Final: Grevemeyer Part 2 (Male and Female Sx)

Question 1

A solitary, 1-cm diameter mass is identified on the penile body of a 13yo Appaloosa breeding stallion. The mass is cauliflower-like in appearance, has a narrow base, and does not appear to invade the penile tunic. The regional lymph nodes are not enlarged. Which of the following procedures would be most appropriate in this case?

a. Wait and recheck the mass in 6mo, and then remove the mass if it has enlarged
b. Perform an en bloc resection because the tumor has likely metastasized
c. Perform a local excision or circumferential posthectomy
d. Perform a phallectomy immediately

Answer 1

c. Perform a local excision or circumferential posthectomy

Question 2

Phallectomy

a. be performed when severe preputial lesions are present.
b. is indicated for horses with severe lesions of the distal penis.
c. involves the removal of a circumferential ring of preputial tissue.
d. should not be performed on geldings

Answer 2

b. is indicated for horses with severe lesions of the distal penis.

Question 3

A 15-year-old American paint gelding is presented for severe preputial swelling with a foul odor. There are multiple SCC lesions on the penis and prepuce. The penis feels thickened, and the superficial inguinal lymph nodes are enlarged. Which of the following techniques is indicated?

a. circumferential posthectomy and lymph node removal
b. phallectomy
c. laser ablation of penile and preputial lesions
d. en bloc resection and penile retroversion with superficial inguinal lymph node removal

Answer 3

d. en bloc resection and penile retroversion with superficial inguinal lymph node removal

Question 4

Local excision of solitary tumors of the equine external genitalia

a. is usually not possible because of rapid metastasis and invasion of lesions.
b. Requires general anesthesia.
c. Can be performed in the standing horse using local or epidural anesthesia
d. Is associated with a high cure rate for the treatment of horses with coalesced melanomas (dermal melanomatosis)

Answer 4

c. Can be performed in the standing horse using local or epidural anesthesia

Question 5

SCC of the penis with involvement of the urethra

a. is associated with a better prognosis for long-term survival than SCC that does not involve the urethra.
b. is associated with a poorer prognosis for long-term survival than SCC that does not involve the urethra.
c. necessitates immediate circumferential posthectomy.
d. has no effect on the prognosis for long-term survival of the horse.

Answer 5

b. is associated with a poorer prognosis for long-term survival than SCC that does not involve the urethra.

Question 6

Laser vaporization of external urogenital tumors

a. has been successful for the treatment of horses with precancerous lesions.
b. is associated with a high risk of complications and should not be attempted.
c. does not require adequate surgical margins because the heat from the laser destroys all tumor cells.
d. is commonly performed using an Nd:YAG laser.

Answer 6

a. has been successful for the treatment of horses with precancerous lesions.

Question 7

Incomplete tumor excision

a. is associated with a transient decrease in proliferation of residual tumor cells and metastases.
b. is associated with a transient increase in proliferation of residual tumor cells and metastases.
c. has no effect on the kinetics of remaining cells.
d. is easily avoided when debulking tumors.

Answer 7

b. is associated with a transient increase in proliferation of residual tumor cells and metastases

Question 8

Perioperative administration of anticancer drugs

a. is not advised because of the high risk of wound dehiscence.
b. is not effective in treating horses with tumors of the external genitalia.
c. decreases the efficacy of the drugs because residual tumor cells are resistant to anticancer drugs.
d. optimizes the efficacy of the anticancer drugs against residual tumor cells

Answer 8

a. is not advised because of the high risk of wound dehiscence.

Question 9

Which of the following drugs reportedly causes priapism in horses?

a. Phenylbutazone
b. Flunixin meglumine
c. Benztropine mesylate
d. Acepromazine maleate

Answer 9

d. Acepromazine maleate

Question 10

Which of the following procedures has been used to treat horses with penile paralysis?

a. Phallopexy
b. Phallectomy
c. Segmental posthectomy
d. All of the above

Answer 10

d. All of the above

Question 11

Lavage of the CCP is indicated in patients with:

a. Priapism
b. Penile paralysis
c. Penile hematoma
d. None of the above

Answer 11

a. Priapism

Question 12

Which of the following drugs is reportedly successful in treating horses with priapism?

