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Senior Sx > Final > Flashcards

Final Flashcards

1
Q

Gold std for grading trach collapse

A

Tracheobronchoscopy

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2
Q

Gold std for grading trach collapse

A

Tracheobronchoscopy

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3
Q

Effectiveness of med mgmt by trch collpase grade

A

always 1/2, most 3, rare effective in 4

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4
Q

Specific rx in trach collapse

A

Stanazolol (Winstrol)- anabolic mm. builder

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5
Q

Location, Complications of extraluminal stent

A

Cervical; recurrent laryngeal n dmg (lar par), necrosis d/t segmental blood supply, up to 10% mortality

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6
Q

Location/complications of intraluminal

A

Cervical and thoracic;; 1+ will occur: migration, stent fracture, pneumonia, granuloma

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7
Q

Effectiveness of med mgmt by trch collpase grade

A

always 1/2, most 3, rare effective in 4

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8
Q

Specific rx in trach collapse

A

Stanazolol (Winstrol)- anabolic mm. builder

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9
Q

Location, Complications of extraluminal stent

A

Cervical; recurrent laryngeal n dmg (lar par), necrosis d/t segmental blood supply, up to 10% mortality

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10
Q

Location/complications of intraluminal

A

Cervical and thoracic;; 1+ will occur: migration, stent fracture, pneumonia, granuloma

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11
Q

Location for temp tracheostomy; 24 hour vs long term

A

4th-6th rings; <24: transverse (less than 50% circumference); >24h: flap; AVOID vertical

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12
Q

Describe post op care for temp trach

A

minimal cuff inflation, reposition in 4h, replace q12h; maintain two tubes (prep in 2% chlorhex), gentle airway suction (<10sec)

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13
Q

Perm trach managment

A

clean/suction q 4-6h for 4w

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14
Q

Tx feline nasal planum tumor

A

radiation, intralesional carboplatin- low recurrence rate, sx mostly curative

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15
Q

Gold standard- feline nasal polyp

A

CT

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16
Q

Timing of heat therapy in rehab

A

NOT within 5-7d of injury

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17
Q

Water level resistance- hock, stifle, shoulder

A

hock 9% less weight; stifle 15%, shoulder 60%

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18
Q

Retrain CP- rehab exercise

A

weight shifting, rhythmic bouncing- takes advantage of extensor reflex to engage mm.

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19
Q

Slings/indications for Shoulder lux

A

Velpeau- for medial (hum head laterally), Spica for lateral lux

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20
Q

Sx tx shoulder lux w/ and w/o glenoid dz

A

Without: medial biceps tendon transpo; abnormal: shoulder arthrodesis

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21
Q

Elbow position/direction in traumatic lux

A

Almost always lateral; Antebrachium ABducted, elbow flexed

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22
Q

Elbow lux reduction steps -3 , post-tx

A

1) Reduce anconeus (flex elb, push process back twd midline); 2) reduce radial head (push medially via ABduct antebrachium 3) rads check; coapt in extension

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23
Q

What does campbells test for, describe

A

Elbow collateral stability- Pronation 45 (more= medial), Sup 70 (more = LCL injury)

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24
Q

Excessive varus suggests

A

lat collat inj in any limb, valgus = MCL

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25
Q

Injuries with hyperextension of carpus, dx

A

ruptured palmar fibrocartilage +/- ventral carpal ligaments- NOT flexor tendons; stress views

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26
Q

Tx carpus hyperextension; contras

A

Partial carpal arthrodesis- fuse C-MC and middle carpal joints; NOT for antebrachiocarpal injury- preserves ROM

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27
Q

Long components of tarsus are taut in ______

A

extension (short- flexion)

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28
Q

Sigmt, tx Proximal intertarsal sublux

A

Shelties/collies with no trauma, partial tarsal arthrodesis

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29
Q

Direction of tarsus shearing injuries

A

Medial

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30
Q

Which prostate cysts communicate with UGT; tx all

A

prostatic (not paraprost)- more likely to get infected; Omentalization w/castration > aspiration (recurrence)

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31
Q

What penetrates dorsal surface of prostate; where is hypogastric

A

Prostatic a. and pelvic n.; with vas def.

