Improve 1 Flashcards
What muscle lies over and protect the radial nerve of the lateral aspect of the humerus? Anconeus Superficial pectoral Brachiocephalicus Bracialis
Brachialis
What is the treatment for severe shoulder dysplasia? Artrodesis Amputation Replacement Conservative
Artrodesis
What is the most common manifestation of elbowdysplasia?
Medial compartment disease
Ununited medial epicondyle of the humerus
OCD of the medial epicondyle of humerus
Un united anconeal process
Medial compartment disease
How is it best to manage a partially torn and painful biceps tendon?
- Tenotomy and or/ tenodesis
- Tenotomy and surgical excision
- Tenotomy and steroids
- Conservative management
Tenotomy and or/ tenodesis
Radial carpal bone fractures are most common in which dog breed: • Labradors • Boxers • Terriers • Lurchers
Boxers
Which of the following answers regarding distraction index is correct?
• Hip osteoarthrosis is more likely with a distraction index < 0.3
• Hip osteoarthrosis is more likely with a distraction index > 0.3
• Hip osteoarthrosis is more likely with a distraction index < 0.7
• Hip osteoarthrosis is more likely with a distraction index > 0.7
Hip osteoarthrosis is more likely with a distraction index > 0.7
What is characteristic for type IV central tarsal bone fractures?
• Dorsal slab, no displacement
• Dorsal slab, displacement
• Sagittal fracture, displacement of medial fragment
• Both dorsal and medial slab fractures, displacement
Both dorsal and medial slab fractures, displacement
Gastrocnemius tendon avulsion with intact SDFT (superficial digital flexor tendon) is considered • Type I Achilles tendon rupture • Type IIa Achilles tendon rupture • Type IIb Achilles tendon rupture • Type IIc Achilles’ tendon rupture
Type IIc Achilles’ tendon rupture
OCD lesions usually occur
• 96% on the medial aspect of the lateral femoral condyle
• 96% on the lateral aspect of the lateral femoral condyle
• 96% on the medial aspect of the medial femoral condyle
• 96% on the lateral aspect of the medial femoral condyle
96% on the medial aspect of the lateral femoral condyle
In patella alta the ratio of patellar ligament length to patellar length measurement is
- < 1.45
- > 1.45
- < 1.97
- > 1.97
• > 1.97
Which of the following implants resists shear forces at the fracture site? • IM pin • Lag screw • External fixator • Cerclage wire
External fixator
What is the correct insertion technique for placing an IM pin in the tibia?
• Normograde, medially, caudal to patella tendon
• Normograde, laterally, caudal to patella tendon
• Retrograde exiting laterally proximally
• Retrograde exiting medially proximally
Normograde, medially, caudal to patella tendon
You are presented with an oblique fracture of the tibia. You elect to use cerclage wires as part of the repair. Which of the following statements is false?
• It is recommended to place two cerclage wires
• The full circumference of the bone must be reconstructable when using cerclage wires
• Pushing the knot over at the end of twisting results in a loss of tension
• Cerclage wires interfere with the blood supply to the bone
Cerclage wires interfere with the blood supply to the bone
LC-DCP plates are considered to have a number of advantages compared to DCP plates. Which statement is false?
• The LC-DCP can be used to create compression across the fracture
• The design of the LC-DCP prevents stress concentration at the screw holes
• The design of the LC-DCP interferes with the vascularity of the bone
• The LC-DCP can be contoured
The design of the LC-DCP interferes with the vascularity of the bone
5) Which of the following statements about conventional screw-plate systems is false?
• The stability of the conventional screw-plate construct relies upon frictional force generated between the plate and bone
• During ambulation axial forces transmitted along bone are converted to shear forces at the bone-plate interface
• The resistance of screws to shear force can be increased by using screws with a larger core diameter
• Anatomic reconstruction does not contribute to load sharing between the plate and bone
Anatomic reconstruction does not contribute to load sharing between the plate and bone
What is considered the gold standard technique for diagnosis of osteomyelitis? • Serial radiographic examination • Blood culture • Bone biopsy and culture • Scintigraphy
Bone biopsy and culture
What is the commonest organism isolated in cases of osteomyelitis? • Escherichia coli • Pseudomonas • Streptococcus • Staphylococcus aureus
Staphylococcus aureus
Which one of the following thoracic injuries is most commonly seen on thoracic radiographs of dogs with appendicular fractures caused by road traffic accidents? • Pulmonary contusion • Haemothorax • Pneumothorax • Pneumomediastinum
Pulmonary contusion
Platelet rich plasma is a \_\_\_\_\_\_\_\_\_\_\_ bone graft? • Osteoinductive • Osteoconductive • Osteogenic • Osteopromotive
Osteopromotive
Which of the following antibiotics is most suitable for prophylactic use in canine fracture repair? • Ampicillin • Gentamycin • Metronidazole • Second generation cephalosporins
Second generation cephalosporins
A patient with non-ambulatory tetraparesis, reduced muscle tone and reduced spinal reflexes most likley has which of the following? • Peripheral neuropathy • C1-C5 myelopathy • C6-T2 myelopathy • Inflammatory CNS disease
Peripheral neuropathy
When performing a neurological examination on a dog with ambulatory paraparesis you identify a sharp panniculus cut-off at T13. This suggests which of the following neuroanatomical locations?
• A lesion at T13
• A lesion 1-2 vertebral bodies cranially
• A lesion 1-2 vertebral bodies caudally
• A lesion at C6-T2
A lesion 1-2 vertebral bodies cranially
Peripheral vestibular ataxia usually presents with which of the following? • Upper motor neurone paresis • Generalised proprioceptive ataxia • Ipsilateral trigeminal nerve deficits • Ipsilateral Horner’s syndrome
Ipsilateral horners (same side)
Which imaging modality provides the best spatial resolution? • MRI • CY • Radiographs • CT-myelography
Radiographs
Mannitol’s main role is to do which of the following? • Decrease intracranial pressure • Increase brain volume • Decrease brain perfusion • Increase systemic blood pressure
Decrease intracranial pressure
Which of the following would be a contraindication for CSF collection?
• Coagulopathy
• Diffuse cerebral changes
• Pappiloedema with no other neurological signs
• Proprioceptive deficits in all four limbs
Coagulopathy
After performing an MRI you are planning to perform a C6-C7 vertebral distraction-stablisation in a 6 year old Dobermann. Which specific test would you perform prior to surgery?
Electrolytes
• Electromyography
• Biochemistry
• Buccal mucosal bleeding time
Buccal mucosal bleeding time
Which of the following drugs is most likely to be associated with melena when administered in cases of spinal cord injury? • Metronidazole • Methocarbamol • Dexamethasone • Gabapentin
Dexamethasone
What pain relief combination would be appropriate to use in the first 24 hours following an hemilaminectomy? • Methadone and prednisolone • Prednisolone and meloxicam • Gabapentin • Methadone, gabapentin and meloxicam
• Methadone, gabapentin and meloxicam
Which of the following is not a possible complication in a paraplegic patient after a hemilaminectomy • Pressure sores • Laryngeal paralysis • Urine scalding • Dehydration
Laryngeal paralysis
Iodophors are most effective at a: • 0.1% Solution • 1% solution • 10% solution • 100% solution
0.1
The risk of a surgical site infection:
• Doubles for every hour of general anaesthesia indepently of surgical time
• Doubles for every hour of surgical time
• Doubles if single gloving is used instead of closed gloving
• Doubles if prophylactic antibiotics aren’t used
Doubles for every hour of surgical time
The primary cell type expected to be found in surgical wound at 48-96 hours is the: • Platelet • Neutrophil • Macrophage • Fibroblast
Macrophage
Which of the following dressings is most appropriate for the management of a highly exudative open wound? • Adhesive film • Hydrocolloid sheet • Hydrogel • Alginate
Alginate
5) Which of the following statements regarding z-plasty is correct?
