No Species Specific Flashcards
Why is toxoplasmosis a public health concern?
- Results in mild, flu-like illness
- Results in severe cutaneous lesions
- Infants may be infected in utero and later show chorioretinitis along with mental retardation
- Toxoplasmosis is not of public concern
- Results in death of pregnant women
Answer: Infants may be infected in utero and later show chorioretinitis along with mental retardation
Explanation
The correct answer is infants may be infected in utero and later show chorioretinitis along with mental retardation. Flu-like symptoms can occur and lymphadenopathy may persist for months, but this is minor in comparison to the effects on in utero infants. Pregnant women usually do not show any signs of infection. There are no cutaneous lesions in humans associated with Toxoplasma gondii infection.
Interestingly, greater than 95% of AIDS patients suffering from toxoplasmosis are a result of cyst reactivation in the brain and not due to a recent infection. Their main signs are encephalitis, chorioretinitis, and sometimes pneumonia. To prevent exposure to pregnant women, recommend that they do not change their cat’s litter box (avoid feces).
Which of the following suture patterns used for closing hollow viscera purposefully enters the lumen?
- Horizontal mattress pattern
- Connell pattern
- Ford interlocking pattern
- Cushing pattern
Answer: Connell patern
Explanation
The correct answer is Connell pattern. Both the Connell and Cushing patterns are used to close hollow viscera because they are very effective at inverting tissue and creating a watertight seal. The difference between these two patterns is that Cushing pattern only goes through the submucosa and does not enter the lumen. The Ford interlocking and horizontal mattress patterns are not used for closing hollow viscera.
Fistulous withers refers to inflammation of the________
- Intraspinatus
- Nuchal ligament
- Bicipital bursa
- Supraspinous bursa
Answer: Supraspinous bursa
Explanation
The correct answer is supraspinous bursa. This bursa is variable in size and location but is usually found between the second and fifth thoracic vertebrae and can extend ventrolaterally to the margin of the scapular cartilage. The etiology is thought to be infectious. Clinical signs are pain, heat, and swelling in the region of the bursa. After days to weeks, the bursa can rupture resulting in drainage of fluid.
Brucella aborts has been identified in up to 80% of clinical cases by serology and culture. Treatment consists of flushing the fistula and appropriate antibiotics.
Which of these zoonotic infections are of most concern from drinking raw unpasteurized cow’s milk?
- Mycobacterium bovis
- Escherichia coli 0157:H7
- Shigella
- Salmonella typhi
- Clostridium botulinum
Answer: Mycobacterium bovis
Explanation
The correct answer is mycobacterium bovis. M. bovis is a very serious zoonosis transmitted to humans by raw milk and has been largely controlled by institutional measures and milk pasteurization in the United States. E. coli 0157:H7 is found mainly in raw ground beef (probably fecal contamination). The other diseases listed are foodborne infections but of less serious concern in raw milk than M. bovis. S. typhi is the cause of typhoid fever and is not carried by farm animals, only by humans. Likewise, Shigella is a primate disease.
Which of the following is true about diltiazem?
- Diltiazem speeds up the heart because it is a beta adrenergic agonist.
- Diltiazem slows the heart by antagonizing beta adrenergic receptors.
- Diltiazem slows the heart by inhibiting the influx of calcium into the myocardial cells.
- Diltiazem speeds up the heart rate by increasing the influx of calcium into the myocardial cells.
Answer: Diltiazem slows the heart by inhibiting the influx of calcium into the myocardial cells.
Explanation
The correct answer is diltiazem slows the heart by inhibiting the influx of calcium into the myocardial cells.
Diltiazem is a calcium channel blocker used to slow the heart to treat supraventricular tachycardias, hypertrophic cardiomyopathy, and hypertension.
A cystotomy is on the schedule for today on a 4 year old male Chihuahua. What suture would you not use for closing the bladder?
- Dexon
- Polydioxanone (PDS)
- Vicryl
- Silk
Answer: Silk
Explanation
The correct answer is silk. This suture is non absorbable and thus contraindicated. Leaving non-absorbable suture in the bladder is a potential nidus for infection.
***PowerPage: Suture Materials
The role of a veterinarian in client communication and decision making is an important aspect of professional interaction. Three “styles” of communication have been described for such interactions:
1) Guardian (Paternalistic)
2) Teacher (Consultant)
3) Collaborator (Shared)
Which of these statements correctly describes how the style of a collaborator differs from the other 2 styles?
