End Sem 1 Exam Flashcards by Nicola Beaumont

Match each of the following heart rhythms to its correct description.
- Pulseless electrical activity
- Perfusing rhythm
- Ventricular fibrillation
- Asystole
- Pulseless ventricular tachycardia

Pulseless electrical activity:
- Consistent and repeated QRS complexes, narrow complexes, no pulses associated with the complexes and heart rate of 126 bpm.

Perfusing rhythm:
- Consistent and repeated QRS

Ventricular fibrillation:
- Consistent and repeated QRS complexes not present, random and non-repeatable ECG trace, no pulses detectable

Asystole:
- Consistent and repeated QRS not present

Pulseless ventricular tachycardia:
- Consistent and repeated QRS complexes, wider complexes, no pulses associated with the complexes and heart rate of 228 bpm

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Discuss 2 important litter box considerations when advising clients on designing an optimal litter box plan for their ohuse soiling cat.

1 litter box per social group + 1 extra (or 1 per cat + 1 extra)
Size: at least 1.5 the length of the cat from nose to tail so they can comfortably sit in it
Daily cleaning needed: scooping soiled litter + litter replacement
Complete wash of the litter tray with an enzymatic cleaner at least weekly, but more frequently if a problem is present
Litter type: needs to be the cat’s preference whether it is clay, crystals or paper. Can check preference with a litter box buffet.
Tray location: quiet area where the cat won’t be disturbed or trapped

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A dog suddenly develops asystole during anaesthesia. The ECG was attached to the patient; no pulse was detected. According to the RECOVER CPR guidelines, what should be the first treatment priority?
a) Start fluid therapy (bolus dose)
b) Administer low dose of adrenaline
c) Connect the EtCO2 monitor
d) Chest compressions

d) Chest compressions

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For the following clinical presentation select the most likely diagnosis: 4 year old mixed breed dog with acute onset stertorous breathing & pain on opening mouth.
- Bacterial infection secondary to foreign body
- Bacterial infection secondary to systemic, viral infection
- Oropharyngeal foreign body or injury
- Idiopathic
- Neoplasia
- Coagulopathy (coagulation disorder)
- Tooth root abscess
- Mycotic infection

Oropharyngeal foreign body or injury

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A cat with bradyarrhythmias suddenly has a cardiopulmonary arrest due to asystole. Which of the following is most correct?
- High dose of adrenaline should be used after the first CPR cycle
- Low dose of adrenaline should be used every cycle of CPR
- Atropine should be used every cycle of CPR
- Atropine should be used every other cycle of CPR

Atropine should be used every cycle of CPR

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During vaccination consultation the owners mention their dog “Fluffy” is chewing the door frame when she is left alone during the day and the neighbours have noticed she is barking and howling when alone. What is the best general advice to give to Fluffy’s owners?
- The dog needs to be treated “like a dog” and the owners need to show dominance behaviour towards it
- A barking collar should be used to stop the barking
- The dog will improve with some obedience training
- The dog may have a mental health disorder best addressed through a behavioural consultation
- The dog will likely grow out of the behaviour, so no treatment required

The dog may have a mental health disorder best addressed through a behavioural consultation

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An owner mentions that their dog is very reactive towards unfamiliar dogs when out on walks - when it sees another dog it will lunge towards the dog and bark with its hackles up. The dog has been doing this for the last 6 months since it was about 18 months of age. Select from the following options the most appropriate immediate suggestion you should make.
- Walk the dog as much as possible to expose and socialise it to other dogs
- Take the dog to a “balanced” trainer so that a professional who uses the four quadrants of learning can help the dog
- Stop taking the dog for walks as it is currently not beneficial and likely making the dog worse
- Take the dog to a dog park and let it be surrounded by unfamiliar dogs to get it used to them even if it is reacting aggressively

Stop taking the dog for walks as it is currently not beneficial and likely making the dog worse

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For the following clinical presentation, select the most likely diagnosis: 2 year old male cat, with dyspnoea, tachypnoea and pyrexia.
- Bacterial infection secondary to foreign body
- Bacterial infection secondary to systemic viral infection
- Oropharyngeal foreign body or injury
- Idiopathic
- Neoplasia
- Coagulopathy
- Tooth root abscess
- Mycotic intranasal infection
- Collapsing trachea
- Chronic bronchitis
- Cardiac disease
- Pneumonia
- Dirofilariasis
- Pyothorax
- Pneumothorax
- Pulmonary oedema

Pyothorax

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List the 4 M’s of dog behaviour treatment.

Psychotropic MEDICATION
Behaviour MODIFICATION
Environmental MANAGEMENT
MONITORING progress

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A dog is being treated for generalised anxiety with Fluoxetine 1mg/kg once daily. Four weeks after starting treatment the owner reports that there is no improvement in the dog’s behaviour. The owner is disappointed and wants to see some progress. What should be done next?
- Stop the fluoxetine immediately and start a different baseline medication
- Wean the dog off fluoxetine over 4 weeks and then start a different baseline medication
- Increase the fluoxetine to 2mg/kg SID
- Continue the fluoxetine for another 4 weeks before reassessing its effect

Continue the fluoxetine for another 4 weeks before reassessing its effect

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A 10 year old male neutered 31kg mixed breed dog is presented because of frequent coughing and mild lethargy over the last 24 hours. His vital signs are: rectal temp 39.5, heart rate of 80 beats per minute with a respiratory sinus arrhythmia, respiratory rate of 30 breaths per minute. On thoracic auscultation, loud harsh sounds are heard over the trachea and lung fields and a grade IV/VI systolic murmur is heard the loudest over the left apex beat.
Based on this data is the dogs cough more likely to reflect a primary respiratory system problem or a primary cardiovascular system problem? Explain your reasoning.

Primary respiratory.
- Mild pyrexia fits respiratory infection not cardiac insufficiency
- Harsh respiratory sounds and mild lethargy: if cardiovascular might expect soft crackles over lung fields and marked lethargy.
- Normal HR: if cardiovascular might expect tachycardia
- Sinus arrhythmia heard: if cardiovascular might expect dog to be stressed and therefore to not hear respiratory sinus arrhythmia

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“Troy” a 5 year old female speyed Great Dane presents with weight loss and intermittent diarrhoea of 2 months duration. No changes in appetite, thirst or activity level have been noticed.
On examination you find the following:
- Mucous membranes pink and moist
- CRT 1 second
- HR 80
- Abdominal palpation appears normal
- Temp 38.2
- Body condition score 3/9

Based on the history and clinical signs which of the following differential diagnoses is most likely?
- Intestinal nematodes, cryptosporidiosis, exocrine pancreatic insufficiency, intussusception
- Inflammatory bowel disease, giardiasis, intestinal lymphoma, food intolerance
- Parvovirus infection, Salmonellosis, hepatic failure, Addison’s disease
- Arsenic poisoning, rotavirus infection, intestinal nematodes, Campylobacter infection

Inflammatory bowel disease, giardiasis, intestinal lymphoma, food intolerance

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A prescription hydrolysed diet could be considered for Troy. What is the mechanism of action of these diets?
- Pre-digestion of proteins results in peptides that are too small to aggregate IgE
- Hydrolysis of carbohydrates reduces their antigenicity
- Proteins are pre-digested to aid absorption through the intestinal wall
- Hydrolytic enzymes in the diet complement amylase, lipase and trypsin

Pre-digestion of proteins results in peptides that are too small to aggregate IgE

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You perform all of the following:
- Faecal sample - negative for bacterial, parasitic and protozoal pathogens
- Haematology and biochemistry profile - all parameters within normal ranges
- Abdominal radiographs - no abnormal findings
- Abdominal ultrasonography - no abnormal findings
- Endoscopy performed by a specialist - intestines appear normal

