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Flashcards in NON-SPECIFIC Deck (18)
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1

How does Clostridium botulinum toxin affect the nervous system?

a. The toxin binds acetylcholine, making it unable to bind with the post synaptic receptor

b. The toxin destroys acetylcholine so it cannot bind with the post-synaptic receptor

c. The toxin acts as an acetylcholinesterase and breaks down acetylcholine as it is released

d. The toxin blocks acetylcholine release by binding the presynaptic membrane

d. The toxin blocks acetylcholine release by binding the presynaptic membrane

The correct answer is the toxin blocks acetylcholine release by binding the presynaptic membrane. Clostridium botulinum produces a toxin that causes progressive motor paralysis and generalized progressive weakness. Death usually occurs due to respiratory paralysis. The bacteria often proliferate in decomposing animal or plant tissue.

2

Which correctly describes the innervation of the iris sphincter muscle in mammals?

a. Innervated by parasynpathetic nervous system by cranial nerve V

b. Innervated by parasympathetic nervous system by cranial nerve III

c. Innervated by sympathetic nervous system by cranial nerve III

d. Innervated by sympathetic nervous system by cranial nerve V

b. Innervated by parasympathetic nervous system by cranial nerve III

The correct answer is that it is innervated by parasympathetic nervous system by cranial nerve III. The iris sphincter is stronger than the iris dilator. It receives parasympathetic innervation by cranial nerve III. It is comprised of smooth muscle in mammals, unlike birds, where it is striated. The innervation makes sense if you consider that when your sympathetic nervous system is activated, your eyes become dilated; that leaves the parasympathetic nervous system to constrict the pupil, which is the responsibility of the sphincter.

3

Which of the following tests has the highest specificity for 200 cats, 100 with the disease and 100 without?

a. 50 true positive, 80 true negative, 50 false negative 20 false positive

b. 75 true positive, 95 true negative, 25 false negative, 5 false positive

c. 95 true positive, 65 true negative, 5 false negative, 35 false positive

d. 85 true positive, 85 true negative, 15 false negative, 15 false positive

b. 75 true positive, 95 true negative, 25 false negative, 5 false positive

The correct answer is 75 true positive, 95 true negative, 25 false negative, 5 false positive. Specificity is determined by the percentage of true negatives versus false positives in cats that do not have the disease of interest.

4

You are looking at Diff-quick stained slides of joint fluid from a 7-year old Labrador with shifting-leg lameness and fever. You see a moderate to large number of nondegenerate neutrophils, accounting for 95% of the cell population, and scattered small mononuclear cells (accounting for 5% of the cell population). How would you describe this joint fluid?

a. Suggestive of neoplasia

b. Granulomatous inflammation

c. Suggestive of osteoarthritis

d. This is a normal cell population for joint fluid

e. Pyogranulomatous inflammation

f. Suppurative, nonseptic inflammation

f. Suppurative, nonseptic inflammation

The marked predominance of nondegenerate neutrophils without apparent intracellular organisms makes this suppurative, nonseptic inflammation. Primary differentials include immune-mediated polyarthritis and polyarthritis due to rickettsial disease.

A small mononuclear cell population is normally present in joint fluid, but neutrophils are not. "Granulomatous" describes a predominantly mononuclear cell population (lymphocytes, macrophages, plasma cells), and "pyogranulomatous" describes a mixed population of neutrophils and mononuclear cells. Osteoarthritis may result in a mild increase in mononuclear cells with a few neutrophils, but should not produce markedly inflammatory joint fluid.

5

Which of the following is an absorbable suture type?

a. Nylon

b. Silk

c. Polypropylene (Prolene)

d. Polymerized caprolactam (Vetafil)

e. Polyglyconate (Maxon)

 

e. Polyglyconate (Maxon)

The correct answer is polyglyconate (Maxon). Maxon is a synthetic monofilament absorbable suture. It maintains over 50% of its tensile strength for 3 weeks.

6

Technicians often assist you with your procedures and would like to be more involved. You have several procedures planned for the following week. Which of these should not be performed by a licensed veterinary technician?

a. Esophagostomy tube placement

b. Lymph node aspiration

c. Nasogastric tube placement

d. Anesthetic induction and intubation

e. Joint taps

a. Esophagostomy tube placement

Veterinary technicians are prohibited from performing surgical procedures, prescribing medications, and making diagnoses. Surgery is defined in most states as any procedure in which the skin or tissue of the patient is penetrated, pierced, or severed for therapeutic purposes, other than giving injections.

Esophagostomy tube placement requires an incision through skin and esophagus to place the feeding tube. This constitutes surgery and should not be performed by a technician, even with supervision.

The other procedures could be performed by a licensed veterinary technician if delegated and supervised by a veterinarian. Veterinarians should only delegate those tasks commensurate with the education, training, and demonstrated abilities of the person being supervised.

