Flashcards
Colic etc
Cards in this deck (99)
- 1What indicates the pain has passed?Shaking and chewing
- 2How often do we want to check a horse with colic?2 hours
- 3What is the typical age of occurence of enteroliths?Over 5y because it takes time for the stone to form
- 4Where does the enterolith usually get stuck?At the narrow areas- transverse colon
pelvic flexure
small colon - 5What is prone to be caught in a nephro splenic entrapment? (3)LDC
LVC
Pelvic flexure - 6What are the options to treat nephro splenic entrapment? (3)1. Phenylephrine will shrink the spleen
2. Roll the horse
3. Sx - 7What is more prone to be trapped in the epiploic foramen?The Ileum, but any other part of the small intestine might as well
- 8What does the sternal flexure separate?The RVC and the LVC
- 9What does the pelvic flexure separate?LVC and LDC
- 10What does the diaphragmatic flexure separate?LDC and RDC
- 11Where is the typical ascarid impaction? What is the typical age?Small intestine- distal jejunum or ileum. Until the age of 2y
- 12What HR should indicate immediate NG tube, before rectal exam?60 or higher
- 13What horses are more likely to develop neprho splenic entrapment?Warmbloods,Arabian
- 14How does Strongylus vulgaris cause colic?The worms get stuck in the intestinal artery, mostly in the colon, causing non strangulating infarctions
- 15What is the common outcome of large intestine problems?Medical Tx. except for large colon volvulus that requires immediate Sx and some obstructions that aren't reacting to Tx
- 16What is the common outcome of small intestine problems?Surgery
- 17What is the mortality of colic?25% (20-30)
- 18What is the mortality in medically treated colics?3%
- 19What is the mortality in surgically treated colics?34%
- 20What is the mortality in unstrangulated lesions?18%
- 21What is the mortality in strangulated lesions?60%
- 22The horse's abdomen is distended. Where is the problem?Most likely in the colon. The small intestine can distend but usually not to an extent where it pushes the body walls.
- 23What would small feces/cow-like feces indicate?A lot of concentrated food consumption, containing a lot of fluid
- 24There is fibrin on the feces. What is the explanation?There was some stasis and the stool was in the rectum for a long time. It was probably there for 12 hours.
- 25What is the normal frequency of passing feces ?Every 2-3 hours
- 26Why is every horse with colic considered 5% dehydrated?Because their body's response is to flow fluids to the GI lumen
- 27What happens if the NG tube is being pushed too dorsally?The Ethmoid might get hurt and bleed a lot
- 28What is the use of Metamucil (psyllium)?Avoiding sand impaction. If the situation is already acute, we don't start our treatment with that
- 29What volume of reflux defines ileus?More than 20L over 24h/more than 8L in one time/more than 2L in one time
- 30What two small intestine pathologies are very similar?Proximal enteritis and ileus
- 31What is the target of Betanechol?Smooth muscles of the intestine. It is cholinomimetic.
Works mainly in the colon - 32What is the mechanism of pramine?Works on the parasympathetic system.
Dopamine antagonist. The dopamine has an inhibitory effect in the parasympathetic system. Crosses BBB and causes excitation.
Works at the myenteric plexus level - 33What is the mechanism of Cisapride?Serotonin agonist, activating the parasympathetic system
- 34Why should a combination of Erythromycin and Cisapride be avoided?It causes a heart problem- a possibly fatal arrhythmia
- 35What is the problem with giving Erythromycin to foals?It impedes the body's temperature regulation
- 36What is the mechanism of Erythromycin?Motilide receptors.
When activated for a long time, they become less sensitive and the reaction decreases - 37What is quidding?A long chewing of the food and then spitting it. A clinical sign of teeth problems
- 38What is a cap?When the base of the desiduous tooth is destroyed by the permanent tooth but the rest of it stays, sits on the permanent tooth and cuts the gums
- 39How often is interval deworming performed?2-6 months
- 40What is the way to avoid future restistance of worms?Selective treatment
- 41Where are most of the ulcers in foals?Squamotic stomach and margo plicatus
- 42What co-morbidity is common in weaning foals with ulcers?ALD
- 43When do we give hypertonic saline?If the horse in shock has hyperemic cyanotic MM. It works for a very short time but that is the time needed to balance the horse
- 44What is the classic lab finding in endotoxemia?Low WBC, because they are going to the intestines
- 45What type of colic is associated with vices= cribbing and wind sucking?Colics in general, and especially epiploic foramen entrapment. It probably enlarges intra-abdominal pressure and thus causes the entrapment
- 46What breeds are prone to have inguinal or scrotal hernia?Cold blood and draft horses, which are big.
Less so in QH and arabs - 47The small intestine loops are distended but they're moving. What is the meaning?They are not strangulated.
In non surgical ileus, there is still peristaltics and the loops are moving a little or abnormally. If they're strangulated, they're so distended, they can't move at all - 48What is the survival rate of colic surgery?75%
- 49How long should be the incision in a colic surgery?20-50cm. If a colon impaction is expected, 40-50.
