SaSx Test 2 Flashcards
1
Q
2 main indications for incisional biopsy
A
Suspect false negative from FNA
If Tx is likely altered by results
2
Q
Orientation of incision for incisional biopsy
A
parallel to lines of tension
3
Q
Tru-Cut incisional biopsy
A
14, 16 or 18G
any accessible mass
sedation or local anesthetic bc tumor has poor innervation
4
Q
Punch incisional biopsy
A
> 6mm for diagnostic sample
do not use for hypodermal masses - risk undetected hemorrhage
can punch out entire mass if small
5
Q
Wedge incisional biopsy
A
ulcerated or necrotic tissue or deeply located masses
entire biopsy tract must be removed later
use gelpi retractors to maintain tissue retraction for deeper lying tissues
6
Q
Gelpi retractors
A
retract tissues for deep wedge incisional biopsies
7
Q
Excisional biopsies
A
post treatment, if invasive or high risk to get biopsy
prevent seeding, eliminate dead space, don’t drain
8
Q
Pseudocapsule
A
reactive zone, microscopic extensions of satellite tumor cells
9
Q
Enneking Classification
A
intralesional - debulk lipomas
marginal - breach pseudo capsule; extremities, eyes, perianal region
Wide - excise around pseudocapsule
Radical - remove entire body compartment
10
Q
Mast Cell tumor margins - 2 methods
A
1) Fulcher - mark out 1, 2 and 3cm from tumor. 100% clean for gr I and II at 3cm and 2 fascial planes deep (grade dependent)
2) Pratschke Modified - widest diameter of tumor = your lateral margin (unless >4cm is always 4cm), 1 fascial plane deep
11
Q
benign tumor resection margins
A
1cm lateral and 1cm deep
12
Q
Inking of biopsies
A
ink all cut surfaces, let dry 15-20 mins before setting in formalin
Davidson dye - yellow or black
13
Q
Biopsy submission
A
incomplete bread loafing
formalin:tissue = 10:1
small samples in cassettes
tissue 0.5-1cm thick
14
Q
Holding layer of the stomach?
A
submucosa
15
Q
_________ resection may be needed when doing a ventral midline celiotomy.
A
Falciform ligament
16
Q
Used for retraction in stomach surgeries
A
Balfour retractors
17
Q
T/F: the best suture material to close the stomach is braided.
A
False, don’t use braided
18
Q
Closure of the stomach (hint, its two layers)
A
Double inverting Cushing (serosa, muscularis, submucosa) oversewn with Lembert (serosa + muscularis)
19
Q
Most common indication for a gastrotomy
A
Gastric foreign body
20
Q
3 predispositions to pica
A
- Iron deficiency
- Hepatic encephalopathy
- Pancreatic exocrine insufficiency
21
Q
Gastric foreign bodies
A
Dx of choice: RADS
- do rads right before Sx because FB can move
Tx w/ gastrotomy - incise ventral hypovascular area between greater and lesser curvature, lavage with sterile saline (98.6-101.2F)
22
Q
What is FALSE regarding Congenital Pyloric stenosis?
A) seen commonly in brachycephalics + siamese cats
B) involves hypertrophy of the mucosa of stomach
C) Treated with pyloromyotomy or Transverse Pyloroplasty
D) Clinical signs evident at weaning
A
B IS FALSE - involves hypertrophy of the circular mm of muscularis layer
23
Q
Pyloromyotomy
A
Fredet-Ramstedt procedure
Tx congenital pyloric stenosis
1-2cm incision through serosa and muscularis
24
Q
Transverse pyloroplasty
A
Heineke-Mikulicz procedure
Tx congenital pyloric stenosis
3-5cm full thickness incision over pylorus, orient incision transversely and close w/ appositional pattern
25
A puppy comes into your clinic presenting with intermittent vomiting. Owner tells you he just got the puppy from a breeder who mentioned the puppy had just been weaned. What is your diagnostic test of choice?
A) Rads to look for foreign body
B) Endoscopy to look for mucosal hyperplasia
C) ELISA to look for phycomycosis
D) Contrast rads to look for congenital pyloric stenosis
D - look for apple core sign
26
A 10y old male intact Shih Zhu is brought to your clinic because he has been vomiting. You conduct abdominal US and notice the muscularis of his stomach is 6mm and the pyloric wall is 10mm in thickness. What do you suspect? What are 2 surgical corrections you can potentially do?