Even though tissue is penetrated during blood draws, lymph node aspirations, joint taps, etc; these constitute non surgical sample collection and are allowed in most states.

7

A practice is using an FeLV test with a sensitivity of 90% and a specificity of 95%.  Assuming the prevalence of feline leukemia in the area is 5%, what is the predictive value positive (PVP) of the test?

a. 45%

b. 90%

c. 55%

d. 88%

e. 48%

e. 48%

The trick with this kind of question is to pick an imaginary number of animals that you test, like 1000, and fill out your 2x2 table from there.

If prevalence is 5%, then there must be 50/1000 cats with FeLV and 950 cats that are disease -free.  A 90% sensitive will correctly call 45/50 positive (box "a"), and IN-correctly call 5/50 negative, (box "c": these are the false negatives).

If 50/1000 animals are infected, then 950/1000 are disease-free.

Your 95% specific test will correctly call 902/950 disease-free (box "d": 0.95x950=920) and IN-correctly call 48/950 positive (box "b": these are the false positive)

 

Now your a, b, c, d boxes are all filled, it is easy to calculate PVP=a/(a+b)=45/(45+48)=48%

8

When building a successful practice, it is important to provide outstanding client service. Which of the following statements is true about how client service at a veterinary hospital is different from standard customer service in retail or other service industries?

a. Customer typically develop close relationship with employees whereas clientsdo not

b. Retail establishments desire repeat customers but the client-veterinary relationship involves a single interaction or transaction

c. Customer service is more closely associated with value of the transaction than client service

d. Client service involves a personal, long-term relationship whereas customer service typically involves a single transaction

d. Client service involves a personal, long-term relationship whereas customer service typically involves a single transaction

The most important difference between clients and customers is that client services involves a personal long-term relationship. In veterinary medicine, this includes a relationship with the veterinarian(s), but other staff members (technicians, receptionists, etc) are the primary providers of client service. Such relationships should span the lifetime of one or multiple pets.

Higher levels of client service result in perception of greater value. A lack of quality service is one of the most common reasons that clients switch veterinary practices.

9

Which of the following gas anesthetic agents will result in the quickest recovery?

a. Sevoflurane

b. Ether

c. Halothane

d. Isoflurane

a. Sevoflurane

The correct answer is sevoflurane. The reason for this is that it has a very low blood-gas partition coefficient. This means that sevoflurane does not readily dissolve in the blood. As a result, the alveolar concentration is close to the same concentration present in the brain, and the concentrations will reach equivalence very rapidly. This is in contrast to ether, which is very soluble in blood, resulting in accumulation of ether in other tissues. This accumulation results in longer times for a patient to fall asleep and wake up. Halothane and isoflurane are not as soluble as ether, but sevoflurane has the least solubility. Do not confuse solubility with MAC (minimum alveolar concentration). Remember, MAC represents the concentration at which half the population would be anesthetized. For example, the MAC of sevoflurane is approximately 2.4 whereas that for Halothane is 0.89.

10

A practice you recently interviewed with told you they will offer you a number of ancillary benefits if you work full time. This may include:

a. Health insurance

b. Percentage of gross production or salary

c. Professional membership dues

d. Vacation allowance

e. Holidays off

c. Professional membership dues

An ancillary benefit is an additional benefit not part of the expected core offer. Examples of these benefits include membership dues, continuing education allowance, DEA license dues, moving expenses, gym memberships, etc.

In this question, a vacation allowance, holidays off, salary, and health insurance are all expected benefits in a core offer for a full-time employee at a veterinary clinic.

11

A 5 year old male intact dog is brought into your clinic by his owner who states that he bit a neighbor child in the face yesterday. He wants the dog immediately euthanized and wants to bury the dog on his ranch property. He said he had all his shots as a puppy. What is the best course of action?

a. Collect a blood sample from the dog to submit to the laboratory for rabies testing prior to euthanasia

b. Have the owner sign the euthanasia form and euthanize the dog, but keep the body in case the dog needsto be tested for rabies

c. Have the owner sign a euthanasia form and euthanize the dog; because this is an owned pet and not a stray, quarantine is not required

d. Contact your local public health authorities to determine if this animal needs to be quarantined prior to euthanasia and what procedures need to be followed

d. Contact your local public health authorities to determine if this animal needs to be quarantined prior to euthanasia and what procedures need to be followed

Potential rabies exposure constitutes a significant public health concern. Because we know this animal bit someone, it is important to ascertain what the state law is where you practice.

Most states require that the animal be quarantined for 10 days prior to euthanasia, EVEN IF IT IS CURRENT on its rabies vaccination. If the euthanasia is performed before the 10 day quarantine, the refrigerated (not frozen) head must be submitted for rabies testing. A blood sample is not a proper specimen for testing.

Because this animal bit someone, quarantine will likely be needed. If the euthanasia is performed, the head must be submitted (not just saved "in case").

