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Small animal surgery I > Reproduction > Flashcards

Reproduction Flashcards

1
Q

What are the types of mammary gland diseases we will see?

A

Tumors, hyperplasia, carcinoma

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2
Q

How many pairs of mammary glands do dogs have?

A

5

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3
Q

T/F: Mammary tumors are the most common neoplasm in intact female dogs

A

True. 70%

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4
Q

T/F: Mammary tumors in male dogs is common

A

False.

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5
Q

How often are mammary tumors malignant in a dog?

A

50%

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6
Q

T/F: The glandular area is most commonly the origin of neoplasm

A

True

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7
Q

Which glands of the mammary are most commonly affected?

A

4 and 5

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8
Q

T/F: Watch and wait is the best way to deal with mammary tumors

A

False

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9
Q

What do you do to pre-op a CMT?

A

bloodwork, radiographs (for mets), ultrasound/imaging

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10
Q

What is the only way to differentiate a malignant from a benign mammary tumor?

A

Biopsy

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11
Q

T/F: you want to perform an incisional biopsy for diagnostic purposes

A

False. Excisional

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12
Q

What are the criteria of malignancy (COM)?

A

Rapid growth, size, fixation in skin, circumscribed, ulceration/inflammation

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13
Q

How wide do you want to make your marginal excision?

A

2-3 cm

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14
Q

T/F: A benign mass can become a malignant one

A

True

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15
Q

What is a lumpectomy?

A

Removal of a small solitary mass with 1 cm margin

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16
Q

What should you do if the mass suited for a lumpectomy is in the middle of a gland?

A

Remove the entire gland (simple mastectomy)

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17
Q

When would you perform a simple mastectomy?

A

When there is a solitary mass 1-2 cm within the gland

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18
Q

How wide are your margins in a simple mastectomy?

A

2-3 cm

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19
Q

What shape is your incision for a simple mastectomy?

A

Elliptical

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20
Q

What would have to happen is the mass is greater than 2 cm, has multiple COM, or the 2-3 cm for a simple mastectomy is not enough?

A

Removal of multiple glands

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21
Q

What glands are to be removed, if a mass affects glands 1 and/or 2?

A

Glands 1-3

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22
Q

What glands are to be removed, if a mass affects glands 4 and/or 5?

A

Glands 3-5

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23
Q

What lymph node is removed along with gland 5 in a regional mastectomy?

A

Superficial inguinal lymph node

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24
Q

What are the chances a dog with a mass on one side will have recurrence on the other side?

A

60%

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25
Q

If gland 3 is affected, what do you do?

A

Chain mastectomy

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26
Q

How long do you wait to perform another chain mastectomy after the first one?

A

4-6 weeks

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27
Q

What is the mean survival time of a malignant CMT with no metastasis?

A

1-2 years

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28
Q

What are the most common sites of metastasis with CMT?

A

Lung, liver, bone, lymph node, kidney, spleen

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29
Q

What can you do to prevent CMT?

A

Spay your dog

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30
Q

What is the cutoff age for prophylactic spay for CMT?

A

2 years

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31
Q

If you had to do both a spay and a mastectomy, which would you do first?

A

Spay

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32
Q

How do you treat canine mammary hyperplasia?

A

You don’t. It’s physiologic (progesterone) and will regress on its own

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33
Q

What signs do you see with inflammatory carcinoma?

A

Edema, erythema pain, multiple firm glands

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34
Q

What is the mean survival time for inflammatory carcinoma?

A

<1 month

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35
Q

What surgery do you use to treat inflammatory carcinoma?

A

Not recommended to do surgery

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36
Q

How might you treat inflammatory carcinoma?

A

NSAIDs may help

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37
Q

T/F: Feline mammary tumors are more common than canine

A

False

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38
Q

T/F: Feline mammary tumors are usually benign

A

False

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39
Q

What is usually the type of cancer from a mammary tumor?