If the faecal sample had revealed giardia trophozoites, what would have been the most effective treatment for Troy?
- A 2 week course of potentiated sulphonamides
- A 5 day course of fenbendazole
- A single dose of milbemycin
- Two doses of praziquantel given 7 days apart

A 5 day course of fenbendazole

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Which of the following tests would be LEAST valuable in the further investigation of Troy?
- Intestinal biopsies taken at the time of endoscopic examination
- Prescription diet trial
- Barium radiographic contrast study
- Measurement of Trypsin like immunoreactivity

Barium radiographic contrast study

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A 10 year old Rottweiler has been vomiting intermittently for the past week. The dog is mildly lethargic and the owners believe it may be slightly polydipsic. Appetite is reduced. The owners have brought the dog in because there was a small quantity of blood in the vomitus this morning. What would be the most appropriate course of action?
- Feeding a bland diet for 3 days along with a course of maropitant
- Prescribing a 5 day course of metoclopramide
- Analysing a blood sample for evidence of metabolic disease
- Admitting the dog to hospital for fluid therapy and observation

Analysing a blood sample for evidence of metabolic disease

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A 5 year old male intact Beagle presents with a 2 day history of vomiting followed by acute lethargy. Physical examination reveals tacky mucous membranes, a heart rate of 140bpm, guarding of the abdomen and a temperature of 39.9. Which of the following would be the most likely diagnosis?
- Pancreatitis
- Prostatitis
- Gastritis
- Hepatitis

Pancreatitis

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If Troy was eventually diagnosed with lympho-plasmacytic enteritis, what would be the most appropriate treatment combination?
- Metronidazole and a low fat diet
- Prednisolone and a limited antigen diet
- Loperamide and a hydrolysed diet
- Sulphasalazine and a bland diet

Prednisolone and a limited antigen diet

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The owners of a 3 year old 15kg Staffy inform you they have seen the dog swallow a smooth pebble approx. 3cm in diameter approx. 24 hours ago. What is the most appropriate recommendation?
- Advise that the pebble is likely to pass naturally
- Wait to see if it is vomited back up
- Perform a laparotomy to allow surgical removal
- Admit the dog for abdominal radiography

Admit the dog for abdominal radiography

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Which of the following statements concerning bacterial tonsilitis in dogs is most correct?
- It is commonly seen in dogs following infection with parainfluenza virus
- Bacterial tonsilitis does not occur in dogs
- It can be associated with dental disease in small breed dogs
- The most obvious clinical sign is a productive cough

It can be associated with dental disease in small breed dogs

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Which of the following is the most likely cause of oesophagitis?
- Anaesthesia
- Chronic coughing
- Myasthenia gravis
- Lead poisoning

Anaesthesia

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A 4 month old German Shepherd dog is presented for persistent regurgitation that occurs immediately after eating. What is the most likely diagnosis?
- Persistent right aortic arch
- Helicobacter infection
- Ruptured gall bladder
- Gastric carcinoma

Persistent right aortic arch

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Which of the following liver disorders is least likely to be seen in a cat?
- Nodular hyperplasia
- Suppurative cholangiohepatitis
- Hepatic lipidosis
- Lymphocytic cholangitis

Nodular hyperplasia

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What constitutes the syndrome referred to as “triaditis” in cats?
- Pancreatitis, inflammatory bowel disease, cholangitis
- Cholangitis, pancreatitis, gastritis
- Lymphadenitis, pancreatitis, cholangitis
- Pancreatitis, hepatic lipidosis, inflammatory bowel disease

Pancreatitis, inflammatory bowel disease, cholangitis

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What best describes the characteristics of pancreatitis in dogs? - It is an acute disease associated with high mortality - It typically causes a palpable abdominal mass in the cranial abdomen - It causes release of pancreatic lipase into the circulation - It is seen more commonly in toy breeds

- It causes release of pancreatic lipase into the circulation

Which combination of increased liver enzymes typically indicates cholestasis? - ALP and GGT - ALT and ALP - ALT and AST - AST and ALP

- ALP and GGT

What is the mode of action of Urso-deoxycholic acid (UDCA)? - Stimulates bile flow - Reverses hepatic lipidosis - Anti-oxidant effect - Appetite stimulant

- Stimulates bile flow

A 7 year old male neutered kelpie is presented for mild lethargy. Examine the CBC results below. 1) What is the single most important abnormality? 2) What is the likely diagnosis? 3) What drug is recommended to treat this condition?

1) Marked lymphocytosis (increased lymphocytes) 2) Lymphocytic leukemia 3) Chlorambucil

Match the disease on the left with the most appropriate corresponding statement on the right. You can only use each answer once. - Megaoesophagus - Gastric ulceration - Oesophagitis - Suppurative cholangiohepatitis - Campylobacter infection - Exocrine pancreatic insufficiency - Pancreatitis - Histiocytic ulcerative colitis - Inflammatory bowel disease - Hepatic lipidosis

Megaoesophagus: - Can be secondary to myasthenia gravis Gastric ulceration - Can be caused by renal failure Oesophagitis - Can be seen following general anaesthesia Suppurative cholangiohepatitis - Is associated with ascending... Campylobacter infection - Is more common in dogs fed a... Exocrine pancreatic insufficiency - Is most commonly seen in German Shepherd dogs Pancreatitis - Can be triggered by a high fat diet Histiocytic ulcerative colitis - Is most commonly seen in Boxers Inflammatory bowel disease - Requires treatment with prednisolone Hepatic lipidosis - Can be caused by anorexia

What is the specific medical term for the lesions seen in this dog's oral mucous membrane (small red / purple dots) and what is the blood abnormality most likely to cause this?

- Petechiae - Thrombocytopenia

The following haematology values are from a 9 year old female dog with lymphosarcoma, immediately before her first dose of chemotherapy with vincristine (baseline) and then one week post vincristine. The dog is anaemic at baseline and in week 1. Which of the following statements is the best explanation?

- Normocytic, normochromic, non regenerative anaemia due to lymphosarcoma

A 12 year old male neutered cat was presented for sudden onset inappetence and lethargy. The cat had no previous health problems and was normal the day before the signs were noticed. Physical examination was unremarkable apart from pale mucous membranes. Laboratory investigation included a complete blood count and serum chemistry panel. The only serum chemistry abnormality was slightly increased bilirubin. 1) Taking into account the history and laboratory test, what is your assesment of this cat's condition? 2) List 2 logical tests or procedures you would like to perform to further investigate the cat's condition. For each test or procedure provide a very brief reason for your recommendation.

- Moderate normocytic normochromic non-regenerative anaemia - This reflects chronic disease or pre-regenerative post loss (bleeding, haemolysis) - Heinz bodies normal in cat but raise possibility of oxidative damage (toxin e.g. onion or garlic) - Icteric serum with raised bilirubin suggests haemolysis - No history or physical evidence of bleeding but cannot rule out bleeding in body cavity - Reduced platelet count might support consumption due to bleeding or platelet destruction - Bleeding in GIT unlikely since serum chemistry is normal Tests to perform: - Abdominal ultrasound to check for potential peritoneal cavity effusion (bleeding) - Thoracic radiographs to check for potential pleural cavity effusion (bleeding) - Saline (auto) agglutination +/- Coomb's test to check for immune-mediated haemolytic anaemia

