Capstone 1 Flashcards by jared Jensen

The etiology is salivary mucoceles is

generally unknown

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What two large tributaries join together to make up the external jugular vein

Linguofacial vein

Maxillary vein

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T/F: esophageal surgery is associated with a greater risk of dehiscence than stomach or small intestine

True

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What are the 4 layers of the esophagus

1) Mucosa
2) Submucosa
3) Muscularis (dogs striated throughout, cats smooth muscle at termination)
4) Adventitia

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What are the pros and cons of nasal feeding tubes

Pros: no GA, feed immediately

Cons: prone to clog, liquid diets only, easy dislodgement, inadvertent airway placement

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What are the pros and cons of E-tubes

Pros: simple, well tolerated, minimal complications from premature removal, can feed once animal is recovered from anesthesia, feed blenderized normal diets, medicate through tube

Cons: requires general anesthesia, stoma issues, insult to esophagus

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What are the pros and cons of G-tubes

Pros: well tolerated, large, feed blenderized normal diets, medicate through tube, decompression, multiple ways to place

Cons: Wait 12-24 hours before feeding, leave in 7-10 days regardless, risk of peritonitis with premature removal

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What are the pros and cons of jejunostomy tubes

Pros: feed in the face of vomiting, use immediately, well-tolerated

Cons: invasive, small diameter, hospitlization (continuous feeding), risk of peritonitis with premature removal

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What tube is preferable to esophagotomy when gastric decompression is warranted

G-tube

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How do you place a G-tube

Blindplacement
PEG
Flank approach
Midline laparotomy
Laparoscopy

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What pattern and suture should you use for closure of enterotomy

Simple continuous or interrupted appositional

with an absorbable monofilament

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What should you do to rule in/out small intestinal obstruction when radiographs are inconclusive

abdominal ultrasound

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How does the stomach twist in a typical GDV when looking at the dog from tail towards head

pylorus travels clockwise from right to the left

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1) mentation of animal (ambulatory vs recumbent vs comatose)
2) preoperative arrhythmias,
3) serum lactate concentration >6mmol/L -
4) evidence of gastric necrosis via gastric lavage
5) Evidence of sepsis or DIC

potentially time to recognition and time to surgery

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Where in the stomach should you pexy for prophylactic elective gastropexy

Antrum to right side of the body wall

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T/F: need of splenectomy during GDV results in increase in mortality for dogs

True

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What liver enzymes are hepatocellular

ALT, AST, SDH

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What liver enzymes are cholestatic

ALP, GGT, total bilirubin

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How do you treat a gallbladder mucocele

Medical management (-Treat infection
-Treat predisposing factor
-Ursodiol
-Sam-E, hepatoprotectants
-Low fat diet )

Surgery: cholecystectomy

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T/F: dogs with low histologic grade tumors have a better prognosis

True

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Cat with 2 week history of progressive lethargy and inappetence. You notice splenomegaly and FNA shows mast cell tumor. Blood count is 15,000 circulating mast cells/uL. What is most reasonable treatment for owner

Splenectomy

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What are the major complications of surgery to hemangiosarcoma

1) Hemorrhage*
2) Thromboembolic events (pulmonary and portal system thrombus)
3) DIC
4) cardiac arrhythmias (do continuous ECG 12-36 hours post-op),
5) intra-abdominal/incisional tumor seeding

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T/F: hemangiosarcoma is most likely diagnosis when non-traumatic hemoabdomen is present

True 65-75% are HSA

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After hemangiosarcoma surgery, what increases the survival time

Doxorubicin after splenectomy

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What provides the least favorable prognosis for dogs with dermal hemangiosarcoma

Invasion into the SQ tissues on histopathology

What breeds are predisposed to transitional cell carcinoma?

Scottish terrier, shetland sheepdog, beagles, wirehaired fox terrier, west highland white terrier, lhasa apso

You are concerned about urothelial carcinoma in a westhighland white terrier. What should you do to screen?

BRAF and Abdominal ultrasound

What risk of malignant mammary tumors do dogs have?

50% risk- treat with lumpectomy

What risk of malignant mammary tumors do cats have?

90% risk - do radical mammectomy

What factors suggest feline high-grade lymphoma rather than an indolent small cell

High grade Large Cell (Type 1 or B cell) Acute onset within 2 weeks Large mid-abdominal mass effect

What tests can you do to differentiate small cell lymphoma from IBD

PARR and IHC

What test can help differentiate B from T cell lymphoma in dogs

Flow cytometry

Incidental adrenal gland lesions are found in what percentage of dogs imaged with CT or ultrasound

<10%

What might result due to a partial pancreatectomy to treat an insulinoma

1) Pancreatitis 2) Diabetes mellitus 3) Pancreatic insufficiency-if both the pancreatic and accessory pancreatic duct are sacrificed