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32
Q

Prostate met method, pattern

A

LN and ventral vertebral plexus; Iliac LN > lungs > bladder > rectum, pelvis, lumbar spine

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33
Q

US appearance in prostatitis; tx abscess

A

hypo to an-echoic, assymetric megaly; Sx! drain, omentalization with tunnel&tack, drag thru

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34
Q

Pathophys of prostate cysts

A

2* to BPH- squam metaplasia occludes ducts and secretions develop

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35
Q

Which prostate cysts communicate with UGT; tx all

A

prostatic (not paraprost)- more likely to get infected; Omentalization w/castration > aspiration (recurrence)

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36
Q

Prostate mineralization indicates

A

Most likely neo

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37
Q

SE of complete prostatectomy; palliative cancer tx

A

LAST RESORT- 100% incontinent; urinary diversion via urethral stent

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38
Q

Closed pyo MOA, timing; CS

A

Increased secretion and decreased contractiility; Diestrus- 6-12w post-estrus; GNephritis, azotemia, etc

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39
Q

Med mgmt- Pyo

A

Open- PGF2a +/- lavage; Sx: OVH 1cm cranial to cervix, lavage

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40
Q

Periop mgmt- pyo

A

Large incision, monitor urine output, BP, give Abx

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41
Q

Conservative vs tap/tube trauma pneumo

A

<25% conserve, >25% or dys- tap/tube

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42
Q

Tx tension pneumo

A

ER! Re-expand via tap, tube placement, continuous suction

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43
Q

Infxs spon pneumo- agent

A

Klebsiella, ecoli

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44
Q

Pthophys spon pneumo in primary lung dz

A

pneumonia/emohysema + collagent defect –> bullae –> reptured alvoli

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45
Q

Spon pneumo- Tx, best Px

A

Median sternotomy with partial or total lobectomy via TA stapler; Trauma > spon, high recur w/o sx

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46
Q

Flail- inspiration moves in what direction

A

Inward; exp- out

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47
Q

Flail- tx

A

External stabilization

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48
Q

Trachea- grade collapse, name mm.

A

1- 25, 2- 50, 3- 75, 4- 100% of lumen obliterated; dorsal trachealis mm. majority of change in 1-3

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49
Q

Pathophys of collapse

A

Increased airway resistance, work of breathing- leads to chronic resistance, pulmonary hypertension, respectively

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50
Q

Trach collapse- dx sensitivity, gold std

A

Insp rads- sens; exp rads: non sens; Gold: tracheobronchoscopy

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51
Q

Meg mgmt indications, methods- trach collapse

A

Grade 1&2, some 3; stanazolol- anabolic steroid long term

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52
Q

Best sx tx for focal or trauma cervical trach collapse; complications

A

Exraluminal- ring prosthetic around cartilage AND mm.; lar par (10% perm trach), necrosis via disruption of segmental blood supply, migration, fracture, pnuemonia, granuloma

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53
Q

Med mgmt post- intraluminal trach stent

A

Enro, diphenoxylate, +-/ anti-inflam steroids

54
Q

Trach RNA: amount to resect, thoracic approach, closure, post op

A

RIGHT 3rd ICT space; puppies 25, up to 50% experiment; Post: +/- chest tube, neck flexion splint, 4 w exercise restriction

55
Q

Temp trach approach; technique for short/long term; post op

A

4th-6th- cut 30-40% circumf horizontally; short: transverse, long term: flap (vertical- dont use, casues nexrosis); Reposition q4h, replace q12h with second soaked in 2% chlorhex

56
Q

Cat MST for perm trach

A

20d

57
Q

When is lar par surgical

A

Idiopathic (polyneuro, myop, etc - medical)

58
Q

Describe polyneuropathy assoc with lar par

A

Denervation atrophy of cricoarytenoideus dorsalis m., voice chg/esoph decrease d/t recu laryng- failure of arytenoid cartilage to ABduct

59
Q

Dx lar par- gold standard; Rx to avoid, Rx to use

A

Laryngeal exam (propofol and scope); Ace, opioids, alpha-2s, benzos; Dopram- CNS stimulant to exacerbate paradoxical motion and arytenoid adduction

60
Q

Tx lar par

A

Arytenoid lateralization - crycoarytenoid (> thyroarytenoid); perm trach if megaesoph

61
Q

PeriOp Lar Par

A

NPO 24h, then 12 post, IV metoclopramide during/after sx, IV NSAIDs, locals post-op;

62
Q

Stage laryngeal collapse in BAS; Sx options

A

1: lar saccule eversion; 2: cuneiform cartilate ADduction; 3: corniculate process adduction; perm trach reliable, tieback- dont do it, salvage- unsure of efficacy)

63
Q

When is repair indicated in hip lux

A

1st time, no DJD, no Fx, no dysplasia

64
Q

Tx stifle with steep tibial plateau angle

A

TPLO

65
Q

Most common cause of forelimb lameness, describe

A

Elbow dysplasia- FMCP,* UAP, OCD medial hum cond, elbow incongruency

66
Q

Rads: elbow dysplasia

A

ML 90, ML flexed, CrCau, CrL-CaM oblique

67
Q

FCMP pathophys

A

incongruent R/U leads to MCP suprephysio loading–> fatigue fractures

68
Q

4 Sx for FCMP; key to success

A

fragment removal with abrasion chondroplasty; subtotal coronoidectomy, prox ul osteotomy, sliding hum psteotomy- varied success d/t differing underlying- intervene before cartilage dmg (fair to good- poor with dmg)

69
Q

When is UAP called, signalment

A

not fused by 24w, MALES, GSD, basset

70
Q

Desc muscle tendon high grade injury; signs are worse in what mm.

