Gastro- Equine GIT Disease Identification Practice MCQ

A 3-month-old foal presents with diarrhoea, colic, poor weight gain, and ventral oedema. Ultrasound shows thickened small intestine, and the foal is hypoproteinaemic. What is the most likely diagnosis?

A. Rhodococcus equi pneumonia

B. Lawsonia intracellularis (Proliferative enteropathy)

C. Salmonella enteritis

D. Equine rotavirus

B. Lawsonia intracellularis (Proliferative enteropathy)

A 6-day-old foal is found suddenly dead after a short period of bloody diarrhoea and colic signs. A rapid PM reveals haemorrhagic enteritis. What is the most likely diagnosis?

A. Clostridium perfringens Type C enterotoxaemia

B. Lawsonia intracellularis

C. Salmonella septicaemia

D. Rotavirus

A. Clostridium perfringens Type C enterotoxaemia

A 1-week-old foal shows jaundice, severe depression, and dies rapidly. Necropsy reveals massive hepatic necrosis. What is the most likely cause?

A. Theiler's disease

B. Equine rotavirus

C. Tyzzer’s disease (Clostridium piliforme)

D. Hepatic lipidosis

C. Tyzzer's disease (Clostridium piliforme)

A 5-day-old foal develops watery diarrhoea, but remains bright and continues nursing. Several other foals on the stud show similar signs. What is the most likely diagnosis?

A. Equine adenovirus

B. Equine rotavirusC. Rhodococcus equi

D. Clostridium difficile

B. Equine rotavirus

A 15-year-old gelding presents with repeated attempts to swallow, bilateral nasal discharge containing feed material, hypersalivation, and distress after eating. What is the most likely diagnosis?

A. Esophageal rupture

B. Esophageal stricture

C. Choke (esophageal obstruction)

D. Gastric ulceration

C. Choke (esophageal obstruction)

A horse with a recent history of choke now has weight loss, regurgitation, and recurrent nasal discharge. You suspect a complication of the original condition. What is the most likely diagnosis?

A. Megaesophagus

B. Esophageal stricture

C. Gastric impaction

D. Displaced colon

B. Esophageal stricture

A young Thoroughbred colt presents with acute, severe abdominal pain, HR of 90 bpm, toxic mucous membranes, and large volumes of gastric reflux. On rectal exam, tight bands and distended small intestine are palpated. What is the most likely diagnosis?

A. Non-strangulating jejunal impaction

B. Epiploic foramen entrapment

C. Pelvic flexure impaction

D. Large colon torsion

B. Epiploic foramen entrapment

A broodmare shortly after foaling presents with acute colic, abdominal distension, and shock. Rectal exam reveals gas-distended colon. Exploratory surgery confirms a 360° volvulus at the base of the mesocolon. What is the diagnosis?

A. Large colon displacement

B. Large colon torsion

C. Caecal impaction

D. Right dorsal displacement

B. Large colon torsion

A horse presents with moderate, intermittent colic, and reduced faecal output. Rectal exam reveals a firm mass in the pelvic flexure. What is the most likely diagnosis?

A. Caecal impaction

B. Gastric rupture

C. Pelvic flexure impaction

D. Sand colic

C. Pelvic flexure impaction

A horse recently treated with NSAIDs at high doses develops weight loss, intermittent colic, and ventral oedema. What is the most likely diagnosis?

A. Equine gastric ulcer syndrome

B. Colonic displacement

C. Right dorsal colitis

D. Anterior enteritis

C. Right dorsal colitis

A yearling filly is found dead. PM reveals feed material in the thoracic cavity, and tearing of the caudal cervical esophagus. What is the most likely cause?

A. Primary megaesophagus

B. Esophageal neoplasia

C. Esophageal rupture secondary to choke

D. Gastric rupture

C. Esophageal rupture secondary to choke

A horse shows signs of mild colic, inappetence, and intermittent ptyalism. Nasogastric intubation retrieves >8L of reflux. What is the most likely diagnosis?

