low fat diet, anti-inflammatory pred Px - fair |
| What are some DDx for protein losing enteropathy in adult and young dogs and cats? | Adult K9 - IBD, LSA, lymphangiectasia Young K9 - parasite, chronic intussusception Cat - uncommon |
| What's the etiology, signalment, clin signs, Dx, Tx, Px of IBS? | Et -unknown Sig - dogs (GSD or small breed) C/S - large bowel diarrhea Dx - Dx of exclusion Tx - fiber supplement and anticholinergic Px - good |
| What's the etiology, signalment, clin signs, Dx, Tx, Px of LSA? | Et - may be FeLV in cats Sig - cats > dogs C/S - malabsorption, diverticuli and/or intestinal obstruction, diarrhe/vomit Dx - histopath of GI biopsy is best Tx - chemo Px - poor |
| Hematochezia, tenesmus, and dyschezia are seen w/ what lesions, and what are some DDx for them? | Distal colon or lower urinary tract lesions DDx - colitis, constipation, colon mass, anal sac DZ, perianal fistulae or hernia |
| What are some perianal DZ? | Anal sac DZ, perianal hernia, anal sac adenocarcinoma, perianal adenoma/carcinoma |
| What's the etiology, signalment, clin signs, Dx of perianal fistulae? | Et - chronic inflammation Sig - GSD (esp mature intact male) C/S - constipation, odor, rectal pain/discharge Dx - draining tracts around anus |
| How do you Tx perianal fistulae? | Cyclosporine Tacrolimus Abx for 2˚ infection Hypoalergenic diet Neuter Sx (remove tract, amputate tail, deroof & fulguration) |
| What are some causes of anal sac DZ? | Impaction, Sacculitis, Sac rupture, Abscess, Fistula |
| What's the etiology, signalment, clin signs, Dx of megacolon? | Et - idiopathic Sig - mostly cats C/S - anorexia, vomit, dehydration Dx - fecal mass palpable on PE |
| How do you Tx megacolon? | Acute - use fluids, enemas, PEG soln Chronic - altered fiber diet, stool softener (lactulose), motility modifier (cisapride) Sx - subtotal colectomy (last resort) |
| Pancreatic enz are activated by what? | Enterokinase in brush border of small intestine. Trypsinogen -> trypsin -> everything else |
| What's the pathophysiology of pancreatitis? | Blocking/inhibiting substances or stimulation of trypsin to activate other enz leads to pancreatitis....pancreas digests itself |
| How do you Dx pancretitis? | TLI in dogs PLI in cats US > rads Biopsy is the only way to def Dx in cat |
| What pancreatitis tests are useless in cats? | Amylase and lipase tests |
| What are some sequelae/complications of pancreatitis? | Fatal acute pancreatitis assoc w/ thrombus formation Extrahepatic biliary obstruction chronic inflammation -> pancreatic insufficiency |
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