A

Adenocarcinoma

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40
Q

T/F: Male cats get mammary tumors more often than male dogs

A

True

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41
Q

How many pairs of mammary glands do cats have?

A

4

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42
Q

When would you not want to perform surgery on a mammary tumor?

A

If metastasis is present

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43
Q

What surgery do you do for every feline mammary tumor?

A

Chain mastectomy, regardless of number or size

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44
Q

What is the mean survival time for a feline mammary tumor that is <2 cm? >3 cm?

A

3 years; 6 months

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45
Q

What molecule is fibroadenomatous hyperplasia of the mammary gland dependent on?

A

Progesterone

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46
Q

What age of cat most commonly has fibroadenomatous hyperplasia of the mammary gland

A

<2 years

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47
Q

How can you definitively diagnose fibroadenomatous hyperplasia in a cat?

A

Histopathology

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48
Q

How would you treat fibroadenomatous hyperplasia of the mammary tumor?

A

Spay, with a flank approach

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49
Q

T/F: Nonfunctional ovarian cysts are typically incidental findings

A

True

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50
Q

What is the best way to deal with a nonfunctional or functional ovarian cyst?

A

surgical excision with histopathology

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51
Q

What type of functional ovarian cyst is most common?

A

follicular cyst, estrogen

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52
Q

How old are the animals when affected by a functional ovarian cyst?

A

Dogs <3

Cats <5

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53
Q

What hormone is dominant during proestrus and what happens to the dog?

A

estrogen, enlarged vulva, attractive to males

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54
Q

What hormone surges and activates ovulation during estrus?

A

Luteinizing hormone

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55
Q

What hormone is dominant during diestrus?

A

Progesterone

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56
Q

What would you see with a ovarian tumor with stromal origin?

A

Pyometra

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57
Q

How do you diagnose an ovarian tumor?

A

Radiographs, ultrasound

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58
Q

T/F: Metastasis is common with ovarian neoplasia

A

false

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59
Q

What causes ovarian remnant syndrome?

A

Surgical error. Ovarian tissue is left behind

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60
Q

T/F: Ectopic tissue is reported in dogs

A

False. Reported in cats

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61
Q

How do you diagnose ovarian remnant syndrome?

A

Cytology of vagina while in heat, hormone assays

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62
Q

What is an ovariectomy and is it an acceptable form of spay?

A

Removal of only the ovary. It is acceptable

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63
Q

When would you perform a unilateral ovariectomy?

A

To treat cystic disease only

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64
Q

What forms after ovulation and what does that make?

A

Corpus luteum makes progesterone

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65
Q

What does progesterone do to the endometrial glands?

A

Increases number and secretion

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66
Q

What can occur with abnormal progesterone exposure?

A

Cysts, neoplasia, remnants

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67
Q

What is cystic endometrial hyperplasia caused by and what is it filled with?

A

excess progesterone.

filled with aqueous material, mucus, or blood

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68
Q

How do you diagnose cystic endometrial hyperplasia?

A

Ultrasound

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69
Q

T/F: Cystic endometrial hyperplasia is a medical emergency

A

False.

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70
Q

How do you treat CEH?

A

Spay

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71
Q

What hormone causes pyometra?

A

Progesterone via uterine secretions

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72
Q

What is most common bacteria isolated in pyometra?

A

E. coli

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73
Q

How do bacterial toxins cause PU/PD? know this

A

Inhibition of ADH

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74
Q

If an intact female is sick, what is immediately on your rule out list?

A

Pyometra

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75
Q

What will you see on PE for a dog with pyometra?

A

fever, painful abdomen, vaginal discharge

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76
Q

What’s the CBC for a dog with pyometra?

A

left shift neutrophilia, thrombocytopenia, hypoalbuminemia, mild cholestasis

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77
Q

When would you medically treat pyometra?

A

not systemically ill or if owner does not want to spay

78
Q

How would you medically treat pyometra?

A

Prostaglandins, systemic antibiotics

79
Q

For surgical treatment of pyometra, do you want to ligate before or after you place your clamps?