Chronic hypertrophic pyloric gastropathy (CHPG)
- hypertrophy of mucosa and muscularis (normal thickness are <4mm for muscularis and <9mm for pyloric wall)
Two possible Sx:
1) Y-U Advancement pyloroplasty
2) Bilroth I - Gastroduodenostomy
27
Y-U Advancement Pyloroplasty
single pedicle advancement to Tx chronic hypertrophic pyloric gastropathy
Pro: inc diameter of pylorus, access to excise hypertrophied mucosa
Con: potential necrosis of flap tip (make sure it is a U and not a V)
28
Bilroth I
Gastroduodenostomy
- remove portion of pylorus including pyloric sphincter and reattach stomach + duodenum
Pro: all dz tissue can be removed
Con: technically demanding, inc risk dumping syndrome + reflux gastritis
29
Phycomycosis
Gulf coast states, transmural thickening, gastric outflow area, eosinophilic pyogranulomatous infection
antifungals do not work
very poor prognosis
30
You live in Florida and a dog comes into your clinic with signs of vomiting and diarrhea. You palpate a thickened mass in its abdomen where its stomach is. You perform an ELISA and it reveals P. insidiosum antibodies. What is your next course of action?
A) Give antifungals for 4w
B) hug your client and say sorry because this dog is a goner
C) Gastrotomy
D) It is self limiting, no tx necessary
B - very poor prognosis, this dog will likely die in a month (antifungals DONT work)
31
Billroth II complications (3)
Gastroenterostomy
1) alkaline gastritis
2) blind loop syndrome
3) marginal ulceration
32
How can you assess gastric viability?
gastric wall thickening - slip
serosal surface colour
capillary perfusion
peristalsis (pinch it)
33
Poster breed for GDV?
great danes
34
T/f: GDV is predisposed in a dog that has a primary relative that has the disease
True
35
Most common type of gastric displacement
Clockwise torsion (<180)
36
A dog comes in with GDV (oh no)! You open it up and notice the stomach is covered by omentum. Which way did the stomach turn?
Clockwise (omentum doesn't cover stomach if counterclockwise)
37
A large dog comes into your clinic and collapses. You ask the owner to describe any clinical signs leading up to their visit. The owner says the dog was vomiting, drooling, and seemed weak. He was also in a "praying posture". What do all of these CS lead you to suspect?
GDV
38
```
What is the first goal of treating a dog with GDV?
A) Untwist the stomach
B) Splenectomy
C) Stabilization
D) gastric decompression
```
C - stabilize CV, resp and renal systems
39
What are the best and worst views to visualize GDV on rads?
Best - R lateral, see punching glove stomach
Worst - ventral dorsal, can predispose to reflux or aspiration
40
What drug can be used as a free radical scavenger for a dog with GDV?
Lidocaine
41
Which of the following is FALSE regarding surgical management of GDV?
A) Gastropexy prevents dilation and volvulus of the stomach
B) push down on funds with R hand, grasp antrum w/ L hand and rotate counter clockwise
C) spleen should be evaluated
D) confirm proper reduction by assessing gastroesophageal junction
A is false, gastropexy prevents volvulus but does NOT prevent dilation!
42
Recurrence of GDV with and without gastropexy
without gastropexy - 50%
with gastropexy - 4%
*doesnt prevent dilation*
43
Which is TRUE regarding gastropexy and GDV?
A) prevents dilation of stomach
B) circumcostal involves seromuscular flap around 14th rib
C) can be done prophylactically in high risk breeds
D) reduces risk of GDV to 50%
C is true
A) - doesnt prevent dilation
B) - is around 13th rib
D) reduces risk of GDV to 4%
44
```
Post op GDV deaths occur:
A) never
B) 1st day
C) first 4 hours
D) first four days
```
D - first four days
45
MC arrhythmias associated with GDV? When do you treat and with what?
Ventricular arrhythmias
Tx if Vtach >180-190bpm, pulse deficits, weakness, multifocal PVCs
Lidocaine bolus or CRI (monitor ECG)
46
Prophylactic antibiotic of choice for intestinal surgery
Cefazolin
47
What suture pattern is great to minimize mucosal eversion (intestinal surgery)?
