The Tune-Up (high-value topics) Flashcards

Question

What is the diameter of the distal feline ureter? Is ureteral dimension affected by neutering?

Answer 1

0.4mm No, it has no effect in adult cats.

Answer 2

Calculation of the moment of inertia for a nail uses the radius to the fourth power, and for a plate it's the thickness to the third power. The area moment of inertia in the solid section of an 8 mm interlocking nail is: 6.8 times that of a 3.5mm DCP 3.5 times that of a 3.5 mm broad DCP

Answer 3

1. Placed near neutral axis so takes compression rather than bending in weightbearing 2. Large AMI (radius^4 vs thickness^3 for plate) gives more resistance to bending 3. Locking mechanism gives stability in torsion and compression 4. Intramedullary location eliminates risk of failure via screw pull out

Answer 4

A locking compression plate combines the benefits of locking and compression via combi holes. "Can be used as conventional compression plate or pure internal fixator (bridging plate)."

Answer 5

Decrease von Willebrand factor and Factor 8 Interfere with fibrin clot stability Impaired platelet function

Answer 6

>1ml/kg/min Osmotic stimulation of pulmonary C-fibers, which leads to vagally mediated hypotension, bradycardia, and bronchoconstriction. Hemolysis/phlebitis if given in small veins due to the hypertonicity of the fluid. Arrhythmias if given via jug cath to R atrium **dehydrated patients are volume depleted and won't benefit much/will get more dehydrated

Answer 7

Horner's syndrome Phrenic nerve paralysis (respiration) urine retention

Answer 8

L7-S1 space It has relatively low lipophilicity so it hangs around up to 24hr

Answer 9

It is in the veil of the greater omentum according to all documents. Book says the dorsal leaf of the greater omentum (you gotta lift/tear the ventral portion to get there).

Answer 10

Prostaglandin E1 - prevents and helps heal GI ulceration - Also inhibits IL-1, TNF, TxA, histamine release, enhances effect of NSAID

Answer 11

Generally speaking - cats heal weaker and you should leave their sutures in a little longer. * Cats have lower cutaneous perfusion for the first week (by 2 weeks, no difference) * Cats have a significantly lower wound breaking strength 1 week post-op * Open wounds in cat heal largely by contraction whereas dogs heal largely by central “pull” of fibroblasts and epithelialization *at 14 days 44% of canine wounds are reepithelialized compared to just 13% of cats

Answer 12

Contracture - trunk Epithelialization - limbs

Answer 13

Resting: Hypogastric sympathetic (store) beta receptors relax detrusor Active: Pelvic (pee) nerve parasympathetic to muscarinic receptors -> contract detrusor Somatic: pudendal n.

Answer 14

Intrinsic: enteric nervous plexus in the rectal wall senses distention -> involuntary rectal contraction and internal sphincter relaxation Extrinsic: pelvic plexus Parasympathetic (pelvic n.) ->rectal contraction and internal sphincter relaxation Sympathetic (hypogastric n.) -> inhibit rectal contraction and excite/constrict anal sphincter. Intrinsic system is weaker than the extrinsic -> allows conscious control. Sensory from pudendal lets brain know defecation is imminent, then extrinsic control kicks in to allow voluntary constriction/hold poop in.

Answer 15

Pericardial effusion

Answer 16

Physical = graphs and printouts verifying temp/pressures achieved Chemical = React to parameters with color changes - six classes you want a class 1 (sterilization tape) on outside and another class inside the pack Biological = BEST indicators of efficacy do it weekly Geobacillus stearothermophilus (steam, ozone, plasma) Bacillus atrophaeus (Ethylene oxide)

Answer 17

MOA: varies with concentrations Lower concentrations: bacteriostatic effect by interfering with the cell membrane and causing leakage of cell contents High concentrations: bactericidal effect caused by coagulation of cellular contents Yes MRSA NO spores Yes ototoxic (don't prep the ear with it) Chlorhexidine gluconate precipitates over time in the presence of citrate or chloride ion.

