Mary Dulish Board Questions

Question 1

What are the 4 cardinal signs of intussusception?

Answer 1

Vomiting, Abdominal Pain, hematochezia, Palpable Mass

Question 2

What are the components of an Intussusception?

Answer 2

Intussusceptum (inside)
Intussuscipiens (outside)

Question 3

How do you reduce an intussusception?

Answer 3

Apply gentle pressure upon the intussuscipiens and traction upon the intussusceptum.

Question 4

What is the most common site for intussusception in dog, cat, and children?

Answer 4

Dog: Iliocolic
Cat: Jejunal-jejunal
Children: Ileocecal

Question 5

What dog breed is particularly predisposed to intussusception?

Answer 5

German Shepherd

Question 6

How common are recurrences following surgical therapy of intussusception? Where do the normally occur?

Answer 6

According to Larose et all. VetSurg 2024 (Retrospective, n:153)
Median age: 10 months
Post-op complications: 34% (14% severe → Diarrhea, constipation, septic peritonitis)
Recurrence rate: 3%
14-day mortality: 6%

1. Larose PC, Singh A, Giuffrida MA, et al. Clinical findings and outcomes of 153 dogs surgically treated for intestinal intussusceptions. Veterinary Surgery. 2020;49(5):870-878. doi:10.1111/vsu.13442

Question 7

What are methods to decrease the recurrence of intestinal intussusception?

Answer 7

Enteroplication
Enteropexy

Question 8

What is the most common cause of intussusception in cats?

Answer 8

Lymphoma

Question 9

How many pairs of salivary glands in dogs?

Answer 9

4

Question 10

Considering a sialocele involving the sublingual and mandibular glands, what are 3 ways the condition may clinically manifest?

Answer 10

Ranula (Sublingual)
Cervical
Pharyngeal

Question 11

Three possible clinical presentations of a sialocele affect the mandibular and sublingual glands. How is each one treated?

Answer 11

Ranula (Sublingual) - Sialoadenectomy of mandibilar and sublingual +/- marsupialization
Cervical - Sialoadenectomy of mandibilar and sublingual
Pharyngeal - Sialoadenectomy of mandibular and sublingual

Question 12

According to Poirier et all (JVIM 2018), what is the recurrence rate following surgical therapy of sialoceles in dogs?

Answer 12

5-14%
All treated dogs responded to radiation.
27% recurred within 12 months but were successfully re-treated.

Question 13

In a cat with pleural effusion and no history of trauma, what are the 4 main rule-outs?

Answer 13

Pyothorax (purulent exudate)
Cardiac (transudate)
Chylothorax (Chile)
Neoplasia (Modified transudate)

Question 14

You have a dog with hypercalcemia and high PTH, strongly suggesting primary hyperparathyroidism. During surgery you do not observe a parathyroid mass. What do you do? What is the main potential detrimental consequence of this decision?

Answer 14

IV New Methylene Blue
May cause Heinz Body Anemia

Question 15

What factors determine knot security?

Answer 15

Two suture factors:
Suture material (affects Coefficient of friction)
Suture size (also affects Coefficient of friction)

Two knot factors:
Knot configuration
Knot tension

Question 16

You intubate a patient who has arrested, but you cannot inflate the lungs. Give 8 reasons why this may be occurring.

Answer 16

1) ET tube obstruction
2) Upper airway obstruction
3) Esophageal intubation
4) Severe lung hemorrhage
5) Severe atelectasis
6) Severe pulmonary edema
7) Pleural space disease (air, fluid, or mass)
8) Diaphragmatic hernia

Question 17

Describe and draw an in-circle vaporizer system

Answer 17

In the in-circle system, the anesthetic gas vaporizer is located in the inspiratory conduit and is part of the system. Gas exhaled though the expiratory limb passes through the expiratory valve and works upon a breathing bag and pressure-relief valve connected to the circuit. Expired air then passes through a CO2 absorber and receives gas before passing through the vaporizer and entering the inspiratory limb again.

Question 18

Describe and draw an out-of-circle vaporizer system

Question 19

Name 4 advantages of a closed-circle anesthetic system

Answer 19

1) Economy of anesthetic consumption.
2) Warming and humidification of the inspired gases.
3) Reduced atmospheric pollution.
4) More efficient use of soda lime than in Waters’ canister.

Question 20

Name 5 disadvantages of a closed-circle anesthetic system

Answer 20

1) Expensive and rather bulky.
2) Unstable if used closed.
3) Slow changes in the inspired anesthetic concentration with low flows and out-of-circuit vaporizers.
4) The soda-lime and valves in the system increase resistance to breathing.
5) Inhalation of soda-lime dust.

Question 21

From a ventilatory perspective, what is the main disadvantage of a non-rebreathing anesthetic system like the Bain or Ayres models? What needs to be done to circumvent this deficiency partially and what is the consequence of not knowing about this fact?

Answer 21

Non-rebreathing systems do not have check valves so that the patient may re-breath exhaled gas from the outer corrugated tube. This is avoided by keeping a sufficiently high gas flow through the system. Low flow may lead to excessive CO2 rebreathing and respiratory acidosis.

Question 22

Draw and describe an in-circle vaporizer

Answer 22

Total fresh gas flow (FGF) enters and splits into carrier gas (much less than 20%, which becomes enriched- saturated, actually- with vapor) and bypass gas (more than 80%). These two flows rejoin at the vaporizer outlet. The splitting ratio of these two flows depends on the ratio of resistances to their flow, which is controlled by the concentration control dial, and the automatic temperature compensation valve.

Question 23

List 4 methods to decompress a GVD patient

Answer 23

Orogastric tube
Right (typical) abdominal trocharization
Temporary right paracostal gastrostomy
Definitive surgery

Question 24

Name 3 ways to convert a patient in ventricular tachycardia and stabilize the heart

Answer 24

1) Electrical defibrillation (only for pulseless V-tach)
2) For V-tach with pulses: Lidocaine 2-4 mg/kg bolus followed by 40-60 ug/kg/min OR Procainamide
3) For V-tach with pulses if lidocaine fails: Mexiletine or Quinidine

Question 25

Simple rule to estimate prognosis with Salter-Haris system

Answer 25

The higher the number, the worse the prognosis.

Question 26

What is the difference between epiphysis and apophysis?

Answer 26

Epiphysis: The extremities of long bones, separated from the diaphyses by the physis.

Apophysis: Bone process or outgrowth with its own ossification center. Typically an origin or insertion for tendons and ligaments.

Question 27

Name 5 apophysis

Answer 27

Acromion for the scapula
Olecranon
Tuber Ischii
Great trochanter
Calcanous