test questions

Question 1

Which statement is TRUE about skin tension lines?
a. When planning a tumor removal, the most important thing when making your skin incision is assessing the skin tension on your particular patient pre-op.
b. You should orient your incision perpendicular to the skin tension line.
c. You must always consult a textbook with illustrations depicting skin tension lines before
making an incision.
d. Zebras and tigers have stripes that are perpendicular to the skin tension lines.
e. None of the above.

Answer 1

When planning a tumor removal, the most important thing when making your skin incision is assessing the skin tension on your particular patient pre-op.

Question 2

Which technique is frequently used to elevate and separate the skin edge from the underlying subcutaneous tissue allowing you to advance the skin toward midline to close an incision?
a. Undermining
b. Walking sutures
c. Skin stretchers
d. Releasing incisions
e. Z-plasty

Answer 2

a. Undermining

Question 3

Which is the most commonly used type of free skin graft? a. Punch
b. Strip
c. Stamp
d. Mesh
e. Sheet

Answer 3

d. Mesh

Question 4

The blood supply from free skin grafts comes from:
a. A direct cutaneous artery and vein
b. The subdermal plexus
c. Ingrowth of new vessels, plasmatic imbibition, and inosculation (in that order)
d. Plasmatic imbibition, inosculation, and ingrowth of new vessels (in that order)
e. Anastomosis of donor and recipient vessels by the surgeon

Answer 4

d. Plasmatic imbibition, inosculation, and ingrowth of new vessels (in that order)

Question 5

Which technique is least likely to create dead space when attempting to close a wound? a. Advancement flap
b. Undermining
c. Transposition flap
d. Walking sutures
e. Closure using just simple interrupted sutures in the skin (no subcutaneous sutures)

Answer 5

d. Walking sutures

Question 6

Which of the following is NOT important for skin graft survival?
a. Age and breed of the animal
b. Plasmatic imbibition
c. Inosculation
d. Vascular ingrowth of vessels
e. Health of the recipient wound bed surface

Answer 6

a. Age and breed of the animal

Question 7

Between what layers of the skin would you undermine to elevate an axial pattern flap?
a. Between the direct cutaneous artery and the skeletal muscle
b. Between the panniculus muscle and the subdermal plexus
c. Above the skeletal musculature and below the subdermal plexus
d. Below the skeletal musculature
e. Between the dermis and subdermal plexus

Answer 7

c. Above the skeletal musculature and below the subdermal plexus

Question 8

Jackson-Pratt drain and explain how it works.

Answer 8

When you squeeze the bulb of the drain, you create a negative pressure vacuum, so the fluid inside the body cavity gets sucked into the bulb through the inlet port, without damaging the tissue. The negative pressure is enough to suck
the fluid out, but not enough pressure to damage tissues. The ridges (supporting struts) on one side of the tube prevent it from
collapsing under pressure. Once the bulb is full of fluid, you can empty the fluid through the drainage port.

Question 9

What is the most common simple gravity drain used in surgical and accidental wounds? This drain
is made from what material?

Answer 9

Penrose drain
-Made of latex rubber

Question 10

What is the name of this common style of closed suction drain (cross section shown below- flat with triangular ridges on one side)? This drain is made from what material?

Answer 10

S-Jackson-Pratt drain
-Made of soft Silastic (silicone)

Question 11

What are three major (ie. important, not trivial) advantages of a closed suction drainage system
versus a gravity drain (eg. Penrose drain)?

Answer 11

Better at preventing ascending infection
-Fluid volume can be measured and character of fluid can be assessed -More effective fluid removal

Question 12

What are two advantages of a Penrose drain?

