End Sem 1 Exam Flashcards
Match each of the following heart rhythms to its correct description.
- Pulseless electrical activity
- Perfusing rhythm
- Ventricular fibrillation
- Asystole
- Pulseless ventricular tachycardia
Pulseless electrical activity:
- Consistent and repeated QRS complexes, narrow complexes, no pulses associated with the complexes and heart rate of 126 bpm.
Perfusing rhythm:
- Consistent and repeated QRS
Ventricular fibrillation:
- Consistent and repeated QRS complexes not present, random and non-repeatable ECG trace, no pulses detectable
Asystole:
- Consistent and repeated QRS not present
Pulseless ventricular tachycardia:
- Consistent and repeated QRS complexes, wider complexes, no pulses associated with the complexes and heart rate of 228 bpm
Discuss 2 important litter box considerations when advising clients on designing an optimal litter box plan for their ohuse soiling cat.
- 1 litter box per social group + 1 extra (or 1 per cat + 1 extra)
- Size: at least 1.5 the length of the cat from nose to tail so they can comfortably sit in it
- Daily cleaning needed: scooping soiled litter + litter replacement
- Complete wash of the litter tray with an enzymatic cleaner at least weekly, but more frequently if a problem is present
- Litter type: needs to be the cat’s preference whether it is clay, crystals or paper. Can check preference with a litter box buffet.
- Tray location: quiet area where the cat won’t be disturbed or trapped
A dog suddenly develops asystole during anaesthesia. The ECG was attached to the patient; no pulse was detected. According to the RECOVER CPR guidelines, what should be the first treatment priority?
a) Start fluid therapy (bolus dose)
b) Administer low dose of adrenaline
c) Connect the EtCO2 monitor
d) Chest compressions
d) Chest compressions
For the following clinical presentation select the most likely diagnosis: 4 year old mixed breed dog with acute onset stertorous breathing & pain on opening mouth.
- Bacterial infection secondary to foreign body
- Bacterial infection secondary to systemic, viral infection
- Oropharyngeal foreign body or injury
- Idiopathic
- Neoplasia
- Coagulopathy (coagulation disorder)
- Tooth root abscess
- Mycotic infection
- Oropharyngeal foreign body or injury
A cat with bradyarrhythmias suddenly has a cardiopulmonary arrest due to asystole. Which of the following is most correct?
- High dose of adrenaline should be used after the first CPR cycle
- Low dose of adrenaline should be used every cycle of CPR
- Atropine should be used every cycle of CPR
- Atropine should be used every other cycle of CPR
- Atropine should be used every cycle of CPR
During vaccination consultation the owners mention their dog “Fluffy” is chewing the door frame when she is left alone during the day and the neighbours have noticed she is barking and howling when alone. What is the best general advice to give to Fluffy’s owners?
- The dog needs to be treated “like a dog” and the owners need to show dominance behaviour towards it
- A barking collar should be used to stop the barking
- The dog will improve with some obedience training
- The dog may have a mental health disorder best addressed through a behavioural consultation
- The dog will likely grow out of the behaviour, so no treatment required
- The dog may have a mental health disorder best addressed through a behavioural consultation
An owner mentions that their dog is very reactive towards unfamiliar dogs when out on walks - when it sees another dog it will lunge towards the dog and bark with its hackles up. The dog has been doing this for the last 6 months since it was about 18 months of age. Select from the following options the most appropriate immediate suggestion you should make.
- Walk the dog as much as possible to expose and socialise it to other dogs
- Take the dog to a “balanced” trainer so that a professional who uses the four quadrants of learning can help the dog
- Stop taking the dog for walks as it is currently not beneficial and likely making the dog worse
- Take the dog to a dog park and let it be surrounded by unfamiliar dogs to get it used to them even if it is reacting aggressively
- Stop taking the dog for walks as it is currently not beneficial and likely making the dog worse
For the following clinical presentation, select the most likely diagnosis: 2 year old male cat, with dyspnoea, tachypnoea and pyrexia.