Modified Gambee
48
Principles of transverse wedge intestinal biopsy
<20-25% circumference
full thickness
3-4mm wide
perpendicular to long axis
49
Difference between the vomiting pattern in a proximal and distal small intestinal obstruction.
Proximal (duodenum or proximal jejunum) - persistent vomiting
Distal (distal jejunum, ileum, ileocecal junction) - occasional vomiting
50
A 8m old kitten presents with vomiting, depression, and painful abdomen on palpation. You do rads and notice the small intestine is plicated. What do you suspect?
Linear foreign body
51
Important spot to check on any cat with a linear foreign body
Under the tongue
52
Where should you remove a non-linear small intestinal foreign body during a complete abdominal exploratory?
A) Aboral to foreign body on the anti mesenteric axis
B) Aboral to foreign body on the mesenteric axis
C) Oral to foreign body on the anti mesenteric axis
D) Oral to foreign body on mesenteric axis
B - Aboral on mesenteric axis
53
Typhlectomy
removal of the cecum
54
Classic US lesion associated with intussusception
target lesion
55
Which is FALSE regarding intussusception?
A) manual reduction increases risk of tearing the serosal layer
B) enteroplication prevents recurrence
C) more common in older dogs
D) resection and anastomosis is done if reduction not possible
C - it is more common in puppies
56
Mesenteric volvulus
German Shepherds
rare, often fatal
intestines twist on mesenteric axis, ischemia
non-responsive to oronasogastric intonation
Tx w/ rapid fluids, resection/anastamosis if possible
57
Begin intestinal anastomosis at the ________ border
mesenteric
58
How do you leak test an intestinal resection/anastamosis procedure?
occlude intestine proximal and distal, inject saline until evenly distended, gently compress, look for leaks
59
Methods to manage intestinal luminal disparity during an anastamosis?
cut segment at angle
space sutures closer together on smaller segment
fish mouth or Cheattle incision
place mesenteric + anti mesenteric sutures
60
```
Highest bacterial population:
A) Small intestine
B) Stomach
C) Large intestine
D) ross university gym
```
C - large intestine
61
Where is a colopexy done?
Left side of abdomen, attaches the descending colon to transversus abdominis
62
2 Indications for colopexy
recurrent rectal prolapse or perineal hernia
63
Another name for feline progressive dysautonomia (large intestine)
Key-Gaskell
64
Suspected reason that you preserve the ileocecal valve during a colectomy?
prevent bacterial overgrowth
65
T/F enemas and stool softeners improve efficacy of a colectomy as a treatment for megacolon
False, Sx is already contaminated so this is a baaaad idea
66
tx of choice for megacolon
Colectomy
67
```
When are post op complications most likely to occur after a colectomy tx for megacolon?
A) Day 1
B) Day 2-3
C) Day 3-5
D) Never
```
C - day 3-5
68
```
You are going to do a colectomy to treat a kitty with megacolon. What is the antibiotic you are going to give prophylactically (considering the fact that you are dealing with a fecal ridden area)?
A) Doxycycline
B) Penicillin
C) Metronidazole
D) Cefazolin
```
D - Cefazolin is prophylactic AB of choice for intestinal surgery
69
4 risk factors for dehiscence after intestinal surgery
1) ingest foreign body or trauma
2) pre-op albumin <2.5g/dL
3) post op increase of band neutrophils
4) pre-op peritonitis
70
A client comes in because their dogs bum looks "messed up." You perform a PE and notice what appears to be tissue protruding from the dog's anus. You decide to conduct a probe test. The probe is passed completely through. What does this mean?
Intussusception - surgical emergency!
71
Perianal fistula
German shepherds, immune mediated cause
| Tx w/ cyclosporine
72
Rectal adenomas
distal rectum
| always submit excised mass, 25% come back as more aggressive tumor
73
Which of the following is FALSE regarding surgical approaches to colorectal adenocarcinoma?
A) Anal - lesions of caudal rectal or anal canal
B) Dorsal - anal canal
C) Rectal pull through - midrectal or distal colonic not approachable through abdomen
D) Swenson's pull through - extend beyond peritoneal reflection into abdominal cavity
B - dorsal is for midrectum but not anal canal
74
T/F: it is okay to excise the external anal sphincter
False, dissect around it
75
Anal sac disease is most common in what sized dogs?
small ones (poodles, chihuahuas)
76
How would you decide to do an open or closed anal sacculectomy?