A

Disruption to function- action of mm helps dx, tx; weight bearing mm. REMEMBER! Prolonged healing in important mm.-tendon units

71
Q

Med mgmt indications- UAP, Sx indications

A

<6m old- confine, restrict activity, monthly rads (or older with OA); Sx: >1yr with minimal DJD

72
Q

Indications, Three steps- UAP sx

A

Excise UAP, stabilize AP: PUO- prox ulnar osteotomy +/- lag screw; good Px if remove before 1 yr, do removal or PUO

73
Q

Dobie or lab with achilles tendon injury

A

Gastroc tendinopathy d/t activity overload

74
Q

Elbow dysplasia salvage procedures- 2

A

Total elb replacement, joint resurfacing (Canine unicompartmental elbow CUE)

75
Q

Desc muscle tendon high grade injury; signs are worse in what mm.

A

Disruption to function- action of mm helps dx, tx; weight bearing mm.

76
Q

Post op scap lux tx

A

2w carpal flexion bandage, +2w cage rest, gradual return to exercise over 4-8w

77
Q

Poor healing in tendon repair due to; desc sx

A

GAP >3mm, increased risk rupture; Locking Loop pattern - grab bundles of tendon fibers- USE PROLENE NON ABS (or can use 3-loop pulley)

78
Q

Main cause quad contracture

A

distal femoral fx in young, atrphy and fibrosis to Fx callus

79
Q

Ddx compartnemt syndrome

A

> 20mmHg pressure (interstitial hydrostatic) leading to necrosis and NM dysfxn

80
Q

Tx compartment syndrome

A

Fasciotomy with delayed primary closure

81
Q

Active dog circumducting limb up stairs, tx

A

Infraspinatus contracture; PT/compression early, tenotomy later - good Px

82
Q

What is painful in bicipital tenosynovitis, pathophys

A

flex shoulder/extend elbow (arm back); repeat strain injuries cause sheath/tendon abhesions

83
Q

Tx bicipital tenosynovitis

A

Biceps tenotomy- release!

84
Q

OCD- prox humerus info

A

Caudal humeral head, unilat; pain on shoulder extension, Sx if lame >6w (remove, tx SCB/edges via forage)

85
Q

OCD- distal humerus info

A

Trochlear ridge of medial condyle; pain on supination; Sx in no DJD- medial arthrotomy, removal, curette, microFx

86
Q

Stifle OCD

A

Medial aspect of lateral fem condyle

87
Q

OCD- tallus

A

Medial trochlear ridge (rotties: lateral)pain on hyperextension of TC joint- freq contains bone bc joint cap vascularization

88
Q

Define OCD bed healing

A

hyaline replaced by fibrocart

89
Q

Candle flame o rads- dx, location, seq

A

retained cartilage core- usually distal ulnar physis (cartilage in physis failed ossification)

90
Q

Best exposure for PDA ligation

A

ICT at 4/5th rib (scalenus at 5!) ductus median to vagus n between pulm and ao; ligate with silk

91
Q

Close median sternotomy

A

appose pectorals wth 3-0 or 4-0 mono nonasbs

92
Q

Pericardiocentesis approach

A

right 5/6

93
Q

Top 2 approaches for pericardectomy

A

thorascopic > median stern (IC fine)

94
Q

Breed- atrial standstill, SSS

A

AS: springer; SSS- mini schnauz

95
Q

Endocardial and epicardial pacemaker placement

A

Endo- intravasc; epi- sx; bipolar VVI most common; generator in transversus abdominus

96
Q

Pre/periOp for pacemaker

A

Increase CO via HR NOT SV; isoproterenol, external lead trans venous;

97
Q

Define rheobase programming

A

min voltage to depolarize x2 (5V)

98
Q

Lap cholecystectomy case selection; post-op considerations

A

uncomplicated GB dz, table, NEED EXPERIENCED operator; EHBO (panc, mucus), bile peritonitis

