AVPC exam style questions

Question 1

Explain the clinical reasons for placing a tracheostomy tube (2 marks)

Answer 1

Unable to intubate ie UAO, maintain airway patency, mechanical ventilation, airway protection, laryngeal paralysis

Question 2

Explain what respiratory physiotherapy techniques can be applied in patients with tracheostomy tubes. (3 marks)

Answer 2

Nebulise with saline Q4-6 hrs

Coupage post nebulisation Q4-6 hrs

Respiratory check Q2hrs

FL PROM

Regular exercise

Postural drainage and positioning

Question 3

Explain a method of oxygen delivery to a British shorthair in respiratory distress

								(1 mark)

Answer 3

Oxygen tent, oxygen kennel or cage, face mask, IPPV

Question 4

Please list four contraindications for thoracic physiotherapy

(4 marks)

Answer 4

Rib fractures or flail chest/Diaphramatic Hernia

Pneumothorax or haemopneumothorax

Pain

Unstable cardiovascular condition

Thrombocytopenia (<30,000 platelets/µl)

Thoracic tumours

Open wounds

Mentation

Question 5

Explain what is assessed in a Primary Assessment (4 marks)

Answer 5

Assess Airway, Breathing & Circulation

A: - Does the patient have a patent airway?

B- Is the patient making useful breathing efforts?

C: Does the patient have evidence of spontaneous circulation? (Heartbeat/Pulses).

Neurological assessment: is the patient conscious or unconscious?

Mentation

Question 6

Provide four blood donor criteria for canines. (4 marks)

Answer 6

UK resident, no travel abroad

fully vaccinated

Up to date with preventative treatments

Never had a BT before

> 25kg

1-8yrs old

No regular medication

In good health, no heart murmer

Good temperament

Question 7

A hospitalised Labrador is receiving a blood transfusion at the Veterinary Practice.

Identify six specific visual indications that it might display if it is suffering a transfusion reaction. (6 marks)

Answer 7

Facial oedema

Pyrexia/Hyperthermia (>1 degrees)

Urticaria

Dyspnoea or tachypnoea

Tachycardia

bradycardia

Discomfort, crying, whimpering

Circling, disorientation, tremors

Vomiting

Collapse

Haematuria.

Seizures/fitting

Diarrhoea

Panting

Question 8

Explain the procedure to follow in the above and subsequent treatment that might be administered.

Answer 8

switch off transfusion

summon vet immediately

Treatment- crystalloid therapy, supportive therapy ie corticosteroids, oxygen, antihistamines, adrenaline. anticonvulsants

Monitor vital signs

Reduce rate of transfusion if continuing transfusion

Possible blood sampling to assess PCV

Question 9

Explain how to care for a central venous catheter (4 marks)

Answer 9

Aseptic technique

Redress once to twice a day to check for infection/inflammation etc

Flush the ports not in use Q4hrs with heparinised saline

Ensure ports are swabbed for 15 seconds prior to use

Keep caps on the end of ports to prevent infection

Ensure lines are clamped if not in use

Use diluted heparin saline where necessary to maintain lines

Label ports to detail usage

Monitor for extravasation

Question 10

State the equipment required for delivering whole blood to a canine recipient, include two pieces of monitoring equipment in the answer (6 marks)

Answer 10

New catheter or well maintained and checked IV catheter

Whole blood either in a specialised blood collection bag or drawn up into syringes

Giving set with appropriate haemo-nate filter

If via CRI extension set with micro-aggregate filter

Gloves- aseptic technique

Saline for flushing of IV to check patency

One mark each; Thermometer, ECG machine, stethoscope

Monitoring sheet

Stopwatch/timer

Question 11

Outline the storage requirements for whole blood and packed red blood cells. (5 marks)

Answer 11

Store in a fridge designated for blood products

Ideally do not use domesticated fridge

Agitate the blood daily or EOD minimum

Temp- 2-6 degrees

Ensure lockable fridge

Thermostat- digital monitor on the outside to allow recording

Record Min/Max temps daily

Question 12

Explain the difference between a primary and secondary survey (5 marks)

Answer 12

Primary:

Should take 30-60 seconds to perform (1)

Assess Airway, Breathing & Circulation (1)

Neurological assessment: is the patient conscious or unconscious (1)

Secondary:

This is a more thorough assessment of the patient (1)

The secondary survey should look for any other abnormalities or injuries by systematically working from head to tail. (1)

Question 13

State what information should be given to a veterinary surgeon regarding a treated first aid casualty presenting after a dog attack to the sternum, the dog attack has occurred in the last 10 minutes. (4 marks)

Answer 13

Time of attack, breed of dog that attacked

Clinical signs seen so far

Location of wounds

Extent of injury

Relevant medical hx- especially allergies or intolerances

Any treatment provided by owners

Primary and secondary survey results

Focus on RR/effort, SPO2, auscultation

Question 14

The dog bite is extensive, explain the potential wound care and closure for this patient, state what type of wound classification this would be? (6 marks)

Answer 14

Non-selective debridement should be utilised via the hydrodynamic method, this would involve lavaging the wound with isotonic fluids. The wound would be lubricated with sterile lubricant and clipped prior to irrigation. Once lavaged and the patient is stable, the wound would be debrided via selective surgical debridement.

This is a clean-contaminated wound, the wound would be closed using delayed primary closure.

Question 15

Describe the physiotherapy nursing interventions required for a recumbent patient post partial lung lobectomy. (4 marks)

Answer 15

Position the patient in lateral, sternal, lateral recumbency

Q2-4hrs depending on patient and condition

Ensure adequate mobilisation

Postural drainage may be required

Utilise soft pillows, duvets, foam wedges to prop the patient up

Physiotherapy techniques such as coupage can be utilised if appropriate

Nebulisation if applicable

Question 16

A client phones in distress, their Rottweiler has fallen off a ledge when out on a walk. The dog is conscious but in a considerable amount of pain as the hindlimb appears to be broken. What advice could be provided in terms of safety and handling of this patient? (4 marks)

Answer 16

Stay calm

Call for emergency assistance due to size of the patient and location

Send someone out from the practice to assist

Do NOT put the client in any danger

Ensure more than one person lifts the patient

Any relevant answer related to securely moving the patient preventing further injury

Question 17

The Rottweiler is admitted to hospital, a right pneumothorax is discovered.

Explain the reason for placing a chest drain in this case (1 mark)

Answer 17

Remove Air from the pleural cavity

Question 18

Explain the purpose of Blood gas analysis and Sp02 monitoring for this patient. (4 marks)

Answer 18

BGA- Assesses ventilation (1), oxygenation (1), acid base status of the patient (1)

Sp02- Measures the percentage of haemoglobin saturation/measures oxygen saturation (1)

Both these evaluation methods help determine if a patient requires oxygen therapy or if the intervention is working (1)

Question 19

A Springer spaniel requires parenteral nutrition however, due to underlying Immune mediated Thrombocytopenia placing a central line is contraindicated. Partial parenteral

nutrition is prescribed, explain the care of the intravenous catheter in this case. (5 marks)

Answer 19

Place a new IV prior to starting PPN

Handle aseptically

DO NOT flush once in use

Check patency regularly- in this case signs of extravasation

Q4hrs

Ensure no medication is given via this route and the line is never disconnected

Change dressing daily

Assess site for infection, inflammation, extravasation