- Bacterial infection secondary to foreign body
- Bacterial infection secondary to systemic viral infection
- Oropharyngeal foreign body or injury
- Idiopathic
- Neoplasia
- Coagulopathy
- Tooth root abscess
- Mycotic intranasal infection
- Collapsing trachea
- Chronic bronchitis
- Cardiac disease
- Pneumonia
- Dirofilariasis
- Pyothorax
- Pneumothorax
- Pulmonary oedema
- Pyothorax
List the 4 M’s of dog behaviour treatment.
Psychotropic MEDICATION
Behaviour MODIFICATION
Environmental MANAGEMENT
MONITORING progress
A dog is being treated for generalised anxiety with Fluoxetine 1mg/kg once daily. Four weeks after starting treatment the owner reports that there is no improvement in the dog’s behaviour. The owner is disappointed and wants to see some progress. What should be done next?
- Stop the fluoxetine immediately and start a different baseline medication
- Wean the dog off fluoxetine over 4 weeks and then start a different baseline medication
- Increase the fluoxetine to 2mg/kg SID
- Continue the fluoxetine for another 4 weeks before reassessing its effect
- Continue the fluoxetine for another 4 weeks before reassessing its effect
A 10 year old male neutered 31kg mixed breed dog is presented because of frequent coughing and mild lethargy over the last 24 hours. His vital signs are: rectal temp 39.5, heart rate of 80 beats per minute with a respiratory sinus arrhythmia, respiratory rate of 30 breaths per minute. On thoracic auscultation, loud harsh sounds are heard over the trachea and lung fields and a grade IV/VI systolic murmur is heard the loudest over the left apex beat.
Based on this data is the dogs cough more likely to reflect a primary respiratory system problem or a primary cardiovascular system problem? Explain your reasoning.
Primary respiratory.
- Mild pyrexia fits respiratory infection not cardiac insufficiency
- Harsh respiratory sounds and mild lethargy: if cardiovascular might expect soft crackles over lung fields and marked lethargy.
- Normal HR: if cardiovascular might expect tachycardia
- Sinus arrhythmia heard: if cardiovascular might expect dog to be stressed and therefore to not hear respiratory sinus arrhythmia
“Troy” a 5 year old female speyed Great Dane presents with weight loss and intermittent diarrhoea of 2 months duration. No changes in appetite, thirst or activity level have been noticed.
On examination you find the following:
- Mucous membranes pink and moist
- CRT 1 second
- HR 80
- Abdominal palpation appears normal
- Temp 38.2
- Body condition score 3/9
Based on the history and clinical signs which of the following differential diagnoses is most likely?
- Intestinal nematodes, cryptosporidiosis, exocrine pancreatic insufficiency, intussusception
- Inflammatory bowel disease, giardiasis, intestinal lymphoma, food intolerance
- Parvovirus infection, Salmonellosis, hepatic failure, Addison’s disease
- Arsenic poisoning, rotavirus infection, intestinal nematodes, Campylobacter infection
- Inflammatory bowel disease, giardiasis, intestinal lymphoma, food intolerance
A prescription hydrolysed diet could be considered for Troy. What is the mechanism of action of these diets?
- Pre-digestion of proteins results in peptides that are too small to aggregate IgE
- Hydrolysis of carbohydrates reduces their antigenicity
- Proteins are pre-digested to aid absorption through the intestinal wall
- Hydrolytic enzymes in the diet complement amylase, lipase and trypsin
- Pre-digestion of proteins results in peptides that are too small to aggregate IgE
You perform all of the following:
- Faecal sample - negative for bacterial, parasitic and protozoal pathogens
- Haematology and biochemistry profile - all parameters within normal ranges
- Abdominal radiographs - no abnormal findings
- Abdominal ultrasonography - no abnormal findings
- Endoscopy performed by a specialist - intestines appear normal
If the faecal sample had revealed giardia trophozoites, what would have been the most effective treatment for Troy?
- A 2 week course of potentiated sulphonamides
- A 5 day course of fenbendazole
- A single dose of milbemycin
- Two doses of praziquantel given 7 days apart
- A 5 day course of fenbendazole
Which of the following tests would be LEAST valuable in the further investigation of Troy?