a. Atropine
b. Phenylephrine
c. Benztropine mesylate
d. Acepromazine maleate

Answer 12

c. Benztropine mesylate

Priapism secondary to acepromazine therapy; Cholinergic blocker; IV

Question 13

Which of the following techniques is effective in the treatment of horses with priapism?

a. Segmental posthectomy
b. Phallopexy
c. Lavage of the CCP
d. All of the above

Answer 13

c. Lavage of the CCP

Question 14

Which of the following can be used to treat superficial prepubic carcinomas?
a. 5-FU ointment

b. Cryotherapy
c. Segmental posthectomy
d. All of the above

Answer 14

d. All of the above

Question 15

In horses, the most common preputial neoplasm is

a. fibropapilloma
b. squamous cell carcinoma
c. sarcoid
d. hemangioma

Answer 15

b. squamous cell carcinoma

Question 16

Phallectomy techniques used in horses include

a. Visnot
b. Scott
c. Williams
d. All of the above

Answer 16

d. All of the above

Question 17

Partial posthiopasty is indicated to treat patiens with

a. invasive SCC
b. local dermal SCC
c. cutaneous habronemiasis
d. b and c

Answer 17

d. b and c

Question 18

Radical resection of the penis and prepuce is indicated in patients with

a. SCC of the terminal glans penis
b. invasive neoplasia of the glans and prepuce
c. proximal urethral cicatrix
d. none of the above

Answer 18

b. invasive neoplasia of the glans and prepuce

Question 19

Circumferential posthectomy (reefing)
a. is performed only for severe, infiltrative lesions of
the prepuce and penis.
b. is associated with a poor prognosis when compared
with other surgical techniques for external genital
tumors.
c. should be performed only as a salvage procedure in
stallions.
d. involves the removal of a circumferential ring of
preputial tissue.

Answer 19

d. involves the removal of a circumferential ring of
preputial tissue.

Question 20

What are the 2 indications for a phallectomy?

Answer 20

Irreparable penis damage (e.g. penile paralysis)

Extensive neoplasia

Question 21

What is the most common penile tumor?

Answer 21

SCC

Question 22

Which of these is NOT involved in patient preparation for a phallectomy?

a. Castrate 3-4 weeks pre-op
b. General anestehsia
c. Catheterization of the urethra
d. Right lateral recumbency
e. Tourniquet

Answer 22

d. Right lateral recumbency

Dorsal recumbency

Question 23

What penile tourniquet technique is this (with the top of the trangle incision pointing to the tourniquet)?

Answer 23

William’s Technique

Question 25

En bloc resection and penile retroversion

a. are warranted for the treatment of horses with extensive lesions of the penis and/or prepuce with metastasis.
b. involve the resection of only the distal penis, including the glans.
c. are associated with an excellent prognosis.
d. should not be performed on geldings because of the change in urination behavior.

Answer 25

a. are warranted for the treatment of horses with extensive lesions of the penis and/or prepuce with metastasis.

Question 26

Bolz’ technique is for which surgery?

Answer 26

Phallopexy

Question 27

What procedure is performed to prevent aspiration of air into the vagina?

Answer 27

Vulvoplasty/ Caslick’s operation

Causes = poor conformation and injury

Question 28

Which instrument is used to remove tissue during a vulvoplasty?

Answer 28

Mayo scissors

Question 29

What procedure is indicated if a vulvoplasty fails?

Answer 29

Perineal body reconstruction

Question 30

A vaginoplasty is the ____ relocation of the _____ fold.

Answer 30

Caudal

Transvere

Question 31

The preferred surgical treatment for vesicovaginal reflux in mares is a(n)

a. Urethrotomy
b. Urethrostomy
c. Urethroplasty
d. Vulvoplasty

Answer 31

c. Urethroplasty

Question 32

Which of the following is NOT a urethroplasty technique?

a. Visnot
b. Brown
c. Shires
d. McKinnon

Answer 32

a. Visnot

Phallectomy technique

Question 33

Which of the following methods can be used to remove cystic calculi in mares?

a. Laparocystotomy
b. Manual removal through the urethra
c. Sphincterotomy
d. All of the above