• There is a gain in length along the central limb of the z
• The central limb of the z is parallel to the wound
• There is an increase in tension along the central limb of the z
• There is a decrease in tension parallel to the length of the wound
There is a gain in length along the central limb of the z
What is the most common tumour of the salivary glands? • Adenoma • Adenocarcinoma • Lymphoma • Fibrosarcoma
Adenocarcinoma
Dissection must be performed under which muscle to achieve complete mandibular/sublingual salivary gland excision? • Digastricus • Masseter • Stylohyoideus • Hyoglossus
Digastricus
A dog runs onto a stick on a walk. The stick penetrates via the mouth and is palpable in the neck. Which structure in the neck is most commonly damaged? • Oesophagus • Larynx • Vagosympathetic trunk • Salivary Gland
Oesophagus
How could you treat gastric adenocarcinoma in the pylorus of a dog? • Chemotherapy • Pyloroplasty • Pylorectomy • Gastric bypass
Pylorectomy
Which of the following is a risk factor for development of gastric dilatation and volvulus? • Sibling that has had a GDV • Feeding table scraps • Previous gastric surgery • Obesity
Sibling that has had a GDV
Which artery must be retained when performing subtotal colectomy (including the iliocolic valve) for feline megacolon? • Left colic artery • Middle colic artery • Right colic artery • Cranial rectal artery
• Cranial rectal artery
What is the recommended treatment for an insulinoma in the distal left limb of the pancreas • Euthanasia • Medical management with prednisolone • Marginal resection • Partial pancreatectomy
Partial pancreatectomy
What is the most appropriate treatment for biliary mucocele • Medical management • Cholecystotomy and lavage • Cholecystectomy • Common bile duct stent
Cholecystectomy
Which of the following liver masses has the best outcome after surgical resection, assuming that there is a single large mass that is amenable to surgical resection? • Hepatocellular adenocarcinoma • Cholangiocellular carcinoma • Haemangiosarcoma • Carcinoid
Hepatocellular adenocarcinoma
What is the most commonly performed surgery for perineal rupture/hernia?
• Muscle apposition plus gluteal muscle flap
• Muscle apposition plus internal obturator muscle flap
• Muscle apposition plus prosthetic mesh
• Muscle apposition plus semitendinosus flap
Muscle apposition plus internal obturator muscle flap
A 6 year old female (n) Bassett Hound presented with two episodes of haematuria, which were self-limiting. Clinical examination was unremarkable.
On diagnostic evaluation
Biochemistry profiles were within normal limits. Haematology revealed a mild anaemia (28 % PCV).
Platelet count, clotting profiles and Von Willebrands factor were within normal limits.
Urine culture was sterile; on analysis the only abnormality was numerous red blood cells
Intravenous urogram, retrograde urethrogram and ultrasound examination were unremarkable
Which treament option is most suitable for this case?
• Celiotomy and nephrectomy
• Chemotherapy
• Serial monitoring of PCV and TP
• Cystoscopy, celiotomy and nephrectomy
Serial monitoring of PCV and TP
2) A 7 year old male (n) Great Dane is presented with a football sized scrotum after castration the day before. The scrotum is still dripping blood.
Heart rate is 145, peripheral pulses are thready, mucus membranes are pale and the dog is subdued. PCV is 18%, total protein is 53 g/l.
What is your treatment plan?
• Blood transfusion and cold pack the scrotum
• Blood transfusion followed by anaesthesia and celiotomy once perfusion has improved and ligation of the testicular artery
• Blood transfusion
• Blood transfusion followed by anaesthesia once perfusion has improved; scrotal haematoma removal and ligation of the testicular artery.
Blood transfusion followed by anaesthesia and celiotomy once perfusion has improved and ligation of the testicular artery
A 6 year old Domestic Short Hair cat presents with a 3 week history of a caudal solitary mammary mass, no other clinical signs are present.
Your initial advice to the owner is:
• It is most likely to be benign, monitor and remove if it grows in the next few weeks
• It is most likely to be benign, excised and submit for histopathology
• It is most likely to be malignant it should be removed by radical mastectomy
• It is most likely to be malignant but can be removed with a lumpectomy
It is most likely to be malignant it should be removed by radical mastectomy
A 7-year-old female (n) Cross-bred was presented with a two-week history of stranguria, pollakiuria and haematuria. Clinical examination was unremarkable.
On diagnostic evaluation:
Urinalysis revealed a pH of 9.0, numerous red blood cells, 50-100 WBC per HPF, large numbers of cocci, proteinuria and struvite crystalluria.
Urine culture yielded staphylococcus intermedius
Radiographic examination of the abdomen revealed two relatively large radiodense smooth mineral densities in the bladder.
A presumptive diagnosis of infection-induced struvite urolithiasis was made based on the above information.
A struvite dissolution diet was fed and a two-week course of amoxicillin-clavulanic acid was started at 22 mg/kg PO twice daily.
At the 4 week re-examination the urine was persistently infected with staphylococcus and there was little change in the uroliths.
Which of the following is the most likely reason for treatment failure?
• Non-struvite urolith composition
• Concurrent Pyelonephritis
• Owner non compliance
• Inappropriate duration of antibiotic treatment
• Inappropriate duration of antibiotic treatment
After intravesicular correction (neoureterocystostomy) the most common complication is pyelonephritis
An American cat is presented for assessment of a kidney transplant. On clinical examination the cat is bright but has been losing weight (about 10% over the last 3 months) despite appropriate medical management of the kidney failure.
On screening for the transplant program the following information is noted
Which of the below would exclude the cat from the transplant programme?
• A fine needle aspirate of the kidneys under ultrasound guidance demonstrates renal amyloidosis.
• Blood profiles reveal azotaemia, with a creatinine level of over 400 umol/L
• The cat is 9 years of age
• A viral upper respiratory tract infection is present
A fine needle aspirate of the kidneys under ultrasound guidance demonstrates renal amyloidosis
A 10 year Yorkshire Terrier presents to you with a goose honk cough. You suspect that the patient may have tracheal collapse. What would be considered the gold standard method for diagnosis of this condition?
• Radiography
• Bronchio-alveolar lavage
• Presence of goose honk cough on clinical examination
• Tracheoscopy
Tracheoscopy
A 10 year old Labrador Retriever presents to you with excessive panting, exercise intolerance, increased inspiratory noise and a recent change in vocalisation. Which is your most likely differential diagnosis based on these clinical signs?
• Laryngeal collapse
• Elongated soft palate with everted laryngeal saccules
• Laryngeal paralysis
• Laryngeal neoplasia
Laryngeal paralysis
A 5 month Bulldog presents to your clinic with lethargy, increased respiratory rate, a moist cough and moist lung sounds bilaterally. You take a radiograph as displayed below. What advice is most appropriate to the owner?
- The radiograph shows no abnormalities and the best action at present is to send the patient home with oral antibiotics and careful monitoring. If the patient deteriorates, you will see the patient again and repeat the radiographs in case the radiographic picture changes.
- The radiograph shows evidence of aspiration pneumonia and the best course of action is to send the patient home with oral antibiotics and re- see the patient in 48 hours or sooner if concerned.
- The radiographs shows evidence of aspiration pneumonia and the best course of action is intravenous antibiotics and hospitalization.
- The radiograph shows evidence of aspiration pneumonia and a hypoplastic trachea and the best course of action is intravenous antibiotics and hospitalization.
The radiograph shows evidence of aspiration pneumonia and a hypoplastic trachea and the best course of action is intravenous antibiotics and hospitalization.
You are currently the locum veterinary surgeon and are presented with a case for which you have not previously seen. On the clinical notes, you read that your next patient is a Bulldog returning from a local referral practice for a post operative check having recently had surgery for an elongated soft palate and everted laryngeal saccules. The notes suggest that the dog was also diagnosed with grade II laryngeal collapse. Which of the following would you expect to have been noted on laryngoscopy with this diagnosis?
• Laryngeal saccule eversion alone
• Laryngeal saccule eversion with collapse of the epiglottis dorsally
• Laryngeal saccule eversion with medial displacement of cuneiform process of arytenoid cartilage
• Laryngeal saccule eversion with medial displacement of the corniculate process of the arytenoid cartilage
• Laryngeal saccule eversion with medial displacement of cuneiform process of arytenoid cartilage
A 13 year old domestic shorthaired cat presents with bilateral epistaxis. Biochemistry, haematology and coagulation profiles are all normal and a CT scan is performed revealing large mass in the caudal nasal chamber. A blind nasal grab biopsy confirms nasal lymphoma. Which of the following would be the recommended treatment option in order to maximise the survival time of the patient?
• Rhinotomy and surgical resection of the mass
• Chemotherapy
• Radiotherapy
• Rhinotomy and surgical resection of the mass with concurrent chemotherapy
Radiotherapy
Which of the following is an essential requirement in cases of chest trauma? • Chest tube • Oxygen • Thoracic imaging • Thoracocentesis
Oxygen
What finding may be suggestive of traumatic myocarditis? • Atrial flutter • Ventricular premature complexes • Diastolic murmur • Weak peripheral pulses
• Ventricular premature complexes
Which is the most common lung lobe to undergo torsion in pugs? • Right caudal • Right cranial • Left caudal • Left cranial
Left cranial
When is surgery indicated in cases of pyothorax?