Closed - tumors or infected glands
| Open - not common, for ruptured sacs
77
2 words that describe treatment of perianal gland adenomas (male intact dogs hint hint)
Castration + resection
78
Apocrine Gland Adenocarcinoma
Paraneoplastic hypercalcemia, PU/PD, renal failure
| Px: no mets - 16-18m, mets <1y
79
Safest division to do hepatic surgery?
Left division
| R has a lot of vasculature, central has gall bladder
80
The closer the injury to the liver hilus, the ______ chance of needing surgery
greater
81
Bile duct stunting is used to relieve obstruction due to
extraluminal compression
82
If an animal has necrotizing cholecystitis and the gall bladder ruptures, it will have ________
septic peritonitis
83
Which is FALSE regarding biliary mucoceles?
A) older dogs, breeds = shelties and cocker spaniels
B) Hyperplasia of mucus secreting cells so excessive mucus secretion
C) Classic kiwi sign on ultrasound
D) labs will show decreased liver enzymes
D - liver enzymes will be increased
84
Tx of choice for a biliary mucocele?
cholecystectomy - take out gall bladder
85
Cholecystoduodenostomy
Biliary diversion
- initial size of stoma 2.5-3cm long to dec risk of gallbladder becoming impacted w/ ingesta (causing cholangiohepatitis or cholecystitis)
86
Abdominal effusion that is diagnostic for bile peritonitis?
effusion bilirubin >2x serum bilirubin
87
For cholecystectomy, where should you transect?
at cystic duct
88
2 organs not drained by liver? what are they drained by?
Kidneys and adrenals
| phrenicoabdominal vein
89
You are doing an exploratory laparotomy on a yorkie, and notice a large vessel entering the caudal vena cava cranial to the vein draining the adrenal glands. What is the significance of this vessel?
This is likely an extrahepatic portosystemic shunt
- signalment and because the phrenicoabdominal vein (drains adrenals) should be the most cranial vein entering the caudal vena cava
90
2 veins commonly associated with extrahepatic PSS
left gastric and splenic veins
91
Intrahepatic PSS
```
large breeds (labs, goldens, aussies, OES)
- patent ductus venosus
```
92
Portal vein atresia
ascites, hypoproteinemia
| No Sx, only medical management
93
You are conducting a necropsy on a dog. You notice there are multiple small vessels around the kidneys that appear to be connected to the liver. Which of the following is likely TRUE?
A) This dog shows evidence that it had systemic hypertension
B) This dog shows evidence that it had portal hypertension
C) This dog shows evidence of kidney failure
D) This dog has a intrahepatic shunt
B - multiple acquired shunts are caused by diseases associated with portal hypertension
94
A middle aged Schnauzer comes into your clinic for a routine check up. The owner mentions the dog seems to be more sensitive to drugs (not sure how the owner knew but very good finding)! You run some liver tests and blood work and find the following:
- bile acids slightly elevated
- protein C >70%
- nuclear scintigraphy - shunt fraction near normal
What is the likely diagnosis?
portal vein hypoplasia
95
Multiple acquired liver shunts are a result of?
vestigial embryonic communications that can open up to prevent lethal portal hypertension to develop
96
Cat presents with copper irises, hyper salivation, aggression and a palpable thrill in the abdomen (Bruit). What is likely?
Macrovascular shunt
97
```
What is TRUE regarding ammonium biurate crystals?
A) Evident on rads
B) Associated with macrovascular shunts
C) Common finding in all dogs
D) Associated with microvascular shunts
```
B
A- not seen on rads
C - only normally seen in Dalmatians
D - I made this up
98
A non-invasive way to document PSS?
nuclear scintigraphy
99
CT angiography is ____ times more likely to diagnose a PSS vs an abdominal ultrasound
5.5
100
3 important places to look during an abdominal exploratory in regards to PSS
epiploic foramen
omental bursa
esophageal hiatus
101
Max pressure change when measuring portal pressures?
9-10cmH2O
102
what vein do you inject contrast in during portography?
mesenteric vein
103
spleen is attached to the stomach via the
gastrosplenic ligament
104
```
Which of the following is NOT an aberrant non-pathology of the spleen?