Answer 18

Temporary Ligation Times in Normothermic Animals: Descending thoracic aorta → 5-10 minutes Abdominal aorta → 30 minutes

Answer 19

Sex hormones (reticularis)

Answer 20

Blue-green

Answer 21

Increased peak inspiratory pressure causes decreased venous return -> decreased stroke volume and therefore decreased cardiac output. You should set an initial PIP of 12mmHg and set tidal volume at 10-15ml/kg then titrate to right level to maintain end tidal. I:E ratio should be 1:2

Answer 22

The point at which a tendon inserts into bone, where the collagen fibers are integrated into bone tissue. Those dense bands of collagen fibers that penetrate into cortical bone are Sharpey's fibers.

Answer 23

Mepivacaine In order Mepivacaine < Ropivacaine < bupivacaine

Answer 24

Type 1 fibers are rich in mitochondria, rely heavily on oxidative metabolism, and are slow-contracting and slow-fatiguing. They are SMALLER fibers with smaller nerves. Called red muscle from myoglobin. Type 2 fibers have fewer mitochondria and are glycolytic, fast-contracting, and more easily fatigable. They have LARGER fibers for strength.

Answer 25

With a swaged needle, the suture is placed inside the hollowed end of the needle and crimped in place by the manufacturer. This anchors the suture to the needle, and the suture must be cut to free the needle. Swaged needles are less tissue traumatic than non-swaged (which have an eye for threading)

Answer 26

Reverse cutting needles are the same as a conventional cutting needle except the third cutting edge is on the outside or convex curvature. These needles are stronger than conventional cutting needles and have a *lower chance of pulling through* because the flat edge is parallel to your incision - less risk of larger hole/path.

Answer 27

Twist: 70-100N Loosens at 260N Single loop: 150-200N Loosens at 260N Double loop: 300-500N Loosens at 666N

Answer 28

Third intention - closure after granulation tissue forms!

Answer 29

Idiosyncratic NOT dose dependent

Answer 30

Local and systemic effects. Local: NSAIDs diffuse across gastric mucosal epithelial cell membranes into the cytoplasm, where they cause direct cellular injury. Systemic: Through prostaglandin suppression which affects natural defense of mucus, mucosal layer, blood flow.

Answer 31

PGE2 (COX 1) and PGI2 (COX 2) are important for maintaining renal bloodflow and ion transport via medullary vasodilation **even when the renal arteries are vasoconstricted** So If you take away this protection by giving NSAIDs - any insult or disease condition can be worse.

Answer 32

Chlorhexidine is ototoxic

Answer 33

Beta-adrenergic agonist (very little alpha) Positive inotrope Positive chronotrope May cause seizures in CATS

Answer 34

Low dose = dopaminergic receptors cause vasodilation Intermediate dose= Beta1 agonist, positive chronotrope and inotrope High dose = Alpha agonist, causes vasoconstriction -> reverses vasodilation **weird phrase on test: "Dopamine can be used as part of balanced anesthesia to reverse the vasodilation caused by anesthetic drugs."

Answer 35

The splenic artery (a branch of the celiac)

Answer 36

ileocolic artery

Answer 37

Somatostatin

Answer 38

1:1 (it's a circle)

Answer 39

Compressive shear forces Compressive loading + oblique shear = oblique Fx of osteons -> propagates along Haversian canal.

Answer 40

Converts sound waves to nerve impulses in the ear

Answer 41

10-20 mL/kg

Answer 42

Increased respiratory rate

Answer 43

Intracellular cations, especially phosphorus (Mg, K too) they get moved to ECF to support function. When food is reintroduced, they rush back into cells, causing mayhem as they decrease the plasma concentrations.

Answer 44

The "cut/cutting" setting (NOT coag)

Answer 45

To clear out/prevent rebreathing of CO2 FGF= 3x Minute Volume (MV = TV (10-20mL/kg) x resp rate)

Answer 46

Keeps expired air away from patient (can't flow back)

Answer 47

Reduce pressure of incoming O2 to 45-50psi if coming from a higher pressure container/line (just like a SCUBA regulator)

Answer 48

Absorb CO2 by converting to carbonic acid which decays into calcium carbonate making heat and water. Soda lime is sodium hydroxide, potassium hydroxide, water, and calcium hydroxide It has an indicator dye that reacts to acid (purple) when it is present. It is granular and 4-8 mesh in size.