- In client communication, a veterinarian with a collaborator style presents all options with equal weight regardless of their treatment preference whereas a veterinarian with a teacher or guardian style does indicate their preference for treatment
- In client communication, a veterinarian with a collaborator style allows the client to be the primary decision maker whereas a veterinarian with a teacher or guardian style is the primary decision maker
- In client communication, a veterinarian with a collaborator style is the primary decision maker whereas a veterinarian with a teacher or guardian style has the client be the primary decision maker
- In client communication, a veterinarian with a collaborator style does not dominate the conversation while the veterinarian with either the guardian or teacher style does dominate the conversation
Answer: In client communication, a veterinarian with a collaborator style does not dominate the conversation while the veterinarian with either the guardian or teacher style does dominate the conversation
Explanation
The guardian style of veterinarian communicates in the following manner: They dominate the conversation and provide all of the information to the client. They typically present only the treatment option they feel is best and are therefore, the primary decision maker.
The teacher style of veterinarian provides information to the client but may also encourage them to seek additional information on their own. They typically dominate the conversation and present all options without emphasis toward the veterinarian’s own treatment preference.
The collaborator style of veterinarian shares decision making power and is approximately equal to the client in terms of doing most of the talking. They share medical information with the client that is relevant to the preferences provided by the client. All options are given and the client’s and veterinarian’s preferences are shared until a collaborative decision is made.
Any individual veterinarian can take on multiple roles depending on the situation and client but in general, the collaborator is viewed as the optimal choice for both veterinarian and client in the majority of situations.
Which correctly describes the innervation of the iris sphincter muscle in mammals?
- Innervated by sympathetic nervous system by cranial nerve V
- Innervated by sympathetic nervous system by cranial nerve Ill
- Innervated by parasympathetic nervous system by cranial nerve V T
- Innervated by parasympathetic nervous system by cranial nerve Ill
Answer: Innervated by parasympathetic nervous system by cranial nerve Ill
Explanation
The correct answer is that it is innervated by parasympathetic nervous system by cranial nerve Ill. The iris sphincter is stronger than the iris dilator. It receives parasympathetic innervation by cranial nerve Ill. It is comprised of smooth muscle in mammals, unlike birds, where it is striated. The innervation makes sense if you consider that when your sympathetic nervous system is activated, your eyes become dilated; that leaves the parasympathetic nervous system to constrict the pupil, which is the responsibility of the sphincter.
***PowerPage: Cranial Nerve Examination and Diseases
Out of all the medications you frequently prescribe, which does not fall under the FDA’s regulatory control?
- Interceptor (milbemycin oxime) oral heartworm and parasite control
- Gentamycin betamethasone topical spray
- Frontline topical flea and tick medication
- Non-steroidal anti-inflammatories (carprofen, deracoxib, etc.)
- Compounded generic oral medication
Answer: Frontline topical flea and tick medication
Explanation
Preparations used as topical insecticides are regulated by the Environmental Protection Agency, or EPA. This regulation is provided by the Federal Insecticide, Fungicide and Rodenticide Act which was amended and updated in 1972. This only applies to topical applications. If any product in this group is to be given systemically, the regulation goes back to the FDA.
Oral medications such as Interceptor, NSAIDs, and even generics are regulated by the FDA. Topical antibiotics and corticosteroids such as the gentamycin betamethasone spray are regulated by the FDA.
You are asked to interview an applicant for a veterinary technician job at your clinic. Which of the following is an acceptable interview question for you to ask the applicant?
- What is your native language?
- Do you have any disabilities?
- When did you graduate from college?
- Do you have a high school diploma or equivalent?
- How many children do you have?
- Do you wish to be addressed as Mr., Mrs., Miss, or Ms?
Answer: Do you have a high school diploma or equivalent?
Explanation
When interviewing a potential employee, it is important to know what questions are not appropriate. In general, questions should focus on the requirements of the job and specific qualities that it takes to perform the job. In this case, a high school diploma may be a job requirement.
Discrimination laws prohibit questions based on gender, age, nationality, race, religion, sexual orientation, and disability. Questions about an individuals personal status that are not job-related are also inappropriate (i.e. do you have children?). While questions like this may seem like standard small-talk, they are not appropriate in a job interview. The other answer choices listed here all allude to such potentially discriminatory information.
Questions should be phrased in a way that is specific to the needs of the job..for example:
Do you have any responsibilities that may interfere with the hours you can work or your ability to do the job?