A) Siderotic plaque
B) Accessory spleen
C) Ectopic splenic tissue
D) Splenic neoplasia
```
D!!!
105
Siderotic plaques of the spleen caused by
Ca or Fe deposits
106
T/F: neoplasia is a common cause of splenic torsion
FALSE it doesnt cause splenic torsion
107
What stomach disease is splenic torsion associated with?
GDV
108
US appearance of splenic torsion
mottled/diffuse hypo echoic areas, intraluminal echogenic densities in veins, no flow in splenic vessels
109
T/F: ideally you should deteriorate spleen prior to splenectomy
NO
110
A Great Dane comes into your clinic with abdominal distension and CV instability. You do an ultrasound and see that there is splenic torsion. You decide to do a splenectomy. What other surgical procedure should you consider doing based on the signalment of the patient?
Gastropexy (reduce risk of GDV)
111
Why shouldn't you race to perform Sx on an animal with splenic infarction?
because it is likely a systemic issue - treat the underlying cause
112
2 causes of diffuse or nodular splenic hyperplasia?
immune stimulation (rickettsia) or splenic hyperactivity (IMHA)
113
Treatment of splenic trauma
compression bandage, splenectomy
114
What is the rule of 2/3 in regards to the spleen?
2/3 dogs with splenic masses will have malignancy and 2/3 of the malignancies will be HSA (equivalent to 44% dogs w/ splenic mass will have HSA)
115
Presence of hemoperitoneum always indicates the chance of malignancy of HSA is 80%
False, this is only true in large dogs
116
small dog that is predisposed to HSA ?
wheaten terriers
117
Arrhythmias in a splenectomized patient increase risk of death by
2 times
118
Px of splenic neoplasia (HSA)
poor bc most have micro metastasis by the time of Dx
Sx: 1-3m
Sx + chemo: 5-6m
Sx + chemo + immunotherapy: 425d if stage 1, no change if stage 2
119
2 methods of complete splenectomy
1) ligation of individual hilus vessels - time consuming, less risk post op hemorrhage
2) ligation of splenic and short gastric vessels - faster, preserves branch to left limb, risk hemorrhage w/ technique failure
120
A non-invasive way to document PSS?
nuclear scintigraphy
121
CT angiography is ____ times more likely to diagnose a PSS vs an abdominal ultrasound
5.5
122
3 important places to look during an abdominal exploratory in regards to PSS
epiploic foramen
omental bursa
esophageal hiatus
123
Max pressure change when measuring portal pressures?
9-10cmH2O
124
what vein do you inject contrast in during portography?
mesenteric vein
125
spleen is attached to the stomach via the
gastrosplenic ligament
126
```
Which of the following is NOT an aberrant non-pathology of the spleen?
A) Siderotic plaque
B) Accessory spleen
C) Ectopic splenic tissue
D) Splenic neoplasia
```
D!!!
127
Pancreatic abscess
ascites + hypoproteinemia
hyperbilirubinemia, elevated liver enzymes due to EHBO
need feeding tube
bad prognosis
128
T/F: neoplasia is a common cause of splenic torsion
FALSE it doesnt cause splenic torsion
129
What stomach disease is splenic torsion associated with?
GDV
130
US appearance of splenic torsion
mottled/diffuse hypo echoic areas, intraluminal echogenic densities in veins, no flow in splenic vessels
131
T/F: ideally you should deteriorate spleen prior to splenectomy
NO
132
A Great Dane comes into your clinic with abdominal distension and CV instability. You do an ultrasound and see that there is splenic torsion. You decide to do a splenectomy. What other surgical procedure should you consider doing based on the signalment of the patient?
Gastropexy (reduce risk of GDV)
133
Why shouldn't you race to perform Sx on an animal with splenic infarction?
because it is likely a systemic issue - treat the underlying cause
134
2 causes of diffuse or nodular splenic hyperplasia?
immune stimulation (rickettsia) or splenic hyperactivity (IMHA)
135
Treatment of splenic trauma
compression bandage, splenectomy
136
What is the rule of 2/3 in regards to the spleen?
