Upper Gastrointestinal Disorders

1. Is Christy vomiting or regurgitating?

a. Vomiting
b. Regurgitating

2. Based on the signalment and history, what is your top differential diagnosis for the cause of Christy’s signs?

a. Dietary indiscretion
b. Megaesophagus
c. Gastric foreign body
d. Roundworms

3. Based on results of thoracic radiographs, what is your diagnosis?

a. Vascular ring anomaly
b. Esophageal foreign body
c. Hiatal herniad
d. Megaesophagus
e. Normal thoracic radiographs

4. Aspiration pneumonia is a common complication of this problem. Based on the results of the physical examination and thoracic radiographs, do you think Christy has aspiration pneumonia?

a. Yes
b. No

5. How would you characterize the abnormalities on the CBC?

a. Neutrophilia with a left shift
b. Regenerative anemia
c. Leukopenia
d. Thrombocytopenia
e. No abnormalities

6. Was Bo vomiting or regurgitating?

a. Vomiting
b. Regurgitating

7. What complications may occur secondary to an esophageal foreign body?

a. Esophagitis
b. Esophageal perforation
c. Esophageal stricture
d. All of the above

8. Based on the follow-up videoendoscopy, what complication is present in Bo?

a. Esophagitis
b. Esophageal perforation
c. Esophageal stricture
d. No complications are present

9. A bone is lodged in the esophagus of a dog and you endoscopically push it into the stomach rather than removing it out the mouth. Can it subsequently be completely digested by gastric secretions?

a. Yes
b. No

10. Were Pedy’s presenting signs more consistent with vomiting or with regurgitation?

a. Vomiting
b. Regurgitation

11. What is considered "symptomatic" treatment of vomiting?

a. Hold off food for 24 hours
b. Offer small amounts of water frequently
c. Antiemetics
d. H₂ receptor blockers
e. All of the above

12. What two antiemetic drugs are commonly used in dogs (choose two)?

a. Antacids
b. Omeprazole
c. Propulsid
d. Pepto-bismol
e. Metoclopramide

13. Dogs become infected with Physaloptera rara by eating an intermediate or transport host containing the infective larvae.

Which of the following are intermediate hosts for Physaloptera?

a. Cockroach
b. Cricket
c. Beetle
d. All of the above

14. What is the most common way that the clinical diagnosis of gastric Physaloptera in dogs is made?

a. Fecal flotation
b. Necropsy
c. Endoscopy
d. Presence of parasites in vomitus or feces
e. Abdominal radiographs

15. Based on the history, do you think Balai is vomiting or requrgitating?

a. Vomiting
b. Regurgitating

16. What underlying pathophysiologic mechanism is suggested by the history?

a. Gastric ulceration
b. Delayed gastric emptying

17. What is your interpretation of the abdominal radiographs?

a. Normal
b. Gastric distention
c. Gastric torsion
d. Intestinal obstruction

18. Based on the history, abdominal radiographs, and profile abnormalities, what is the most likely acid-base abnormality?

a. Metabolic acidosis
b. Respiratory acidosis
c. Respiratory alkalosis
d. Metabolic alkalosis

19. What test could be performed for definitive characterization of Balai’s acid-base status?

a. Biochemical profile
b. Complete blood count
c. Blood gas analysis
d. None of the above

20. What is the fluid composition of choice to treat Balai?

a. Lactated Ringer's solution
b. 0.9% saline with KCl
c. 5% dextrose in water
d. Plasmalyte

21. What is your final diagnosis of Balai‘s gastric disorder?

a. Gastric neoplasia
b. Gastric foreign body
c. Chronic gastritis
d. Chronic hypertrophic pyloric gastropathy (CHPG)

22. What is the prognosis after surgery?

a. Poor
b. Guarded
c. Good

23. When gastric ulceration is suspected, the owner should always be questioned as to whether the dog has received what type (or category) of drug?

a. NSAIDS
b. Amoxicillin
c. Heartworm preventatives
d. Antacids

24. Which systemic metabolic disorder can be complicated by GI ulceration?

a. Renal failure
b. Liver disease
c. Addison’s disease (hypoadrenocorticism)
d. Gastrinoma
e. All of the above

25. What characteristic type of anemia occurs secondary to CHRONIC gastrointestinal blood loss?

a. Non-regenerative anemia
b. Iron deficiency anemia
c. Hemolytic anemia
d. Anemia is not a complication

26. What findings might be present on the CBC if this type of anemia occurred?

a. Regenerative anemia
b. Microcytosis (decreased MCV)
c. Decreased MCHC
d. Thrombocytosis
e. All of the above

27. What type of bacteria do the spiral bacteria probably represent?

a. E. coli
b. Pseudomonas
c. Helicobacter
d. Streptococcus

28. Have these bacteria been shown to be a cause of gastric lymphoma in humans?

a. Yes
b. No

29. Have these bacteria been shown to be a cause of gastric lymphoma in dogs?

a. Yes
b. No

30. Which of the following is not an H₂-receptor blocker?

a. Cimetidine (Tagamet®)
b. Famotidine (Pepcid®)
c. Omeprazole (Prilosec®)
d. Ranitidine (Zantac®)
e. Nizatidine (Axid®)