During your desexing clinic training you have been instructed to use the most appropriate instrument for each step of a procedure, taking into consideration the size of the animal. For the following steps choose the most appropriate instrument. - To extend your initial blade scalpel stab incision into the linea alba to open up the abdomen in a 3kg cat - To make the stab incision into the linea alba of a 2kg cat - To hold the linea alba whilst making the initial stab incision to enter the abdomen in a 3kg cat - To hold up the linea alba whilst making the initial stab incision to enter the abdomen in a 30kg dog - The instrument used to make a subcutaneous tunnel, by elevating the subcutaneous tissue from the external rectus sheath, exposing the linea alba in a 15kg dog spay - To clamp the uterine body before ligation in a 4kg cat - To clamp the ovarian pedicle before ligation in a 6 month old prepubescent kitten spay weighing 2kg - To clamp the ovarian pedicle before ligation in a 10kg dog spay - To clamp the ovarian pedicle before ligation in a 40kg dog spay - To extend your initial scalpel blade stab incision into the linea alba and to open up the abdomen in a 30kg dog - To grasp the proper ligament to assist manipulation of the uterine horn and ovary during a spay - The forceps used to atraumatically grasp abdominal contents in a cat eg. bladder or intestines - To provide temporary haemostasis of a small bleeding vessel in the subcutaneous tissue - Tissue forceps used when applying skin sutures in a cat - Grasping the subcutaneous tissue during a simple continuous layer closure in a dog castrate - To retract both medial edges of the subcutaneous tissue to improve visualisation during linea alba suturing - After ligation of the spermatic cord the instrument used to grasp the ductus deferens only, immediately before releasing the pedicle back into the tunics

To extend your initial blade scalpel stab incision into the linea alba to open up the abdomen in a 3kg cat - Straight Metzenbaum scissors To make the stab incision into the linea alba of a 2kg cat - Scalpel - number 15 blade To hold the linea alba whilst making the initial stab incision to enter the abdomen in a 3kg cat - Adson forceps To hold up the linea alba whilst making the initial stab incision to enter the abdomen in a 30kg dog - Rat tooth forceps The instrument used to make a subcutaneous tunnel, by elevating the subcutaneous tissue from the external rectus sheath, exposing the linea alba in a 15kg dog spay - Curved Metzenbaum scissors To clamp the uterine body before ligation in a 4kg cat - Curved crile forceps To clamp the ovarian pedicle before ligation in a 6 month old prepubescent kitten spay weighing 2kg - Halstead Mosquito forceps To clamp the ovarian pedicle before ligation in a 10kg dog spay - Curved Crile forceps To clamp the ovarian pedicle before ligation in a 40kg dog spay - Curved Rochester Carmalt forceps To extend your initial scalpel blade stab incision into the linea alba and to open up the abdomen in a 30kg dog - Straight Mayo scissors To grasp the proper ligament to assist manipulation of the uterine horn and ovary during a spay - Halstead Mosquito forceps The forceps used to atraumatically grasp abdominal contents in a cat eg. bladder or intestines - DeBakey forceps To provide temporary haemostasis of a small bleeding vessel in the subcutaneous tissue - Halstead Mosquito forceps Tissue forceps used when applying skin sutures in a cat - Adson Brown forceps Grasping the subcutaneous tissue during a simple continuous layer closure in a dog castrate - Adson Brown forceps To retract both medial edges of the subcutaneous tissue to improve visualisation during linea alba suturing - Allis Tissue forceps After ligation of the spermatic cord the instrument used to grasp the ductus deferens only, immediately before releasing the pedicle back into the tunics - Halstead Mosquito forceps

The perforated section of a chest drain ideally sits: - Along the dorsal aspect of the chest - In the middle of the chest (1/2 way between spine and sternum) - Along the ventral floor of the chest - Partially in the subcutaneous tissues and partially in the thoracic cavity

- Along the ventral floor of the chest

With regards to tracheostomy tube placement in dogs which of the following is correct? - Provide permanent airway access for laryngeal collapse - Should be about 70% the diameter of the trachea - Should pass greater than 6 tracheal rings when in situ - None of the above

- None of the above

Regarding "Flail chest" in a dog choose the correct answer. - It is an inherent weakness of an anatomically normal chest wall due to old age - A condition that develops when 1 rib is fractured - A condition that develops when 2 or more ribs are fractured, once along each rib - A condition that develops when several adjacent ribs are fractured, in two or more places along each rib

- A condition that develops when several adjacent ribs are fractured, in two or more places along each rib

A client calls up in distress. "Lucky" her 10 year old male neutered Golden retriever has just collapsed in the back yard and is unable to get up. She thinks he isn't breathing well and feels cold to touch. She is driving to the veterinary hospital and will arrive in 3 minutes. List the steps within the primary survey you should take to assess "Lucky" when he arrives.

3H's: History / Hello - introduction to the patient (the primary complaint, time of onset, past pertinent medical conditions) Help - triage is a team game, optimum is 5 people for the animal to recover Hazard - ensure the team is safe (drugs, protective gloves, restraint devices, muzzles) A - air - immediately provide O2 to critical patients, check if there is a patent airway B - breathing - assess how the patient is breathing (e.g. cyanosis, open mouthed breathing) C - circulation - assess how perfusion is to tell if we are in shock (pulse presence & strength, MM colour, CRT, HR & rhythm, temp, BP, lactate) D - demeanour - neurological assessment (Alert, responsive to Voice, responsive only to Pain, Unresponsive, Pupil check) E - everything else

In severe tracheal trauma it is possible to resect up to ... percentage of the total tracheal length - 5% - 10% - 15% - 20% - 25%

- 20%

Regarding "Flail chest" on a dog choose the correct answer: - The flail chest segment expands on inspiration - The flail chest segment collapses on expiration - The flail chest segment collapses on inspiration - The flail chest segment has no effect on respiration

- The flail chest segment collapses on inspiration

When in shock patients may present with several different clinical signs or measurable abnormalities. List any 6 of these.

- Vasoconstriction: pale MM, prolonged CRT, peripheral temperature < core temperature, reduced urine output - Decreased mentation - Tachycardia (cats may present with bradycardia) - Hypotension (poor pulse quality) - Reduced oxygen saturation (low SpO2) - Lactate >2 mmol/L - Metabolic acidosis

Which of the following statements regarding mammary neoplasia is most correct? - Surgical lumpectomy is an appropriate treatment for a small solitary mass in a single gland in the dog and cat - Surgical lumpectomy is an appropriate treatment for a small solitary mass affecting a single gland in the dog but not in the cat - Surgical lumpectomy is an appropriate surgical treatment for a small solitary mass in the cat but not in the dog - Surgical lumpectomy is never an appropriate treatment for a small solitary mass affecting a single gland in the dog or the cat

- Surgical lumpectomy is an appropriate treatment for a small solitary mass affecting a single gland in the dog but not in the cat

Which of the following statement regarding oral tumours in cats is most correct? - Squamous cell carcinoma is the most commonly identified oral tumour in cats - Oral melanomas at this location is relatively benign and rarely spreads - Biopsy of oral masses or ulcers is rarely indicated as it does not affect the surgical treatment - Surgery is rarely an option for oral neoplasia in cats as the bone is frequently involved

- Squamous cell carcinoma is the most commonly identified oral tumour in cats

Regarding cervical sialocoele in dogs which of the following responses is most correct? - Removal of the mandibular and sublingual salivary glands on the ipsilateral side is indicated - The mucocoele is surrounded by a secretory lining that must be excised - Repeated needle drainage is effective in 50% cases and should be performed first - Removal of the parotid and sublingual salivary glands on the ipsilateral side is indicated

- Removal of the mandibular and sublingual salivary glands on the ipsilateral side is indicated

Which of the following is NOT a reason to elect to perform a hysterectomy over hysterotomy for caesarean section in the bitch? - Where there is evidence of foetal distress - To minimise abdominal contamination - To minimise surgical time - Where there are dead foetuses

- Where there is evidence of foetal distress

Regarding pyometra in the dog which of the following statements is NOT correct? - Pyometra occurs in oestrus typically 4-10 weeks after last dioestrus - Cystic endometrial hyperplasia develops first followed by asceding infection with bacteria from the vagina or lower urinary tract - Pus may enter the abdomen from uterine rupture or via the oviducts - Clinical signs of polyuria and polydipsia, lethargy and vaginal discharge are often accompanied by azotaemia and dehydration