- 50What is the indication for a paramedian approach?If the horse has recently been through a Sx and the midline is still healing. We'd rather make a new incision than infect the former
- 51How is the enterotomy closed?2 layers. Ther first one is continuous and the second is inverted, in order to bury this area and decrease chance of adhesions
- 52What are the indications for high enema? (2)1. Small colon problem
2. Obstruction or FB in the transverse colon - 53—large colon volvulus. We can see the color changes.
- 54—Small intestinal strangulation
- 55—Small intestinal strangulation
- 56Where does the large colon volvulus usually occur?at the Cecocolic ligament
- 57How is the abdominal wall closed?SI
Thick
strong
absorbable - 58What is the time needed for the abdominal incision to heal and return to its preop state?2 months.
6 months later, it will be stronger than preop - 59How much of the small intestine can we remove?up to 60%
- 60How is a hand sawn anastomosis closed? Layers+sewing techniqueOne layer.
Lembert- interrupted or continuous - 61What are the common causes of ileal impaction? (2)1. Coastal bermuda grass hay=יבלית
2. Tape worms=תולעי סרט. Usually anoplocephala P - 62What strategy can we choose to improve Px in ascarid impaction surgery?Avoid enterotomy!
It causes septic abdomen or adhesions (elevated risk of adhesions also because they are young). Instead the worms should be decompressed to the cecum using fluids. Use lubrication. In the cecum their presence is not a problem and they will be excreted. - 63What time of the year does ascarid impaction usually occur?In the fall, september to november
- 64What are the complications of ascarid impaction? (2)1. Intussusception
2. Volvulus of the impacted area - 65What amounts of reflux are seen in proximal/anterior enteritis=AE?10L/h
- 66What known pathogen is involved in anterior enteritis?Clostridium deficile
- 67בניתוח סוס חשוד לסטרנגולציה בפתיחת הבטן נראו דימומים קשים במעי הפרוקסימלי, מפטכיות בודדות בג'ג'ונום הפרוקסימלי-דודנום ועד לדימומים מפושטים ונזק בלתי הפיך. What does it mean?No strangulation. It's AE. The Sx doesn't have to be stopped and the intestine can be decompressed manually.
- 68What is the typical signalment of strangulating lipoma?18y
More in QH and arabs
More in castrated - 69—AE
- 70—AE
- 71—Typical pedunculated lipoma
- 72What is the Px of pedunculated lipoma?60-70%
- 73—Epiploic foramen entrapment
- 74What is the major concern about epiploic foramen entrapment Sx?Ruptured vein
- 75In what age is it more common to see small intestinal volvulus?2-4m but it can occur in every age
- 76What is a known cause of small intestine and cecal intussusception?Tape worms that accumulate at the ileo-cecal valve
- 77What is the leading cause of cecal impactions?Orthopedic Sx. Probably because of the analgesics and premed given that stop bowel movement
- 78What size is the incision made in pelvic flexure enterotomy?6-10cm
- 79Where does sand usually accumulate?Large colon
- 80What are the predispositions for enterolithiasis?תזונה שעיקרה אספסת, כנראה בגלל מינרלים שקיימים בה
Arab
California
Florida - 81The horse is sitting like a dog. Why?It helps relieving cranial abdominal pain-
enterolithiasis in the transverse or dorsal colon
or diaphragm rupture - 82What is the concern about phenylephrine (given in nephrosplenic entrapment or LC displacement)?It might be lethal. Horses over 15 are predisposed to bleeding and at that age it should be avoided
- 83What can be done to prevent recurrence of nephrosplenic entrapment?Sewing the medial capsule of the spleen to the nephrosplenic ligament. Done in standing laparoscopy
- 84Who is predisposed to RDD, LDD and LC volvulus?Brood mares and tall big horses
- 85What is problematic about determining viability based on the color of the serosa?The serosa might be pink while the mucosa is black
- 86What support is crucial in large colon volvulus?There is a massive loss of protein, so colloids should be given, ideally plasma. Protein levels should be monitored- PCV will rise and TS will decrease because of DH. The larger the gap, the worst the Px
- 87The large colon volvulus returned for the second time in the same horse. What's recommended?Colopexy. It is sewn to the body wall. The best way is to attach the cranial LVC.
- 88When is colopexy not recommended?Usually not done in the first volvulus.
Not done in sport horses, but standing horses- a sudden big movement might tear the colon off the body wall and cause septic abdomen - 89What is a unique finding in small colon impaction?In rhe rectal exam, the feces can be felt separately and they might be very firm
- 90How is the small colon recognized?Broad tenia and a sacculation
- 91What pathogen should be checked in horses with small colon fecal impaction?Salmonella
- 92What is special about small colon impaction?The small lumen, the thin wall and the strong muscularis might cause necrosis if the impaction is left untreated for too long
- 93—Rectal tear grade 3
- 94Px of rectal tear Sx~50%
- 95How to avoid distal part prolapse in loop colostomy?שטיפות
- 96Typical age of EGUS in foals1. Neonates
2. foals and weanlings under 6 months - 97Hallmarks of colitis (6)1. Big amounts of watery diarrhea
2. Dehydration
3. Pitting edema
4. acidosis
5. colic
6. Arrythmia - 98What is the most common cause of acute colitis?Idiopathic
- 99Typical age for epiploic foramen entrapment11y
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- Final Equine medicine Flashcards on Colic etc, created by tomerba28 on 01/04/2016.
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