Josephine has just purchased a small animal practice. The practice currently pertorms tecal parasite testing in-house using a flotation-only method. Josephine knows that fecal centrifugation and flotation is a more sensitive method for fecal parasite testing. She would like to have the staff change testing methods right away. She plans to write a standard operating procedure to aid the transition for the staff. When creating a standard operating procedure for fecal centrifugation and flotation, which is the most appropriate plan for Josephine?
- Hold a meeting about the correct procedure for fecal centrifugation, print the instructions and place them in a binder in the veterinarian’s office, and update the document before official inspections.
- Send the staff an e-mail including the instructions, place the standard operating procedure in a folder in the pharmacy, and hold a yearly meeting about the correct procedure.
- Write instructions using advanced medical terminology, place the standard operating procedure in a binder at the front desk, and update the document once yearly.
- Create a written document using language that is easily understood by the staff, hang the document on the wall above the fecal centrifuge, and routinely screen for necessary changes in the instructions.
Answer: Create a written document using language that is easily understood by the staff, hang the document on the wall above the fecal centrifuge, and routinely screen for necessary changes in the instructions.
Explanation
Standard operating procedures (SOPs) should be written in clear, direct language. The SOPs should be placed in an easily visible and accessible area. SOPs should be continually updated to ensure incorporation of new techniques. When communicating SOPs, written documents are necessary. The SOP should be located in an easily accessible and convenient area. Placing SOPs in a binder away from the location of the procedure is not recommended. SOPs should be updated continuously depending on recommended changes to the procedure in question. While holding a meeting about correct procedures is helpful, the information should remain continuously available and easily accessible for all staff.
Source: Handbook of Veterinary Communication Skills. Edited by Carol Gray and Jenny Moffett. Wiley-Blackwell, 2010. Pages 137-139.
*Which of these options is true regarding worker’s compensation insurance?
- It pays employees a portion of their salary if they are laid off or fired
- It covers injuries that occur on and off the job
- It is legally required for veterinary practices to have it for full and part time employees
- The cost can be deducted from the employee’s paycheck
Answer: It is legally required for veterinary practices to have it for full and part time employees
Explanation
Worker’s compensation insurance covers injuries sustained on the job. It is required in all states and is paid for by the practice.
A 12 year old Yorkie presents for euthanasia due to various medical problems and you have never seen the dog before. It is a walk-in appointment, as they were unable to be seen by their regular vet today. The dog is clearly in poor condition. The man presenting the dog states that this is his mother’s dog and she is not able to bring the dog herself.
What would be the best option of the choices below?
- Euthanize the dog as long as the man signs the consent form, because the dog is in poor condition and this is the most humane option.
- Do not euthanize the pet since you have never seen this pet before and the owner is not present. The owner will need to be present to sign the authorization.
- Have the medical records faxed from the regular vet so that you can confirm the history and conditions for why the dog is presenting for euthanasia, then perform the procedure after the man signs a euthanasia request form.
- Call the owner directly to confirm her wishes for euthanasia and have another employee confirm over the phone as an additional witness. Have the agent sign the euthanasia request form.
Answer: Call the owner directly to confirm her wishes for euthanasia and have another employee confirm over the phone as an additional witness. Have the agent sign the euthanasia request form.
Explanation
This is a tricky situation and can be difficult to handle when the client’s emotions are involved. Clearly the dog is in poor condition and the request for euthanasia is not unreasonable. However, the owner needs to give direct permission for this to occur. Calling the owner for consent for the euthanasia is the correct way to approach this case. If the owner cannot be reached and there is no documentation for consent, then it is best to wait until there is valid documentation.
If a euthanasia appointment is scheduled in advance and they are new clients, have them bring the medical records and ensure you will have the appropriate documentation you will need to carry out the euthanasia to try and avoid this type of conflict. When they schedule the appointment, if the owner will not be present, let them know confirmation by the owner over the phone or a written statement will be needed and should be brought and kept in the medical record.
Failure to receive such consent from the dog’s owner is a serious liability for you as the veterinarian. Despite the appearance, this man could be bringing the dog in for euthanasia against the dog’s owner’s wishes and it is your responsibility to properly document that euthanasia was requested by the owner.
While state practice acts vary in regard to requirements for medical record keeping, there are common principles. Which of the following medical records would be unacceptable based on these practice acts?
- Medical records are discarded 5 years after the patient was last seen
- One medical record is used for a client that brings in 3 of her dogs
- The medical record is in someone’s handwriting other than the veterinarian
- The medical record states that the heart and lungs were not ausculted on an exam
Answer: One medical record is used for a client that brings in 3 of her dogs
Explanation
The common requirements among almost all states are the following:
1) Separate record for each patient
2) Accurate record
3) Complete record- what was normal, abnormal, and not examined
4) Legible- Can be dictated to someone else
5) Unalterable
6) Easily accessible
7) Retained for 3-5 years
What is the clinical study design that best addresses the “temporality” of disease causation (exposure must precede disease)?