A. Duodenitis-proximal jejunitis (anterior enteritis)

B. Gastric rupture

C. Sand colic

D. Large colon impaction

A. Duodenitis-proximal jejunitis (anterior enteritis)

A horse presents with sudden death and PM shows generalized peritonitis with ingesta in the abdomen. What is the most likely cause?

A. Gastric rupture secondary to ulceration

B. Caecal rupture

C. Cecocolic intussusception

D. Colonic displacement

A. Gastric rupture secondary to ulceration

A horse is exhibiting recurrent mild colic and increased reflux, with ultrasound showing dilated small intestines with hypomotility. What is a likely early surgical lesion?

A. Large colon displacement

B. Strangulating small intestinal volvulus

C. Gastric impaction

D. Rectal tear

A 12-year-old cob presents with slow eating, quidding, and halitosis. Oral exam reveals sharp enamel points and ulceration of the buccal mucosa. What is the most likely cause?

A. Equine gastric ulcer syndrome

B. Periodontal abscess

C. Dental overgrowths causing mucosal trauma

D. Esophageal stricture

C. Dental overgrowths causing mucosal trauma

A foal develops colic signs, is dull, and passes reduced faeces. Rectal reveals gas-distended loops of intestine. No reflux is obtained on passing a tube. What is the most likely diagnosis?

A. Small intestinal volvulus

B. Meconium impaction

C. Caecocolic intussusception

D. Anterior enteritis

B. Meconium impaction

A recently weaned foal presents with colic, abdominal distension, and tachycardia. Rectal exam is unremarkable but ultrasound reveals swirling of mesentery. What is the most likely diagnosis?

A. Large colon displacement

B. Small intestinal volvulus

C. Pelvic flexure impaction

D. Sand impaction

B. Small intestinal volvulus

A 20-year-old gelding has a history of chronic weight loss, despite a good appetite. Dental exam reveals missing cheek teeth and step mouth. What is the most likely cause?

A. Poor nutrition

B. Pituitary pars intermedia dysfunction

C. Chronic dental disease with malocclusion

D. Equine metabolic syndrome

C. Chronic dental disease with malocclusion

A horse presents with colic signs, dry mucus membranes, and no reflux on intubation. Rectal exam reveals a firm mass in the right dorsal abdomen. What is the most likely diagnosis?

A. Gastric rupture

B. Right dorsal displacement of the colon

C. Pelvic flexure impaction

D. Epiploic foramen entrapment

B. Right dorsal displacement of the colon

A horse treated with excessive flunixin develops soft faeces, ventral oedema, and hypoalbuminaemia. What is the most likely diagnosis?

A. Colonic impaction

B. Equine grass sickness

C. Right dorsal colitis

D. Anterior enteritis

C. Right dorsal colitis

A yearling colt presents with sudden onset of severe colic, unresponsive to sedation. Abdominocentesis reveals serosanguinous fluid with high lactate. What is the most likely cause?

A. Simple impaction

B. Large colon displacement

C. Small intestinal strangulation

D. Gastric ulceration

C. Small intestinal strangulation

A horse with a history of crib biting presents with signs of colic. What serious complication is this horse predisposed to?

A. Pelvic flexure impaction

B. Gastric ulceration

C. Epiploic foramen entrapment

D. Right dorsal displacement

C. Epiploic foramen entrapment

A horse with mild colic, firm faeces, and a sand-like sediment layer in a faecal float test is most likely suffering from:

A. Gastric ulceration

B. Large colon impaction

C. Sand colic

D. Caecal impaction

C. Sand colic

A young horse presents with colic, low-grade fever, and hypovolaemia. Rectal exam is unremarkable. Abdominal tap reveals turbid fluid with increased protein and neutrophils. What is your top differential?

A. Peritonitis

B. Gastric impaction

C. Large colon torsion

D. Choke

A. Peritonitis

A horse has been intermittently quidding and resists the bit. Oral exam reveals a blind wolf tooth with ulceration of the adjacent cheek. What is the next best step?