A

Before

80
Q

What clamps do you use for pyometra?

A

Doyen clamps

81
Q

When does metritis occur?

A

12 hours to 1 week postpartum

82
Q

What could you see with an animal with metritis?

A

foul-smelling reddish-brown vaginal discharge, signs of systemic illness

83
Q

How would you diagnose metritis?

A

Based on timing following parturition

84
Q

How do you treat metritis?

A

Antibiotics that are safe for nursing, or surgical exploration

85
Q

How do you surgically treat metritis?

A

Spay, or hysterotomy

86
Q

What suture material and size do you use to close a metritis surgery?

A

3-0 or 4-0 absorbable monofilament

87
Q

T/F: Do not penetrate the mucosa when suturing after a metritis

A

True

88
Q

What is most commonly associated with uterine torsion and how do you treat it?

A

Dystocia, spay or C-section

89
Q

How would you treat a uterine prolapse?

A

Spay

90
Q

T/F: Uterine neoplasia is usually an incidental finding

A

True

91
Q

T/F: During parturition, it is normal for the temperature to >100 F

A

False. <100F

92
Q

How long does labor have to be before diagnosing dystocia?

A

24 hours, or >4 hours between puppies

93
Q

What breed is predisposed to dystocia?

A

Brachycephalics

94
Q

How do you medically treat dystocia?

A

Oxytocin

95
Q

When is medical treatment contraindicated for dystocia?

A

Active contractions, fetal malposition or size, fetal distress

96
Q

How do you surgically treat dystocia?

A

C-section (hysterotomy)

97
Q

Where do you cut with a C-section?

A

Linea alba

98
Q

How do you position the fetus to the incision with a hysterotomy?

A

“milk” them towards it. do NOT cut your way to them

99
Q

What should you do to the uterus after removing all the fetuses, before closing it?

A

Lavage

100
Q

What suture material and size do you use to close a hysterotomy?

A

3-0 or 4-0 absorbable monofilament

101
Q

What needle type do you use to suture after a hysterotomy?

A

taper needle

102
Q

When should you perform an elective C-section?

A

63-65 days after the LH surge

103
Q

What are the two surgical approaches with vaginal surgery?

A

Episiotomy (vaginal lesions) or ventral approach (very invasive)

104
Q

What should you expect when cutting into a episiotomy and what can you do to prevent it?

A

moderate hemorrhage. prevent via electrocautery

105
Q

How many layers do you need to close for an episiotomy?

A
  1. Mucosa/submucosa, muscle/SQ, skin
106
Q

What clamps would you use for an episiotomy?

A

Doyen. non-crushing

107
Q

What risks are associated with the transpelvic approach?

A

damaging the obturator nerve and/or the blood supply near of the local viscera

108
Q

What types of lesions can you see with vestibulovaginal stenosis?

A

vertical septal, annular fibrotic, hypoplastic

109
Q

What structures are included in a septal vestibulovaginal stenosis?

A

Mucosa only

110
Q

What structures are included in a septal vestibulovaginal stenosis?

A

Mucosa and submucosa. May or may not contain muscularis

111
Q

What are some clinical signs associated with V-v stenosis?

A

recurrent vaginitis, UTI, urinary incontinence

112
Q

T/F: Fixing the vestibulovaginal stenosis will not fix the incontience

A

True

113
Q

How would you diagnose a V-v stenosis?

A

digital exam, contrast vaginourethrogram, vaginoscopy

114
Q

What contrast agent do you use for a vaginourethrogram?

A

Iodinated contrast (NOT BARIUM)

115
Q

What does a ratio of min:max in vaginal diameter <0.2 indicate?

A

Severe stenosis

116
Q

What is the best way to image the lower urinary and repro tracts?

A

Vaginoscopy

117
Q

How do you treat a septal V-v stenosis?

A

Episiotomy or endoscopy with laser ablation

118
Q

How do you treat an annular V-v stenosis?