- Cross-sectional
- Retrospective
- Case-control
- Cohort
Answer: Cohort
Explanation
Hill’s Criteria for disease causality includes the requirement for “temporality,” meaning that an exposure cannot be under consideration (hypothesized) as a causal factor unless it precedes the disease. Thus, any study design that does not document that exposure precedes disease cannot logically address the causal question.
A cohort study design is the only one of the options that first documents that a subject has been exposed, following initially only non-exposed subjects. The non-diseased subjects are followed to observe whether they become exposed (an “exposed” cohort), and then followed further over time to observe for disease. At the termination of the study, the risk (proportion) of disease observed in the exposed cohort is compared to that for the non-exposed cohort, by use of relative risk (RR) and attributable risk (AR).
The case-control design (also known as retrospective design) begins not with unexposed subjects but with diseased individuals (cases) that are compared with respect to exposure to a factor, using a comparison group of non-diseased subjects (controls). There is no observation over time. Similarly, cross-sectional designs compare two groups based on disease status and compare how they differ with respect to exposure status. There is no way to know whether exposure preceded disease in any of these types of designs.
Ref: Kleinbaum, Kupper, Morgenstern, Epidemiologic Research pgs. 62-70; Martin, Meek, Willeberg, pgs.155-174.
The relationship among incidence (I), prevalence (P), and duration (D) of disease is best expressed as:
- P=I-D
- I=P-D
- I=PD
- P=ID
Answer: P=ID
Explanation
The correct formula to use is P = I x D. Prevalence can generally be viewed as the product of incidence and disease duration.
Incidence is defined as the number of new cases of a disease in a given period, and prevalence is the number of total cases prevailing (counted) in the given period.
This formula is helpful in a clinical scenario to help evaluate risk. Prevalence can increase (or decrease) in two ways: 1) the number of new cases (incidence) increases (or decreases), and 2) the duration of disease increases (or decreases). If a disease goes untreated, for example, duration would likely increase (compared to treated cases), and prevalence would increase.
Similarly, if the risk of acquiring a disease increased, the prevalence would increase. Note, for example, that if the weekly incidence of a disease were 5 new cases and the duration was 2 weeks per case (on average),
generally one would expect the weekly prevalence to be 5 cases/week x 2 weeks = 10.
Ref: Veterinary Epidemiology: Principles and Methods, 1987 pg. 81, Martin, Meek, Willeberg
A payroll service will typically perform all of the following EXCEPT which of these choices?
- Directly deposit money into employee accounts
- Track vacation and sick time
- Sign checks
- File and send tax returns to the IRS
- Generate payroll reports
Answer: File and send tax returns to the IRS
Explanation
A payroll service will typically perform direct deposit or sign checks to employees. They will also track vacation and sick time and generate payroll reports. Payroll services do perform tax withholding but they do not file actual tax returns; this is the responsibility of each individual employee.
You are reviewing a practice’s balance sheet in preparation to buy the practice. For most practices, the single largest asset never shows up on the balance sheet. What is this asset?
- Practice’s goodwill
- Practice’s cash
- Practice’s land
- Practice’s accounts receivable
- Practice’s equipment and inventory
Answer: Practice’s goodwill
Explanation
All of the items listed here are practice assets. The only item that typically is not on a balance sheet is the practice’s goodwill. Assets on a balance sheet represent cost, not current value. Therefore, unless the practice’s goodwill was purchased from someone else, it does not appear on the balance sheet.
The practice’s goodwill is its reputation, client base, knowledge, technical skill, research, brand awareness, and associations that the practice maintains.
***PowerPage: Reading a Balance Sheet
Dr. Johnson has been an associate at a multi-doctor equine hospital for the past nine months. Her boss, Dr. Sharpe, sends an e-mail stating that Dr. Johnson will need to give a presentation at an upcoming career fair. The career fair is two weeks away, on a Saturday, and is scheduled for the same day as an important Johnson family event. Dr. Johnson lets her boss know that she will be unable to attend. Dr. Sharpe insists, saying that attending the event is one of Dr. Johnson’s required work responsibilities. The disagreement creates a dysfunctional working relationship, and Dr. Johnson leaves the practice for another position. Which of the following is the most appropriate way for Dr. Sharpe to communicate duties and responsibilities to associate veterinarians in the future?