- Pyometra occurs in oestrus typically 4-10 weeks after last dioestrus

Regarding oral tumours in dogs which of the following statements is most correct? - Wide surgical excision with rostral mandibulectomy may be curative for a small squamous cell carcinoma associated with the lower central incisor teeth - Malignant melanoma appears as a dark pigmented tumour on the gingiva, lip or tongue - There is a vaccination available for management of fibrosarcoma after surgery available from oncologists - Pulmonary spread of fibrosarcoma is common around 80%

- Wide surgical excision with rostral mandibulectomy may be curative for a small squamous cell carcinoma associated with the lower central incisor teeth

Charlie a 12 month old Labrador is presented with a distal cervical oesophageal foreign body as seen in the radiograph below. The owners observed the dog swallow the foreign body 3 days ago. What clinical signs would you expect this dog to show? - Regurgitation after eating, diarrhoea, severe dyspnoea - Regurgitation after eating and drinking, ptyalism, dehydration, coughing

- Regurgitation after eating and drinking, ptyalism, dehydration, coughing

What would be the best treatment option for Charlie? (Dog with distal cervical oesophageal foreign body) - Attempt endoscopically oral retrieval first, if unsuccessful perform a cervical esophagostomy - Push the foreign body into the stomach, as it is easier to remove from that location - Proceed immediately to a cervical esophagostomy - Place the dog on intravenous fluids to allow rehydration of the surrounding soft tissues and then wait for the foreign body to pass through the gastrointestinal tract

- Attempt endoscopically oral retrieval first, if unsuccessful perform a cervical esophagostomy

Which of the following statements about oesophageal healing is correct?

- Tension on an oesophageal wound closure is likely to result in stricture formation

When closing a distal cervical esophagotomy, to achieve the greatest initial strength it is best to: - Close the mucosa and muscularis in two layers, leaving the mucosal knots intraluminally - Close the mucosa and muscularis in a single layer, leaving the knots extraluminally - Close the mucosa and muscularis in a single layer, but leave the knots intraluminally - Either single or two layered closure can be used as both closures have similar initial strength and healing potential

- Close the mucosa and muscularis in two layers, leaving the mucosal knots intraluminally

Dumbo an 8 month old male castrated Basset hound is presented with a history of vomiting and anorexia for 2 days. No diarrhoea has been observed by the owner. The dog is now lethargic. You take the following radiographs. If Dumbo has a gastric dilatation and volvulus (GDV) which of the following statements is correct regarding serum lactate levels? - A very high lactate level means the dog will die, so surgical exploration is not indicated - Dogs with a lactate level over 6 have a worse prognosis due to a higher chance of gastric necrosis - Dogs with a decrease in serial lactate levels of 40% taken 2 hours apart have a good prognosis - It is normal for the lactate level to stay high for 48hr post GDV surgery

- Dogs with a lactate level over 6 have a worse prognosis due to a higher chance of gastric necrosis

Antibiotic coverage for a small bowel resection surgery should be ideally started: - After surgery has finished - Intravenously at induction to obtain high circulating blood levels at the time of surgery - Orally to achieve high concentrations in the gut at the time of surgery - Subcutaneously at the time of pre medication

- After surgery has finished - Intravenously at induction to obtain high circulating blood levels at the time of surgery

You speak with Dumbo's owners about the radiographic findings and strongly suggest that the pup needs an exploratory surgery. From the list below select the most important concern that you should discuss with them about the risks of taking the pup to surgery. - Hyperproteinaemia will delay wound healing - Hypoproteinaemia will increase the risk of dehiscence of the bowel if resection is needed - Paralytic ileus may not be reversed as the bowel is too distended - The peripheral effusion will affect the pup's ability to ventilate under anaesthesia during the laparotomy

- Hypoproteinaemia will increase the risk of dehiscence of the bowel if resection is needed

When you open an abdominal cavity the intestines need to be moved outside the abdominal cavity and kept there whilst you inspect the deeper structures. Select the best way to decrease surgical trauma to the exteriorised bowel from the following options: - Place dry laparotomy sponges down on the drapes prior to exteriorising the gut - Place the gut directly onto the drapes but cover with moist laparotomy sponges - Place the bowel between moistened laparotomy sponges - Place the gut directly onto the drapes and cover with a sterile impermious plastic sheet

- Place the bowel between moistened laparotomy sponges

Dumbo (possible obstruction / GDV on radiographs). From the two radiographs above the primary finding that will guide you whether to surgical explore the abdomen is: - The pup probably has a partial intestinal obstruction - There is a large peritoneal effusion - The pup probably has a complete intestial obstruction - The pup has a gastric dilatation volvulus

- The pup probably has a complete intestial obstruction

If at Dumbo's surgery you found this foreign body in the jejunum, where would you make your enterotomy? A - just to the left of the obstruction (oral direction) B - at the obstruction (oral direction) C - at the obstruction (aboral direction) D - to the right of the obstruction (aboral direction)

Incising on the antimesenteric border from point C to D (aboral)

After an intestinal resection and anastomosis, what type of suture pattern causes the least intraluminal narrowing? - Inverting - Everting - Appositional - All cause similar amounts of narrowing

- Appositional

What suture material should ideally be used for the anastomosis of the large intestine in a low tension situation? - Short acting e.g. Poliglecaprone - Medium acting braided e.g. Polyglactin 910 - Long acting Monofilament e.g. Polydioxanone - None absorbable monofilament e.g. Nylon

- Long acting Monofilament e.g. Polydioxanone

If at Dumbo's surgery you find that the ileum has become intussuscepted into the colon at the ileocaecal colic junction, your next step would be to: - Manually reduce the intussusception via gentle traction and assess the viability of the bowel prior to resecting any tissue that appears not to be viable - Resect the entire ileocaecal colic junction en bloc and perform ileocolic end to end anastomoses without attempting to reduce the intussusception - Do not perform surgery on the intussusception as the dead bowel inside will pass into the colon and be passed with the stool - Leave the intussusception as is, then pursue medical management as intussusceptions are usually due to intestinal parasites which are easily treated

- Manually reduce the intussusception via gentle traction and assess the viability of the bowel prior to resecting any tissue that appears not to be viable

If you were to reduce the intussusception, how would you assess the viability of the intestines after reduction? - Good pink colouration of all of the affected tissue - Evidence of peristalsis returning to the section of gut - Pulses in the mesenteric vessels supplying the affected gut - All of the above are indicators of viability

- All of the above are indicators of viability

You plan to monitor Dumbo for any early signs of infectious peritonitis in case the anastomosis site dehisces. This is best done by: - Palpating the abdomen for post operative pain - Radiographing the abdomen every 24 hours looking for the ground glass appearance - Performing an ultrasound of the abdomen every 24 hours - Placing active suction drains in the abdomen at the time of surgery and performing cystology and glucose levels on the abdominal fluid

- Placing active suction drains in the abdomen at the time of surgery and performing cystology and glucose levels on the abdominal fluid

When closing the linea alba after a laparotomy, what layer has the most strength and must be included in a simple continuous closure? - Internal rectus sheath - Rectus abdominus muscle - External rectus sheath - Peritoneum

- External rectus sheath

What effect will just removing the ileocaecal valve have on Dumbo? - The dog will not be able to absorb any vitamin B - The dog will have an increased functional transit time (slows down passage) - The dog will have a decreased functional transit time (speeds up passage) - Stricture formation is more likely than in other areas of the small or large intestinal tract

- The dog will have a decreased functional transit time (speeds up passage)

A 10 year old DSH cat weighing 4kg needs a tooth extraction. If using lignocaine 1% in the local block, what would be the usual volume of lignocaine considered to be safe in this cat? - 0.04 mls - 0.4 mls - 1.4 mls - 2.0 mls

- 0.4 mls (10% bodyweight)

Regarding the local anaesthetic agent used in local blocks, which of the following statements is correct? - Lidocaine has a rapid onset (2-5 minutes) but limited duration (30-120 minutes) - Bupivicaine has a slightly longer onset (30-60 minutes) than lidocaine but has a longer duration (>12 hours) - Bupivicaine administration should not exceed 3 mg/kg in dogs or cats - Lidocaine administration should not exceed 2 mg/kg in dogs or cats

- Lidocaine has a rapid onset (2-5 minutes) but limited duration (30-120 minutes)

Which of the following oral nerve blocks is most appropriate to extract a right upper canine tooth fracture?