A

If caudal to pelvis - vag resection and anastomosis with dorsal approach

if intrapelvic - vaginectomy with ventral abdominal + transpelvic approach

119
Q

T/F: a dorsal approach enters the lumen of the vaginal vault

A

False

120
Q

How do you treat a hypoplastic v-v stenosis?

A

Vaginectomy with ventral approach. Spay if not already done

121
Q

How do you diagnose a recessed vulva?

A

You look at it

122
Q

What are some clinical signs of a recessed vulva?

A

Skin fold dermatitis or vaginitis. Urine pooling

123
Q

How do you treat a recessed vulva?

A

Clean the area.

Surgery with episioplasty if needed

124
Q

T/F: Episioplasties often have complications

A

False

125
Q

What is an episioplasty?

A

Resection of the skin around the vulva. Treats recessed vulvas

126
Q

What happens to the mucosa with vaginal edema/hyperplasia?

A

It becomes edematous and protrudes from the vulva

127
Q

How do you treat vaginal edema?

A

It resolves at the end of the estrus cycle, but spay will prevent recurrence.

Can also resect the mucosa

128
Q

Vaginal prolapse is usually secondary to what?

A

Dystocia, constipation, forced separation

129
Q

How do you treat a vaginal prolapse?

A

Manual reduction or spay

130
Q

What type of dogs are usually affected by neoplasm in the vagina/vulva?

A

Intact females < 10 years old

131
Q

What signs can you see with vaginal neoplasia?

A

discharge, dysuria, tenesmus

132
Q

How do you definitively diagnose vaginal neoplasia?

A

Biopsy

133
Q

T/F: Most vaginal neoplasias are benign

A

True

134
Q

What is the most common type of vaginal neoplasm?

A

Leiomyoma

135
Q

How do you treat a vaginal neoplasm?

A

Excisional biopsy via episiotomy

136
Q

If malignant, what is the most common type of vaginal neoplasia?

A

Leiomyosarcoma

137
Q

T/F: Leiomyosarcomas of the vagina are low risk of metastasis but are locally invasive

A

True

138
Q

How far are the margins of resection with leiomyosarcomas of the vagina?

A

2-3 cm

139
Q

What type of surgery do you perform to treat vaginal leiomyosarcomas?

A

Vulvovaginectomy

140
Q

Where you do cut open for a vulvovaginectomy and what else do you need to do?

A

Ventral approach, requires perineal urethrostomy

141
Q

What are some testicular or scrotal diseases for surgical management?

A

Cryptorchidism
testicular torsion
testicular neoplasia
scrotal ablation

142
Q

At what age do the testicles usually descend?

A

30-40 days

143
Q

At what age of the dog can you definitively diagnose cryptorchidism?

A

6 months

144
Q

T/F: Cryptorchidism is genetic

A

True

145
Q

Where are the origin and insertions of a testicle?

A

Caudal pole of the kidney and scrotum respectively

146
Q

Can you palpate an abdominal cryptorchidism?

A

No, you must use an ultrasound or exploratory laparatomy

147
Q

Where do you incise for a prescrotal cryptorchid procedure?

A

Directly over the testicle, it’s at the prescrotal area

148
Q

Where do you incise for an abdominal cryptorchid procedure?

A

Caudal celiotomy - skin adjacent to prepuce, then open the abdomen and follow the artery or vas deferens

149
Q

What fatal condition can occur if the cryptorchid testicle is left untreated?

A

Testicular torsion

150
Q

What types of testicular neoplasia can occur?

A

Interstitial cell, sertoli cell, seminoma

151
Q

What is feminism syndrome caused by?

A

Sertoli cell tumor releasing excess estrogen. Alopecia

152
Q

What causes excess testosterone and perineal hernia and adenoma/carcinoma?

A

Interstitial cell tumor of the testicles

153
Q

Why do you run X-rays on a do with testicular neoplasia?

A

To check for mets

154
Q

How often do mets occur in dogs with testicular neoplasia?