Answer 12

Inexpensive
-Simple to use, less maintenance required -Safe
-Versatile

Question 13

What are the two main determinants of oxygen delivery (DO2)?
a. Stroke volume and systemic vascular resistance
b. Cardiac output and total oxygen content
c. Heart rate and stroke volume
d. Cardiac output and hemoglobin saturation
e. Heart rate and total CaO2

Answer 13

b. Cardiac output and total oxygen content

Question 14

All of the following are correct, regarding a contaminated wound EXCEPT:
a. Infection rates range from 25-50%
b. Caused by major breaks in aseptic technique
c. Results from gross spillage of contents from GI tract
d. Results from traumatic wounds
e. Acute inflammation is present

Answer 14

a. Infection rates range from 25-50%

clean/comtaminated- 3-11
contaminated 10-17
dirty- 27-40

Question 15

An acceptable postoperative infection rate goal should average:
a. 5-20%
b. 10-15%
c. 15-20%
d. <2%
e. None of the above

Answer 15

e. None of the above

Question 16

systemic prophylaxis should be administered at what time to be effective?
a. Intravenously at the time of catheter placement
b. Anytime around the start of surgery
c. Orally the morning of surgery
d. Subcutaneously 3 hours before surgery
e. When the skin incision is made

Answer 16

. Intravenously at the time of catheter placement

30-60 minutes before surgery

Question 17

Wound infections are commonly caused by all the following organisms EXCEPT:
a. Staphylococcus aureus
b. Staphylococcus epidermis
c. Pseudomonas aeruginosa
d. Peptostreptococcus oralis
e. Proteus mirabilis

Answer 17

e. Proteus mirabilis

Question 18

A postoperative wound infection reveals an exudate with a sweet musky smell. While awaiting culture confirmation, you believe it is most likely:
a. Escherlichia coli
b. Bacteroides fragilis
c. Pseudomonas aeruginosa
d. Staphylococcus epidermis
e. Streptococcus faecalis

Answer 18

c. Pseudomonas aeruginosa

Question 19

Which of the following is an example of good surgical technique used to reduce infection:
a. Shave the surgical site 24 hours in advance of scheduled surgery

b. Admit the surgery patient 24-48 hours ahead to allow for acclimatization

c. Use a drug like epinephrine to reduce skin bleeding

d. A closed suction drain for evacuation of hematomas and seromas

e. Braided suture is preferred because it is stronger

Answer 19

d. A closed suction drain for evacuation of hematomas and seromas

Question 20

Potential complications with the improper use of electrocautery include all the following EXCEPT:
a. Secondary hemorrhage
b. Prolonged wound healing
c. Skin burns
d. Wound infections increased
e. Reduced blood loss

Answer 20

e. Reduced blood loss

Question 21

In wound classification- the following describes what type of wound? The gastrointestinal,
respiratory, or genitourinary tracts are invaded, inflammation is present, and aseptic technique is not maintained during the procedure.

Answer 21

-contaminated

Question 22

Systemic prophylaxis antibiotics should be administered when relative to the beginning of surgery?

Answer 22

30 to 60 min prior
or if longer then 3 hours

Question 23

Your assessment of a postoperative wound reveals an exudate with a foul smell- you take a culture and submit this to microbiology. Pending culture results your most likely bacterial group causing this infection is:

Answer 23

anaerobic bacteria

Question 24

Cryosurgery results in the most cell death by:
a. Recrystalization
b. Prolonged healing time
c. Coagulating vessels only
d. Preserving normal tissue
e. Rapid thawing

Answer 24

a. Recrystalization

Question 25

Monopolar cautery is best described by which one of the following: a. Inactive electrode
b. Requires two ground plates
c. Coagulates in wet and dry fields
d. Cuts and coagulates tissue
e. Uses bayonet forceps

Answer 25

d. Cuts and coagulates tissue

Question 26

Which of the following agents is the preferred cryogen?
a. Dry ice
b. Nitrous oxide
c. Liquid nitrogen
d. Freon
e. H2O in a gaseous state

Answer 26

c. Liquid nitrogen

Question 27

Which of the following clinical problems is least likely to respond to cryosurgery?
a. Osteosarcoma
b. Anorectal fistulas
c. Dermatological lesions- precancerous/ cancerous
d. Ophthalmic lesions involving the conjunctiva
e. Oral squamous cell carcinoma

Answer 27

a. Osteosarcoma

Question 28

A chemical for cauterizing small vessels is:
a. Silver nitrate
b. Ferrous sulfite
c. Sodium subsulfate d. Hydrochloric acid e. None of the above