- Right infraorbital nerve block

Below are the radiographs of a 7 year old Golden Shepherd presenting with sudden onset gagging and pacing. What is the diagnosis?

- Gastric dilatation with volvulus

What is the normal number of adult teeth in the dog?

What is the normal number of adult teeth in the cat?

This radiograph of the rostral lower jaw of a 10 year old domestic shorthair cat named "Higgins" shows that all the mandibular incisors are missing. Using the modified Triadan system what is the number given to the tooth marked with a red arrow (left mandibular canine).

304

"Bob" a 4 year old Labrador was booked in for a dental scale and polish. His upper right 4th premolar is pictured below. Once anaesthetised you manage to advance a probe into the pulp canal. Using the modified Triadan tooth system, what is the number that corresponds to this tooth?

108

This radiograph of the rostral lower jaw of a 10 year old domestic shorthair cat named "Higgins" shows that all the mandibular incisors are missing. What type of tooth resorption (TR) is occuring with both of Higgin's teeth in this radiograph? - Type 1 (inflammatory) TR - Type 2 (idiopathic) TR - Type 3 (mixed) TR - There is no TR present

- Type 1 (inflammatory) TR

"Bob" a 4 year old Labrador was booked in for a dental scale and polish. His upper right 4th premolar is pictured below. Once anaesthetised you manage to advance a probe into the pulp canal. What damage has occurred to Bob's tooth? - Enamel ... - Crown-root fracture - Uncomplicated crown fracture - Complicated crown fracture

- Complicated crown fracture

Higgins has type 1 (inflammatory) tooth resorption. What treatment is indicated for both of Higgin's teeth in the radiograph? - Extraction - Crown amputation and intentional retention of the roots - Root canal therapy - No treatment is indicated

- Extraction

Bob's tooth has a complicated crown fracture. What is the most appropriate treatment plan for Bob's tooth? - Extraction - Root canal - Monitor until it causes a problem - Both extraction and root canal should be offered to the client

- Both extraction and root canal should be offered to the client

How common are caries (tooth decay) lesions in the cat? - Most cats develop them as they get older - They are not common - They have occasionally been reported - They have never been reported in the cat

- They have never been reported in the cat

If type 2 (idiopathic) tooth resorption is diagnosed in a cat's tooth it is likely that: - Only the one tooth is affected - Another one or two teeth are likely affected - Many or all teeth are affected, but this may only be microscopic - The diagnosis is ... since cats always have an underlying cause

- Many or all teeth are affected, but this may only be microscopic

The following history and radiograph relate to the next 3 questions. Below is a radiograph of the RIGHT caudal mandible of a 10 year old poodle. The largest tooth in the radiograph is the right mandibular carnassial tooth. The blue arrow is pointing to the tooth immediately caudal to the carnassial. The tooth the blue arrow is pointing to is the: - 1st molar - 2nd molar - 3rd premolar - 4th premolar

- 2nd molar

The following history and radiograph relate to the next 3 questions. Below is a radiograph of the RIGHT caudal mandible of a 10 year old poodle. What disease process is occurring in the tooth the blue arrow is pointing to? (Looks like hole between tooth & gum line) - Type 1 tooth resorption - Type 2 tooth resorption - Periodontal disease - Root fracture

- Periodontal disease

Tooth with periodontal disease (hole between tooth & gum). What is the treatment of choice for the tooth the blue arrow is pointing to? - Complete extraction - Guided tissue regeneration - Root canal treatment - No treatment is required

- Complete extraction

Consider the patients below and their signalments. Which patient would be at the highest risk of an adverse systemic reaction whilst receiving Paralysis Tick Antiserum if required? - A 5 year old cat that has received a Tick antitoxin serum infusion only once before - A 13 year old cat that has received a blood transfusion - A 6 month old dog that is ... - A 16 year old dog with severe chronic kidney disease

- A 5 year old cat that has received a Tick antitoxin serum infusion only once before (Cats are high risk, even without receiving a transfusion before. Cats already sensitised to TAS have a very high risk of transfusion reactions and careful monitoring should be instituted)

When using the gait and respiratory scoring system for tick paralysis in a dog or cat, which of the following factors is NOT associated with a worse prognosis? - Low respiratory score on presentation - High gait score on presentation - Old age - Rapid worsening of clinical signs

- Low respiratory score on presentation

An acutely ill unvaccinated 6 month old puppy with a fever, vomiting and diarrhoea, tachypnoea, an enlarged liver and corneal oedema should be suscpected of having which of the following infections? - Canine Parvovirus - Canine Distemper Virus - Canine Adenovirus 1 - Severe Canine Tracheobronchitis

- Canine Adenovirus 1

A 4 year old cat is presented for acute onset tetraparesis after being seen playing with a brown-coloured snake. A snake venom detection test and coagulation test results are compatible with brown snake envenomation. To reduce the chance of a systemic adverse reaction, what should the cat be medicated with before during infusing a vial of brown snake antivenom? - Low dose Adrenaline only - Anti-histamine and corticosteroid together - Cortcicosteroid only - None of the above

- None of the above

Which of the following is NOT a zoonosis? - Feline immunodeficiency virus - Toxoplasmosis - Rabies - Leptospirosis

- Feline immunodeficiency virus

A new puppy owner has been told by the breeder that she should not vaccinate her puppy with a C5 vaccine because one of the breeder's dogs was vaccinated with a C5 vaccine and got kennel cough as a result. With regard to this reasoning, which of the following is NOT correct? - The breeder's dog may have had preclinical tracheobronchitis at the time of the vaccination - The intranasal vaccine can cause mild transient clinical signs and that is normal - Respiratory virus vaccines do not provide 100% protection against disease - Using the intranasal vaccine subcutaneously avoids causing clinical disease

- Using the intranasal vaccine subcutaneously avoids causing clinical disease

What distinctive and diagnostically useful clinical feature of canine distemper often develops about day 7 to 21 of illness? - Cardiomyopathy - Conjunctivitis - Fever - Myoclonus (e.g. facial "ticks")

- Myoclonus (e.g. facial "ticks")

All of the following are true features of the feline calicivirus (FCV) carrier state EXCEPT: - Virus is shed continuously by carriers - High, medium and low level shedders exist - Virus is shed from the tonsils and oropharynx Only about 50% of carriers are shedding by 75 days post infection - Vaccination prevents carriers from shedding virus

- Vaccination prevents carriers from shedding virus

Apart from wasting and cachexia, what are the most common "terminal phase" features of feline immunodeficiency virus infection? - Stomatitis, gingivitis - Panleukopenia like illness, acute diarrhoea - Neurological signs, rage - Severe anaemia, pallor

- Stomatitis, gingivitis

What is a likely cause of severe conjunctivitis ("red eye") in a cat that starts in one eye and several days later spreads to involve the other eye? - Feline immunodeficiency virus - Chlamydia felis

- Chlamydia felis

In geriatric patients cardiac output is often increased. True / false?

False

Due to the hormonal and associated physiological changes in pregnant animals the minimum alveolar concentration of inhalant anaesthetics is increased. True / false?

False

You decide to test a cat for feline immunodeficiency virus (FIV) infection. Consider the list below of possible reasons for false positive and false negative diagnostic test results. a) Healthy, uninfected 10 week old kitten bore to an infected mother b) Recently infected cat c) Recently vaccinated cat d) Overwhelming end-stage disease in an infected cat Which 2 of these 4 choices could most plausibly cause false negative test results when using a conventional 'in practice' rapid immunomigration diagnostic test kit for diagnosis of FIV infection?

b & d (recently infected cat + overwhelming end-stage disease in an infected cat)

List 3 methods you can use to confirm correct placement of an endotracheal tube following intubation?