• In every case
• After unsuccessful conservative management
• In every cat
• Where CT is not available
After unsuccessful conservative management
What is the reported overall percentage survival to discharge in patients undergoing surgery within 24h to correct a traumatic diaphragmatic hernia, according to Gibson et al (Gibson, TWG, Brisson, BA, Sears, W. Perioperative survival rates after surgery for diaphragmatic hernia in dogs and cats: 92 cases (1990–2002), Journal of the American Veterinary Medical Association July 1, 2005, Vol. 227, No. 1, Pages 105-109)
• 89% were discharged alive after surgery
• 99% were discharged alive after surgery
• 59% were discharged alive after surgery
• 29% were discharged alive after surgery
89%
1) Use of drain in oncological surgery increases the risk of:
• Metastases
• Local recurrence
• Extent of tumour if the excision is incomplete
• risk of infection
Extent of tumour if the excision is incomplete
2) The diagnostic accuracy of FNAs for mesenchymal tumours is:
• equal to the accuracy for round cell tumours
• 30-40%
• 70-100%
• 50-61%
50-61%
Which surgical dose is necessary for curative intent surgery? • marginal and wide resections • marginal and radical resections • debulking and wide resection • wide and radical resection
wide and radical resection
During tumour resection it is acceptable to:
• directly handle the tumour
• manipulate the tumour with stay sutures or atraumatic instruments
• shell out well encapsulated masses
• use multifilament sutures
manipulate the tumour with stay sutures or atraumatic instruments
Histological grading is important for • Canine MCT • Feline MCT • Feline STS • Canine melanoma
Canine MCT
What is the most commonly used approach to the shoulder joint for removal of an OCD flap? • Caudal • Caudolateral • Craniolateral • Cranial
Caudolateral
Elbow arthroscopy is most commonly performed on the: • Lateral aspect of the joint • Medial aspect of the joint • Caudal aspect of the joint • Caudal aspect of the joint
Medial
Incomplete ossification of the humeral condyle is most common in which dog breed? • Cavalier King Spaniel • Portuguese water spaniel • English springer spaniel • Welsh springer spanie
English springer spaniel
5) Partial carpal arthrodesis includes fusion of all carpal joints except the: • Carpometacarpal joint • Intercarpal joint • Antebrachiocarpal joint • Metacarpophalangeal joint
Antebrachiocarpal joint
The prognosis for stifle OCD is • Excellent • Good • Guarded • Poor
Guarded
What is the appropriate angle of arthrodesis for the stifle joint? • 100º • 120º • 140º • 160º
140
Supracondylar fractures are best stabilised with • IM pin • Plates • K-wires • Lag screws
Plates
The most common type of distal physeal femoral fractures in dogs is • Type I Salter Harris • Type II Salter Harris • Type III Salter Harris • Type IV Salter Harris
Typ 2 sAlter
A above
The prevalence of lateral congenital patella luxation in small breed dogs is • 0% • 25% • 50% • 75%
25
What is the maximum interfragmentary strain that will permit primary bone formation to occur? • 2% • 5% • 10% • 20%
2%
Under what biological conditions will gap healing occur?
• Absolute stability and a fracture gap < 10mm
• Absolute stability and a fracture gap < 5mm
• Absolute stability and a fracture gap < 3mm
• Absolute stability and a fracture gap > 3mm
Gap <3mm
What is the critical strain level for bone formation in granulation tissue? • 10% • 20% • 75% • 100%
100%
What fracture pattern develops following a compressive force to a long bone? • Transverse • Oblique • Comminuted • Butterfly
Oblique
What nerve is being tested when stimulating the sensory field on the dorsal aspect of the metacarpals and paw? • Ulna • Median • Radial • Peroneal
Radial
Which of the following factors is not a cause of delayed union? • Large fracture gap • Excessive motion at the fracture site • Hypothyroidism •Use of a synthetic bone allograft
Use of a synthetic bone allograft
In the radiograph below what terms best describes the type of implant?
På billedet er der mellemrum mellem distale og proksimale del i knoglen • Neutralization • Compressive • Bridging • Elastic
Bridging
When repairing a comminuted fracture with minimimally invasive osteosynthesis which of the following is considered to be the main advantage?
• Preservation of optimal biological environment for osteosynthesis
• Accurate anatomic reduction
• Load sharing between bone-implant construct
• Rigid fixation
Preservation of optimal biological environment for osteosynthesis
What term best describes the type of non union in the radiograph below?
Billedet viser en meget stor bulet knogle der nærmest ser tumorøs ud. • Oligotrophic non union • Hypertrophic non union • Dystrophic non union • Necrotic non union
Hypertropisk mon union
Haematogenous osteomyelitis typically occurs in which anatomical region of long bones? • Metaphysis • Epiphysis • Diaphysis • Joint surface
Metafyse
Epi-Meta-Dia-Meta-Epi
A 5-year-old Dachshund with non-ambulatory paraparesis and exaggerated pelvic limb spinal reflexes most likely has a spinal lesion at which neuroanatomical location? • C1-C5 • C6-T2 • T3-L3 • L4-S2
T3-L3
Which of the following statements about the paw placement test is correct?
• It tests conscious proprioception alone
• Intact motor function is not required
• It tests unconscious proprioception alone
• It is a postural reaction test
Postural reaction test
Disc extrusions typically result in which of the following myelographic patterns • Normal • Extradural • Intradural-extramedullary • Intramedullary
Extradural
Which of the following conditions can consistently be definitively diagnosed and accurately localised with radiographs alone? • Acute intervertebral disc extrusion • Caudal cervical spondylomyelopathy • Spinal neoplasia • Atlanto-axial instability
Atlanto-axial instability
What is the onset of action of rectally administered diazepam when treating seizures? • Immediate • Within 5 minutes • 10-40 minutes • Over 40 minutes
10-40 minutes
What it the most common clinical sign in cases of mild cervical intervertebral disc disease? • Pain • Proprioceptive deficits • Lack of segmental spinal reflexes • Obtundation
Pain
A 4 year old, GSD was presented with a history of one generalized tonic clonic seizure. Which drug would you give the owners for emergency treatment at home? • Phenobarbitone orally • Diazepam orally • Diazepam rectally • Propofol
Diazepam rectally
A dog was presented with a history of spinal trauma and you suspect a vertebral fracture and/or subluxation. The dog has no deep pain. Which of the following options would you initially choose?
• Laterolateral and horizontal-beam ventrodorsal radiographs
• Laterolateral and a ventrodorsal radiographs
• MRI
• Scintigraphy
Laterolateral and horizontal-beam ventrodorsal radiographs
A 3 year old, male neutered Dachshund was presented with paraplegia. MRI revealed a left sided extradural lesion at the level of T13-L1 consistent with a disc extrusion. Which surgery would you recommend? • Right hemilaminectomy • Left hemilaminectomy • Corpectomy • Dorsal laminectomy
Left hemilaminectomi
A 1 year old, female Yorkshire Terrier was presented with seizures which were progressively becoming more frequent, more severe and were usually occurring a couple of hours after being fed. The neurological examination was consistent with a diffuse or multifocal localization. What is your main differential diagnosis? • Meningioma • Granulomatous meningoencephalitis • Cerebrovascular accident • Hepatic encephalopathy
Hepatic encephalopathy
Which of the following describes the least traumatic way to use scissors?
• Double-blade cutting with the tips only
• Double-blade cutting with the length of the blade
• Blunt dissection with the tips only
• Blunt dissection with the length of the blade
Double-blade cutting with the tips only
Which of the following antiseptics has a residual action when used as a surgical scrub? • Alcohols • Iodophors • Chlorhexidine • Triclosan
Chlorhexidine
Which of the following is an absorbable monofilament suture material? • Monofilament nylon • Polypropylene • Polyglactin 910 • Polydioxanone
Polydioxanone
An axial pattern flap derives its blood supply principally from which of the following? • Musculocutaneous arteries • Deep dermal plexus • Superficial dermal plexus • Direct cutaneous artery
Direct cutaneous artery
Which salivary gland/duct is most likely to be damaged in a cat with a cervical mucocele? • Mandibular • Sublingual • Parotid • Molar
Sublingual
Where in the oesophagus are bone foreign bodies most commonly located (for dogs referred for endoscopy)? • Caudal to the pharynx • Thoracic inlet • Base of heart • Caudal thorax
Caudal thorax
Which animals are susceptible to oesophageal stricture after ingestion of oral medications? • Cats • Dogs • Rabbits • Ferrets
Cats
Which breed of dog has the highest risk of developing a GDV • Shar Pei • Irish Setter • Great Dane • weimernaer
Grand danois
What drug is given for treatment of ventricular arrhythmias in dogs with GDV? • Lidocaine • Ketamine • Metoclopramide • Magnesium
Lidocaine
What is the most appropriate treatment for biliary mucocele • Medical management • Cholecystectomy • Cholecystotomy and lavage • Common bile duct stent
Cholecystectomy
What is the mortality rate after surgical treatment of septic peritonitis? • 10% • 30% • 50% • 70%
50%
During laparotomy, you notice the small intestines have changed from a normal pink to a dark purple colour. What is the most likely cause?