Answer 28

a. Silver nitrate

Question 29

regarding bipolar coagulation, all of the following are correct, EXCEPT:
a. Less current required
b. Coagulation in a wet surgical field
c. Requires an inactive electrode
d. Coagulates tissue
e. Good for neurosurgery

Answer 29

c. Requires an inactive electrode

Question 30

Regarding cryosurgery, all the following are correct, EXCEPT:
a. Recrystalization occurs

b. Used for dermatological lesions

c. Direct injury to tissue

d. Destroys tissue

e. Wound healing is different

Answer 30

e. Wound healing is different

Question 31

the term for large crystal formation during a cryosurgery procedure is called:

Answer 31

recrystallization

Question 32

Monopolar cautery requires what two components to operate safely?

Answer 32

handpiece (active electrode) and ground plate (inactive electrode)

Question 33

The major indication for electrocautery in surgery is:

Answer 33

hemostasis/coagulation of vessels

Question 34

Major clinical problems treated using cryosurgery include (list at least 2):

Answer 34

skin lesions, oral tumors, anorectal lesions, ophthalmic lesions

Question 35

What is the preferred cryogen agent?

Answer 35

liquid nitrogen

Question 36

if you want to use a laser to ablate neoplasia deep to clear fluid (thus transmit through the
fluid) what characteristic of the laser is most critical to having the energy absorbed just by the neoplastic tissue?
a. The power of the laser
b. The wavelength of the laser
c. The spot size of the laser
d. The energy density of the laser
e. The distance of the tissue from the laser fiber

Answer 36

a. The power of the laser

Question 37

Laparoscopic portals typically require different types of trocars and cannulas, but they all must have what components in common?
a. A sharp trocar tip point to enter the abdomen and a flip valve to maintain insufflation

b. A diaphragm to accommodate a single instrument size and a blunt tipped trocar tip

c. A blunt cannula and a trocar with a retracting blade to protect viscera

d. A diaphragm that will maintain insufflation with an instrument in the cannula and
a valve that is closed when the instrument is out

e. A valve that is manually opened and closed and a blunt tipped, sharp sided trocar blade

Answer 37

. A diaphragm that will maintain insufflation with an instrument in the cannula and
a valve that is closed when the instrument is out

Question 38

Which statement about equine laparoscopic surgery is TRUE?
a. It is typically less expensive than conventional surgery because equipment costs are less

b. It is always better for the patient because it requires only small skin incisions

c. Laparoscopic cryptorchidectomy can be performed in either standing or recumbent anesthetized horses

d. Gastrointestinal laparoscopic surgery is the most common laparoscopic surgery

e. Hemostasis cannot be performed with cautery instruments in the standing awake
horse

Answer 38

c. Laparoscopic cryptorchidectomy can be performed in either standing or
recumbent anesthetized horses

Question 39

Which statement about equine laparoscopy is TRUE?
a. Better visualization is achieved in the recumbent animal.
b. Hemostasis without collateral damage can only be achieved with bipolar cautery.
c. The cannulas have a diaphragm that maintains an airtight seal while the instrument passes through the cannula.
d. Cannulas can be different diameters to accommodate different body wall thickness.
e. The most complication during laparoscopic cryptorchidectomy is intraabdominal
hemorrhage.

Answer 39

c. The cannulas have a diaphragm that maintains an airtight seal while the
instrument passes through the cannula.

Question 40

Procedures commonly performed in the horse via laparoscopy include?
a. Ovariectomy, gastropexy, nephrectomy
b. Cryptorchidectomy, inguinal hernia repair, adhesiolysis
c. Colpotomy, nephrosplenic ablation, ovariectomy
d. Osteotomy, cryptorchidectomy, nephrectomy
e. Cystotomy, ileostomy, splenic resection

Answer 40

b. Cryptorchidectomy, inguinal hernia repair, adhesiolysis

Question 41

Which statement about lasers is TRUE?
a. Laser light can be transmitted, absorbed, or resorbed.

b. Surgical lasers are class I cold power lasers

c. Laser is an acronym for light amplification by the synchronous emission of radiation.

d. The diode laser can be transmitted down a small fiber through the
videoendoscope.

e. Laser light is used to cause coagulation by heating tissue to greater than 100 C.

