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Small animal surgery I > Spleen, Liver, Kidney > Flashcards

Spleen, Liver, Kidney Flashcards

1
Q

What artery supplies the spleen?

A

Celiac to splenic artery

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2
Q

What are some functions of the spleen?

A

Hematopoiesis, reservoir for RBCs and platelets, immunologic function

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3
Q

What are some splenic surgeries that are used?

A

Splenorrhaphy (rare), partial splenectomy, complete splenectomy

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4
Q

How do you close for a splenorrhaphy?

A

interrupted horizontal mattress for capsule with 4 or 5-0 absorbable monofilament

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5
Q

When is a partial splenectomy indicated?

A

Focal, benign diseases : abscess, laceration, partial infarction

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6
Q

How do you close for a partial splenectomy?

A

Suture capsule with double continuous pattern, TA stapler, CO2 laser, electrosurgery device

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7
Q

When is a complete splenectomy indicated?

A

Severe trauma, torsion, neoplasia, diffuse disease, immune-mediated disease

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8
Q

In emergent cases, how do you ligate the hilar vessels associated with the spleen?

A

Rapid 3 clamp technique

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9
Q

How do you surgically approach the spleen?

A

Ventral midline celiotomy

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10
Q

What are some post-op complications with the spleen?

A

Cardiovascular compromise, DIC

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11
Q

T/F: Benign and malignant tumors of the spleen can be differentiated best by abdominal ultrasound

A

False

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12
Q

What are some CxS seen with splenic neoplasia?

A

Inappetence, weakness, non-specific

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13
Q

What is the most common splenic tumor in dogs?

A

Hemangiosarcoma. Locally invasive, highly metastatic

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14
Q

What is the best way to treat hemangiosarcoma?

A

Surgery with Chemotherapy

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15
Q

What will you see with splenic torsion?

A

Vomiting, CV signs, weakness, anemia, hematuria, icterus

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16
Q

What is the most used diagnostic imaging tool for splenic torsion? What do you see?

A

Ultrasound. Absence of blood flow in hilar region

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17
Q

T/F: Before removing the spleen in a splenic torsion case, you want to untorse the spleen before the splenectomy.

A

False. DO NOT UNTORSE

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18
Q

What is the most common source of splenic trauma?

A

Hit by car

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19
Q

T/F: Surgery is the most indicated source of treatment for splenic trauma

A

False. Most cases can be managed conservatively

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20
Q

What arteries supply the right lobe of the pancreas? The left? The body?

A

Right - cranial/caudal pancreaticoduodenol artiers

Left - splenic artery

Body - hepatic artery

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21
Q

Which part of the pancreas takes up 98% of its mass? What is its function?

A

Exocrine pancreas. Makes digestive enzymes

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22
Q

What are some surgical techniques done on the pancreas?

A

Partial/complete pancreatectomy, pancreatic drainage

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23
Q

What methods can you use to get a biopsy of the pancreas?

A

Guillotine

Lobar dissection

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24
Q

When is a partial pancreatectomy indicated?

A

To remove a tumor, biopsy a large lesion

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25
Q

How do you perform a partial pancreatectomy?

A

Incise the capsule, dissect between lobules

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26
Q

T/F: total pancreatectomies are never performed

A

True

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27
Q

What is a pancreatic pseudocyst?

A

Collection of secretions and debris in a non-epithelialized sac. Diagnosed with ultrasound

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28
Q

What are the 3 options for treating pancreatic pseudocysts?

A

US guided aspiration, surgical resection, debridement and drainage

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29
Q

What typically occurs as sequela to pancreatitis?

A

Abscesses

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30
Q

How do you treat pancreatic abscesses?

A

Emergency surgery - debridement and omentalization

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31
Q

What is the most common pancreatic cancer in dogs and cats?

A

Exocrine pancreatic adenocarcinoma

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32
Q

T/F: EPA is highly malignant, locally invasive, and early to metastasize

A

True. Extremely poor prognosis

33
Q

Where can a gastrinoma originate from?

A

Pancreas, duodenum, peripheral lymph nodes, mesentery

34
Q

what % of cases already have metastasis by the time gastrinomas are diagnosed?

A

70%

35
Q

How do you diagnose gastrinoma

A

Fasting gastrin serum concentrations

36
Q

What CxS will you see with insulinomas?