- Intestinal biopsies taken at the time of endoscopic examination
- Prescription diet trial
- Barium radiographic contrast study
- Measurement of Trypsin like immunoreactivity
- Barium radiographic contrast study
A 10 year old Rottweiler has been vomiting intermittently for the past week. The dog is mildly lethargic and the owners believe it may be slightly polydipsic. Appetite is reduced. The owners have brought the dog in because there was a small quantity of blood in the vomitus this morning. What would be the most appropriate course of action?
- Feeding a bland diet for 3 days along with a course of maropitant
- Prescribing a 5 day course of metoclopramide
- Analysing a blood sample for evidence of metabolic disease
- Admitting the dog to hospital for fluid therapy and observation
- Analysing a blood sample for evidence of metabolic disease
A 5 year old male intact Beagle presents with a 2 day history of vomiting followed by acute lethargy. Physical examination reveals tacky mucous membranes, a heart rate of 140bpm, guarding of the abdomen and a temperature of 39.9. Which of the following would be the most likely diagnosis?
- Pancreatitis
- Prostatitis
- Gastritis
- Hepatitis
- Pancreatitis
If Troy was eventually diagnosed with lympho-plasmacytic enteritis, what would be the most appropriate treatment combination?
- Metronidazole and a low fat diet
- Prednisolone and a limited antigen diet
- Loperamide and a hydrolysed diet
- Sulphasalazine and a bland diet
- Prednisolone and a limited antigen diet
The owners of a 3 year old 15kg Staffy inform you they have seen the dog swallow a smooth pebble approx. 3cm in diameter approx. 24 hours ago. What is the most appropriate recommendation?
- Advise that the pebble is likely to pass naturally
- Wait to see if it is vomited back up
- Perform a laparotomy to allow surgical removal
- Admit the dog for abdominal radiography
- Admit the dog for abdominal radiography
Which of the following statements concerning bacterial tonsilitis in dogs is most correct?
- It is commonly seen in dogs following infection with parainfluenza virus
- Bacterial tonsilitis does not occur in dogs
- It can be associated with dental disease in small breed dogs
- The most obvious clinical sign is a productive cough
- It can be associated with dental disease in small breed dogs
Which of the following is the most likely cause of oesophagitis?
- Anaesthesia
- Chronic coughing
- Myasthenia gravis
- Lead poisoning
- Anaesthesia
A 4 month old German Shepherd dog is presented for persistent regurgitation that occurs immediately after eating. What is the most likely diagnosis?
- Persistent right aortic arch
- Helicobacter infection
- Ruptured gall bladder
- Gastric carcinoma
- Persistent right aortic arch
Which of the following liver disorders is least likely to be seen in a cat?
- Nodular hyperplasia
- Suppurative cholangiohepatitis
- Hepatic lipidosis
- Lymphocytic cholangitis
- Nodular hyperplasia
What constitutes the syndrome referred to as “triaditis” in cats?
- Pancreatitis, inflammatory bowel disease, cholangitis
- Cholangitis, pancreatitis, gastritis
- Lymphadenitis, pancreatitis, cholangitis
- Pancreatitis, hepatic lipidosis, inflammatory bowel disease
- Pancreatitis, inflammatory bowel disease, cholangitis
What best describes the characteristics of pancreatitis in dogs?
- It is an acute disease associated with high mortality
- It typically causes a palpable abdominal mass in the cranial abdomen
- It causes release of pancreatic lipase into the circulation
- It is seen more commonly in toy breeds
- It causes release of pancreatic lipase into the circulation
Which combination of increased liver enzymes typically indicates cholestasis?
- ALP and GGT
- ALT and ALP
- ALT and AST
- AST and ALP
- ALP and GGT
What is the mode of action of Urso-deoxycholic acid (UDCA)?
- Stimulates bile flow
- Reverses hepatic lipidosis
- Anti-oxidant effect
- Appetite stimulant
- Stimulates bile flow
A 7 year old male neutered kelpie is presented for mild lethargy. Examine the CBC results below.
1) What is the single most important abnormality?
2) What is the likely diagnosis?
3) What drug is recommended to treat this condition?
1) Marked lymphocytosis (increased lymphocytes)
2) Lymphocytic leukemia
3) Chlorambucil
Match the disease on the left with the most appropriate corresponding statement on the right. You can only use each answer once.