Answer 41

d. The diode laser can be transmitted down a small fiber through the
videoendoscope.

Question 42

Laser is an acronym for:
a. light amplification by the stimulated emission of radiation
b. light attenuated to the simultaneous emitted radiation
c. light action by simultaneous emulsified radioactivity
d. light action to synchronous emission of radioactivity
e. light amplified to synchronous emission of radiation

Answer 42

a. light amplification by the stimulated emission of radiation

Question 43

Laser light is different from typical room lighting because laser light is:
a. coherent, nondivergent, multichromatic
b. incoherent, nondivergent, multichromatic
c. coherent, monochromatic, nondivergent
d. monochromatic, divergent, incoherent
e. multichromatic, divergent, incoherent

Answer 43

c. coherent, monochromatic, nondivergent

Question 44

Which statement is INCORRECT?
a. Equine laparoscopy can be performed in the standing or recumbent animal.
b. Bipolar cautery can be dangerous when used during laparoscopy in the standing sedated horse.
c. The cannulas have a diaphragm that maintains an airtight seal while the instrument passes through the cannula.
d. Cannulas are different diameters and lengths for different size instruments and different body wall thickness.
e. Laparoscopic cryptorchidectomy has less potential complications than standard cryptorchidectomy.

Answer 44

b. Bipolar cautery can be dangerous when used during laparoscopy in the standing sedated horse.

Question 45

Which of the following statements about management of the trauma patient is TRUE?

a. A neurological exam to evaluate limb function should be performed as soon as an animal is admitted.

b. Tissue perfusion during resuscitation is largely dependent on blood hemoglobin
concentration and the heart’s stroke volume.

c. An animal that is admitted unable to breathe because of bite wounds damaging the larynx should have an immediate tracheostomy performed under sedation.

d. An animal that is admitted not breathing because of head trauma should have an immediate tracheostomy performed.

e. None of the above.

Answer 45

b. Tissue perfusion during resuscitation is largely dependent on blood hemoglobin
concentration and the heart’s stroke volume.

Question 46

A 6-year-old male intact mixed breed is admitted ten minutes after being hit by a car. The dog is comatose and only breathing sporadically, and has a large open wound on its left stifle that is slowly bleeding. The priority treatments, in order of importance, for this dog are:

Cover the stifle wound, being IV antibiotics, take thoracic rads

Being IV fluids at shock doses, administer corticosteroids, cover the open wound

Place IV catheter, auscult airway, palpate the abdomen for the presence of a bladder, take thoracic rads

Intubate the dog and assist its ventilation, begin IV fluids, cover the open wound

Complete a detailed PE, begin IV fluids, cover the open wound

Answer 46

Intubate the dog and assist its ventilation, begin IV fluids, cover the open wound

Question 47

dog with a a common bile duct obstruction that needs surgery:

Should be anesthetized with drugs metabolized by the liver.

Requires only a CBC before the procedure.

Is not a candidate for general anesthesia.

Should have a coagulation screen before surgery.

Should not be given Vitamin K before surgery.

Answer 47

Should have a coagulation screen before surgery.

Question 48

antibiotics should be administered: (THIS MAY ALSO BE A PRE-OP QUESTION..)
a. To dogs having routine ovariohysterectomies.

b. Beginning 48 hours pre-operatively to minimize the risk of surgical infection.

c. Peri-operatively to animals in which the likelihood of contamination or infection during surgery exists.

d. Postoperatively for five days even if no contamination is observed during a clean exploratory surgery.

e. Only after the results of culture and sensitivity are available in a case of severe infectio

Answer 48

Peri-operatively to animals in which the likelihood of contamination or infection during
surgery exists.