2/3 dogs with splenic masses will have malignancy and 2/3 of the malignancies will be HSA (equivalent to 44% dogs w/ splenic mass will have HSA)
137
Presence of hemoperitoneum always indicates the chance of malignancy of HSA is 80%
False, this is only true in large dogs
138
small dog that is predisposed to HSA ?
wheaten terriers
139
Arrhythmias in a splenectomized patient increase risk of death by
2 times
140
Px of splenic neoplasia (HSA)
poor bc most have micro metastasis by the time of Dx
Sx: 1-3m
Sx + chemo: 5-6m
Sx + chemo + immunotherapy: 425d if stage 1, no change if stage 2
141
What feeding tube is ideal for a patient being treated for septic peritonitis?
a combo gastric jejunal (GJ) tube
142
hemostatic clips for splenectomy
<4mm vessels
fast + easy but clip instability
leaves non-absorbable material in body
143
electrothermal bipolar system (ligature) for splenectomy
<7mm, minimal thermal damage to surrounding tissue, minimal complications, fast, no foreign material, $$$
144
Cats and dogs have two ducts associated with the pancreas - the pancreatic duct and the accessory ducts
false, cats dont have the accessory duct
145
The pancreatic duct enters the duodenum at the ________ with the ________
major papilla, bile duct
146
Most islet of lagerhans cells are
B cells (insulin producing) - 60-75%
147
pancreatitis is a common surgical problem?
no, it is common but is not surgical
148
An old dog comes into your clinic presenting with anorexia and vomiting. You perform an abdominal ultrasound and notice there is a cystic lesion on the pancreas. A percutaneous FNA determines it is a pseudocyst. What are the two treatment options?
if clinically ill, resect
| if aclinical, percutaneous aspiration
149
Which have the worse prognosis for pancreatic exocrine adenocarcinoma, dogs or cats?
Cats, have Px of <7d compared to dogs 3m
| both have poor Px
150
Whipple's Triad
Dx insulinoma
1) CS associated w/ hypoglycaemia
2) fasting blood [glucose] <40mg/dL
3) relief of neuro signs with glucose or feeding
151
2 things aside from surgery to treat an insulinoma
1) glucocorticoids - increase hepatic glucose production and decrease glucose uptake by cells
2) Diazoxide - hyperglycaemic agent that inhibits pancreatic insulin secretion and glucose uptake
152
Gold standard surgical treatment for insulinoma?
partial pancreatectomy
153
Gastrinoma
highly malignant
ectopic amine precursor uptake decarboxylase (APUD) produce excess gastrin
Zollinger Ellison syndrome - GI ulceration
154
Primary vs Secondary peritonitis
primary - spontaneous inflammation in absence of intraperitoneal source (FIP), gram +, monobacterial
secondary - underlying primary disease process, gram -, polymicrobial
155
Sx is always indicated in cases of peritonitis
No, it is not routine for primary but is requisite for secondary
156
2 important causal agents of septic peritonitis
E. coli and bactericides fragilis --> synergistic together
157
gold standard to confirm septic peritonitis?
cytology
158
describe glucose, lactate, and septic peritonitis Dx
Following are diagnostic:
fluid glucose 20 points less than serum glucose
fluid lactate 2 points higher than serum lactate
159
What is 4 quadrant antimicrobial selection?
covers anaerobic, aerobic, gram neg and pos
160
2 examples of quadrant antimicrobial combinations?
IV ampicillin, aminoglycoside, metronidazole
BUT - can potentiate renal failure so,
go to = IV ampicillin, baytril, metronidazole
161
```
A patient with compromised kidneys has septic peritonitis. Which of the following drugs would not be part of your antibiotic treatment plan?
A) Ampicillin
B) Baytril
C) Aminoglycosides
D) Metronidazole
```
C - aminoglycosides (potentiate renal failure)
162
class 4 malocclusion
wry bite (asymmetrical skeletal malocclusions)
163
Periodontal ligament functions
isolates tooth from surrounding bone and from osteoclasts
| if ligament ossifies, tooth is susceptible to osteoclasts
164
Dental formula of dogs and puppes
puppy: 313/313 = 28
dog: 3142/3143 = 42
165
Dental formula of kittens and cats
kitten: 313/312 = 26
cat: 3131/3121 = 30
166
Deliver nutrients to odontoblasts
dentinal tubules
167
A worried client comes in, thinking her little dog has an oral tumor. You look inside the mouth and see a small raised area behind the maxillary incisors. What is the owner likely worried about?