- Megaoesophagus
- Gastric ulceration
- Oesophagitis
- Suppurative cholangiohepatitis
- Campylobacter infection
- Exocrine pancreatic insufficiency
- Pancreatitis
- Histiocytic ulcerative colitis
- Inflammatory bowel disease
- Hepatic lipidosis
Megaoesophagus:
- Can be secondary to myasthenia gravis
Gastric ulceration
- Can be caused by renal failure
Oesophagitis
- Can be seen following general anaesthesia
Suppurative cholangiohepatitis
- Is associated with ascending…
Campylobacter infection
- Is more common in dogs fed a…
Exocrine pancreatic insufficiency
- Is most commonly seen in German Shepherd dogs
Pancreatitis
- Can be triggered by a high fat diet
Histiocytic ulcerative colitis
- Is most commonly seen in Boxers
Inflammatory bowel disease
- Requires treatment with prednisolone
Hepatic lipidosis
- Can be caused by anorexia
What is the specific medical term for the lesions seen in this dog’s oral mucous membrane (small red / purple dots) and what is the blood abnormality most likely to cause this?
- Petechiae
- Thrombocytopenia
The following haematology values are from a 9 year old female dog with lymphosarcoma, immediately before her first dose of chemotherapy with vincristine (baseline) and then one week post vincristine.
The dog is anaemic at baseline and in week 1. Which of the following statements is the best explanation?
- Normocytic, normochromic, non regenerative anaemia due to lymphosarcoma
A 12 year old male neutered cat was presented for sudden onset inappetence and lethargy. The cat had no previous health problems and was normal the day before the signs were noticed. Physical examination was unremarkable apart from pale mucous membranes. Laboratory investigation included a complete blood count and serum chemistry panel. The only serum chemistry abnormality was slightly increased bilirubin.
1) Taking into account the history and laboratory test, what is your assesment of this cat’s condition?
2) List 2 logical tests or procedures you would like to perform to further investigate the cat’s condition. For each test or procedure provide a very brief reason for your recommendation.
- Moderate normocytic normochromic non-regenerative anaemia
- This reflects chronic disease or pre-regenerative post loss (bleeding, haemolysis)
- Heinz bodies normal in cat but raise possibility of oxidative damage (toxin e.g. onion or garlic)
- Icteric serum with raised bilirubin suggests haemolysis
- No history or physical evidence of bleeding but cannot rule out bleeding in body cavity
- Reduced platelet count might support consumption due to bleeding or platelet destruction
- Bleeding in GIT unlikely since serum chemistry is normal
Tests to perform:
- Abdominal ultrasound to check for potential peritoneal cavity effusion (bleeding)
- Thoracic radiographs to check for potential pleural cavity effusion (bleeding)
- Saline (auto) agglutination +/- Coomb’s test to check for immune-mediated haemolytic anaemia
During your desexing clinic training you have been instructed to use the most appropriate instrument for each step of a procedure, taking into consideration the size of the animal. For the following steps choose the most appropriate instrument.