12

A diagnostic ratio is the ratio of income from diagnostic procedures relative to income from goods (i.e. drugs). Which of the following types of veterinarians usually has the lowest diagnostic ratio?

a. Veterinary specialist

b. Livestock veterinarian

c. Companion animal veterinarian

d. Avial veterinarian

b. Livestock veterinarian

Diagnostic ratio is often used as a measure to evaluate productivity. Companion animal veterinarians often have a ratio near 1:1. Avian practitioners often have higher diagnostic ratios and livestock veterinarians usually dispense many more drugs relative to the number of diagnostic procedures they perform and therefore have a low diagnostic ratio (approximately 1:4). The diagnostic ratio of veterinary specialists varies widely by specialty.

13

Staphylococcus aureus is an important cause of foodborne illness in humans. Which of the following statements is TRUE about Staphylococcal food poisoning?

a. The usual source of infection is from an infected animal

b. Most affected individuals have severe signs and may need to be hospitalized

c. It usually takes 4-7 days after ingestion before any clinical signs are displayed

d. Common signs of foodborne illness with S. aureus include skin rash and headache and fatigue

e. Illness is caused by strains of the bacteria that make a heat-stable enterotoxin

e. Illness is caused by strains of the bacteria that make a heat-stable enterotoxin

S. aureus are Gram-positive cocci. Some strains are capable of producing a highly heat-stable protein toxin that causes foodborne illness in humans.

The usual source of infection is from human contamination by food handlers which then inoculate meat or other dishes.

Typical incubation time is 1 to 8 hours.

Common signs of infection include abdominal cramps/pain, vomiting, diarrhea, nausea, and chills.

Most cases are relatively mild with uneventful recovery in 1-2 days.

14

Which of the following suture patterns used for closing hollow viscera purposefully enters the lumen?

a. Horizontal mattress pattern

b. Ford interlocking pattern

c. Connell pattern

d. Cushing pattern

c. Connell pattern

The correct answer is Connell pattern. Both the Connell and Cushing patterns are used to close hollow viscera because they are very effective at inverting tissue and creating a watertight seal. The difference between these two patterns is that Cushing pattern only goes through the submucosa and does not enter the lumen. The Ford interlocking and horizontal mattress patterns are not used for closing hollow viscera.

15

A veterinary practice has an annual gross income of $600,000. If it currently spends 17% of its income on inventory and it is able to decrease that to 14% without affecting sales, how much additional profit will the practice generate?

a. $18,000

b. $9,000

c. $25,000

d. $84,000

e. $6,000

a. $18,000

Decreasing the amount spent from 17% to 14% of income means that the practice is spending 3% less of its gross income on inventory. Since sales are not changed, 3% of 600,000 is 18,000 which is the amount of additional profit.

16

When valuing a veterinary practice, "practice goodwill" can be one of the most significant assets. Which of the following is NOT considered part of a practice's goodwill?

a. Brand awareness

b. Owner's equity

c. Practice reputation

d. Client base

e. Technical skill

b. Owner's equity

A practice's goodwill refers to its reputation, client base, knowledge, technical skill, research, brand awareness, and associations that the practice maintains.

Owner's equity is a different asset that would be reported on a company's balance sheet and is not lumped under "goodwill".

17

18

Which of the following pairs of tissues can both cause increased serum alanine aminotransferase (ALT) levels in dogs and cats?

a. Pancreas and intestine

b. Kidneys and pancreas

c. Liver and musle

d. Spleen and adrenals

e. Heart and kidneys

c. Liver and musle

Damage to liver and muscle cells of dogs and cats causes increased serum levels of alanine aminotransferase (ALT)

It is a considered a "leakage" enzyme.  High levels are normally found in the cytoplasm of healthy cells.

WHen hepatic or muscle cells are damaged, ALT leaks into adjacent tissue where it is picked up by the venous circulation.

Other animals such as horses, ruminants, pigs, and birds do not have high levels of ALT inside cells.

Aspartate aminotransferase (AST) is the leakage enzyme dominant in these animals.

The magnitude of the elevation of leakage enzymes can be deceiving - are a few cells leaking a lot or many cells are leaking a small amount?

Severe damage to a healthy liver may result in very high levels, while low levels may be seen when significant atrophy or fibrosis of the liver is present and few cells are left.

Prognosis of the former may be good, for the latter it is certainly grim.

Differentiation between muscle and liver as the source of increases in ALT/AST is determined by evaluation of other muscle (creatine phosphokinase (CK) and AST) and liver enzymes (AST, sorbitol dehydrogenase (SDH), gamma glutamyl transferase (GGT), alkaline phosphatase(ALP), the animal, and the clinical evaluation.

Leakage enzymes do NOT provide an estimate of actual liver function.  This is evaluated by measurement of substances dependent on the efficacy of liver function such as bile acids, blood urea nitrogen, albumin, and glucose