1. Visualise with laryngoscope blade on top of tube to see both arytenoids 2. Look for condensation of the ET tube 3. Use a capnograph

During anaesthesia of dogs and cats there are number of common complications which can occur and may result in patient morbidity. List 3 of these common complications and provide the likely cause for each.

Hypotension (MAP <60mmHg or SAP <80 mmHg) = too great anaesthetic depth can cause this Hypercapnia EtCO2 > 50-55mmHg Hypoxaemia SpO2 = 95% or PaO2 <80mmHg Hypothermia T <33-35 Regurgitation leading to aspiration pneumonitis Haemorrhage leading to hypotension, decrease PCV and thus oxygen delivery

The following lead II trace was recorded from a dog under anaesthesia. a) Describe the rhythm = 2nd degree AV block (p waves followed by no QRS complexes) b) Is this rhythm normal? If not, how would you treat it?

Not normal (there are p waves without QRS complexes). Treat with lignocaine bolus +/- CRI

Clomipramine is a: - TCA, which is a triceptide antidepressant, a serotonin and noradrenaline reuptake inhibitor - TCA, which is a tetracyclic antidepressant, a serotonin and noradrenaline reuptake inhibitor - TCA, which is a tricyclic antidepressant, a serotonin and noradrenaline reuptake inhibitor - TCA, which is a tricyclic antidepressant, a specific serotonin reuptake inhibitor

- TCA, which is a tricyclic antidepressant, a serotonin and noradrenaline reuptake inhibitor

Cats can live as solitary hunters or in colonies. When cats form a larger group it is often comprised of: - Linear dominane hierarchy with females being more dominant than males - Mixed male and female groups with frequent changes in social structure - Related females and their offspring - Patrilineal groups of related females

- Related females and their offspring

You are in a consultation with a dog that is showing signs of aggression towards you. It is staring at you, growling, hackles are up and is barking at you. What traffic light zone is this dog in? - Lights out zone - Orange zone - Green zone - Red zone

- Red zone

A dog presents to you in consult with the owner reporting firework phobia every New Year's Eve. You recommend medication, behaviour modification and environmental management steps. Which one of the following medications is not an appropriate "as needed" medication for a dog with noise phobia? - Alprazolam - Diazepam - Acepromazine - Trazadone

- Acepromazine

A 2 year old desexed male German Shepherd dog is presented to you with increasing levels of aggression. He shows aggression to visitors on arrival, aggression to the veterinarian during examination, the owner when she attempts to touch or pet him and towards the other dog in the household whenever the dog walks past him. In addition, he has developed a lick granuloma on his leg and is fearful of thunderstorms and fireworks. - It is clear that this dog suffers from problem behaviours and will need more training to stop his aggression - This dog shows behaviour typical for a young German Shepherd dog and will likely grow out of the aggression with age - Anxiety will be causing the lick granuloma and noise phobias but would not be involved in the aetiology of his aggression - From the history, it seems that this dog is suffering from multiple behaviour problems and will need a full behavioural consultation and treatment program

- From the history, it seems that this dog is suffering from multiple behaviour problems and will need a full behavioural consultation and treatment program

Which of the following statements regarding the psychotropic medications Fluoxetine and Clomipramine is correct? - Both are selective antagonist reuptake inhibitors - Both medications are for short term use, administered "as needed" and can be stopped and started as required - Both have some therapeutic actions at serotonin receptors by blocking serotonin reuptake into the presynaptic membrane - Both have therapeutic actions at the GABA neuroreceptor

- Both have some therapeutic actions at serotonin receptors by blocking serotonin reuptake into the presynaptic membrane

Genetic influences of behaviour are important to take into consideration when looking at behaviour cases. When faced with a fearfully aggressive 2-year old Jack Russel Terrier it is important to educate the owners that: - This breed is considered to be an aggressive breed, due to the breed genetics - Terriers are predisposed to reactivity and aggression due to their selective breeding line - Certain behaviour problems including some cases of aggression may run in family lines, regardless of breed - Genetics are unlikely to play any roll in behaviour of this kind

- Certain behaviour problems including some cases of aggression may run in family lines, regardless of breed

A 3 week old female Cairn terrier puppy began crying yesterday and has drunk no milk since then. She has been having greenish diarrhoea. Five of her six littermates died yesterday. She is euthanised and post mortem examination reveals blotchy haemorrhagic lesions throughout the lungs, liver and kidneys. What is the single most likely aetiological agent in this case?

Canine herpesvirus

A 5 month old female mixed breed dog from rural Victoria is presented with an incomplete vaccination history. The dog suddenly became severely ill with acute vomiting, diarrhoea and abdominal pain. Physical examination late on the first day of illness revealed fever (40.1), abdominal pain, hepatomegaly and tonsillar enlargement. 6 days later after intensive treatment the dog begins to recover but develops bilateral corneal oedema ("blue eye"). What is the single most likely aetiological agent in this case?

Canine adenovirus type 1

The reason why nowadays we so infrequently diagnose canine parvovirus (CPV) associated myocarditis in very young puppies is that: - Modern vaccines are able to break through maternal immunity and induce active immunity in vaccinated puppies early enough to prevent myocarditis - The virus has evolved, panleukopenia has replaced myocarditis as the most likely consequence of infection in very young puppies - CPV has evolved within its new canine host and no longer tends to cause this severe effect. It is gradually becoming less pathogenic in its new host - Much of the adult canine population is now immune: maternally transferred passive immunity protects puppies at the critical, early life stages when this disease can occur - CPV-associated myocarditis is actually difficult to confirm: we are probably failing to detect it although it remains present at a lower level

- Much of the adult canine population is now immune: maternally transferred passive immunity protects puppies at the critical, early life stages when this disease can occur

Feline calicivirus (FCV) vaccines do not provide complete protection against FCV. The most accurate explanation for this is: - Vaccine-induced immunity against this virus is short-lived, often much less than one year. - High, medium and low-level shedders exist - Carriers intermittently shed large amounts of virus, overwhelming the immune defences of vaccinated cats - Cross-protection between vaccine strains and the strains present in the community is incomplete

- Cross-protection between vaccine strains and the strains present in the community is incomplete

Image of cat eye with bright yellow (icterus) around the pupil. What is the most likely infectious cause of this black, feline corneal lesion? - Chlamydia felis - Feline leukemia virus - Feline calicivirus - Feline herpesvirus-1 - Feline immunodeficiency virus

- Feline herpesvirus-1

Why are young puppies repeatedly vaccinated with modified live virus vaccines in their first 16 weeks of life? - The first injection primes the immune system, the subsequent doses produce a stronger and stronger boosting response - Puppies vary in the maturity of their immune systems. Some puppies have a mature immune system when quite young, others take much longer for this maturity to develop. - Almost all vaccines require multiple injections - Maternal interfering antibodies prevent young puppies from mounting an immune response. We repeatedly vaccinate because of uncertainty about when the puppy will respond.

- Maternal interfering antibodies prevent young puppies from mounting an immune response. We repeatedly vaccinate because of uncertainty about when the puppy will respond.

Test kits for rapid diagnosis of FIV infection are commercially available for use in practice. Can these kits distinguish between a FIV-infected cat and an uninfected FIV vaccinated cat at 6 months after vaccination? - Some kits can, one kit cannot. You have to know which kits to use in vaccinated cats. - Yes. The antigens are sufficiently different between vaccine and natural infection. - Sometimes. It depends on how much antibody is "shrouding" the virus antigen - No. The antibody repsonses are too similar, they are indistinguishable. PCR must be used. - Maybe. It depends on which FIV clade or strain is infecting the cat.