Answer 49

5,7,12 It is the only voluntary phase

Answer 50

A conditioning layer of secretions (protein, polysaccharides) around the implant. Bacteria then adhere to the layer via adhesins that interact with the fibronectin on the film.

Answer 51

In both the dermis and hypodermis (this is why if dermis is lost burned/scarred areas have no hair/normal glands)

Answer 52

Pepsinogen -> pepsin ->protein breakdown

Answer 53

Gastric acid -> pump out hydrogen ions to keep pH 2-3 **only cell that makes HCL Also make intrinsic factor for B12 Do not confuse with Oxyntic glands which contain all three (mucus neck/chief and parietal cells)

Answer 54

Apply for the shortest possible time, but 1.5-2hr max NO - Not if you think it is infected either *width is inversely related to pressure so use a wider one to prevent local injury from pressure. (LaPlace's Law)

Answer 55

gastrin, histamine, serotonin They are in the body of the stomach

Answer 56

NO Adventitia

Answer 57

Carry oxygenated blood

Answer 58

Cricothyroideus

Answer 59

A GABA agonist, propofol increases CNS inhibition

Answer 60

7.5 days dog 19 days cat

Answer 61

Intracellular is 2/3 Extracellular is 1/3

Answer 62

99% (Test said 97% last year)

Answer 63

Low cytokine levels (only 5% normal FGF-2) Poor capillary perfusion

Answer 64

COX inhibition - COX enzymes play a role in central sensitization

Answer 65

It is intraabdominal BUT extraperitoneal

Answer 66

The nitrogen in air is not absorbed, so it stays in the alveolus to keep it structurally open. If you're on 100%, it can just collapse.

Answer 67

Class 1 = tape on outside Class 2 = Bowie-Dick (air removal) Class 3 = temp or time indicators Class 4: multiparameter Class 5: all types of parameters for that type of sterilization Class 6: Unique indicators for specific diseases (Prions) or specific instruments A class 1 on outside and class 5 inside

Answer 68

5-10% At 3-4 weeks is 25%

Answer 69

Humerus 8 week Tibia 12 week *Greater weights of bone were consistently harvested from the humerus than from the tibia. Restoration of cancellous bone was more rapid and complete in the humerus than in the tibia.

Answer 70

IGF-1 PDGF TGF-B

Answer 71

An infection in a patient hospitalized for >48hr before onset of signs/symptoms of infection

Answer 72

5.9% (previous years 3.5-5%)

Answer 73

30 seconds

Answer 74

Repolarization of the ventricles

Answer 75

For dental occlusion checks in oral procedures.

Answer 76

NMDA receptor antagonist (was an antiviral and then used for Parkinson's due to dopa/NMDA effects).

Answer 77

Bupivacaine (180-480min) Prilocaine (120-180 min) Mepivacaine (90-180 min) Lidocaine (60-120)

Answer 78

Bupivacaine 30 (times that of procaine) Lidocaine 3.6 Yes, CNS and cardiotoxic

Answer 79

Nares, nasal cavity, pharynx, larynx, trachea, bronchi, and bronchioles. (the conducting airways/anatomic dead-space) Alveolar dead-space is caused by alveoli that are poorly perfused with blood, so that gas exchange cannot occur optimally. Physiologic dead-space is the sum of the anatomic and the alveolar dead-space.

Answer 80

* Type I: Fracture through the physis; most common * Type II: Fracture across the physis and extends into a portion of the metaphysis * Type III: Fracture involving the physis and epiphysis (this type extends into the joint) * Type IV: Fracture involving the physis, epiphysis, and metaphysis (this type also extends into the joint) * Type V: Compression injury of the physis

Answer 81

CHF = ASA 4 if active / ASA3 if resolved GDV = ASA 4 Pneumothorax = ASA 4 Pneumonia is probably a 4? (constant threats to life). Renal failure = 3

Answer 82

Resting (epiphyseal side) Proliferative Hypertrophic Mineralization (diaphyseal side) When the chondrocytes in the epiphyseal plate cease their proliferation and bone replaces the cartilage, longitudinal growth stops. All that remains of the epiphyseal plate is the epiphyseal line.