A

<10%

155
Q

T/F: Testicular disease is often secondary to scrotal abnormalities

A

False. Scrotum secondary to testicles

156
Q

How would you treat testicular neoplasia?

A

Bilateral castration with scrotal ablation

157
Q

What hormone is still intact with a vasectomy?

A

Testosterone

158
Q

What structure is ligated with a vasectomy?

A

Vas deferens (double-ligation)

159
Q

What breed is most commonly affected by hypospadias?

A

Boston Terriers

160
Q

What are some potential locations for hypospadias?

A

Glandular, penile, scrotal, perineal, anal

161
Q

How do you treat hypospadias?

A

Urethrostomy proximal to the abnormality (upstream)

Also, excise the exposed mucosa

162
Q

What is paraphimosis?

A

Inability to retract the penis into the prepuce

163
Q

What causes acquired paraphimosis?

A

Trauma, infection, priapism

164
Q

How do you medically treat paraphimosis?

A

Reduce the swelling with hyperosmolar solution or cold packs, lube

165
Q

When would you surgically treat paraphimosis?

A

If the condition is recurrent or the opening is too small, necrosis

166
Q

What surgical treatments are available for paraphimosis?

A

Preputial advancement, phallopexy

167
Q

How do you perform a preputial advancement for paraphimosis?

A

Half circle incision cranial to prepuce, suture preputial muscles together to shorten and extend the prepuce

168
Q

How do you perform a phallopexy?

A

Make dorsal midline incisions on penis and prepuce, then suture together

169
Q

What suture pattern and material is used for a phallopexy?

A

3-0 or 4-0 absorbable monofilament, simple pattern (interrupted or continuous)

170
Q

What surgical procedure is most indicated with penile trauma or neoplasia?

A

Penile amputation

171
Q

What is the most commonly reported neoplasia of the prepuce?

A

Mast cell tumor

172
Q

Which of the tumor types is not usually treated surgically?

A

TVT

173
Q

What is surgically done with a penile amputation?

A

Urinary catheter placed for urethra identification, urethrostomy proximal to resection (2-3 cm margins), tuck stump into SQ of caudal abdomen

174
Q

When would you have to perform a penile amputation with disease on the prepuce?

A

When there are large tumors on the prepuce

175
Q

T/F: Benign prostatic hyperplasia is painful and assemtrical

A

False

176
Q

How do you treat benign prostatic hyperplasia?

A

Castration

177
Q

What is the most common organism with prostatic abscesses?

A

E. coli

178
Q

How does the prostate get infected?

A

Ascending infection from the urethra

179
Q

How do you diagnose prostatitis?

A

palpation, ultrasound, cytology

180
Q

How do you treat mild cases of prostatitis?

A

antibiotics, fluids, castration

181
Q

How do you treat severe cases of prostatitis?

A

antibiotics, exploratory, omentalization, castration

182
Q

T/F: omentalization is very successful for prostatitis

A

True

183
Q

How do you diagnose a prostatic cyst?

A

U/S (double bladder), fluid aspiration (brown and watery)

184
Q

How do you treat large cysts that communicate with the urethra?

A

Partial resection with omentalization

185
Q

What do you do regardless of the cyst size?

A

Castration

186
Q

What is a potential complication and cause with surgical treatment of a prostatic cyst?

A

Urinary incontinence caused by anatomic changes in the urethra

187
Q

T/F: Prostatic neoplasia is usually benign

A

False

188
Q

T/F: Prostatic neoplasia is usually metastatic

A

True

189
Q

What is the type of cancer with prostatic tumors?

A

Adenocarcinoma

190
Q

How does castration help with prostatic neoplasia?

A

It doesn’t, increases incidence, risk of metastasis

191
Q

How does prostatic neoplasia lead to lameness?

A

Metastasis of bone

192
Q

What is a palliative treatment option for prostatic neoplasia?

A

Tube cystostomy, urethral stent

Small animal surgery I (8 decks)

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