• Arterial thromboembolism
• Hypovolaemia
• Accidental ligation of the cranial mesenteric artery
• Iatrogenic volvulus of the small intestine
Iatrogenic volvulus
How would you treat a dog with perianal fistulas? • Surgical excision of fistula • Prednisolone and hypoallergenic diet • Ciclosporin • Topical tacrolimus
Ciclosporine
A 10 year old Male Labrador presents with dysuria, haematuria, pyrexia, anorexia and a painful caudal abdomen. On clinical examination his temperature is 40.2° C and an irregular firm caudal abdominal mass is palpable at the pelvic inlet. On rectal palpation the prostate is enlarged, asymmetrical and painful. Haematology blood profiles are unremarkable bar a neutrophilia of 23 x 10⁹/l with a left shift. Biochemistry blood profiles are within normal limits. Ultrasound examination reveals a large (4cm) cavitary lesion within the prostate. Culture of the urine reveals an E Coli infection. Which of the following is the most suitable treatment option?
• Percutaneous drainage of the prostatic lesion under ultrasound guidance followed by castration and antibiotic therapy
• Surgical drainage of the prostate, biopsy of the parenchyma followed by closed suction drain placement, castration and antibiotic therapy
• Surgical drainage of the prostate, biopsy of the parenchyma followed by omentalization with castration and antibiotic therapy
• Surgical drainage of the prostate, biopsy of the parenchyma followed by marsupialisation, castration and antibiotic therapy
Surgical drainage of the prostate, biopsy of the parenchyma followed by omentalization with castration and antibiotic therapy
A 6 year old female West Highland white terrier presents with haematuria and stranguria. Urine culture and analysis yields no growth, urine analysis reveals haematuria and reactive epithelial cells. Ultrasound examination of the bladder reveals a mass affecting the trigone of the bladder.
A catheter biopsy is consistent with a transitional cell tumour of the bladder. What is your advice to the owner?
• This is a slow growing tumour that is best treated with surgical resection, with average survival times after surgery in the order of 18-24 months
• This is an aggressive tumour but very responsive to chemotherapy with survival times in the order of 18-24 months
• This is a benign tumour that can be treated with non-steroidal anti-inflammatories
• This is an aggressive tumour which may respond to chemotherapy with survival times in the order of 4-10 months
This is an aggressive tumour which may respond to chemotherapy with survival times in the order of 4-10 months
When repairing a cystostomy incision which of the following statements is correct?
• A two layer appositional suture pattern has a higher bursting strength at 24 hours post surgery than a two layer inverting suture pattern.
• An inverting suture pattern results in better primary healing compared to an appositional suture pattern
• An inverting suture pattern reduces the risk of urine leakage when compared to an appositional suture pattern
• There is no difference in bursting strength at 24 hours post-surgery when comparing single and double appositional suture patterns
There is no difference in bursting strength at 24 hours post-surgery when comparing single and double appositional suture patterns
What is the most likely reason for the appearance of this dog with a testicular tumour? På billeder ser man alopeci på bagbenene
• Pain/ inflammation causing excessive perineal licking
• Testerosterone secretion by a seminoma
• Oestrogen secretion by a sertoli cell tumour
• Concurrent hypothyroidism
Oestrogen secretion by a sertoli cell tumour
A 4 year old male (n) domestic short hair cat is presented after a road traffic accident with a flaccid bladder which is easily expressible. There is no tail tone but pain sensation is present at the base of the tail. Radiographic examination reveals a sacro-coccygeal luxation. What is your advice to the owner?
• The cat is unlikely to regain urinary continence
• The cat is likely to regain urinary continence but it is likely to take 2-3 months
• The cat is likely to regain urinary continence with the week but it may take up to 6 weeks
• The cat is likely to lose motor function in the hind limbs over the next few days
The cat is likely to regain urinary continence with the week but it may take up to 6 weeks
Which of the following is the most common lingual tumour in cats? • Squamous cell carcinoma • Malignant melanoma • Fibrosarcoma • Mast cell tumour
Squamous cell carcinoma
Which of the following is the main blood supply to the hard palate? • Minor palatine artery • Major palatine artery • Infraorbital artery • Angularis oris artery
Major palatine artery
Which of the following gingival tumours has the highest metastatic rate? • Squamous cell carcinoma • Fibrosarcoma • Melanoma • Acanthomatous ameloblastoma
Melanoma
Which of the following is a primary cause of otitis externa? • Abnormal ear conformation • Excessive moisture due to swimming • Otitis media • Atopic dermatitis
Atopic dermatitis
Which of the following is the most common cause of otitis media in cats?
• Ascending upper respiratory tract infection
• Extension of otitis externa
• Haematogenous spread
• External ear neoplasia
Ascending upper respiratory tract infection
A 10 year Yorkshire Terrier presents to you with a goose honk cough. You suspect that the patient may have tracheal collapse and elect to perform tracheoscopy. On tracheoscopy, the trachea appears dorsoventrally collapsed by approximately 75% of the normal trachea. What grading of tracheal collapse would this represent? • Grade 1 • Grade 2 • Grade 3 • Grade 4
Grad 3
A Pug is presented to you with increased upper respiratory noise, snoring and occasional episodes of exercise intolerance and cyanosis. You suspect correctly that the patient has brachycephalic obstructive airway syndrome and are prepared to induce the patient for examination with concurrent surgery under the same anaesthetic. On examination the patient has stenotic nares, everted laryngeal saccules, collapse of the cuneiform process and an elongated soft palate. When documenting this in your clinical records, what grade of laryngeal collapse would you assign to the patient? • I • II • III • IV
Grad 2 cuneiform
An 8 -month Bulldog presents to you with clinical signs of brachycephalic obstructive airway syndrome (BOAS). Which of the following is NOT a recognised clinical sign associated with this condition? • Regurgitation • Cyanosis • Stertorous breathing • Change in vocalisation
Change in vocalisation
A three year old German Shepherd presents with unilateral mucopurulent nasal discharge and intermittent unilateral epistaxis. You suspect that the patient may have nasal aspergillosis. Which is the best diagnostic technique to be certain that you have nasal aspergillosis?
• CT of the nose
• MRI of the nose
• A positive serology antibody
• Biopsy and culture of a suspicious area of plaques visualized by rigid rhinoscopy
Biopsy and culture of a suspicious area of plaques visualized by rigid rhinoscopy
A patient presents with nasal depigmentation, epistaxis and mucopurulent nasal discharge. You suspect the patient has nasal aspergillosis and start to discuss the diagnostic tests, treatments and prognosis with the owner. Which of the following is true regarding the treatment and prognosis?
• The most appropriate treatment is a rhinotomy to debride and remove the fungal plaques. The success of this depends on the location of the fungal plaques
• The most appropriate treatment is topical clotrimazole (either through the frontal sinus or the nose) but the long term prognosis for most cases is very guarded.
• The most appropriate treatment is oral itraconazole as the literature has shown this to have the highest success rate for long term resolution
• The most appropriate treatment is topical clotrimazole. The prognosis is generally very good but often multiple treatments are needed.
The most appropriate treatment is topical clotrimazole. The prognosis is generally very good but often multiple treatments are needed.
When performing an intercostal thoracotomy, which muscle can be used as a landmark for rib identification?
• scalenus, which attaches on rib 5
• scalenus, which attaches on rib 7
• latissimus dorsi, which attaches on rib 5
• latissumus dorsi, which attaches on rib 7
Scalenus, rib 5
Which of the following is a potential complication associated with median sternotomy?
• reduced access to the thoracic cavity compared with a lateral thoracotomy
• seroma formation
• lung adhesions
• traumatic myocarditis
Seroma
When should a thoracostomy tube be placed? • following any lung resection/biopsy • following any cardiac surgery • following any median sternotomy • following any thoracic procedure
following any thoracic procedure
Where is the needle placed during thoracocentesis? • between 7-8 intercostal space • between 4-5 intercostal space • between 9-10 intercostal space • between 5-6 intercostal space
Mellem 7e og 8e intrakostalrum
Which of the following is true?
• lidocaine cannot be placed down thoracostomy tubes
• Heimlich valves are useful in cases of pyothorax
• A buster collar is essential for patients with thoracostomy tubes
• General anaesthesia is mandatory for placement of a MILA chest tube
A buster collar is essential for patients with thoracostomy tubes
The Vaccine-Associated Feline Sarcoma Task Force (VAFSTF) recommends:
• Not vaccinating cats every year
• Surgical resection of a FISS with 5 cm margins and one fascial plane
• Obtaining a biopsy specimen of a mass located at the site of a vaccine or injection based on the 3-2-1 rule
• Excisional biopsy of the mass
Obtaining a biopsy specimen of a mass located at the site of a vaccine or injection based on the 3-2-1 rule
A five year old Male Siamese cat is presented with vomiting, anorexia and weight loss. A mass is palpable in the cranial abdomen. This patient is most likely to have: • A gastrointestinal stromal tumour • Extrahepatic biliary obstruction • Lymphoma • An adenocarcinoma
Lymphoma
A six year old female neutered DSH is presented with halithosis, inappetence and a soft swelling of the mandible. Several teeth are loose and a plaque like lesion is visible on the mucosa. The diagnosis and treatment for this patient is most likely.