T/F: FDG PET/CT scan is helpful in diagnostic imaging of insuloma

False

FNA of mass on perineal skin near the anus tells it is an epithelial neoplasm. What is the likely diagnosis

Perianal adenoma or adenocarcinoma

What are well-known complications of unilateral anal sacculectomy

infection local recurrence transient or permanent fecal incontinence rectal perforation rectucutaneous fistula hypocalcemia

What is the MST for dogs receiving curative intent therapy for appendicular OSA

12 months

What tools can be used to perform an incisional bone biopsy

-Jamshidi needle -Michele trephine -scalpel and small bone currette

What do dogs most typically die of when receiving palliative care for appendicular OSA

euthanasia as a result of local tumor progression (increasing tumor pain or pathologic fracture)

Curative intent for OSA, what does limb salvage surgery need to followed by

carboplatin chemotherapy

What is the 3-2-1 rule

Client contact if lump persist for more than 3 months after vaccination, lump becomes larger than 2cm in diameter, or increasing in size 1 month after vaccination

What is the expected 3 year local control rate in curative intent radiation therapy following incomplete excision of a soft tissue sarcoma

85%

What is the recommended surgical margins when attempting a wide local excision of a soft tissue sarcoma for a local cure

3cm margins lateral to tumor and one uninvolved fascial layer deep to tumor

T/F: recurrence of soft tissue sarcoma is common after conservative resection

True

Smooth facial deformity secodnary to rapidly growing mass. Biopsy revealed probable dx of reactive fibroplasia. What do you do next?

Recommend skull CT to be performed to better characterize the extent of the lesion for treatment planning and possible wide local excision

You should never biopsy a maxillary mass

through the lip or cheek tissue

Dog with precaval syndrome secondary to mediastinal mass, probable thymoma. Dog is PU/PD. What do you do

Ionized calclium PTH and PTHrp send out test

You do a mediastinal mass aspiration which shows lymphocyte rich aspirate. What do you do next

Flow cytometry of a fresh aspirate of the mediastinal mass

3cm mass in lungs noticed on ultrasound. How do you determine what it is for diagnosis?

Perform an exploratory thoracotomy with lung lobectomy for histopath

What nasal biopsy technique should you avoid for nasal tumors causing cribriform plate lysis in dogs

Hydropulsion -do rhinoscopy, curette, or core

What PE finding might help you distinguish pulmonary valve stenosis from subaortic stenosis in a dog

intensity of the peripheral arterial pulse

What is the normal VHS for a dog

8.5-10.7

What is the normal VLAS for a dog

1.4-2.3

What are causes of pulmonary hypertension

1) Left heart disease (ie MMVD) 2) Respiratory disease (chronic bronchitis) , hypoxia 3) Pulmonary thromboemboli 4) Heartworm Disease

T/F: pulmonary valve stenosis causes pulmonary hypertension

False

How do you treat pulmonary hypertension

Sildenafil treat the underlying cause (bronchitis, hypoxia, HWD, left heart disease, thromboemboli, etc)

What are surgical options for a dog with MMVD

1) mitral valve repair under cardiopulmonary bypass 2) Transcatheter edge to edge mitral valve repair

What heart diseases can be treated with cardiopulmonary bypass

Septal Defect Repair AV valve disease Tetralogy of fallot

What procedures can be done with venous inflow occlusion

Intracardiac masses Cor triatriatum Cardiac foreign body

What is a palliative procedure for tetralogy of fallot

Modified Blalock-Taussig Shunt - attaches the left subclavian to the pulmonary artery

What is the first treatment to do in cats with thromboembolisms

Pain- fentanyl, hydromorphone, methadone

After treating a cat with thromboembolism with analgesia, what is your next step

Anti-platelet therapy (Clopidogrel) Anti-thrombotic therapy - Apixaban +/- furosemide

What are possible causes of concentric hypertrophy in a cat

Hyperthyroidism Systemic Hypertension Primary Hypertrophic Cardiomyopathy

What might help you tell a cat's respiratory distress is cardiac in etiology

Thoracocentesis and SNAP NT-proBNP

How do you treat pyothorax in cats

Bilateral chest tubes- accompanied by regular pleural lavage with sterile saline IV empiric antibiotics

What is the main consequences of BOAS dogs

Increased airway resistance

What is not an indication for mechanical ventilation

Pneumothorax

What is the expected PaO2 on arterial blood gas for a normal healthy dog receiving 100% oxygen supplementation

500mmHg

In a patient who is hypoxemic secondary to hypoventilation. What is the Aa gradient

<10

How do you evaluate etiology and severitiy of hypoxemia when breathing room air

Aa gradient

What sedative drug can be used because its secondary effect is vasodilation for expediting cooling

Acepromazine

What is PEEP

Positive End Expiratory pressure this prevents cyclic recruitment and collapse of small airways and alveoli