- To extend your initial blade scalpel stab incision into the linea alba to open up the abdomen in a 3kg cat
- To make the stab incision into the linea alba of a 2kg cat
- To hold the linea alba whilst making the initial stab incision to enter the abdomen in a 3kg cat
- To hold up the linea alba whilst making the initial stab incision to enter the abdomen in a 30kg dog
- The instrument used to make a subcutaneous tunnel, by elevating the subcutaneous tissue from the external rectus sheath, exposing the linea alba in a 15kg dog spay
- To clamp the uterine body before ligation in a 4kg cat
- To clamp the ovarian pedicle before ligation in a 6 month old prepubescent kitten spay weighing 2kg
- To clamp the ovarian pedicle before ligation in a 10kg dog spay
- To clamp the ovarian pedicle before ligation in a 40kg dog spay
- To extend your initial scalpel blade stab incision into the linea alba and to open up the abdomen in a 30kg dog
- To grasp the proper ligament to assist manipulation of the uterine horn and ovary during a spay
- The forceps used to atraumatically grasp abdominal contents in a cat eg. bladder or intestines
- To provide temporary haemostasis of a small bleeding vessel in the subcutaneous tissue
- Tissue forceps used when applying skin sutures in a cat
- Grasping the subcutaneous tissue during a simple continuous layer closure in a dog castrate
- To retract both medial edges of the subcutaneous tissue to improve visualisation during linea alba suturing
- After ligation of the spermatic cord the instrument used to grasp the ductus deferens only, immediately before releasing the pedicle back into the tunics
To extend your initial blade scalpel stab incision into the linea alba to open up the abdomen in a 3kg cat
- Straight Metzenbaum scissors
To make the stab incision into the linea alba of a 2kg cat
- Scalpel - number 15 blade
To hold the linea alba whilst making the initial stab incision to enter the abdomen in a 3kg cat
- Adson forceps
To hold up the linea alba whilst making the initial stab incision to enter the abdomen in a 30kg dog
- Rat tooth forceps
The instrument used to make a subcutaneous tunnel, by elevating the subcutaneous tissue from the external rectus sheath, exposing the linea alba in a 15kg dog spay
- Curved Metzenbaum scissors
To clamp the uterine body before ligation in a 4kg cat
- Curved crile forceps
To clamp the ovarian pedicle before ligation in a 6 month old prepubescent kitten spay weighing 2kg
- Halstead Mosquito forceps
To clamp the ovarian pedicle before ligation in a 10kg dog spay
- Curved Crile forceps
To clamp the ovarian pedicle before ligation in a 40kg dog spay
- Curved Rochester Carmalt forceps
To extend your initial scalpel blade stab incision into the linea alba and to open up the abdomen in a 30kg dog
- Straight Mayo scissors
To grasp the proper ligament to assist manipulation of the uterine horn and ovary during a spay
- Halstead Mosquito forceps
The forceps used to atraumatically grasp abdominal contents in a cat eg. bladder or intestines
- DeBakey forceps
To provide temporary haemostasis of a small bleeding vessel in the subcutaneous tissue
- Halstead Mosquito forceps
Tissue forceps used when applying skin sutures in a cat
- Adson Brown forceps
Grasping the subcutaneous tissue during a simple continuous layer closure in a dog castrate
- Adson Brown forceps
To retract both medial edges of the subcutaneous tissue to improve visualisation during linea alba suturing
- Allis Tissue forceps
After ligation of the spermatic cord the instrument used to grasp the ductus deferens only, immediately before releasing the pedicle back into the tunics
- Halstead Mosquito forceps
The perforated section of a chest drain ideally sits:
- Along the dorsal aspect of the chest
- In the middle of the chest (1/2 way between spine and sternum)
- Along the ventral floor of the chest
- Partially in the subcutaneous tissues and partially in the thoracic cavity
- Along the ventral floor of the chest
With regards to tracheostomy tube placement in dogs which of the following is correct?
- Provide permanent airway access for laryngeal collapse
- Should be about 70% the diameter of the trachea
- Should pass greater than 6 tracheal rings when in situ
- None of the above
- None of the above
Regarding “Flail chest” in a dog choose the correct answer.
- It is an inherent weakness of an anatomically normal chest wall due to old age
- A condition that develops when 1 rib is fractured
- A condition that develops when 2 or more ribs are fractured, once along each rib
- A condition that develops when several adjacent ribs are fractured, in two or more places along each rib
- A condition that develops when several adjacent ribs are fractured, in two or more places along each rib
A client calls up in distress. “Lucky” her 10 year old male neutered Golden retriever has just collapsed in the back yard and is unable to get up. She thinks he isn’t breathing well and feels cold to touch. She is driving to the veterinary hospital and will arrive in 3 minutes.
List the steps within the primary survey you should take to assess “Lucky” when he arrives.