• Dental disease, removal of teeth and oral care will result in full cure
• Fibrosarcoma with local aggressive surgical resection a 40% recurrence rate is likely
• Squamous cell carcinoma. Surgical resection will most likely result in a high risk of local recurrence, radiation therapy will unlikely result in increased survival times.
• Melanoma, local aggressive surgery can result in median survival times of 6 months
Squamous cell carcinoma. Surgical resection will most likely result in a high risk of local recurrence, radiation therapy will unlikely result in increased survival times.
A preoperative biopsy should always be performed for: • Cerebellar mass • Splenic mass • lung mass • cutaneous mass
Cutaneous Mass. FNA ?
The most sensitive diagnostic test to diagnose pulmonary metastases is: • CT • MRI • 3-view radiographs • Scintigraphy
CT
Lower urinary tract obstruction in the cat can cause alterations in serum electrolytes. What is a common abnormality to diagnose with this disease? • Hypokalaemia • Alkalaemia • Reduced total body potassium • Hypernatraemia
• Reduced total body potassium
Which of the renal veins may receive a contribution from which other organ?
• Right renal from the caudate process of the caudate liver lobe
• Right renal from the right ovary
• Left renal from the left colic vein
• Left renal from the left testicle
• Left renal from the left testicle
Kan også være venstre ovarie
You are presented with a 13 year old Siamese cat with a large left kidney. Investigations find no evidence of urinary tract obstruction and it appears that there is a mass lesion affecting the kidney. What course of action would be sensible, considering the most likely differential diagnosis? • Complete ureteronephrectomy • Open surgery and wedge renal biopsy • Open surgery and trucut needle biopsy • Ultrasound guided trucut needle biopsy
Open surgery and trucut needle biopsy
You remove a left renal adenocarcinoma in a 7 year old castrated male standard poodle. You have identified a renal artery and vein, double ligated them and transected. Copious haemorrhage ensues as you continue dissection to remove the kidney. Pressure is applied and you have time to think; what manipulation will you perform to best visualise the paralumbar gutter and why might there be bleeding despite having identified and ligated the artery and vein ?
• Colonic manoeuvre; supernumerary renal arteries can be present
• Colonic manoeuvre; iatrogenic injury to cava likely
• Duodenal manoeuvre; supernumerary renal arteries can be present
• Duodenal manoeuvre; iatrogenic injury to cava likely
Colonic manoeuvre; supernumerary renal arteries can be present
Fra testes/ovarie
What is the anatomical location of the ureter?
• Entirely abdominal
• Entirely retroperitoneal
• Proximal third retroperitoneal, remainer abdominal
• Proximal 2/3 retreperitoneal, remainder abdominal
Proximal 2/3 retreperitoneal, remainder abdominal
What is the most sensitive and specific imaging study to diagnose ectopic ureter?
• Ultrasound of the urinary tract, especially identification of ureteral jets
• Retrograde dual contrast urethracystography
• Antegrade positive contrast ureterography
• Computed tomographic excretory intravenous ureterogram
Computed tomographic excretory intravenous ureterogram
What feature can be visualised using ultrasound to confirm the identity of an intrabdominal testicle? • Mediastinum testis • Hyperechoic tunica • Gubernaculum testis • Sustentaculum testis
Mediastinum testes
What type of ureterolith are most common in small dogs and cats? • Calcium oxalate • Ammonium biurate • Struvite • Cysteine
Calcium oxalat
What concurrent surgical procedure might be recommended in a dog with cysteine urolithiasis? • Hepatic biopsy • Bladder wall culture • Castration • Renal biopsy
Castration
What intervention is the current gold standard for idiopathic renal haematuria? • Sclerotherapy • Partial renal artery occlusion • Ureteronephrectomy • Frusemide therapy
Scleroterapy
What is the radiographic diagnosis in this case? • Metastatic neoplasia • Oesophageal foreign body • Oesophageal neoplasia • Primary lung tumour
Billedet viser en ujævn forændring i relation tililende esophagus lige cranialt for diafragma. Esophagus forløb kan ikke følges videre
• Oesophageal foreign body
You are presented out of hours with a 5yr old Great Dane who is non-productively retching after a long walk. The dog ate a full meal a couple of hours ago. His abdomen appears bigger than usual according to his owner. What radiographic view is the most appropriate choice to investigate this patient further?
• Dorso-ventral projection
• Horizontal beam at the level of the costo-chondral junction
• Lateral projection in right lateral recumbency
• Ventro-dorsal projection
Lateral projection in right lateral recumbency
Indicate one drug that MAY result in oesophageal perforation • Corticosteroids • H-2 antagonists • Sucralfate • Tetracycline
Corticosteroids Tertracyclinderivat (doxycyclin) kan dog give esophagit
Which is the most common location of oesophageal foreign bodies? • Base of the heart • Lower oesophageal sphincter • Thoracic inlet • Upper oesophageal sphincter
Lower oesophageal sphincter
Which salivary glands are more commonly affected by a salivary mucocele? • Mandibular and sublingual • Zygomatic and parotid • Parotid and mandibular • Maxillary and sublingual
Mandibular and sublingual
You have performed an intestinal resection. Indicate which is the strongest intestinal layer that must therefore be incorporated in the sutures for an end-to-end anastomosis? • Mucosa • Muscularis • Serosa • Submucosa
Submucosa
2) What is the name of the procedure consisting in the removal of the gallbladder? • Cholecystotomy • Cholecystectomy • Choledochotomy • Cholecystostomy
Cholecystectomy
These photographs show a hepatic mass being removed. Indicate the precise name of the instrument being used for the partial hepatectomy. • Linear cutter stapler • Lobectomy stapler • Surgical stapler • Thoracoabdominal stapler
Thoracoabdominal stapler
Which of the following suture pattern should be used to close an enterotomy? • Single layer appositional pattern • Single layer inverting pattern • Double layer appositional pattern • Double layer everting pattern
Single layer appositional pattern
In the presence of diffuse pancreatic disease, what is the preferred site to perform a pancreatic biopsy?
• Body of the pancreas
• Middle of the left limb of the pancreas
• Tip of the left limb of the pancreas
• Tip of the right limb of the pancreas
Tip of right limb
Which of the following is the most common labial tumour in dogs? • Melanoma • Squamous cell carcinoma • Fibrosarcoma • Mast cell tumour
Melanoma
Which of the following statements regarding the palatine tonsils is correct?
• Efferent lymphatic drainage is to the superficial cervical lymph nodes.
• They have no afferent lymphatic supply
• They are supplied by a single tonsillar artery
• They are located in the nasopharynx
Thet have no affærent lymphatic supply
Which of the following gingival tumours has the lowest metastatic rate? • Squamous cell carcinoma • Fibrosarcoma • Acanthomatous ameloblastoma • Melanoma
Acanthomatous ameloblastoma
Which of following is NOT a primary cause of otitis externa in dogs? • Ear mites • Atopic dermatitis • Foreign body • Otitis media
Otitis media
Which of the following is the most common cause of otitis media in dogs?
• Extension of otitis externa
• Ascending upper respiratory tract infection
• Haematogenous spread
• External ear neoplasia
Extension of otitis externa
You examine a 6-month Bulldog and suspect that he is displaying clinical
signs of brachycephalic obstructive airway syndrome (BOAS). You plan to
examine the patient and take thoracic radiographs and perform corrective
surgery under the same anaesthetic, should this be required. Which of the
following is not possible to correct surgically?
• Elongated soft palate
• Hypoplastic trachea
• Everted laryngeal saccules
• Stenotic nares
Hypoplastic trachea
A 10-year-old Yorkshire Terrier presents to you with a 2 month history of an
intermittent goose honk cough and a tracheal collapse is suspected. A grade
2 tracheal collapse is confirmed on tracheoscopy. Which of the following
would me the most appropriate initial treatment?