What is an obstructive breathing pattern

Slow and deep respirations

What is a restrictive breathing pattern

Rapid and shallow respirations

What murmur do you commonly hear with DCM

2/6 left apical systolic murmur

What is the appearance of a chorioretinal scar

Hyper-reflective scar (post-inflammatory change of chorioretinitis)

If you notice a chorioretinal scar, are there any concerns of the cat's current health

No- retinal change is chronic and does not indicate anything is going on

Dog acutely blind, no menace response. Dilated pupils and absent PLR. What are your top two differentials

SARDS and Optic neuritis

How do you differentiate SARDS from optic neuritis

ERG

What signs are consistent with orbital neoplastic lesion

Exophthalmia, 3rd eyelid elevation, non-painful retropulsion, chronic onset

Surgical procedure where you remove the eye and as much extraocular tissue as needed

Exenteration

Most common neoplastic eyelid lesion

Meibomian gland adenoma

What do we supect most common underlying cause for corneal SCC in dogs

KCS

What ocular meds should you use for complicated infected corneal ulceration

Ofloxacin or Ciprofloxacin

T/F: uveal melanoma in cats has a high metastatic risk

True

What anti-glaucoma med is most effective in decreasing IOP in a short time and can be used as glaucoma medication

Latanoprost 0.005% ophthalmic solution

What topical drug is used to treat KCS

Cyclosporine- KCS is immune mediated disease allow for tear production

What topical ocular drugs cause mydriasis

Atropine Tropicamide Phenylephrine

What drugs are anti-collagenase medications used to stabilize the cornea with keratomalacia

Serum Acetylcysteine* Doxycycline EDTA

How do you treat anterior uveitis

Topical prednisolone and atropine

How do you treat feline herpes ulcerative keratoconjunctivitis

Topical cidofovir and erythromycin ophthalmic ointment

What species have bullae with a septum

cat

What is a complication of lateral wall resection

Dehiscence Stenosis of horizontal ear canal Selt trauma

What are complications of TECA-LBO sx

-Facial nerve palsy -Horner's syndrome -Vestibular syndrome -hemorrhage -fistula formation -infection

What makes a diaphragmatic hernia an emergency

Rads, stomach is in thoracic cavity

How do you minimize recurrence of an aural hematoma

Drain hematoma, place suture to allow the cartilage to heal and treat underlying ear infection

What technique for perineal hernia has lowest risk of complications and best outcome

Internal obturator muscle transpoition

When reducing a chronic diaphragmatic hernia in a cat. What complication is specific to cats in post-operative period

Pulmonary edema

What do you need to do to retropulse stones from urethra to bladder

Anesthesize patient Large rigid catheter Use mixture of sterile saline and lubricant to flush stones

What causes transudate in pleural space several weeks after traumatic diaphragmatic hernia

entrapment of liver lobe

Male dog, best location for urethrostomy

Scrotal urethrostomy

What are the components of the BOAS syndrome

Stenotic nares Elongated soft palate Everted laryngeal saccules Laryngeal collapse hypoplastic trachea macroglossia Aberrant nasal turbinates

What is the best anatomic landmark to use to determine if soft palate is elongated in a brachycephalic dog

Epiglottis

T/F: tracheal stent is a treatment for BOAS

False

What is the most common complication of arytenoid lateralization

Aspiration pneumonia

12yo lab with inspiratory stridor and exercise intolerance. What is top differential for cause of laryngeal paralysis

Idiopathic polyneuropathy

How do you close a cystotomy

single layer, full thickness, appositional, simple continuous

What are the type of common subdermal skin flaps

Advancement Rotational Transposition Skin Fold Flaps

always undermine the flap deep to the

cutaneous muscle

What are the principles of reconstructive surgery

Use simplest technique possible atraumatic tissue handling debride wounds of chronic edges

What are the advantages of laparoscopy

1) Shorter hospitalization times 2) decreased post-operative complications 3) less pain 4) Less soft tissue trauma 5) Better visualization

What might occur at the placement of trocar during laparoscopy

Bowel perforation Splenic laceration SQ emphysema Bladder perforation

CCUS is caused by

lymphoplasmacytic inflammation of oral tissue in response to plaque

Dog inability to close mouth. When you attempt to close mouth, it is painful What might be the cause

1) Fracture/Trauma 2) Dental disease 3) TMJ luxation

T/F: Trigeminal Neuropathy is painful

False

Peripheral odontogenic fibromas originate from the

periodontal ligament

Attachment loss in feline periodontal disease is a sum of what

Gingival recession and periodontal pocket depth

Supereruption commonly affects what teeth

maxillary canine teeth

What oral tumor can be diagnosed with radiographs alone

Odontoma

Dog oral odontogenic tumor that is benign but grows very aggressively causing signficiant bone destruction and requires surgery

Canine Acanthomatous Ameloblastoma

Dog with drooling, difficulty eating and weight loss What orsl condition do you think of

Idiopathic osteonecrosis

Capstone 1 Flashcards

(122 cards)