Answer 83

Moving outward from point of greatest energy: - Zone of coagulation: no viable tissue remains - Zone of stasis: reduced perfusion due to damage to RBC membrane proteins and reduced luminal diameter of capillaries due to increased interstitial pressure (FROM EDEMA). **Tissues in this zone may be saved or may deteriorate (vulnerable) - Zone of hyperemia - Primary zone of the inflammatory response

Answer 84

Atracurium antagonizes acetylcholine by binding competitively with cholinergic receptor sites on the motor end-plate. (a non-depolarizing block). Reverse with acetylcholinesterase inhibitors: neostigmine, edrophonium, and pyridostigmine.

Answer 85

Reduce extraosseous blood supply compromise reduce screw hold stress by evenly distributing it along the plate

Answer 86

four major elements, including: (1) mechanical environment (2) osteoconductive scaffolds (3) osteogenic cells (4) growth factors

Answer 87

DOWN - no bowls facing up as need all air to displace/go down.

Answer 88

No evidence to suggest they help?

Answer 89

Chlorhexidine Chlorhex + alcohol prep has best residual activity

Answer 90

Atropine has faster onset, shorter duration Glyco slower onset, longer duration, 4x as potent - Atropine causes sedation because it crosses the BBB - Both cause decreased GI motility and reduce LES tone Dose of atropine: 0.01mg/kg to 0.04mg/kg

Answer 91

Only 5-10% of normal

Answer 92

Clindamycin

Answer 93

Prolonged PR intervals Normal PR is 0.16 sec, >0.2sec is prolonged PR

Answer 94

Water and proteoglycans

Answer 95

PTE Responds well to supplemental O2

Answer 96

For platelet drugs you don't have to stop them. But if you did, it would be 7-8 days (platelet lifespan is 6-8 days). For others you do a bridging therapy with LMW Heparin (enoxaparin) starting 2-3 days before, last dose is 24hr before.

Answer 97

Left atrial dilation and left sided failure

Answer 98

Longissimus Accessory processes extend caudolaterally from the pedicles and are the attachment site for the tendon of the longissimus lumborum musculature.

Answer 99

The first spinal nerve and the associated vasculature.

Answer 100

Cancellous

Answer 101

MOA incompletely understood - we think the molecular iodine (I2) is substituted in stuff or oxidizes which denatures proteins. Involves disordering protein structure, blocking protein synthesis, and altering the cell membrane. They are inactivated in blood and organic debris and can be irritating to skin

Answer 102

Initial compression of the veins draining from the lung lobe causes engorgement and swelling of the lobe with blood -> increased hydrostatic pressure in the vessels -> pleural effusion begins to develop as hemorrhagic fluid leaks from the surface of the lung.

Answer 103

Arteries have elastic fibers in the tunica media / veins have "valves" BOTH have three layers - externa/media/intima

Answer 104

two... but the cranial one is difficult to delineate (it is confluent with pharyngeal structures)

Answer 105

They can set your drape on fire or burn tissue

Answer 106

Xenon - less yellow (more like natural light), very bright

Answer 107

NO Use midaz if you have to, it's metabloites are not active.

Answer 108

Meniscofemoral ligament (moves with femur)

Answer 109

The atlas does not have a "body" It is two lateral masses joined by dorsal and ventral arches, constituting a bony ring for the beginning of the vertebral canal. The lateral masses present two cranial articular fovea for articulation with the paired occipital condyles and two caudal articular fovea for articulation with articular surfaces of axis.

Answer 110

Saline or blood

Answer 111

Non-crushing

Answer 112

vWF, factor 8, fibrinogen, fibronectin Commonly used in von Willebrands patients for procedures

Answer 113

At 4C for up to 35 days

Answer 114

In general they tell you that the conditions for sterilization were met, but not that everything is truly sterilized.