this is the incisive papilla that overlies the vomeronasal organ
168
T/F: pulp narrows as an animal ages
true
169
Triadan Quadrants
right maxilla = 1
left maxilla = 2
left mandible = 3
right mandible = 4
170
Rule of 4 and 9 with teeth numbering
canine = 4
| 1st molar = 9
171
Retained deciduous teeth
toy breeds + cats
canine + incisors MC
erupt lingual to deciduous teeth except maxillary canines which erupt rostral to deciduous canines
172
Which is TRUE regarding retained deciduous teeth?
A) All adult canine teeth erupt ROSTRAL to deciduous canines
B) All adult canine teeth erupt LINGUAL to deciduous canines
C) Mandibular adult canines erupt ROSTRAL to deciduous teeth while maxillary adult canines erupt LINGUAL
D) Mandibular adult canines erupt LINGUAL to deciduous teeth while maxillary adult canines erupt ROSTRAL
D is correct, maxillary erupt rostral, mandibular erupt lingual
173
dental crowding
MC in brachycephalics, maxillary 3rd premolars
174
supernumerary teeth
MC in maxilla, 3rd premolars
175
T/F if a deciduous tooth is congenitally absent, adult tooth will also likely be missing
true
176
shelf on palatal surface of maxillary incisors where mandibular incisors occlude
cingulum
177
MC class 1 malocclusion of teeth
base narrow canines
178
Lance tooth
sheltie, retained deciduous teeth, extraction
179
2 cross bites associated w/ class 1 malocclusions
rostral and caudal
180
Class 2 malocclusions
mandibular brachygnathism, parrot mouth
181
class 3 malocclusions
mandibular prognathism, undershot
182
level bite
type of class 3 malocclusion, incisor crowns meet, attrition
183
class 4 malocclusion
wry bite (asymmetrical skeletal malocclusions)
184
A dog presents with a painful tooth. Upon examination, you notice a blue hued cyst surrounding a tooth in the dogs mouth. what is it and how would you treat it?
Dentigerous cyst, extract tooth and remove lining of cyst
185
what drug can cause yellow teeth in puppies?
tetracyclines
186
damage to ameloblasts during enamel development =
enamel hypoplasia
187
Attrition vs abrasion of teeth
attrition - wearing due to contact w/ opposing tooth
| abrasion - abnormal contact of tooth w/ foreign object
188
Draining tract associated with teeth
parulis
189
3 causes of gingival hyperplasia
```
periodontal disease (focal)
generalized (boxers)
Ca channel blockers (amlodipine)
```
190
MC tooth fractured
upper 4th premolar
191
complicated vs uncomplicated crown fracture
complicated - pulp exposed
| uncomplicated - pulp not exposed
192
When is vital pulpotomy most successful?
young dogs <18-24m, within 24h of pulp exposure
193
When is a root canal most successful?
on a mature tooth, >24m
194
Tooth avulsion
displaced from alveolus, emergency if you want to save tooth, after 30m success goes down, put tooth in milk
195
4 systemic antibiotics important in treating periodontal disease
1 - clindamycin
2 - clavamox
3 - metranidazole
4 - doxycycline
196
Which type of tooth resorption is associated with periodontal disease?
type I
197
clinical signs of a cat with tooth resorption
drop food, chatter, anorexia
198
How does treatment of type I and II tooth resorption differ?