• Referral for investigations and possible placement of an intratracheal stent
• Referral for investigations and possible placement of extra-tracheal prosthetic rings
• Medical management with a sedative, e.g. ACP
• Medical management with antitussives, e.g. Lomotil
• Medical management with antitussives, e.g. Lomotil
A 12 year old cat presents to you with a bilateral superficial crusting on the nasal planum. Oral examination reveals moderate tartar on the teeth and there is unilateral left sided mild submandibular lymphadenopathy. Which of the following is most likely:
• The nasal crusting represents nasal squamous cell carcinoma with metastatic spread to the submandibular lymph node
• The nasal crusting represents nasal lymphoma, with metastatic spread to the submandibular lymph node
• The nasal crusting represents nasal squamous cell carcinoma with lymphadenopathy associated with dental disease
• The nasal crusting represents nasal lymphoma with lymphadenopathy associated with dental disease
The nasal crusting represents nasal squamous cell carcinoma with lymphadenopathy associated with dental disease
A 10 year old Labrador Retriever presents to you with excessive panting, exercise intolerance, increased inspiratory noise and a recent change in vocalisation. Which is your most likely differential diagnosis based on these clinical signs?
• Laryngeal collapse
• Elongated soft palate with everted laryngeal saccules
• Laryngeal paralysis
• Laryngeal neoplasia
Laryngeal paralysis
What is the major souce of septic peritonitis in dogs? • Gastrointestinal tract • Gall bladder • Urinary Tract • Genital tract
Gastrointestinal tract
What is the most common complication following thoracotomy? • Osteomyelitis • Wound infection • Seroma formation • Haemorrhage
Seroma formation
Which diagnostic test is NOT required on fluid removed from a cat's chest? • Cytology • Biochemistry • Bacteriology • Virus titres
Virus titers
4) Which surgical approach is not used for pericardectomy? • Median sternotomy • Trans-diaphragmatic approach • Thorascopic approach • Right intercostal thoracotomy
Trans-diaphragmatic approach
Which of the following is a surgical option for treatment of chylothorax? • Thoracic duct ligation • Pericardectomy • Cysterna chyli ablation • All of the above
All of the above
Which of these biopsy techniques is seen as gold-standard for diagnosing soft tissue sarcomas? • Fine needle aspiration • Needle core (Trucut) biopsy • Incisional biopsy • Excisional biopsy
Incisional biopsy
2) What is the correct ration of formalin:tissue when submitting samples for histopathological analysis? • 1:10 • 1:5 • 5:1 • 10:1
10 formalin:1 tissue
What effect does using adjunctive radiotherapy in cases of incompletely excised soft tissue sarcomas in dogs?
• Reduce the risk of postoperative infection
• Reduce the risk of local tumour recurrence
• Reduce the risk of wound complications
• Reduce the risk of distant metastasis
• Reduce the risk of local tumour recurrence
4) Which of these is a recognised grading system for canine cutaneous mast cell tumours? • Henderson • Patnaik • Gruber • Enniking
Patniak
What is the most common intestinal tumour in cats? • Adenocarcinoma • Mast Cell Tumour • Leiomyoscarcoma • Lymphoma
Lymphoma
A 9month old Labrador has forelimb lameness clinically attributable to the elbow. Radiographs were unremarkable. Following on from the work of Moores et al 2009, what is the most effective work-up for accurate diagnosis of medial coronoid process disease?
- Arthroscopy alone
- CT alone
- Contrast CT elbow
- CT and arthroscopy
CT + arthroscopy
Elbow dysplasia is a development disease process, which type of incongruity is correctly associated with the subsequent pathology?
• Positive radioulnar incongruity (short radius) medial coronoid disease
• Positive radioulnar incongruity (short radius) ununited anconeal process
• Negative radioulnar incongruity (long radius) medial coronoid disease
• Humeroulnar incongruity and humeral intracondylar fissure
Positive radioulnar incongruity (short radius) medial coronoid disease
Which of the following is not an option for traumatic medial shoulder luxation? • Lateral biceps tendon transposition • Medial biceps tendon transposition • Arthrodesis • Modified Campbells prosthetic suture
Lateral biceps tendon transposition
You are suspicious of left shoulder lameness in a 7 year old Border Collie. You perform a shoulder abduction test, which of the following suggests medial joint instability?
• Abduction of 30 degrees in left and right
• Abduction of 50 degrees in left and right
• Abduction of 50 degrees in left and 35 in right
• Abduction of 30 degrees in left and 25 in right
Abduction of 50 degrees in left and 35 in right
A 3 year old female neutered Boxer is presents with chronic pain and lameness of the left forelimb. Radiographs show a linear radiolucency in the radial carpal bone and signs of degenerative joint. Which of the following is the most adequate treatment considering the reported long-term prognosis for the different options? • Conservative management • Fragment removal • Lag screw fixation • Pancarpal arthrodesis
Pancarpal arthrodesis
You have an 8 year old Staffordshire Bull Terrier presenting with right hind limb lameness and stifle effusion. Mild cranial draw is detectable in flexion only. What does this signify and why?
• Craniomedial band rupture – as caudolateral band is tense in extension only
• Craniomedial band rupture – as caudolateral band is tense in flexion only
• Caudolateral band rupture - as caudolateral band is tense in extension only
• The cruciate is entirely intact
Craniomedial band rupture – as caudolateral band is tense in extension only
What is the key difference between a block recession and wedge recession sulcoplasty?
• The block develops a deeper recession proximally and increases the area of retropatellar contact.
• The wedge develops a deeper recession proximally and increases the area of retropatellar contact.
• The block develops a deeper recession distally and increases the area of retropatellar contact.
• The wedge develops a deeper recession distally and increases the area of retropatellar contact.
The block develops a deeper recession proximally and increases the area of retropatellar contact
What is the main reported concern with cemented hip replacements? • Bone fracture • Post-operative infection • Luxation • Aseptic loosening
Aseptic loosening
Which meniscus is most commonly damaged in association with cruciate ligament rupture and why?
• Lateral meniscus due to its attachment to the femur (meniscofemoral ligament).
• Medial meniscus due to its attachment to the tibial (meniscotibial ligament) and the medial collateral.
• Medial meniscus due to its greater size and load bearing than the lateral meniscus
• Both are equally affected due to their intermeniscal ligament attachment
Medial meniscus due to its attachment to the tibial (meniscotibial ligament) and the medial collateral.
What is the main complication associated with pantarsal arthrodesis according to the published literature? • Implant failure • Bone fracture • Plantar necrosis • Infection
Plantar necrosis
Apply a supportive dressing to a fracture whilst awaiting surgery or transporting is recommended for which of the following?
- Fractures including the shoulder and below
- Fractures below the shoulder
- Fracture including the elbow and below
- Fractures below the elbow
Fractures below the elbow
2) What strain is reported to be the limit of tolerance for bone formation?
- 100%
- 50%
- 10%
- 2%
2
Which Salter Harris classification of fracture involves the joint? • Type I • Type II • Type III • Type V
Typ 3
SaLter
L for Low
Which of the following best defines stress when considering bone biomechanics?
• Local force expressed in units of force per unit area (N/m2)
• Local deformation expressed as length per length
• The ultimate load a material can withstand before failure
• The rate at which at material deforms when a load is applied
Local force expressed in units of force per unit area (N/m2)
Which of the following is not a site where avulsion fractures typically occurs?
- Tibial tuberosity
- Olecranon
- Calcaneus
- Sacrum
Sacrum
Which of the following is NOT one of the AO principles of fracture repair?
- Anatomical Reduction
- Stable Fixation
- Careful soft tissue handling
- Early active mobilization
Careful soft tissue handling
Locking plates are typically NOT recommended in which of the following fractures?
• Simple transverse diaphyseal fractures
• Metaphyseal fractures
• Comminuted diaphyseal fractures
• Pelvic fractures
Simple transverse diaphyseal fractures
3) Bone graft obtained from within the greater trochanter of the humerus and
applied to a fracture site within the same patient is otherwise know as what?
- Cancellous autogenous bone graft
- Corticocancellous autogenous bone graft
- Corticocancellous allograft
- Cancellous allograf
Cancellous autogenous bone graft
Autograft fra patienten selv, Allograft fra et andet dyr af same art.
A cortical bone graft confers better structural support than cancellous bone, but has fewer cells and slower revascularization
Cortical tættere overflade. Cancelleous, marv
The bending moment of inertia of an IM pin is equal to which of the following?
- Radius * 2
- Radius * 3
- Radius * 4
- Radius * 5
Radius *4
Which of the following is NOT one of Halsted’s principles?
• Gentle handling of soft tissue
• Minimum tension in tissues
• Appropriate selection of suture material
• Preservation of blood supply
Appropriate selection of suture material
Name 3 passive shoulderstabilisatours
Joint capsule
Lateral glenohumeral ligament
Medial glenohumeral ligament
3 or more active shoulderstabilsators
Supraspinatous
Infraspinatus
Subscalpullaris
Biseps brachii
Teresminor
Deltoideus
Name two orthopedic tests for the shoulder joint
Bicep tendon test (awake)=Flex shoulder extend elbow then apply pressure on the intratuberculare groove on craniomedial aspect of the proximal humerus
Shoulder abduction test (sedated)
What has happened if you can extend the elbow fully while flexing the shoulder
Bicep tendon rupture
Describe the meaning of a positive shoulder abduction test
Indicates rupture of medial ligamentous joint instability
What is the normal shoulder abduction angles? What can affect the angle?