Answer 115

Geobacillus stearothermophilus (steam, ozone, plasma) Bacillus atrophaeus (Ethylene oxide)

Answer 116

sliding, pressing, sawing, and scraping 1. Slide cuts yield precise depth, length, and control of direction and are used most commonly for making skin incisions. 2. Press cuts or stab incisions are useful for opening fluid-filled chambers or making initial entry into a body cavity. Pressure and motion occur in the same direction with a press cut, but depth is poorly controlled. 3. Sawing (e.g., transecting a ligated pedicle) allows continuation of a cut without removal and reinsertion of the blade (newbies saw the skin) 4. Scraping is a method of separating tissue layers. Incisions with a scalpel have 2x the wound strength of electrosurgery at 10 days

Answer 117

Superficial incisional (skin, SQ, 30 days) Deep incisional (muscle, fascia, 30-90 days *procedure dependent) Organ/Space (any area other than the incision that was encountered at surgery 30-90 days)

Answer 118

protein C (stops 5a and 8a) antithrombin III (binds thrombin and X) Tissue factor pathway inhibitor (binds Xa, VII, TF)

Answer 119

Experimental TNF specific monoclonal antibodies have been used to treat Crohn's diseases and rheumatoid arthritis. **Inhibition of TNF alpha for rheumatoid arthritis has been associated with recrudescence of pulmonary mycobacterial infection.

Answer 120

Hypoproteinemia can lead to a more pronounced effect of most anesthetic drugs that are highly protein-bound. With less available plasma proteins to bind the drug molecules, there will be more active form of the drug. Hypoalbuminemia results in reduced colloid oncotic pressure. -> tissue edema. If the plasma oncotic pressure is significantly reduced, normal arterial blood pressure may be hard to maintain during anesthesia.

Answer 121

Double action type (Mr. Chompy)

Answer 122

Pro: TNF-a, IL-1B, IL-6, IL8 (TAB cola, 1968) Anti: IL-1Ra, IL-10 (Rah-ten (rotten)) 6 may do both.... (the 60's were swinging)

Answer 123

Should be 75% (but test may say 80%?)

Answer 124

First degree: All normal P waves are followed by QRS complexes, but the PR interval is longer than normal (>0.2sec). Second degree: (PR is 0.25-0.45sec) Mobitz type I - the PR interval progressively lengthens with each beat until the atrial impulse is not conducted and the QRS complex is dropped (Wenckebach phenomenon); AV nodal conduction resumes with the next beat, and the sequence is repeated Mobitz type II - the PR interval remains constant. Beats are intermittently nonconducted and QRS complexes dropped, usually in a repeating cycle of every 3rd (3:1 block) or 4th (4:1 block) P wave Third degree: P does not conduct to QRS Escape rhythms

Answer 125

The hallmark of cardiac tamponade is elevation and equalization of diastolic pressures in all cardiac chambers. Elevated left end diastolic pressure = increased preload, decreased stroke volume, decreased perfusion of coronary vessels. *KNOW that contractility is not affected, but coronary perfusion is. Poor myocardial perfusion -> hypoxia

Answer 126

Irreversible antagonist of the platelet P2Y12ADP receptor Pro-drug so it requires hepatic biotransformation to the active compound

Answer 127

6 cartilages: Epiglottic, Thyroid, Cricoid, Sesamoid, Interarytenoid, Arytenoid 6 intrinsic muscles: CAD, CAL, Thyroarytenoideus, Arytenoideus transversus, Hyoepiglotticus, Cricothyroideus 2 extrinsic muscles: Cricopharyngeus and thyropharyngeus Drains to deep cervical LN

Answer 128

TEG measures the whole clotting response, it is best for hypercoagulability and if normal is a good indicator of a technical cause of bleeding. D-dimers are degredation products that indicate active coagulation and fibrinolysis. Sensitive for thrombotic conditions but not specific (are good negative predictive indicator - if normal, unlikely to be throwing clots/in DIC). If you don't have TEG for hypercoag - can use D-dimers, just less specific