3H’s:
History / Hello - introduction to the patient (the primary complaint, time of onset, past pertinent medical conditions)
Help - triage is a team game, optimum is 5 people for the animal to recover
Hazard - ensure the team is safe (drugs, protective gloves, restraint devices, muzzles)
A - air - immediately provide O2 to critical patients, check if there is a patent airway
B - breathing - assess how the patient is breathing (e.g. cyanosis, open mouthed breathing)
C - circulation - assess how perfusion is to tell if we are in shock (pulse presence & strength, MM colour, CRT, HR & rhythm, temp, BP, lactate)
D - demeanour - neurological assessment (Alert, responsive to Voice, responsive only to Pain, Unresponsive, Pupil check)
E - everything else
In severe tracheal trauma it is possible to resect up to … percentage of the total tracheal length
- 5%
- 10%
- 15%
- 20%
- 25%
- 20%
Regarding “Flail chest” on a dog choose the correct answer:
- The flail chest segment expands on inspiration
- The flail chest segment collapses on expiration
- The flail chest segment collapses on inspiration
- The flail chest segment has no effect on respiration
- The flail chest segment collapses on inspiration
When in shock patients may present with several different clinical signs or measurable abnormalities. List any 6 of these.
- Vasoconstriction: pale MM, prolonged CRT, peripheral temperature < core temperature, reduced urine output
- Decreased mentation
- Tachycardia (cats may present with bradycardia)
- Hypotension (poor pulse quality)
- Reduced oxygen saturation (low SpO2)
- Lactate >2 mmol/L
- Metabolic acidosis
Which of the following statements regarding mammary neoplasia is most correct?
- Surgical lumpectomy is an appropriate treatment for a small solitary mass in a single gland in the dog and cat
- Surgical lumpectomy is an appropriate treatment for a small solitary mass affecting a single gland in the dog but not in the cat
- Surgical lumpectomy is an appropriate surgical treatment for a small solitary mass in the cat but not in the dog
- Surgical lumpectomy is never an appropriate treatment for a small solitary mass affecting a single gland in the dog or the cat
- Surgical lumpectomy is an appropriate treatment for a small solitary mass affecting a single gland in the dog but not in the cat
Which of the following statement regarding oral tumours in cats is most correct?
- Squamous cell carcinoma is the most commonly identified oral tumour in cats
- Oral melanomas at this location is relatively benign and rarely spreads
- Biopsy of oral masses or ulcers is rarely indicated as it does not affect the surgical treatment
- Surgery is rarely an option for oral neoplasia in cats as the bone is frequently involved
- Squamous cell carcinoma is the most commonly identified oral tumour in cats
Regarding cervical sialocoele in dogs which of the following responses is most correct?
- Removal of the mandibular and sublingual salivary glands on the ipsilateral side is indicated
- The mucocoele is surrounded by a secretory lining that must be excised
- Repeated needle drainage is effective in 50% cases and should be performed first
- Removal of the parotid and sublingual salivary glands on the ipsilateral side is indicated
- Removal of the mandibular and sublingual salivary glands on the ipsilateral side is indicated
Which of the following is NOT a reason to elect to perform a hysterectomy over hysterotomy for caesarean section in the bitch?
- Where there is evidence of foetal distress
- To minimise abdominal contamination
- To minimise surgical time
- Where there are dead foetuses
- Where there is evidence of foetal distress
Regarding pyometra in the dog which of the following statements is NOT correct?
- Pyometra occurs in oestrus typically 4-10 weeks after last dioestrus
- Cystic endometrial hyperplasia develops first followed by asceding infection with bacteria from the vagina or lower urinary tract
- Pus may enter the abdomen from uterine rupture or via the oviducts
- Clinical signs of polyuria and polydipsia, lethargy and vaginal discharge are often accompanied by azotaemia and dehydration
- Pyometra occurs in oestrus typically 4-10 weeks after last dioestrus
Regarding oral tumours in dogs which of the following statements is most correct?
- Wide surgical excision with rostral mandibulectomy may be curative for a small squamous cell carcinoma associated with the lower central incisor teeth
- Malignant melanoma appears as a dark pigmented tumour on the gingiva, lip or tongue
- There is a vaccination available for management of fibrosarcoma after surgery available from oncologists
- Pulmonary spread of fibrosarcoma is common around 80%
- Wide surgical excision with rostral mandibulectomy may be curative for a small squamous cell carcinoma associated with the lower central incisor teeth
Charlie a 12 month old Labrador is presented with a distal cervical oesophageal foreign body as seen in the radiograph below. The owners observed the dog swallow the foreign body 3 days ago.
