Final: Grevemeyer Part 2 (Male and Female Sx) Flashcards
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
c. Perform a local excision or circumferential posthectomy
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
b. is indicated for horses with severe lesions of the distal penis.
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
d. en bloc resection and penile retroversion with superficial inguinal lymph node removal
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)
c. Can be performed in the standing horse using local or epidural anesthesia
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.
b. is associated with a poorer prognosis for long-term survival than SCC that does not involve the urethra.
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.
a. has been successful for the treatment of horses with precancerous lesions.
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.
b. is associated with a transient increase in proliferation of residual tumor cells and metastases
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
a. is not advised because of the high risk of wound dehiscence.
Which of the following drugs reportedly causes priapism in horses?
a. Phenylbutazone
b. Flunixin meglumine
c. Benztropine mesylate
d. Acepromazine maleate
d. Acepromazine maleate
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
d. All of the above
Lavage of the CCP is indicated in patients with:
a. Priapism
b. Penile paralysis
c. Penile hematoma
d. None of the above
a. Priapism
Which of the following drugs is reportedly successful in treating horses with priapism?
a. Atropine
b. Phenylephrine
c. Benztropine mesylate
d. Acepromazine maleate
c. Benztropine mesylate
Priapism secondary to acepromazine therapy; Cholinergic blocker; IV
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
c. Lavage of the CCP
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
d. All of the above
In horses, the most common preputial neoplasm is
a. fibropapilloma
b. squamous cell carcinoma
c. sarcoid
d. hemangioma
b. squamous cell carcinoma
Phallectomy techniques used in horses include
a. Visnot
b. Scott
c. Williams
d. All of the above
d. All of the above
Partial posthiopasty is indicated to treat patiens with
a. invasive SCC
b. local dermal SCC
c. cutaneous habronemiasis
d. b and c
d. b and c
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
b. invasive neoplasia of the glans and prepuce
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.
d. involves the removal of a circumferential ring of
preputial tissue.
What are the 2 indications for a phallectomy?
Irreparable penis damage (e.g. penile paralysis)
Extensive neoplasia
What is the most common penile tumor?
SCC
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
d. Right lateral recumbency
Dorsal recumbency
What penile tourniquet technique is this (with the top of the trangle incision pointing to the tourniquet)?
William’s Technique
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.
a. are warranted for the treatment of horses with extensive lesions of the penis and/or prepuce with metastasis.
Bolz’ technique is for which surgery?
Phallopexy
What procedure is performed to prevent aspiration of air into the vagina?
Vulvoplasty/ Caslick’s operation
Causes = poor conformation and injury
Which instrument is used to remove tissue during a vulvoplasty?
Mayo scissors
What procedure is indicated if a vulvoplasty fails?
Perineal body reconstruction
A vaginoplasty is the ____ relocation of the _____ fold.
Caudal
Transvere
The preferred surgical treatment for vesicovaginal reflux in mares is a(n)
a. Urethrotomy
b. Urethrostomy
c. Urethroplasty
d. Vulvoplasty
c. Urethroplasty
Which of the following is NOT a urethroplasty technique?
a. Visnot
b. Brown
c. Shires
d. McKinnon
a. Visnot
Phallectomy technique
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
d. All of the above
5-fluorouracil (5-FU) ointment is used in horses to treat:
a. Habronemiasis
b. Fungal infections
c. SCC
d. None of the above
c. SCC
Which of the following methods is most useful in diagnosing urolithiasis in horses?
a. Ultrasound
b. Radiographs
c. Endoscopy
d. Thermography
c. Endoscopy
In male horses, the preferred surgical approach fto the urethral lumen is
a. ventral midline
b. dorsal midline
c. lateral lognitudinal
d. ventral transverse
a. ventral midline
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
c. Perineal urethrotomy
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
d. Corpus cavernosum penis
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
a. Laparocystotomy
First degree perineal laceration involve the _______ and the _____ only.
Second degree perineal lacerations involve the _____ and _____.
Third degree perineal lacerations involve the ___________, ___________, and _____________.
1st: Mucosa vestibula, vulva
2nd: Mucosa, submucosa
3rd: perineal body, anal sphincter, floor of the rectum
What are the 4 basic surgical principles when repairing perineal lacerations?
- Minimum tension on the suture line
- Broad contact of wound surfaces
- Strong suture material
- Reduce amount of feces
Rectovesctibular repair can occur in one or two stages. Name one single-stage and one two-stage repair technique.
Single: Goetze or Vaughan
Two: Aanes
Note double a = 2 stage
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
c. 2-3 weeks after the first stage
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
b. 6 weeks
What is the term for a laceration of the dorsal vestibula into the rectum without disruption of the perineal body or anal sphincter?
Rectovestibular fistula
What 2 approaches can be made to repair a rectovestibular fistula?
Via rectum
Via vestibula/perineal body
T/F: A unilateral ovariectomy is performed to eliminate nyphomania.
False, bilateral
What are the 3 options for performing a standing ovariectomy?
Flank
Colpotomy (Transvaginal)
Laparoscopy
When performing a colpotomy, where are the large vessels that run along the uterus which must be avoided located? Where are the incisions made?
3 o’clock and 9 o’clock
Incision at 2 o’clock and 10 o’clock
Which instrument is used for a ovariectomy via colpotomy?
Ecraseur
How many portals are required for a recumbent laparoscopy for an ovariectomy?
4
2 for instruments, 1 for ligatur, 1 for camera
What are these 3 approaches for recumbent ovariectomy?
Left to right
Flank
Median
Paramedian
Why is ligating essential when removing a granulosa cell tumor?
They are very well vascularized
How much time do you have to attempt to deliver a fetus after GA induction before preforming a c-section?
Max 15 min
In how many layers and with what pattern(s) do you close the uterus after a c-section?
2 layers
Patterns: Cushing, Lembert
How long after a c-section can sutures be removed?
10 days