A. Floating the cheek teeth

B. Extraction of the wolf tooth

C. Administer omeprazole

D. Referral for endoscopy

B. Extraction of the wolf tooth

A horse with sudden, violent colic shows marked gastric reflux, distended SI on rectal, and elevated peritoneal lactate. What is the most appropriate next action?

A. Withhold feed and monitor

B. Administer buscopan

C. Refer for emergency surgery

D. Start broad-spectrum antibiotics only

C. Refer for emergency surgery

A 10-year-old gelding presents with moderate colic, HR 60 bpm, dark mucous membranes, and 3L of reflux. Rectal exam reveals distended small intestinal loops. Lactate is 5.2 mmol/L. What is the most appropriate next step?

A. Administer mineral oil and monitor

B. Repeat rectal exam in 4 hours

C. Refer for exploratory laparotomy

D. Withhold feed and give flunixin

C. Refer for exploratory laparotomy(Strangulating SI lesion suspected; high lactate, reflux, and abnormal rectal exam are red flags)

A horse diagnosed with pelvic flexure impaction is otherwise stable. Which is the most appropriate initial medical treatment?

A. Oral fluids, magnesium sulphate, and mineral oil via nasogastric tube

B. Exploratory surgery

C. NSAIDs onlyD. IV antibiotics and flunixin

A. Oral fluids, magnesium sulphate, and mineral oil via nasogastric tube

A 6-year-old mare with caecal impaction appears quiet but has reduced faecal output and mild abdominal discomfort. What is a key risk with this condition if left untreated?

A. Gastric rupture

B. Caecal rupture without severe clinical signs

C. Epiploic foramen entrapment

D. Colonic volvulus

B. Caecal rupture without severe clinical signs

You diagnose a horse with duodenitis-proximal jejunitis (DPJ). What combination of treatment is most appropriate?

A. Flunixin, IV fluids, frequent gastric decompression

B. Omeprazole, antibiotics, and rest

C. Surgical correction and NSAIDs

D. Laxatives and antibiotics

A. Flunixin, IV fluids, frequent gastric decompression

A horse with large colon displacement presents with mild colic and no reflux. Rectal confirms a gas-distended left colon in an abnormal position. What is the next best step?

A. Send to surgery

B. Administer IV fluids and refer

C. Sedate and roll under general anaesthesia

D. Abdominal tap

C. Sedate and roll under general anaesthesia

During exploratory laparotomy, you identify a strangulated jejunal segment with questionable viability. What is the correct course of action?

A. Lavage and replace bowel

B. Perform jejunal resection and anastomosis

C. Close and monitor post-op

D. Ligate mesenteric artery and leave segment

B. Perform jejunal resection and anastomosis

A horse is 12 hours post-op from colic surgery and starts showing signs of pain and reflux. What is the most likely complication?

A. Right dorsal displacement

B. Postoperative ileus

C. Colitis

D. Peritonitis

B. Postoperative ileus

You’re managing a horse with anterior enteritis. Which finding would help you distinguish it from a strangulating SI lesion?

A. Severe reflux

B. Elevated heart rate

C. Hyperaemic mucous membranes

D. Improvement in pain after gastric decompression

D. Improvement in pain after gastric decompression

A horse referred for colic has bright red mucous membranes, CRT >3s, and serosanguinous peritoneal fluid with high protein and lactate. What is your interpretation?

A. Large colon impaction

B. Non-strangulating obstruction

C. Early peritonitis

D. Strangulating lesion with compromised bowel

D. Strangulating lesion with compromised bowel

A horse with a history of NSAID use presents with soft manure, ventral oedema, and mild colic. Bloodwork shows hypoalbuminaemia. What would be the most appropriate initial management?