- Have the office manager send a memo to all of the associate veterinarians regarding the importance of the job fair for the community.
- List all mandatory duties which must be completed outside of work hours in a written job description that is signed by both parties.
- Call a meeting with all of the associates to discuss the duties expected of them outside of working hours.
- Tell the candidates for the associate veterinarian position about the job fair during their initial interview and remind them while signing the employment contract.
Answer: List all mandatory duties which must be completed outside of work hours in a written job description that is signed by both parties.
Explanation
Outlining specific duties and responsibilities is necessary to maintain accountability for job performance and fairness. Job descriptions should be written for specific positions and include all the duties and responsibilities of that position. Ensuring that the duties are spelled out in a written agreement is important. Incorrect options include those which do not provide specific written information about job duties. While verbal reminders about the job fair and communicating the importance of the event are reasonable, these actions will not ensure that associate veterinarians know that participation is a required duty of their job.
Source: The Art of Veterinary Practice Management. Mark Opperman and Sheila Grosdidier. Advanstar
Communications, Inc., 2014. Page 68-69.
When building a successful practice, it is important to provide outstanding client service. Which of the following statements is true about how client service at a veterinary hospital is different from standard customer service in retail or other service industries?
- Client service involves a personal, long-term relationship whereas customer service typically involves a single transaction
- Customer service is more closely associated with value of the transaction than client service
- Customers typically develop close relationships with employees whereas clients typically do not
- Retail establishments desire repeat customers but the client-veterinary relationship involves a single interaction or transaction
Answer: Client service involves a personal, long-term relationship whereas customer service typically involves a single transaction
Explanation
The most important difference between clients and customers is that client services involves a personal long-term relationship. In veterinary medicine, this includes a relationship with the veterinarian(s), but other staff members (technicians, receptionists, etc) are the primary providers of client service. Such relationships should span the lifetime of one or multiple pets.
Higher levels of client service result in perception of greater value. A lack of quality service is one of the most common reasons that clients switch veterinary practices.
Which cranial nerve is most responsible for tear production?
- CN II
- CN VI
- CN V
- CN III
Answer: **CN VII*
Explanation
The correct answer is CN VII. The lacrimal nerve from cranial nerve VII innervates the lacrimal gland, which is located within the orbit. It is responsible for production of much of the aqueous portion of the tear film. For this reason, if an animal has signs of facial nerve problems, tear production should be checked.
***PowerPage: Cranial Nerve Examination and Diseases
What is the correct post-exposure prophylaxis protocol after being exposed to rabies for an unvaccinated human?
- Two injections of approved rabies vaccine
- One injection of human rabies immune globulin followed by 2 injections of approved rabies vaccine
- Three injections of human rabies immune globulin followed by 2 injections of approved rabies vaccine
- Injection of human rabies immune globulin followed by 4 injections of approved rabies vaccine
- Five injections of approved rabies vaccine
Answer: Injection of human rabies immune globulin followed by 4 injections of approved rabies vaccine
Explanation
The correct answer is injection of human rabies immune globulin followed by 4-5 injections of approved rabies vaccine.
The recommended protocol per the 2020 CDC guidelines is as follows: “Postexposure prophylaxis (PEP) consists of a dose of human rabies immune globulin (HRIG) and rabies vaccine given on the day of the rabies exposure, and then a dose of vaccine given again on days 3, 7, and 14.”
HTTP://www.cdc.gov/rabies/
If you are not vaccinated, then you will need an injection of human rabies immune globulin immediately after exposure followed by 4-5 injections of an approved rabies vaccine IM over 2-4 weeks. If you have been vaccinated, all that is needed are to injections of an approved rabies vaccine 3 days apart. PEP is not required for accidental injection of animal rabies vaccine into a human.
When trying to diagnose a bile peritonitis what is the method of choice for making a diagnosis?
- Comparison between bilirubin concentration in the fluid and in serum
- Comparison between low density lipoprotein in the fluid and in the serum
- Comparison between alkaline phosphatase in the fluid and in the serum
- Comparison between alanine aminotransferase in the fluid and the serum
Answer: Comparison between bilirubin concentration in the fluid and in serum
Explanation
The correct answer is comparison between bilirubin concentration in the fluid and in the serum. A concentration of bilirubin that is twice as high as serum is considered diagnostic.
Which of the following best describes Type Ill hypersensitivity?