Normal =around 30. Compare with contra lateral limb
False positive with shoulder atrophy
Name some problems that can be seen on a shoulder x-ray
Shoulder luxation
Dysplasia
OCD
Osteoarthritis
Which part is most commonly involved in a shoulder OCD
Caudal third of the proximal humeral head
What happens if a shoulder OCD flap loosens spontaneously?
If it moves caudaly the lamenes offen disapears.
If it moves cranially it can interfere with the bicep tendon and lamenes continues
What kind of dogs presents wit shoulder OCD?
Giant breed -Great Danes
Retrievers
Border collies
Males more than females
4-7 month
Over 50% bilateral disease
How should shoulder OCD be treated?
Flap removal has good outcome
Synthetic plugs
Conservative
How does shoulder luxation happen? Medial/lateral
Significant trauma
Lateral requires sectioning of the lateral glenohumeral ligament + infraspinatus tendon, medial medial glenohumeral ligament and subscalpularis tendon
How should traumatic shoulder luxation be treated?
If no fractures= reduce luxation and maintane with Velpau sling (medial), Spica splint (lateral) or hobbles.
Use 2 weeks followed by 4 weeks strict cagerest
How do you do work up for shoulderinstability?
MRI Can be helpful but arthroscopy is the most effektive mean to diagnose this condition.it commonly identifies superficial erosion of the cartilage on the caudal region of the humoral head followed by erosions of the medial ridge of the glenoid
How much strain is tolerated for primary bone healing?
2%
Describe strain
Local deformation expressed as a %
Fx 1 mm fracturegap in 10 mm rat femur = 10% strain, 1 mm fracturegap in 300 mm dog femur is 0,3%
When is primary bonhealing essential?
Intraarticular fractures
Indirect boneheling is also known as *2
Secondary bone healing
Biological bone healing
At which 3 locations in the bone is there callus formation and what are the different types called?
Medullary bridging callus
Periostal bridging callus
Intracortical bridging callus
Hvor stærk skal fixationen være for at opnå primær vs sekundær bone healing?
Primær= as strong as required to allow direct bone healing (2% strain)
Sekundær= as strong as needed for callus formation
What is the difference between a comminuted and segmental fracture?
Comminuted = minimum 2 fracture lines whit communication
Segmental= at least 2 lines that do not communicate
How do you describe displacement?
The placement of the distal fragment
Lokation af fraktur beskrives med vilka ord?
Epifys (proximal)
Metafys
Diafys (proximal, mid, distal)
Metafys (dist)
Epifys (mid)
Vilka salter Harris frakturer är artikulera?
Typ III och typ IV
Beskriv salter harris typerna
1 straight
2= Above
3= low
4 =througt everything
5=cRuch
6 = grenstic
Nævn 5 frakturmønster
Transvers
Oblique
Spiral
Segmental
Comminuted
Name the 5 different forces that affekt fractures
Compression
Torsion
Shear
Tension
Bending
Nämn en typ fraktur som kan stabiliseres med skena.
Fraktur som bara påvverkas av bending og tension men är stabil för rotation, shear och compression samt är lokaliserad distraktion för armbåge/knä.
Nämn 3 mekaniska faktorer som gör att starka implantat är nödvändigt?
Gigantras
Flera skadade ben
Ikke reducerbara fragment = ingen inbyggd stabilitet.
Alla dessa ger låg mecanical fracture assessorns score
Nævn 3 mekaniske faktorer der gør at det er nok med en mindre rigid fiksering.
Toybreed
Single limb injurie reducable/partially stable fragments
Nævn 5 faktorer der giver en dårlig biologisk frakturassesement
Gammel
Dårligt helbred (diabets, leverproblem, cushings fx)
Dårligt soft tissucoverage
Highh velocity injurie
Extensive disection
Cortical bone
Nævn 4 faktorer der giver en god fracture assesment (høj)
Ung
ASA 1
Godt soft tissuecoverage
No soft tissuedamage
Cancellous bone
What is cancellous bone?
Cancellous bone, spongy bone or trabecular bone, is characterized by its spongy, porous, honeycomb-like structure and is typically found at the ends of long bones.
What does the biological fracture assesement determine?
How Long the implantat must be functional
Clinical fracture assesement is determined by 2 factors:
Client compliance
Patient compliance
Vad betyder “fracture disease?” Hvilke symptomer kan man se?
Ledstivhed
Muskelatrofi
Muskelkontraktur
Osteoporose
Name 2 bones where you can’t use intramedullary pins
Radius
Mandibel
Name 4 bones where you Can use intramedulary pinns
Humerus
Femur
Tibia
Calcaneus
Metacarpal
When is eksternalfixation best used?
Lower limbs with poor tissue coverage.
Can a cast be used for avulsion fracture?
No
Name some fracture types that ar suitable for anatomical reconstruction
Transverse
Short / long oblique
Segmental
Minimal comminuted
Articular
Name some principles of biological/secondary healing
Indirect fracture reduction= minimal disturbance of soft tissue
Achieving axial alignment
Limited reliance on secondary implants such as cerclage and screws
What is the appropriate size orthopedic whire for a 20 kg dog? How much do the tensilestrenghet increase if you double the diameter for a tensionband ?
18g
4 (formel pi*r^2)
What is appropriatsize cerclage for a cat vs a medium size dog?
22 g
20 g
How much should cerclage whire be spaced apart and how long should the fracture line be to be able to use cerclage?
Minimum 1/2 bone diameter
Fracturline 2-3 times marrow cavity
How large is a steinman pin and K-wire?
Steinman 1,5 mm-6,5mm
K wire=0,9-1,5 mm
How do you insert a pin in the femur?
Normograde preffered, place in trochanteric fossa. Normohrade reducer risk of isciatic injury
How do you place a humural pin?
Normograde is preffered. Drill perpindicular to the surfade and then redirect.
Hos to put a pin in ulna?
Normograde or retrograde, difficult Normograde
How do you place a pin in the tibia?
Normograde, reducera risk for injurie to the stifflejoint. Insett pin from medial side
How to put pins in metacarpal/metatarsal joints?
Retrograde. Avoid large pins
What is a rushpin?
A pin tror only penetrates one cortex and den Travels inside the bonemarrowcanal.
Hvilke 6 dele skal indgå i en neurologisk vurdering?
1) mentation
2) gait evaluation
3) proprioception
4) segmental reflexes
5) sensorium
6) cranial nerve
What is the normal protein levels for CSF from cisterna magna and the lumbar site in dogs and cats?
25 mg/dl c.m.
40 mg/dl lumbar
What is the normal RBC and WBC in CSF?
RBC= 0
WBC less than 5/uL
For every 1000 RBC, how much lower is the true protein and leukocytes?
(In cerebral fluid?)
1 mg/dl less protein
2 WBC less/uL
Hvilke hunde får typisk steroidresponsiv meningitis?
Unge hunde under 2 år
Beagle, bernese mountain dog, boxer
Hvilke hunde får granulomatose meningitis?
Midelaldrende tæver, små racer som malteser, pudel og terrier
Name a intramedullar tumor
Glioma
Name a intradural-extramedular tumor
Nerve sheattumor
Meningioma
Lymphoma
What disk type is most probable in a young chondrodystrophic dog?
Hansen type 1
Extrusion of the nuclear disk material
What are the six sections of a neurological examination?
Mentation
Gait Evaluation
Proprioceptive testing
Segmental spinal reflexes
Sensorium
Cranial nerve examination
Where is the lesion located for a dog with 1. Shiff-Sherrington 2. Decerebrat rigidity 3. Decerebrellate rigidity
- Spinal injury T3-L3
2.+3 Brain injury
How does a dog with Shiff-Sherrington present?
Stiff front limbs and flaccid hind limbs. No neurological defects front limbs.
Describe the 3 types of ataxia
Proprioceptive-unaware of the placements of the limbs
Vestibular- leaning, drifting
Cerebellar-hypermetric
What is paresis and plegia?
Paresis = weakening
Plegia= complete lack of function
If you have lower motor neuron signs in the pelvic limbs, where are yours neuroanatomical localization?
L4 -S2
or peripheral neuropathy
1) What is the most common clinical sign in cases of cervical intervertebral disc disease?
• Neck Pain
• Proprioceptive deficits in the thoracic limbs
• Lack of segmental spinal reflexes in all limbs
• Obtundation
Neck pain
A 4 year old, GSD was presented with a history of one generalized tonic clonic seizure. Which drug would you give the owners for emergency treatment at home?