- Some kits can, one kit cannot. You have to know which kits to use in vaccinated cats.

Although biphasic defibrillators are preferred because of their greater efficiency to treat VF and pulseless VT than monophasic defibrillators. The same dose chart can be used for both types of defibrillators. True / false?

False

The best chest compressions during CPR produce about ...% of cardiac output.

30%

After administration of the first low dose of adrenaline during CPR in a cat with a non-shockable rhythm, how long should you wait before giving another dose of vasopressor?

4 min

The goal of vasopressor therapy during CPR is to: - Correct metabolic acidosis - Increase cardiac contractility - Cause peripheral vasoconstriction - Increase heart rate and blood pressure

- Cause peripheral vasoconstriction

A patient recovering from a femur fracture repair suddenly collapses and becomes apnoeic. After starting the Basic Life Support (BLS) you monitor the ECG and at the end of the first BLS cycle you observe a rhythm with repeated QRS complexes and a rate of 110 bpm. There is no palpable pulse. Your rhythm diagnosis is: - Ventricular fibrillation - Perfusing rhythm - Pulseless Electrical Activity - Pulseless Ventricular Tachycardia

- Pulseless Electrical Activity

During CPR what is the minimum EtCO2 associated with effective chest compressions?

15mmHg

A cardiac murmur louder than S1 and S2 heart sounds that radiates to both sides of the thorax but with no palpable thrill would be most consistent with what grades of heart murmur?

3 or 4

Cardiac depolarisation usually begins in the: - Sino-atrial node - Atrioventricular node - Ventricular myocardium - Atrial myocardium

- Sino-atrial node

On physical examination of a 6-month old DSH cat you detect a systolic heart murmur (grade 5/6) that is loudest over the right heart apex. The murmur has a crescendo-decrescendo pattern. Which of the following is the most likely cause of the murmur? - Atrial septal defect - Tricuspid valve dysplasia - Aortic stenosis - Ventricular septal defect - Patent ductus arteriosus (PDA)

- Ventricular septal defect

Left sided congestive heart failure in the cat most often results in: - Only pulmonary oedema and never ascites or pleural effusion - Pulmonary oedema and pleural effusion - Pulmonary oedema and ascites - Pleural effusion and ascites

- Pulmonary oedema and pleural effusion

When monitoring the ECG of a dog under anaesthesia the only reliable lead to use is lead II. True / false?

False

Most monitoring of the electrocardiogram uses the three-lead system especially the lead II trace. Lead II measures the electrical conduction between which two limbs? - Right forelimb and left hindlimb - Left forelimb and left hindlimb - Right forelimb and left forelimb - Left forelimb and right hindlimb

- Right forelimb and left hindlimb

What is the most common cause of hypoventilation during general anaesthesia?

Too deeply anaesthetised

Which of the following complications is least commonly encountered in the anaesthesia of small animals? - Hypotension - Hypoxaemia - Hypothermia - Hypoventilation

- Hypotension

A dog is to be anaesthetised for removal of a very large cranial abdominal mass. During the procedure this mass is most likely to have a negative effect on the respiratory or cardiovascular system?

Respiratory

Which of the following drugs is least likely to cause a decrease in arterial blood pressure? - Alfaxalone - Acepromazine - Midazolam - Isoflurane

- Midazolam

During pregnancy there are many physiological changes that take place in the dam. Which of the following physiological changes has the LEAST impact on anaesthetic management? - An incease in alveolar ventilation - An increase in circulating blood volume - An increase in oxygen consumption - An increase in gastric emptying

- An increase in gastric emptying

Pre-oxygenation is an important part of patient preparation for anaesthesia. What is the most important physiological change associated with pre-oxygenation and what benefit does it provide?

It causes denitrogenation of the lungs so delays onset of hypoxaemia if apnoeic or difficulty intubating.

Certain breeds / classes of dog have specific characteristics that may increase their anaesthetic risk or require drug / dose modifications. Name a breed or class of dog that has a specific characteristic that can influence its anaesthetic management. In your answer include what this characteristic is and how it may affect your approach to its anaesthesia.

Brachycephalic breeds e.g. Pugs, French bulldogs. Have hypoplastic airways (BOAS - brachycephalic obstructive airway syndrome). Increased risk of hypoxia - preoxygenate prior to induction, leave ET tube in place for as long as possible when recovering, smaller ET tube required

In a patient under general anaesthesia, the EtCO2 was above your threshold to act. After deciding your patient is at an appropriate plane of anaesthesia, what action would you take next? - Manually ventilate for several breaths - Start mechanical ventilation - Increase the fresh gas flow rate - Ensure that the soda lime is not exhausted

- Start mechanical ventilation

When monitoring ETCO2 during anaesthesia above what level of mmHg would you decide to act?

45 mmHg

Which of the following is NOT a potential cause for laryngeal paralysis? - Hypothyroidism - A very large thyroid neoplasm - High negative inspiratory pressures - Cranial mediastinum neoplasia

- High negative inspiratory pressures

Regarding permanent tracheostomies which of the following is / are correct? - Decreases the risk of tracheal collapse - Allow easy access for anaesthesia in the upper airway patient - Is a salvage procedure - Is appropriate treatment for stage 1 laryngeal collapse

- Is a salvage procedure

A 5-year old Maltese terrier is presented to a vet for the first time for a chronic cough. After a thorough diagnostic evaluation you diagnose it with moderate intrathoracic tracheal collapse. How would you initially best manage the dog? - Application of an intraluminal stent into the thoracic trachea - Medical management including anti-inflammatories and anti-tussives - Application of an intraluminal stent in the cervical trachea - Application of external polypropylene rings

- Medical management including anti-inflammatories and anti-tussives

Which of the following are secondary upper airway diseases due to high negative inspiratory airway pressures? - Elongated soft palate - Stenotic nares - Hypoplastic trachea - All stages of laryngeal collapse

- All stages of laryngeal collapse

When performing a staphylectomy in a dog with brachycephalic airway syndrome it is important to resect the correct amount of tissue. What landmark is used to judge this length correctly? - Rostral margin of the tonsil crypt - The base of the epiglottis - Caudal margin of the tonsil crypt - Level with the rostral most portion of the cuneiform process

- Caudal margin of the tonsil crypt

The anatomic sites for chest drain placement are:

Penetrating the chest wall at the 7th or 8th intercostal space

If threatened a cat's preferred first line of defence is: - Escape - Curl up into a ball - Attack - Meow or hiss loudly

- Escape

Feliway is: - A drug used to treat aggression in cats - A synthetic pheromone that mimics the natural familiarity pheromone - A strong-smelling spray to deter cats from soiling outside the tray - A disinfectant used to disguise the smell of urine

- A synthetic pheromone that mimics the natural familiarity pheromone

The critical socialisation period for developing kittens is: - Weaning to 12 weeks - 2-9 weeks - Birth to weaning - 4-16 weeks

- 2-9 weeks

Scratching the furniture in the home is best managed by: - Providing an alternative structure to scratch - Shouting "no" at the cat - Declawing the cat - Using a water pistol on the cat

- Providing an alternative structure to scratch

What is the normal number of adult teeth in the dog?

What is the normal number of adult teeth in the cat?

Generally a tooth should be extracted if it has: - Periodontal disease with >50% bone loss around >1 root - Mobility - A complicated crown fracture where root canal therapy has been declined - Any of the above

- Any of the above

Feline stomatitis (gingivostomatitis) is caused by: - An atypical immune response of unknown cause - Calicivirus - Poor dental hygiene - Mycoplasma

- An atypical immune response of unknown cause

What is a good choice for suture material to be used in the oral cavity? - 2/0 Polydioxanone (PDS) - 4/0 Polydioxanone (PDS) - 0 Polydioxanone (PDS) - 4/0 Glyconate (Monosyn)

- 4/0 Glyconate (Monosyn) 4/0 absorbable suture on a reverse cutting needle is the best choice with Monosyn or cat gut - #Don’t use PDS for oral surgery – very hard / rough > can lacerate tongue

You lift up the right lip in a German Shepherd and see this: upper right carnassial with complicated crown fracture. Using the modified Triadan tooth numbering system which tooth has a complicated crown facture?