- An immediate hypersensitivity reaction involving the interaction of IgE and mast cell degranulation
- An immune complex hypersensitivity involving the interaction of circulating antigen-antibody complexes in blood vessel walls causing neutrophil emigration and tissue damage
- A delayed hypersensitivity reaction involving antigen presenting cells, antigen and T lymphocytes
- An immediate hypersensitivity reaction involving the interaction of IgG to antigens on body tissues
Answer: An immune complex hypersensitivity involving the interaction of circulating antigen-antibody complexes in blood vessel walls causing neutrophil emigration and tissue damage
Explanation
There are four types of hypersensitivity reactions. Type Ill is characterized by antigen-antibody complexes. Type I is the immediate hypersensitivity reaction mediated by IgE, whereas Type Il involves IgG and body tissues (i.e. RBCs). The delayed hypersensitivity reaction (IV) involves the presentation of antigen through antigen presenting cells to lymphocytes.
***PowerPage: Hypersensitivity Reactions
When valuing a veterinary practice, “practice goodwill” can be one of the most significant assets. Which of the following is NOT considered part of a practice’s goodwill?
- Brand awareness
- Practice reputation
- Client base
- Owner’s equity
- Technical skill
Answer: Owner’s equity
Explanation
A practice’s goodwill refers to its reputation, client base, knowledge, technical skill, research, brand awareness, and associations that the practice maintains.
Owner’s equity is a different asset that would be reported on a company’s balance sheet and is not lumped under “goodwill”.
***PowerPage: Reading a Balance Sheet
Many veterinary practices provide discounted goods or services to clients in certain instances. From a business standpoint, which of the following is always true about discounted services?
- Discounts should only be given to clients on their first visit
- Discounts should be given based on the discretion of the attending veterinarian
- An explanation of the available discounts should be clearly displayed in the reception or waiting area
- A discount provided to one client should be provided to all clients
- The client should be told that they are receiving discounted goods or services
Answer: The client should be told that they are receiving discounted goods or services
Explanation
There are many reasons to give discounts and many types of discounts that a veterinary practice may offer depending on the practice philosophy and the types of clients that they are hoping to attract with such discounts. Examples might include discounts for senior citizens, animal rescue organizations, first time clients, employees, or other veterinary professionals. The only way to use discounts to the practice’s advantage is to make sure that clients are aware that they are receiving the benefit of a discount. How a practice may choose to market or advertise a discount may vary based on the practice philosophy. Practice managers or owners are typically responsible for choosing who to offer discounted services to; attending veterinarians often use different criteria when deciding what to discount that may not fit the business and practice interests.
Employees in your veterinary clinic are discussing measures to prevent disease transmission between employees and between patients. One of them asks you if using Purell hand sanitizer will prevent transmission of most pathogens. You remember reading on the label that Purell is a 65% ethyl alcohol-based antiseptic. Which of these agents would be most effectively killed by such a product?
- Parvovirus
- Clostridium difficile
- Antibiotic resistant Staphylococcus aureus
- Giardia
Answer: Antibiotic resistant Staphylococcus aureus
Explanation
Hand sanitizing, alcohol-based products are effective at killing many types of Gram-positive and negative bacteria, including methicillin resistant Staphylococcus aureus (MRSA), tuberculosis, and E. coli. It is also effective against many types of fungi and enveloped viruses such as influenza viruses, HIV, and hepatitis virus (one exception is rabies virus).
They are not effective against non-enveloped viruses (parvovirus), bacterial spores (Anthrax, C. difficile), and protozoan oocysts (Giardia, Isospora, Cryptosporidium).
You are doing paperwork in your office when a dog who has been hit by a car is rushed to the back treatment area. You are told by the receptionist that the owner has no money with them. What should you do?
- Do everything necessary to assess and treat the dog (inducing radiographs, chest tube it needed, et.) as
long as the owner signs a promissory note prior to you speaking to them. - Start basic life saving measures such as oxygen, IV catheter, and fluids for hypovolemic shock. While these things are started you perform a brief exam and evaluation of the pet prior to discussion with the owners.
- Have the receptionist put the owner in a room and go in to discuss treatment and cost prior to providing an exam or care while a technician sits with the dog in the back monitoring vital signs.
- Recommend they take the dog to the emergency clinic.
Answer: ** Start basic life saving measures such as oxygen, IV catheter, and fluids for hypovolemic shock. While these things are started you perform a brief exam and evaluation of the pet prior to discussion with the owners.**
Explanation
While there is no mandated law that requires a veterinarian to provide emergency care, it is the general consensus of the professional community that it is a veterinarian’s duty to provide at least basic life stabilizing care on presentation. In a critical situation, this should be initiated prior to contact with owner.