A. Continue NSAIDs and start antibiotics

B. Stop NSAIDs, start a low-bulk diet, and initiate omeprazole

C. Refer for colic surgery

D. Sedate and perform abdominocentesis

B. Stop NSAIDs, start a low-bulk diet, and initiate omeprazole

A pony presents with recurrent mild colic and poor response to oral fluids and pain relief. You perform abdominocentesis, and fluid is cloudy with elevated WBCs and total protein. What is the most likely diagnosis?

A. Colonic impaction

B. Peritonitis

C. Gastric rupture

D. Caecal rupture

B. Peritonitis

You’re managing a case of sand impaction. The horse is stable with mild colic and a positive sand sediment test. Which combination of treatments is most appropriate?

A. Surgery and IV fluids

B. NSAIDs and confinement

C. Psyllium and magnesium sulphate via nasogastric tube

D. Oral electrolytes and omeprazole

C. Psyllium and magnesium sulphate via nasogastric tube

A young horse presents with acute onset of colic, increasing abdominal distension, and no faecal output for 12 hours. Which finding on rectal exam would most support the need for surgical intervention?

A. Doughy caecum

B. Tight mesenteric bands and gas-distended SI

C. Firm left colon in nephrosplenic space

D. Reduced gut sounds in the left dorsal quadran

B. Tight mesenteric bands and gas-distended SI

You are called to assess a post-operative colic surgery patient. The horse has developed increased HR, fever, injected mucous membranes, and mild colic signs. What is the most likely complication?

A. Post-op ileus

B. Post-op peritonitis

C. Re-displacement of colon

D. Poor wound healing

B. Post-op peritonitis

A horse with colic has a PCV of 48%, TP of 55 g/L, and lactate of 6.1 mmol/L. What does this suggest about the patient’s current status?

A. Normal hydration, no perfusion issues

B. Dehydration with good protein reserves

C. Hypovolaemia and tissue hypoperfusion

D. Liver failure

C. Hypovolaemia and tissue hypoperfusion

During rectal exam, you palpate a gas-distended colon that’s located cranially and medially, and cannot feel the spleen. What is the most likely diagnosis?

A. Left dorsal displacement (nephrosplenic entrapment)

B. Right dorsal displacement

C. Large colon volvulus

D. Small intestinal strangulation

B. Right dorsal displacement

A horse with severe colic receives xylazine and butorphanol, but signs recur within 20 minutes. What does this lack of sustained response to analgesia suggest?

A. Mild impaction

B. Simple colitis

C. Strangulating lesion requiring surgery

D. Gastric ulceration

C. Strangulating lesion requiring surgery

You're treating a horse for anterior enteritis. After placing a nasogastric tube, you remove 10L of reflux. The horse’s pain decreases markedly. What does this response confirm?

A. Large colon torsion

B. Ileal impaction

C. Functional small intestinal obstruction

D. Right dorsal displacement

C. Functional small intestinal obstruction

A horse has recurrent choke episodes, and endoscopy reveals a narrowed segment of the caudal cervical esophagus. What is the best long-term management strategy?

A. Surgical repair of esophageal rupture

B. Balloon dilation of the stricture

C. Long-term NSAIDs and soft feed

D. Placement of permanent feeding tube

B. Balloon dilation of the stricture

A horse presents with intermittent low-grade colic and weight loss. Endoscopy reveals ulceration of the squamous portion of the stomach near the margo plicatus. What is the most appropriate treatment?

A. Sucralfate and flunixin

B. Omeprazole and dietary management

C. Psyllium and IV fluids

D. Metronidazole and rest

B. Omeprazole and dietary management

A horse is diagnosed with large colon displacement and responds to rolling under general anaesthesia. What is your most important post-procedure management recommendation?

A. Start omeprazole

B. Feed large concentrate meals

C. Allow full turnout and return to work

D. Withhold feed and monitor for recurrence

D. Withhold feed and monitor for recurrence

A horse presents with colic, and on ultrasound you identify non-motile, thick-walled small intestinal loops. Which finding on peritoneal fluid analysis best supports surgical intervention?