108

How many roots does the upper right carnassial (108) tooth have?

A cat is presented with idiopathic feline asthma. For home management the owner prefers to give inhalation therapy, rather than oral therapy. From the following list, select the combination of drugs commonly deliverd as inhalation therapy for acute attack episodes as well as for chronic ongoing feline asthma? - Antibiotic (acute), bronchodilators (chronic) - Antibiotic (acute), corticosteroid (chronic) - Bronchodilators (acute), corticosteroid (chronic) - Bronchodilators (acute), non steroidal anti-inflammatory (chronic)

- Bronchodilators (acute), corticosteroid (chronic)

A geriatric golden retriever is presented because of noisy inspiration that is only evident when the dog is exercising strenuously. Select from the list below the most likely cause. - Brachycephalic syndrome - Collapsing trachea - Laryngeal paralysis - Aspergillosis

- Laryngeal paralysis

An elderly dog is presented with 1 week of persistent sneezing and a unilateral mucopurulent nasal discharge. Which of the following options is the approach most likely to lead to diagnosis? - Thorough physical examination, followed by skull radiographs or CT and then rhinoscopy - Complete blood count and chemistry panel followed by rhinoscopy, then CT scan - Complete blood count and coagulation panel followed by rhinoscopy and cytology or biopsy - Rhinoscopy, nasal wash, cytology and/or biopsy followed by skull radiographs or CT

- Thorough physical examination, followed by skull radiographs or CT and then rhinoscopy

Which of the following would be a pre-anaesthetic concern in a brachycephalic dog? - Chronic hypoventilation - Chronic hypoxaemia PaO2 <85 mmHg - Chronic hypercapnia PaCO2 >45 mmHg - All of the above

- All of the above

Which pre-anaesthetic drug is most likely to cause pharyngeal and soft palate relaxation resulting in upper airway obstruction? - Benzodiazepines - Butorphanol - Low dose ACP - Alpha 2 agonists

- Benzodiazepines

In geriatric patients the use of sedatives, analgesics and anaesthetic agents may cause a significant decrease in functional respiratory reserve due to respiratory depression. True / false?

True

In a pregnant bitch, progesterone and beta endorphins are increased, this makes them less sensitive to the effects of all anaesthetic drugs. True / false?

False

Spherocytosis in a blood smear confirms a diagnosis of immune-mediated haemolytic anaemia. True or false?

Somewhat true. It is true for dogs (if there are lots of them it is indicative of haemolytic anaemia) but not for cats (their normal blood can have spherocytes so not indicative of haemolytic anaemia).

Suspected cases of regenerative anaemia can be appropriately evaluated without assessment of RBC morphology on a blood smear. True / false?

False - blood smear is very important in differentiating e.g. microangiopathic vs. IMHA

Anaemia of chronic disease is an uncommon cause of non-regenerative anaemia. True / false?

True

The presence of absolute neutrophils is good evidence that the patient has an infection. True / false?

True?

A normal WBC count rules out the possibility that an infection is present?

No it doesn't

It is more important to know relative than absolute white cell counts. True / false?

False - the absolute numbers are mroe important than relative numbers

It is impossible to interpret modest neutrophilia without assessing the numbers of eosinophils, lymphocytes and monocytes. True / False?

True - need to know about all of the numbers before you can make a sensible decision

In haemolytic anaemia how is bilirubin produced and what should normally happen to it?

- Macrophages produce bilirubin from damaged red cells (spleen, liver, bone marrow) - Liver removes it from circulation - Overwhelmed liver capacity > inability to remove bilirubin quickly enough > icterus

Is icterus more common with intravascular haemolysis or extravascular haemolysis?

Intravascular - Faster rate of haemolysis > liver overwhelmed quicker & unable to keep up with removing bilirubin > icterus

Haemolysis case: 5 year old spayed female cocker spaniel. Acutely lethargic, prior treatment with prednisolone. Physical exam: pale, slightly icteric, MM PCV 12 (37-55), RBC 0.95 (5.5-8.5), retics 123 (<60) Histopathology: polychromasia increased, agglutination present, many spherocytes present. Occasional Howell-jolly body. a) How would you characterise this dog's anaemia? b) What to do next? High BUN (azotemia) - is it pre-renal, renal or post-renal? Not renal as USG >1.030 (kidneys are still concentrating) so must be pre-renal. Increased Bilirubin likely due to IMHA rather than issue in urinary tract. c) Diagnosis & treatment?

a) Severe, regenerative b) Serum chemistry + urinalysis c) IMHA. Treatment = prednisolone + supportive care (may require blood transfusion)

Haemolysis case: - Mild nonregenerative anaemia - Inflammatory leukogram > probably anaemia of inflammatory disease - Marked neutrophilia + bands > inflammation - Lymphopenia > stress or steroids - Thrombocytopenia (decreased platelets) - giant platelets = immature platelets > bone marrow is ok What is the diagnosis?

Disseminated Intravascular Coagulation (DIC): - Damaged cells & exposed collagen trigger excessive clotting - Platelets & clotting factors are consumed - Breakdown of clots inhibits further clotting > bleeding Treatment: - Figure out the underlying disease / cause & fix that - Could be associated with SIRS - In the meantime give the animal supportive care (IVFT) & a drug that will prevent the clot breaking down (Tranexamic acid)

Haemolysis case: 10 year old castrated male Labrador. Four episodes of acute weakness over past 3 months. At time of wellness exam 4 months ago dog had PCV of 44% and TP 8.2 g/dL. Today: pale MM, abdomen slightly distended, PCV 16 (37-55), Hgb 5.3 (12-18), retics 342 (<60), platelets 130 (200-500). a) How would you characterise this dog's anaemia? b) What would you do next? Biochemistry: no abnormalities Abdominal fluid analysis: 95% nondegenerate neutrophils, 5% macrophages c) Diagnosis?

a) Severe regenerative (strongly) b) Serum chemistry + abdominocentesis c) Haemabdomen in an older animal is likely due to a splenic tumour (hemangiosarcoma). Would want to do abdominal imaging to try to determine the cause of the bleeding.

Haemolysis case: Gordon 11yo DSH MN. Did not turn up for breakfast this morning (unprecedented behaviour). History: indoor / outdoor, found on porch chair this morning, vaccinated, has pale MM. Haematology & biochem: - Moderate non-regen anaemia, true thrombocytopaenia, small no. of heinz bodies (normal in cats), high CK = muscle damage, glucose a bit high (stress) Urinalysis: - USG ok (kidney is functioning) - Blood present - could be from cystocentesis or could be blood in urinary tract e.g. UTI (but no WBC's to back that up), trauma, hit by car Gordon has now recovered without doing anything. 5 days later we repeat haematology & biochem & find he is no longer anaemic! Diagnosis?

Likely some sort of trauma > small bleed in the abdomen > can resolve quickly!

Haemolysis case: Phoebe 18yo maltese terrier. Physical exam: dental disease, generalise mild muscle wasting, splenomegaly, superficial lymph nodes very firm & slightly enlarged, harsh respiratory sound on auscultation. Haematology: - Mild anisocytosis, VERY high lymphocytes, anaemia (non-regen) Biochem: - Significantly high urea = azotemia - should check USG next Diagnosis?

This is chronic lymphocytic leukemia (CLL).

When is the socialisation period & fear periods for dogs?

- Socialisation period: 3-14 weeks - Fear periods: 8-11 weeks (and possibly 6-9 months)

End Sem 1 Exam Flashcards

(171 cards)