After initiating these measures whilst doing an exam, you will have a better picture of what type of further care and work-up this pet will need (i.e. chest radiographs, chest tube, antibiotics, surgery, etc.) at which point you can discuss care, prognosis, and costs with the owner. Then they are able to make an informed decision of whether or not to proceed.
The owner brought the dog into the hospital, thus, is expecting some level of care and evaluation. Once there is an implication that the veterinarian will render service (the pet was brought to the treatment area, the veterinarian should continue to render service. While the dog may need transfer to an emergency or overnight facility, you should still attempt to stabilize the dog prior to any transfer.
Standard legal principles say that veterinarians who wish to discontinue medical services should not do so during a critical phase of treatment and must give the client time to find another veterinarian so that no harm occurs to the animal.
A promissory note is when a party makes an unconditional promise in writing to pay a determinate sum of money. It would be better to talk to the owner after providing the basics (oxygen, fluids) to discuss exactly which procedures you would like to do and why, and discuss cost, payment methods, etc. to see how they will be able to proceed financially.
This suture is broken down via phagocytosis.
- Vicryl
- Polydioxanone (PDS)
- Nylon
- Catgut
-Maxon
Answer: Catgut
Explanation
The correct answer is catgut. Catgut is broken down by phagocytosis and retains tensile strength for 14-28 days.
Nylon is a non-absorbable suture. Vicryl, maxon, and PDS are broken down via hydrolysis.
***PowerPage: Suture Materials
You are about to receive an offer from a veterinary hospital for employment. Which of the following is the most common pay package offered as a percentage of gross production, including wages (whether base or percent production) and benefits?
- 31-33%
- 26-30%
- 20-25%
- 17-19%
Answer: 20-25%
Explanation
Most general practice veterinarians are paid a total compensation between 20-25% including pay and benefits.
For example, a veterinarian may be paid 19% of his production and receive health benefits and dues paid with other perks, or may receive a higher production pay such as 23% and no benefits. Some veterinarians choose to have a set salary and benefits. There are many acceptable offers but the most common offer is between 20-25% total production.
Which of the following are listed on a balance sheet of a practice?
- Assets, liability, and owner(s) equity
- Sources and uses of cash over a period of time
- Income and expenses over a period of time
- Salary of each employee of the company
Answer: Assets, liability, and owner(s) equity
Explanation
A balance sheet is a report on the financial condition of the practice. It lists practice assets, liabilities and owners) equity at a specific point in time. It does not track income or cash flow over a period but is more of a snapshot of the company’s condition.
A profit and loss statement is the document which reports on income and expenses over a period of time. A cash flow statement is the document which reports on sources and uses of cash over a period of time.
***PowerPage: Reading a Balance Sheet
“Bark-field” is a large corporation that is buying a previously independent local feline veterinary practice and will be gaining control of that practice. This is an example of which of the following?
- Capital gain
- Buy-out
- Buy-in
- Acquisition
- Merger
Answer: Acquisition
Explanation
This is an acquisition because one entity (Bark-field) is acquiring control of another entity (the independent practice). Acquisitions are the most common form of transfer of practices and may be an internal purchase (associate buy-in) or from an external buyer.
A buy-in or buy-out refers to veterinarians of the practice. A buy-in is when an associate purchases a stake in the practice and a buy-out is when the practice purchases back that share from the associate.
A merger typically occurs when two practices on the same scale combine to create economies of scale. An example is two practices closing one location to operate out of a combined facility. A merger can also involve centralizing of tasks such as bookkeeping, inventory management, and practice management services.
Capital gains are the difference between an asset’s purchase price and selling price, when the selling price is greater.
A practice you recently interviewed with told you they will offer you a number of ancillary benefits if you work full time. This may include:
- Holidays off
- Professional membership dues
- Percentage of gross production or salary
- Vacation allowance
- Health insurance
Answer: Professional membership dues
Explanation
An ancillary benefit is an additional benefit not part of the expected core offer. Examples of these benefits include membership dues, continuing education allowance, DEA license dues, moving expenses, gym memberships, etc.
In this question, a vacation allowance, holidays off, salary, and health insurance are all expected benefits in a core offer for a full-time employee at a veterinary clinic.
You are asked to interview an applicant for a veterinary technician job at your clinic. Which of the following is an acceptable interview question for you to ask the applicant?
- Do you have a high school diploma or equivalent?
- Do you have any disabilities?
- Do you wish to be addressed as Mr., Mrs., Miss, or Ms?
- What is your native language?
- When did you graduate from college?