Question 49

Which of the following is likely to have problems with coagulation during surgery because of a lack of Vitamin K dependent clotting factors?

a.Dog with chronic obstruction of the common bile duct
b. Cat with feline leukemia virus
c. Dog with a splenic hemangiosarcoma
d. Dog with fractured femur
e. Dog with moderate kidney failure

Answer 49

a.Dog with chronic obstruction of the common bile duct

Question 50

Which of the following statements concerning the management of trauma is CORRECT?
a. In a dog with a tension pneumothorax, intubation alone can worsen the dog’s clinical signs.

b. Dogs with closed pneumothorax should have a chest tube placed immediately upon
admission.

c. When performing thoracocentesis and reaching “negative pressure”, the chest should be forcefully aspirated using a large syringe to remove as much air from the pleural space as possible.

d. A chest tube should never be placed directly into an open chest wound (“open pneumothorax”) even in an emergency situation.

e. A subcutaneous tunnel is not an important consideration when placing a chest tube.

Answer 50

b. Dogs with closed pneumothorax should have a chest tube placed immediately upon
admission.

Question 51

Which of the following about an animal with respiratory distress after suffering bite wounds is
INCORRECT?
a. A high-pitched noise (“stridor”) on inspiration is indicative of upper airway obstruction.

b. An animal with respiratory difficulty that stops breathing should be intubated
immediately.

c. Subcutaneous emphysema in the neck is suggestive of tracheal damage.

b. Dogs with closed pneumothorax should have a chest tube placed immediately upon
admission.

d. Thoracocentesis (chest tap) is contraindicated in a severely dypsneic animal with no upper airway stridor and dull lung sounds.

e. In tension pneumothorax, both the lungs and great veins collapse as the pressure in the pleural space increase

Answer 51

d. Thoracocentesis (chest tap) is contraindicated in a severely dypsneic animal with no upper airway stridor and dull lung sounds.

Question 52

6-year-old male intact mixed breed dog is admitted to your clinic ten minutes after being hit by a car. The dog is comatose and only breathing sporadically. Dog has a large open wound on its left stifle region that is bleeding slowly. Priority treatments, in order of importance, are:

a. Covering the stifle wound, IV antibiotics, take thoracic rads

b. Begin IV fluids at shock doses, administer corticosteroids, cover the open wound

c. Intubate the dog and assist its ventilation, begin IV fluids, cover the open wound

Answer 52

c. Intubate the dog and assist its ventilation, begin IV fluids, cover the open wound

Question 53

2-year-old male castrated pit bull is bleeding into its abdomen from a gunshot wound.
Ventilation and gas exchange in the lungs are normal. 2 factors in the circulatory system that must be optimized to ensure adequate delivery of oxygen to the tissues are:

Answer 53

Hemoglobin saturation, oxygen carrying
b. Cardiac output (SV/HR)

Question 54

A car hits 3-year-old male intact mixed breed dog. Dog is having great difficulty breathing, but has no upper airway stridor (noise) that might indicate an upper airway obstruction. Lung sounds are dull. You are concerned that the dog is not stable enough for thoracic rads. Most likely cause of dog’s difficulty breathing is ________ and you should ________ as both a diagnostic and therapeutic procedure.

Answer 54

Pneumothora

Intubate__

Question 55

Dog is bitten in the neck by a larger dog. The dog is having difficulty breathing and making a great deal of upper airway noise with each breath. You are able to carefully place a catheter in the left cephalic vein. As the dog’s condition is worsening, the indicated course of treatment is

Answer 55

Intubation/tracheostomy___

Question 56

Which of the following statements about hemostasis is TRUE?
a. A lack of von Willebrand’s factor affects secondary hemostasis.

b. buccal mucosal bleeding time is a useful test in dogs suspected of having von willebrand’s disease
c. A lack of von Willebrand’s factor prevents fibrin from stabilizing the platelet plug.