99
Q

Adrenalectomy- lap case approach, approach

A

Pre Op CT, tumor < 3-5cm w/o no invasion; cranial pole- less renal V

100
Q

TECALBO indications

A

Cholesteatoma (keratin debris, onion skin, high recurrence)Ear with perm changes, hyperkerat canal, ossification, prloliferative otitis, concurrent OM; USE CT

101
Q

Advanced Lap technique:

A

Cholecystectomy

102
Q

Zepp- lateral wall resection- indications

A

Ulcerative otitis, nonproliferative, polyps, non ossified cartilage, open horix canals

103
Q

Ear hypertrophy Sx

A

vertical canal ablation

104
Q

TECALBO indications

A

Cholesteatoma (keratin debris, onion skin, high recurrence)Ear with perm changes, hyperkerat canal, ossification, prloliferative otitis, concurrent OM; USE CT

105
Q

Non inflam joint dzs

A

DJD/OA, trauma, neoplasia

106
Q

Inflamm non-infx - break down, give examples

A

Immune mediated polyarthropathy (ticks mimic): Erosive- rheumatoid arth; Non-erosive- SLE/lupus, drug; SLE/lupus, drugs, akita, med fever

107
Q

Joint fluid

A

<3000 cells, 2-2.5 protein, hyaluronic acid protein background, 1=2” string, <5% neuts

108
Q

Inflammatory synovial

A

> 12% NEUTS, >5000 cells, decreased viscosity, cloudy

109
Q

Inflam non-ersive polyarth types; Dx

A

1 idio > 2chronic/reactive > 3enterohepatic > 4neo; ++ cells, >44% non-degen neut

110
Q

Dx rheumatoid

A

pick 5- stiff after rest, pain in 1 joint, swelling in 1 joint, swelling of one other joint in 3m, symmetric swelling, SQ nodules on body protub’cs, erosions, +RF IgM, poor mucin clot, synovial histopath, nodular histopath

111
Q

urinary test of choice; describe

A

retrograde cystourethroogram- contrast direct into ureth- no kidney/ureter seen

112
Q

Eval kidneys/ureters/UV Jxn

A

Contrast pyeloureterogram - into pelvis (IV more SE; dont do in hypovol/dehy’d)

113
Q

Dx partial urethral tears

A

retrograde cystourethro

114
Q

Dx blunt renal trauma

A

Excretory urography NOT retro cystourethro

115
Q

Indication for neoureterocystotomy, describe

A

Ureteral trauma MID to DSTAL from kidney, ectopic ureters; reimplantation of ureter to bladder

116
Q

Tx longitudinal or incomplete urethral tears

A

Urainary diversion, stent/catheter

117
Q

AApproach to pelvic urethra transection

A

Preplace stent, anastamosis with 4-0 to 6-0 mono

118
Q

Partial pelvic urethra tears- tx

A

Urethral stent, catheter i wk

119
Q

Seq of urethral obstruction

A

80% decrease in GFR by 24h (reversible before 24-36)

120
Q

Struvite secondary to ___

A

Urease bacteria

121
Q

Prefered location for dog/cat urethrostomy

A

Dog- scrotal; cat: perineal

122
Q

Urethral procedures- complications

A

hemorrhage >48h, recurrent UTI, hematuria >5d

123
Q

Hallmark sign of hip dysplasia

A

decreased ROM in extension; pain found: extension, ext rotation, abduction

124
Q

Test barlows sign

A

first half of ortolani- GA, push remur dorsal at 90*/wt bear; + sublux in lateral/dorsal direction

125
Q

Ortolani results

A

High angle of reduction more severe

126
Q

Least to most painful CCL dz

A

OA/synovitis, CCL tension, instability, meniscal injury

127
Q

CCL Dx

A

pain on extension, lameness, effusion- stability does not dictate diagnosis

128
Q

Hip lux direction

A

Craniodorsal displacement of GT; adduction and external rotation of femur; limb will be shorter

129
Q

Hip stabilizers

A

round lig, jt cap, dorsal acetabular rim (ancill- transverse acetab lig, musc, labrum)

130
Q

Criteria for hip lux closed reduction

A

acute (<10d), no concurrent, 1st time, sound neuro, no fx, no DJD, stable after redution- GA, NM block/epidural, hang limb

131
Q

Describe closed reduction

A

further externally rotate femur away from pelvis, extend leg slightly, rope for counter traction, extend and pull while internally rotating; always aggressively challenge (abd, felx, int rot’n) and check rads

132
Q

Coapt hip lux

A

Ehmer sling- flex, internally rotate, abduct; for 2 weeks (18-21 d) and 6 weeks crate rest

Senior Sx (1 decks)

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