- How many children do you have?
Answer: Do you have a high school diploma or equivalent?
Explanation
When interviewing a potential employee, it is important to know what questions are not appropriate. In general, questions should focus on the requirements of the job and specific qualities that it takes to perform the job. In this case, a high school diploma may be a job requirement.
Discrimination laws prohibit questions based on gender, age, nationality, race, religion, sexual orientation, and disability. Questions about an individuals personal status that are not job-related are also inappropriate (i.e. do you have children?). While questions like this may seem like standard small-talk, they are not appropriate in a job interview. The other answer choices listed here all allude to such potentially discriminatory information.
Questions should be phrased in a way that is specific to the needs of the job…for example:
Do you have any responsibilities that may interfere with the hours you can work or your ability to do the job?
Using animals in research is generally justified by the “greater good” concept, a concept that states that the use of animals in research will result in improvements in health and medicine for both humans and animals. This concept is part of the larger ethical theory known as:
- Contractarianism
- Animal welfare
- Utilitarianism
- Animal rights
- Kantian ethics
Answer: Utilitarianism
Explanation
Utilitarianism dictates that principles of conduct should be guided by providing the greatest happiness to the greatest number of individuals.
The balance sheet for a veterinary practice shown below is complete except for the “Equity” value. Based on the information provided, calculate the equity? Assume all values are in US dollars.
- 80,000
- 120,000
- 20,000
- 40,000
- 10,000
- 200,000
Answer: 120,000
Explanation
The ability to read and understand a balance sheet of a veterinary practice is something that may be tested on board examinations. The critical formula to know for a balance sheet is:
Assets= Liabilities + Shareholder’s Equity
Here, Assets= $200,000 and Liabilities= $80,000. All of the other numbers on the balance sheet are not needed to answer this question as they are just components of the total assets or total liabilities.
Therefore, Equity= $120,000
A laboratory researcher comes to you with a new test for detection of respiratory disease in hamsters. After years of testing, she notifies you that the sensitivity of the test is 90% with 99% specificity. You evaluate the hamsters and notice that the disease is 5% prevalent in the population. What is the positive predictive value?
- Approximately 85%
- Approximately 95%
- Approximately 65%
- Approximately 45%
Answer: Approximately 85%
Explanation
Prevalence = Total Disease/Total x 100
Sensitivity = A/(A+C) × 100
Specificity = D/(D+B)
PPV = A/(A+B) × 100
NPV = D/(D+C) x 100
The question tells you sensitivity, specificity, and prevalence in percentages.
From this information, you need to determine PPV.
PPV is the proportion of the test-positive animals that are truly infected or disease positive.
You’ll want to assume you have a population of 100 to make the math easier.
Prevalence 5% = Total Disease/Total x 100, which means 5 out of 100 total are total disease (true disease
positive).
That means that 95 out of 100 are true disease negative or total non disease. Total non disease = B + D.
Therefore, B + D = 95.
From the chart, you can see that Total Disease = A + C. Therefore, A + C = 5.
Sensitivity = A/(A+C) × 100
90%/100 = A/5
0.9 × 5 = A
4.5 = A
Specificity = D/(D+B) × 100
99%/100 = D/95
2205-6-0
Total Non Disease = B + D
95 = B + 94
95 - 94 = 1 = B
Total Disease = A + C
5 = 4.5 + C
5 - 4.5 = 0.5 = C
PPV = A/(A+B) × 100
PPV = 4.5/(4.5 + 1) × 100 = 81.8%, which rounds up to 82%
An owner is holding her 4 year old male intact Bichon while you are examining a rash on the abdomen. The dog reaches back and bites her on the arm. She had insisted on holding the dog for examination despite the sign posted (see image). This dog has been known to be aggressive in the past. Who is liable for her injury?
- The dog
- The veterinarian
- This would be considered an accident and fault of both parties, therefore no one is liable.
- The owner
Answer: The Veterinarian
Explanation
Even though the owner of the dog insisted on holding for the exam, the veterinarian is still liable for her injury.
While most clients would not pursue damages for an incident such as this, the veterinarian would be found liable should the client pursue litigation.
The best solution to prevent this from occurring is to have a technician or assistant who is trained to restrain animals hold the patients for examination. It is a good idea to post a sign in each exam room stating that owners please not ask to restrain pets during exam. If they insist, let them know that due to liability reasons, the technician will be holding their pet but they are welcome to stand near and talk to the pet, etc. while exam is taking place. In animals that are known to be aggressive, a muzzle should be placed prior to the exam for the safety of all involved.