A

weakness, seizures, collapse

37
Q

How can you identify an insulinoma to diagnose?

A

Ultrasound, CT

38
Q

How do you surgically treat insulinomas?

A

Resect all affected tissue

39
Q

How do you stage insulinomas?

A

Biopsy regional lymph nodes and liver

40
Q

What complications can occur with treatment of insulinomas?

A

Persistent hypoglycemia, hyperglycemia, pancreatitis

41
Q

How many lobes does the liver have?

A

6

42
Q

What arteries supply the liver?

A

Hepatic (20%), portal vein (80%)

43
Q

What are some surgical procedures done with the liver?

A

Biopsy, partial/complete lobectomy

44
Q

T/F: Multiple samples from multiples lobes are ideal with the liver

A

True

45
Q

What are some methods of obtaining liver biopsies?

A

Guillotine, punch, laparascopy, tru-cut, FNA

46
Q

What suture material do you use for a guiliotine biopsy?

A

3-0 absorbable

47
Q

What are the indications for a guillitine biopsy of the liver?

A

lesions at peripheral, generalized disease

48
Q

What are the indications for a punch biopsy of the liver?

A

Superficial lesions, generalized disease

49
Q

T/F: FNA of the liver has the best diagnostic yield

A

False. Poor

50
Q

How do you perform a complete liver lobectomy?

A

Place a ligature at the base of the lobe and resect

51
Q

T/F: Complete liver lobectomies are only good for small dogs and cats on their left lateral and medial liver lobes

A

True

52
Q

Which technique, stapler or sutures, do surgeons most common use for liver lobectomies?

A

Stapler

53
Q

What is the biggest complication with liver surgery?

A

Hemorrhage, accidental ligation of portal veins and ducts

54
Q

What is the most common form of neoplasia in the liver?

A

Metastatic

55
Q

What are the 3 forms of adenocarcinomas in the dog liver?

A

Massive, nodular, diffuse

56
Q

Which of the 3 forms of adenocarcinomas in the dog liver has the best prognosis? Worst?

A

Best - massive

Worst - diffuse

57
Q

Where are cholangiocellular tumors located?

A

Intrahepatic

58
Q

What is the most common malignant liver tumor in cats?

A

Carcinoma

59
Q

What CxS will you see with liver trauma?

A

Acute blood loss

60
Q

What can the pringle maneuver be used to control?

A

Hemorrhage of the liver, but only for short spurts at a time

61
Q

What are two biliary surgeries performed?

A

Cholecystectomy, biliary stenting

62
Q

When is a cholecystectomy indicated?

A

Mucocele, necrosis, cholangitis, lithiasis, neoplasia, trauma

63
Q

What can cause biliary mucoceles?

A

Hypothyroidism, hyperadrenocorticism

64
Q

What are the most common CxS seen with biliary mucoceles?

A

Vomiting, anorexia, lethargy

65
Q

What are some things to cover when doing a cholecstectomy?

A

Ensure the common bile duct is working, collect bile for a culture, save gallbladder for histo

66
Q

What procedure is used to remove stones and sludge from the gall bladder?

A

Choledochotomy

67
Q

What does bile duct stenting do?

A

Promotes patency to the common bile duct

68
Q

When is bile duct stenting most indicated?

A

Severe pancreatitis

69
Q

When is biliary diversion indicated?

A

Irreparable trauma to the common bile duct

70
Q

How large does the stoma need to be for a cholecystoduodenostomy?

A

3 cm

71
Q

What are the most common portosystemic shunt types in small animal patients?

A

Congenital, single, extrahepatic

72
Q

What CxS will you see with PSS on a cat?

A

Aggression, pytalism

73
Q

What will you see on cytology of the urine with PSS?

A

Ammonium biurate crystals

74
Q

What will you see on rads with PSS?

A

Microhepatica, enlarged kidneys

75
Q

What molecule is used or nuclear scintigraphy of the PSS?

A

technetium pertechnetate 99

76
Q

T/F: CT angiography is the most recommended test to run for PSS

A

True

77
Q

When should you give medically treat for PSS?

A

At least 2 weeks before surgery, reduce diet, lactulose, antibiotics

78
Q

T/F: Poor medical response is a sign of poor prognosis with PSS

A

True

Small animal surgery I (8 decks)

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