• Phenobarbitone orally
• Diazepam orally
• Diazepam rectally
• Levetiracetam
Diazepam rectally
A cat was presented with a history suggestive of a thoracolumbar spinal trauma and you suspect a vertebral fracture and/or subluxation. Which of the following diagnostic procedure would you choose first?
• Laterolateral and horizontal-beam ventrodorsal radiographs
• Laterolateral radiographs only
• MRI of the entire spine
• CT scan of the entire spine
Laterolateral and horizontal-beam ventrodorsal radiographs
A 3 year old, male neutered Dachshund was presented with paraplegia. MRI revealed a left sided extradural lesion at the level of T13-L1 consistent with a disc extrusion. Which surgery would you recommend?
• Right hemilaminectomy
• Left hemilaminectomy
• Corpectomy
• Dorsal laminectomy
Left hemilaminectomy
A 1 year old, female Yorkshire Terrier was presented with seizures which were progressively becoming more frequent, more severe and were usually occurring a couple of hours after being fed. The neurological examination was consistent with a diffuse or multifocal localization. What is your main differential diagnosis?
• Meningioma
• Granulomatous meningoencephalitis
• Cerebrovascular accident
• Hepatic encephalopathy
Hepatic encephalopathy
A colleague has removed endoscopically a foreign body from the cervical oesophagus of a West Highland White Terrier. The dog was hypoproteinaemic on presentation and so your colleague wishes to increase nutrition post-procedure by tube feeding. Which of the following techniques would be most appropriate?
• Gastrostomy tube
• Jejunostomy tube
• Naso-oesophageal tube
• Oesophagostomy tube
Gastrostomy tube
This 3-year-old Dachshund was presented with a painless swelling of the upper neck, which, according to the owner has been present, unchanged for 2 weeks. What is the most likely cause of such a swelling?
The picture showed a large mass under the mandible.
• Foreign body abscessation
• Thyroid carcinoma
• Salivary mucocele
• Haematoma
Salivary mucocele
Your initial laboratory database in an Irish Setter dog with suspected gastric dilation volvulus reveals a plasma lactate level of 7.1 mmol/L. Which ONE of the following is the MOST appropriate interpretation of this result?
• Moderate hypoperfusion is present
• Moderate to severe hypoperfusion is present
• Moderate to sever hypoperfusion is present, but gastric necrosis is unlikely
• Moderate to severe hypoperfusion is present and gastric necrosis is very likely
Moderate to severe hypoperfusion is present and gastric necrosis is very likely
Which technique should be used in first instance for treatment of a fish hook oesophageal foreign body?
• Fluoroscopic retrieval
• Administration of emetic agent
• Open surgery
• Fiber optic oesophagoscopy
Fiber optic oesophagoscopy
What is the most common gastric neoplasm in dogs?
Adenocarcinoma
What is the most common gastric neoplasm in cats?
Lymphoma
Name the two main types of bone screws.
What’s the differance
Which one is strongest
Cortical and cancellous
Cortical have more threads/cm and shallower threads. They are always fully threaded.
Cortical screw is stronger
What is the difference between self tapping and non self tapping screw?
The self tapping screw only requires a drilled hole (a little bit bigger than the core of the screw) but no tapping. More heat is generated when inserting a self tapping screw
2.0 self tapping screws break’s easier
What is a locking screw?
The head of the locking screw locks into the plate.
How do yo drill to place a positional screw versus a lag screw?
Positional = almost same diameter as core diameter.
Lag screw = cis cortex drilled with a diameter almost equal to the outer diameter of the screw and trans cortex wit core diameter (smaller diameter)
What is the maximum hole diameter in bone?
20% of bone diameter
You want to use a 2 mm screw (threaded) as a lag screw. What is the core diameter and how big should the drill diameters be?
2mm screw = 1,3 mm core
Use 2 mm for cis cortex and 1,5 fore trans cortex.
How much compression do you achieve if the load guide is used on a 3,5 mm plate?
1mm/screw
How many screws can be put in using load?
Max 4, 2 on each side of the fracture site
Which side should you place a plate on the Femur, Tibia, Humerus, Radius?
Femur = lateral
Tibia = cranial/ medial
Humerus= cranial/medial
Radius = craniomedial or cranial
Place plate on the tension site
A neutralisationplate would not be a good idea in this fracture
a) longe oblique fracture
b) transverse fracture mid radius
c) comminuted fracture that can be reduced accurately using lagscrew/whire
d) spiral fracture
b) transverse fracture mid radius
A compression plate would be ideal here
Describe type 1a,1b, II and type III eksternal skeletal fixators
1a, unilateral, uniplanar only half pins
1b, unilateral, biplanar only half pins
II bilateral fullpinns, modified 2 use both full and half
III bilateral and biplanar
Describe grade 1-3 open fractures
1: small puncture wound less than 1 cm
2: Larger skin defect over 1 cm. Foreign material can be present
3: extensive skin injury contamination and comminution. High risk of complications
A short radius will give problems where?
Long radius?
Medial coronoid process
Processus anconeus
Name a muscle that attatches to the lesser trochanter of the femur
Ileopsoas
Name a muscle that attatches to the greater trochanter of the femur
Middle and deep gluteal
What approach do you use to make a FHNE
Craniolateral approach to the hip. Tenotomy of deep gluteal.
What two fracture types accounts for 75% of all central tarsal fractures?
Type IV+V
IV= Medial slab with dorsal slab
V =Cominutted
Typ 1 er dorsal slab without diceplacement, type 2 with displacement and 3 medial slab
Name the tarsal joints from proximal to distal
Talocrural
Proximal intratarsal (aka talocentral/ calcaneoquatral)
Distal intratarsal
Tarsometatarsal
Where in the tarsus is OCD most common and what breeds are affected?
Plantaromedial talar ridge
Labrador, Rottweiler, bull terrier
Name the 3 tendons that makes the common calcaneus tendon.
1)Gastronemicus t
2) Common tendon of bicepsfemoris, semitendinosus and gracilis
3) The tendon of the superficial digital flexor tendon
What approach is preferred for OCD removal of the shoulder?
Approach to the caudolateral shoulder with separation of the acromial and scapular head of the deltoideus
What priority is an open fracture, how would you care for it?
What priority is an open fracture, how would you care for it?
A
EMERGENCY!
Haemostasis
Cover wound with a sterile dressing whilst preparing for lavage
Wear sterile gloves, hat, mask and gown
Apply water soluble gel or saline soaked swabs to the wound
Clip away hair, working from the wound outwards if possible to reduce contamination
Flush wound with a large amount of of sterile saline to remove debris & dilute bacteria
Take a deep bacterial swab for culture (very important!)
Apply a sterile dressing & bandage
What are the different grades of open fractures? Explain how they are defined.
Grade I - small puncture wound caused by a bone end penetrating skin from the inside out, without skin loss
Grade II - large skin wound caused by external trauma with loss of skin
Grade III - extensive skin and soft tissue damage, often associated with severe comminuted fractures and risks of complications high
What are the two types of growth plate?
A
Pressure growth plates - found at the ends of long bones and responsible for most bone growth
Traction growth plates - found where muscle insert, or originate and these only contribute a little to bone growth
What are the 5 principles for corrective surgery for premature growth plate closure / angular limb deformity?
A
Restore joint congruity
Restore to a functional position
Correct rotation deformity
Correct angular deformity
Restore limb length
Do individual growth plates of the radius and ulna contribute equally to growth?
No. Proximal radius GP contributes to 40% of growth and distal radius GP to 60%. On the other hand, the distal ulna GP is 100% responsible for bone growth.
5 possible consequences of premature ulna GP closure
Radius curvus
Carpal valgus
Rotation of paw
Joint incongruity
Abnormal limb length
What are the most common diaphyseal fractures?
Humeral (most frequently in the distal half to third of the bone)
Distal Radial and Ulna
Femoral
Fractures of the weight bearing axis of the pelvis need surgical repair. Which bone structures are involved in this axis?
The acetabulum, ilium and sacroiliac joint
Where do you make the thoracotomy for the following structures?
PDA
Caudal esophagus
Caudal vena cava
Feline thoracic duct
Left 4th
L/R 7-9th
R 7-9
L8-10
Where do you make the thoracotomy for the following structures?
Canine thoracic duct
Cranial lunglobe
Intermediate lunglobe
Caudal lunglobe
cranial esophagus
Pulmonic valve
Opposite as cat, right 8-10 th
4-5 th
Right 5th (no intermediate on left side)
5-6th
Right 3th or 4 th
Left 4th
What gastric tumor is most common in Dogs? Name some dxx
Adenocarcinoma
Lymphoma
Adenoma
Leiomyoma
When should intraoperative blood be administered?
Intra OP blood loss over 20% of total blood volume and concurrent drop in blood pressure with MAP under 80/ SAP under 100.