What clinical signs would you expect this dog to show?
- Regurgitation after eating, diarrhoea, severe dyspnoea
- Regurgitation after eating and drinking, ptyalism, dehydration, coughing
- Regurgitation after eating and drinking, ptyalism, dehydration, coughing
What would be the best treatment option for Charlie? (Dog with distal cervical oesophageal foreign body)
- Attempt endoscopically oral retrieval first, if unsuccessful perform a cervical esophagostomy
- Push the foreign body into the stomach, as it is easier to remove from that location
- Proceed immediately to a cervical esophagostomy
- Place the dog on intravenous fluids to allow rehydration of the surrounding soft tissues and then wait for the foreign body to pass through the gastrointestinal tract
- Attempt endoscopically oral retrieval first, if unsuccessful perform a cervical esophagostomy
Which of the following statements about oesophageal healing is correct?
- Tension on an oesophageal wound closure is likely to result in stricture formation
When closing a distal cervical esophagotomy, to achieve the greatest initial strength it is best to:
- Close the mucosa and muscularis in two layers, leaving the mucosal knots intraluminally
- Close the mucosa and muscularis in a single layer, leaving the knots extraluminally
- Close the mucosa and muscularis in a single layer, but leave the knots intraluminally
- Either single or two layered closure can be used as both closures have similar initial strength and healing potential
- Close the mucosa and muscularis in two layers, leaving the mucosal knots intraluminally
Dumbo an 8 month old male castrated Basset hound is presented with a history of vomiting and anorexia for 2 days. No diarrhoea has been observed by the owner. The dog is now lethargic. You take the following radiographs.
If Dumbo has a gastric dilatation and volvulus (GDV) which of the following statements is correct regarding serum lactate levels?
- A very high lactate level means the dog will die, so surgical exploration is not indicated
- Dogs with a lactate level over 6 have a worse prognosis due to a higher chance of gastric necrosis
- Dogs with a decrease in serial lactate levels of 40% taken 2 hours apart have a good prognosis
- It is normal for the lactate level to stay high for 48hr post GDV surgery
- Dogs with a lactate level over 6 have a worse prognosis due to a higher chance of gastric necrosis
Antibiotic coverage for a small bowel resection surgery should be ideally started:
- After surgery has finished
- Intravenously at induction to obtain high circulating blood levels at the time of surgery
- Orally to achieve high concentrations in the gut at the time of surgery
- Subcutaneously at the time of pre medication
- After surgery has finished
- Intravenously at induction to obtain high circulating blood levels at the time of surgery
You speak with Dumbo’s owners about the radiographic findings and strongly suggest that the pup needs an exploratory surgery. From the list below select the most important concern that you should discuss with them about the risks of taking the pup to surgery.
- Hyperproteinaemia will delay wound healing
- Hypoproteinaemia will increase the risk of dehiscence of the bowel if resection is needed
- Paralytic ileus may not be reversed as the bowel is too distended
- The peripheral effusion will affect the pup’s ability to ventilate under anaesthesia during the laparotomy
- Hypoproteinaemia will increase the risk of dehiscence of the bowel if resection is needed
When you open an abdominal cavity the intestines need to be moved outside the abdominal cavity and kept there whilst you inspect the deeper structures. Select the best way to decrease surgical trauma to the exteriorised bowel from the following options:
- Place dry laparotomy sponges down on the drapes prior to exteriorising the gut
- Place the gut directly onto the drapes but cover with moist laparotomy sponges
- Place the bowel between moistened laparotomy sponges
- Place the gut directly onto the drapes and cover with a sterile impermious plastic sheet
- Place the bowel between moistened laparotomy sponges
Dumbo (possible obstruction / GDV on radiographs). From the two radiographs above the primary finding that will guide you whether to surgical explore the abdomen is:
- The pup probably has a partial intestinal obstruction
- There is a large peritoneal effusion
- The pup probably has a complete intestial obstruction
- The pup has a gastric dilatation volvulus
- The pup probably has a complete intestial obstruction
If at Dumbo’s surgery you found this foreign body in the jejunum, where would you make your enterotomy?