Answer 56

b. buccl mucosal bleeding time is a useful test in dogs suspected of having von willebrand’s disease

Question 57

which of the following statements about hemostasis is FALSE?
a. A large artery (i.e. renal artery) should be ligated with a transfixation suture. b. Small arteries can be clamped and then ligated using hand ties.
c. Clips are a less secure method of hemostasis than vessel ligation.
d. one clamp technique is an appropriate method for ligating the ovarian pedicle in a large dog

Answer 57

d. one clamp technique is an appropriate method for ligating the ovarian pedicle in a large dog

Question 58

which of the following statements about electrocautery is TRUE?
a. Electrocautery can be safely used to seal vessels 8mm in diameter.

b. monopolar electrocautery can cause burns in animals that do not have an adequate ground plate

c.Electrocautery can be used effectively even with a large amount of blood in the surgical field around the bleeding vessel

Answer 58

b. monopolar electrocautery can cause burns in animals that do not have an adequate ground plate

Question 59

A 5-year-old female intact Doberman comes in with a pyometra requiring immediate surgery. To
make sure the dog doesn’t have a clinically significant deficiency in von Willebrand’s factor you would:

Answer 59

Perform a pre-op buccal mucosal bleeding time test

Question 60

you are removing the left kidney of a 25 kg dog and you have dissected the renal artery. The most secure means of preventing bleeding from this vessel is:

Answer 60

Ligation using a transfixation ligature

Question 61

A decrease in effective circulating blood volume following hemorrhage:
a. Stimulates the vagus nerve, increasing heart rate.
b. Decreases sympathetic tone, resulting in the characteristic “brick red” appearance of
the mucus membranes seen in hemorrhagic shock.
c. Increases the hydrostatic pressure gradient across capillary walls, increasing fluid loss
into the interstitial spaces.
d. Stimulates release of catecholamines and activates the renin-angiotensin system,
causing peripheral vasoconstriction.

Answer 61

d. Stimulates release of catecholamines and activates the renin-angiotensin system,
causing peripheral vasoconstriction.

Question 62

When treating hypovolemic shock secondary to hemorrhage, it is most important to optimize:

Answer 62

Hemoglobin concentration and the heart’s stroke volume

Question 63

Which of the following is NOT part of primary hemostasis? a. Vessel wall constriction
b. Platelet activation
c. Platelet adhesion to subendothelial collagen
d. Conversion of fibrinogen to fibrin by thrombin

Answer 63

d. Conversion of fibrinogen to fibrin by thrombin

Question 64

A 10-year-old Lab is bleeding into its abdomen. You perform an exploratory laparotomy and find a bleeding mass on the spleen, necessitating splenectomy. Best way to prevent bleeding from
the splenic artery is:
a. Coaptive coagulation
b. Ligation using a transfixation ligature
c. Placing two vascular clips

Answer 64

vb. Ligation using a transfixation ligature

Question 65

hich of the following statements is INCORRECT?
a. Bile duct obstruction can be associated with Vit. K deficiency and surgical hemorrhage
b. Blood flow in the caudal vena cava may be temporarily interrupted to remove an
adrenal tumor
c. Surgical bleeding is unlikely to occur in a Doberman with a buccal mucosal bleeding time
of >8 minutes

Answer 65

c. Surgical bleeding is unlikely to occur in a Doberman with a buccal mucosal bleeding time
of >8 minutes

Question 66

A cat with an obstructed common bile duct may have poor blood clotting because of

Answer 66

Vitamin K Deficiency

Question 67

You are performing a hind limb amputation and must ligate the femoral artery. The most appropriate type of ligature for this vessel is _

Answer 67

Transfixation ligature

Question 68

A dog is bleeding from the spleen into its peritoneal cavity. You are concerned the dog may have
a hemangiosarcoma that may have metastasized. Before a splenectomy you would search for distant metastases by

Answer 68

adiographs of thoracic cavity (Lungs) , palpating LN

Question 69

A buccal mucosal bleeding time is a good general test of what part of the hemostatic mechanism?

Answer 69

coagulation

Question 70

the initial platelet plug is stabilized by —

Answer 70

deposition of fibrin

Question 71

% infection rate for clean, clean/con and dirty wounds

Answer 71

clean/comtaminated- 3-11
contaminated 10-17
dirty- 27-40

Question 72

— have fecal smell

Answer 72

E.coli

Question 73

— have foul smell

Answer 73

Anaerobic