Answer 33

d. All of the above

Question 34

5-fluorouracil (5-FU) ointment is used in horses to treat:

a. Habronemiasis
b. Fungal infections
c. SCC
d. None of the above

Answer 34

c. SCC

Question 35

Which of the following methods is most useful in diagnosing urolithiasis in horses?

a. Ultrasound
b. Radiographs
c. Endoscopy
d. Thermography

Answer 35

c. Endoscopy

Question 36

In male horses, the preferred surgical approach fto the urethral lumen is
a. ventral midline

b. dorsal midline
c. lateral lognitudinal
d. ventral transverse

Answer 36

a. ventral midline

Question 37

In male horses, the preferred surgical approach for removal of proximal urethral calculi is:

a. Subischial urethrotomy
b. Laparocystotomy
c. Perineal urethrotomy
d. None of the above

Answer 37

c. Perineal urethrotomy

Question 38

Which of the following structures is not normally incised during a perineal urethrotomy?

a. CSP
b. Skin and subcutis
c. Bulbospongiosus muscle
d. Corpus cavernosum penis

Answer 38

d. Corpus cavernosum penis

Question 39

Which of the following is the preferred therapy for excessively large cystic calculus in a mare?

a. Laparocystotomy
b. Manual removal thru the urethra
c. Sphincterotomy
d. None of the above

Answer 39

a. Laparocystotomy

Question 40

First degree perineal laceration involve the _______ and the _____ only.

Second degree perineal lacerations involve the _____ and _____.

Third degree perineal lacerations involve the ___________, ___________, and _____________.

Answer 40

1st: Mucosa vestibula, vulva
2nd: Mucosa, submucosa
3rd: perineal body, anal sphincter, floor of the rectum

Question 41

What are the 4 basic surgical principles when repairing perineal lacerations?

Answer 41

1. Minimum tension on the suture line
2. Broad contact of wound surfaces
3. Strong suture material
4. Reduce amount of feces

Question 42

Rectovesctibular repair can occur in one or two stages. Name one single-stage and one two-stage repair technique.

Answer 42

Single: Goetze or Vaughan

Two: Aanes

Note double a = 2 stage

Question 43

When is the second stage of the 2-stage rectovesctibular repair performed?

a. Right after the first stage
b. Before parturition
c. 2-3 weeks after the first stage
d. After the foal is born

Answer 43

c. 2-3 weeks after the first stage

Question 44

How long after completing a rectovesctibular repair can a mare be bred?

a. 2-3 weeks
b. 6 weeks
c. 6 months
d. 2-3 months

Answer 44

b. 6 weeks

Question 45

What is the term for a laceration of the dorsal vestibula into the rectum without disruption of the perineal body or anal sphincter?

Answer 45

Rectovestibular fistula

Question 46

What 2 approaches can be made to repair a rectovestibular fistula?

Answer 46

Via rectum

Via vestibula/perineal body

Question 47

T/F: A unilateral ovariectomy is performed to eliminate nyphomania.

Answer 47

False, bilateral

Question 48

What are the 3 options for performing a standing ovariectomy?

Answer 48

Flank

Colpotomy (Transvaginal)

Laparoscopy

Question 49

When performing a colpotomy, where are the large vessels that run along the uterus which must be avoided located? Where are the incisions made?

Answer 49

3 o’clock and 9 o’clock

Incision at 2 o’clock and 10 o’clock

Question 50

Which instrument is used for a ovariectomy via colpotomy?

Answer 50

Ecraseur

Question 51

How many portals are required for a recumbent laparoscopy for an ovariectomy?

Answer 51

4

2 for instruments, 1 for ligatur, 1 for camera

Question 52

What are these 3 approaches for recumbent ovariectomy?

Answer 52

Left to right

Flank

Median

Paramedian

Question 53

Why is ligating essential when removing a granulosa cell tumor?

Answer 53

They are very well vascularized

Question 54

How much time do you have to attempt to deliver a fetus after GA induction before preforming a c-section?

Answer 54

Max 15 min

Question 55

In how many layers and with what pattern(s) do you close the uterus after a c-section?

Answer 55

2 layers

Patterns: Cushing, Lembert

Question 56

How long after a c-section can sutures be removed?

Answer 56

10 days