A - just to the left of the obstruction (oral direction)
B - at the obstruction (oral direction)
C - at the obstruction (aboral direction)
D - to the right of the obstruction (aboral direction)
Incising on the antimesenteric border from point C to D (aboral)
After an intestinal resection and anastomosis, what type of suture pattern causes the least intraluminal narrowing?
- Inverting
- Everting
- Appositional
- All cause similar amounts of narrowing
- Appositional
What suture material should ideally be used for the anastomosis of the large intestine in a low tension situation?
- Short acting e.g. Poliglecaprone
- Medium acting braided e.g. Polyglactin 910
- Long acting Monofilament e.g. Polydioxanone
- None absorbable monofilament e.g. Nylon
- Long acting Monofilament e.g. Polydioxanone
If at Dumbo’s surgery you find that the ileum has become intussuscepted into the colon at the ileocaecal colic junction, your next step would be to:
- Manually reduce the intussusception via gentle traction and assess the viability of the bowel prior to resecting any tissue that appears not to be viable
- Resect the entire ileocaecal colic junction en bloc and perform ileocolic end to end anastomoses without attempting to reduce the intussusception
- Do not perform surgery on the intussusception as the dead bowel inside will pass into the colon and be passed with the stool
- Leave the intussusception as is, then pursue medical management as intussusceptions are usually due to intestinal parasites which are easily treated
- Manually reduce the intussusception via gentle traction and assess the viability of the bowel prior to resecting any tissue that appears not to be viable
If you were to reduce the intussusception, how would you assess the viability of the intestines after reduction?
- Good pink colouration of all of the affected tissue
- Evidence of peristalsis returning to the section of gut
- Pulses in the mesenteric vessels supplying the affected gut
- All of the above are indicators of viability
- All of the above are indicators of viability
You plan to monitor Dumbo for any early signs of infectious peritonitis in case the anastomosis site dehisces. This is best done by:
- Palpating the abdomen for post operative pain
- Radiographing the abdomen every 24 hours looking for the ground glass appearance
- Performing an ultrasound of the abdomen every 24 hours
- Placing active suction drains in the abdomen at the time of surgery and performing cystology and glucose levels on the abdominal fluid
- Placing active suction drains in the abdomen at the time of surgery and performing cystology and glucose levels on the abdominal fluid
When closing the linea alba after a laparotomy, what layer has the most strength and must be included in a simple continuous closure?
- Internal rectus sheath
- Rectus abdominus muscle
- External rectus sheath
- Peritoneum
- External rectus sheath
What effect will just removing the ileocaecal valve have on Dumbo?
- The dog will not be able to absorb any vitamin B
- The dog will have an increased functional transit time (slows down passage)
- The dog will have a decreased functional transit time (speeds up passage)
- Stricture formation is more likely than in other areas of the small or large intestinal tract
- The dog will have a decreased functional transit time (speeds up passage)
A 10 year old DSH cat weighing 4kg needs a tooth extraction. If using lignocaine 1% in the local block, what would be the usual volume of lignocaine considered to be safe in this cat?
- 0.04 mls
- 0.4 mls
- 1.4 mls
- 2.0 mls
- 0.4 mls
(10% bodyweight)
Regarding the local anaesthetic agent used in local blocks, which of the following statements is correct?
- Lidocaine has a rapid onset (2-5 minutes) but limited duration (30-120 minutes)
- Bupivicaine has a slightly longer onset (30-60 minutes) than lidocaine but has a longer duration (>12 hours)
- Bupivicaine administration should not exceed 3 mg/kg in dogs or cats
- Lidocaine administration should not exceed 2 mg/kg in dogs or cats
- Lidocaine has a rapid onset (2-5 minutes) but limited duration (30-120 minutes)
Which of the following oral nerve blocks is most appropriate to extract a right upper canine tooth fracture?
- Right infraorbital nerve block
Below are the radiographs of a 7 year old Golden Shepherd presenting with sudden onset gagging and pacing. What is the diagnosis?
- Gastric dilatation with volvulus
What is the normal number of adult teeth in the dog?
42