type I - extract entire tooth
| type II - amputate the crown
199
Gingivostomatitis
maxillary teeth caudal to canines MC affected
Dx w/ histopath
teeth extraction to Tx
200
Juvenile onset periodontitis
<9m, siamese, maine coon, DSH
| Tx w/ aggressive home care, extractions as needed
201
depressions between ridges of bone and tooth in alveolar process
juga
202
eosinophilic granuloma
rodent ulcerations, hard palate erosion
203
canine ulcerative paradental stomatitis
canine equivalent to feline gengibostomatitis
| kissing lesions in gums
204
MC oral disease/
periodontal disease
205
#1 cause of tooth loss in dogs and cats
periodontal disease
206
mineralized plaque containing bacteria which release endotoxins that cause gingivitis
calculus
207
loosely adhered sub gingival plaque that causes inflammatory response (reversible)
gingivitis
208
Normal sulcus depths
dogs: 1-3mm
cats: 0-1mm
209
Stage 0 periodontal disease
normal
gingival tissue firm + pink
defined stipling
normal sulcus depth
210
stage 1 periodontal disease
gingivitis
erythema
gingival swelling, loss of knife like edge at gingival margin
gingiva bleed when probed
loss of stipling
normal sulcus depth
reversible w/ proper treatment + home care
211
stage 2 periodontal disease
early periodontitis
gingiva bleed when probed
normal-hyperplastic gingiva
minor pockets/gingival recession
<25% attachment loss - evaluate furcation, usually no mobility
periodontitis can be controlled but not reversed
212
stage 3 periodontal disease
gingival hyperplasia +/- recession - horizontal bone loss
25-50% attachment loss - moderate to deep pocket formation, vertical bone loss
furcation exposure, slight to moderate mobility
213
stage 4 periodontal disease
advanced periodontitis
gingival recession w/ horizontal bone loss
deep pocket depth w/ vertical bone loss
>50% attachment loss - furcation exposure, advanced mobility, periodical lucencies
extraction recommended
214
#1 preventative method of periodontal disease
mechanical abrasion
215
T/F - it is especially important to perform extensive dental cleaning and Sx if home care will not be good
false
216
4 systemic antibiotics important in treating periodontal disease
1 - clindamycin
2 - clavamox
3 - metranidazole
4 - doxycycline
217
what is an oral speculum
mouth gag
| careful not to fully compress greater palatine artery esp in cats
218
dental instrument with pointed tip and two cutting surfaces
scaler
219
dental instrument with rounded tip + back with flat face, only one cutting edge, more delicate
curette
220
used to measure sulcus depth
dental probe
221
dental instrument with sharp point used to assess access into pulp cavity
periodontal explorer
222
What drug is given to dogs with sialadeuosis or necrotizing sialometaplasia?
phenobarbital
223
2 critical steps in dental cleanings
sub gingival calculus removal
| polishing
224
purpose of barrier sealants in dental cleaning
retard plaque formation
225
curved root tip
dilaceration
226
expansion of apical portion of tooth root
hypercementation
227
T/F: retained root tips should always be extracted
false, not if type II or III tooth resorption
228
close flaps in oral cavity with ____ suture
3-0 or 5-0 absorbable suture
229
What is key failure in suturing gingiva
TENSION
230
aftercare of gingival flaps
no crunch for 2 weeks
231
cat presents with pulmonary edema and chalk white lesion in the mouth. What is likely cause?
electrical burns - oronasal fistula
232
most common technique to repair an oronasal fistula
single flap technique
233
Highest incidence of jaw fractures in cat + dog
Cat: symphysis + ramus
Dog: evenly distributed
234
tension is highest at what part of mandible
dorsal side (inside teeth)
235
Preferred type of intraoral splint? why?
composite resin because normothermic curing, easy to control application
236
breeds predisposed to lip fold pyoderma
pendulus lipped breeds (spaniels, retrievers, setters)
237
Labial avulsion
lower lip MC
suture effective for maxillary lesions but fails with mandibular - limited soft tissue, edema + swelling, suture moves while eating/drinking
238
Sx considerations for lip reconstruction
suture at lip margin to avoid step deformity
figure of 8 apposes lip margin well
avoid mucosal inversion
239
2 salivary glands removed together
mandibular and sublingual
240
sialadenitis
fever, depression, painful, swollen salivary glands
241
sialadenosis
non painful bilateral enlargement of mandibular gland
| retching, gulping, lip smacking, hyper salivation
242
necrotizing sialometaplasia
similar to sialadeuosis (retching, gulping, lip smacking, hyper salivation) but painful enlargment
243
What drug is given to dogs with sialadeuosis or necrotizing sialometaplasia?
phenobarbital
244
Salivary mucocele
sublingual MC, MC presents cervical
MC dz of salivary system
GSD, poodles
accumulation saliva within non-epithelial, non-secretory lining
Sx removal of gland = definition Tx (except parotid sialocele, ligate duct to result in atrophy)
245
Anatomic landmarks of sublingual gland
lingual nerve is landmark
| 2 muscles to lift and separate - masseter and digastricus