A. Clear fluid, normal protein

B. Turbid fluid, lactate 2.0 mmol/LC. Serosanguinous fluid, high lactate and protein

D. Yellow fluid, low WBC count

C. Serosanguinous fluid, high lactate and protein

You are treating a case of pelvic flexure impaction. After 48 hours of medical treatment, the horse continues to show signs of pain and minimal manure passage. What is your next step?

A. Increase dose of NSAIDs

B. Add psyllium to oral fluids

C. Refer for surgical intervention

D. Withhold feed and continue monitoring

C. Refer for surgical intervention

A horse with gastric ulceration is found to have ulcers in the glandular mucosa. What addition to omeprazole therapy is most supported in these cases?

A. Psyllium

B. Metronidazole

C. Sucralfate

D. Magnesium hydroxid

C. Sucralfate

A pony with a hay-only diet develops firm feces and low-grade colic. Rectal reveals a firm mass at the pelvic flexure. Which diet modification is most appropriate for prevention?

A. Increase concentrate feed

B. Add psyllium and feed soaked hay

C. Transition to straw bedding

D. Increase protein intake

B. Add psyllium and feed soaked hay

A horse undergoes small intestinal resection and anastomosis. What is the most common early complication in the immediate post-operative period?

A. Gastric ulcers

B. Peritonitis

C. Postoperative ileus

D. Abdominal hernia

C. Postoperative ileus

You are called for a recumbent horse with colic, profuse nasal regurgitation of green fluid, and high-pitched salivation. What is your immediate priority?

A. Administer flunixin

B. Sedate and perform rectal

C. Pass a nasogastric tube to relieve pressure

D. Refer for surgery

C. Pass a nasogastric tube to relieve pressure

A horse is diagnosed with nephrosplenic entrapment. Which diagnostic method is most commonly used to confirm the displacement?

A. Faecal sedimentation test

B. Rectal palpation and ultrasonography

C. Endoscopy

D. Complete blood count

B. Rectal palpation and ultrasonography

A horse with recurrent colic episodes has been diagnosed with a non-strangulating SI obstruction. Which surgical procedure is most commonly performed?

A. Caecotomy

B. Enterotomy

C. Jejunal resection and anastomosis

D. Colotomy

C. Jejunal resection and anastomosis

A horse presents with colic, a heart rate of 80 bpm, and brick-red mucous membranes. Rectal exam finds tight SI loops and no manure in the rectum. What diagnostic finding would confirm a surgical emergency?

A. Rebound of appetite after pain meds

B. Presence of sand in faeces

C. Elevated lactate in peritoneal fluid

D. Negative nasogastric reflux

C. Elevated lactate in peritoneal fluid

A foal presents with colic, abdominal distension, and no reflux. Rectal is not possible. Abdominal ultrasound shows gas-dilated SI. What is the most likely cause?

A. Meconium impaction

B. Epiploic foramen entrapment

C. Volvulus of the jejunumD. Ileal hypertrophy

A. Meconium impaction

A horse referred for colic surgery is found to have a large colon volvulus with cyanotic bowel. What is the most appropriate surgical decision?

A. Manually decompress and reposition

B. Perform colotomy and close

C. Resection of devitalised colon segment

D. Lavage and close

C. Resection of devitalised colon segment

A horse is suspected of having gastric ulcers. Which diagnostic modality is most definitive?

A. Fecal occult blood test

B. Gastroscopy

C. Serum gastrin measurement

D. Rectal palpation

B. Gastroscopy

A horse with poor dentition and a history of choke presents with weight loss and coughing while eating. What is the most likely complication?

A. Esophageal diverticulum

B. Aspiration pneumonia

C. Gastric ulcer

D. Epiglottic entrapment

B. Aspiration pneumonia

You’re called to examine a horse with suspected right dorsal displacement. What is the typical rectal finding?

A. Tight bands from ileocaecal region

B. Gas-distended colon medially with spleen shifted

C. Pelvic flexure in the nephrosplenic space

D. Gas-filled colon lateral to caecum

D. Gas-filled colon lateral to caecum