Answer 129

1. Flash sterilization 2. Steam sterilization -> Kills via coagulation and denaturation of proteins by moist heat 3. Plasma sterilization Uses electromagnetic energy to create plasma from H2O2 -> Plasma creates free radicals that deactivate cellular processes** 4. Vaporized hydrogen peroxide 5. Dry heat 6. Ethylene Oxide -> Alkylation of proteins and nucleic acids *lower temp* 7. Ozone sterilization -> Loose oxygen molecule that readily oxidizes other molecules to cause destruction of microorganisms 8. Radiation (cobalt 60 gamma rays)

Answer 130

Cat seem to heal more by contraction along wound edges Dogs healed by central “pull” of fibroblasts and epithelization

Answer 131

Mandibular is at caudomedial angle of mandible medial to the bifurcation of the linguofacial and maxillary veins. The cranial border of the mandibular abuts the sublingual and they share a capsule. Their shared duct opens at the sublingual caruncle lateral to the lingual frenulum. Supplied by the glandular branch of facial artery. Drains to medial retropharyngeal LN

Answer 132

Hypoventilation = progressive elevation of the plateau above the line Hyperventilation = progressive decrease in height of plateau Rebreathing CO2 = baseline is elevated Leak in system = peak reached but trails off downward (no plateau)

Answer 133

Broadly, it's 80% Epi and 20% Norepi Technically, it's species specific: Dogs: 60%(epi), 40% (norepi) Cats: 70% (epi), 30% (norepi)

Answer 134

Prevalence: The number of cases of disease in a known population at a designated time. Incidence: The number of new cases of disease that occur in a known population over a designated period of time.

Answer 135

For contraction: Internal sphincter -> hypogastric n., alpha External sphincter -> pudendal nerve (nicotinic) + pontine micturition center

Answer 136

Acidic: Penicillins inactivated below pH 6.0 Basic: Fluoroquinolones, aminoglycosides more effective in alkaline pH Hypertonic/hyperosmolar: Impaired efficacy of beta-lactams Low oxygen environment: Aminoglycosides inactive. Cidal drugs impaired due to slow reproduction. **Pus is acidic and hypertonic/hyperosmolar Cephalexin is good in abscesses

Answer 137

Steroid anesthetic Enhances GABA- and glycine- mediated CNS depression Can cause cardiac depression and apnea (less than propofol) DON'T USE in DCM

Answer 138

Chief cells make PTH. Externals are at the cranial dorsolateral margin of the thyroid. Internals are at the caudal pole of the thyroid. The externals get blood supply from cranial thyroid. The internals get theirs from thyroid parenchyma. Drainage is thyroid veins.

Answer 139

Complete fusion of the paramesonephric (Mullerian) ducts produces a single cervix in dogs. This also produces the cranial vagina that merges to the urogenital sinus (vestibule).

Answer 140

Amikacin, Gentamicin, Streptomycin Target bacterial ribosomes Bind to the 30s ribosomal subunit Binding is non-reversible -> cidal activity, concentration dependent Oxygen dependent for cell entry -> not good for anaerobes - but if combine with something that targets cell wall can do better

Answer 141

Medial collaterals: Long part - Taut in extension Tibiocentral (short) - Taut in extension Tibiotalar (short) - Taut in FLEXION *Most substantial component of MCL Lateral collaterals: Long lateral ligament - Taut in extension Calcaneofibular short ligament - Taut in extension *Most substantial compontent of LCL Talofibular (short) - Taut in FLEXION (The two talar ones (tibiotalar and talofibular) are taut in flexion)

Answer 142

40 degrees (a regular DCP is only up to 25 degrees, both are 7 degrees transverse)) AO also says the symmetrical holes allow you to angle that 40 deg in either direction and apply compression at any level on the plate.

Answer 143

Antagonism of NMDA Dissociation = higher brain function separated from unconscious function. Any systems not under conscious control (laryngeal function, respiration) remain normal. Increases muscle rigidity and pressures (IOP, ICP) Increases myocardial workload **(do not use in heart patients or renal dz)

Answer 144

You can't do both jugular veins or both carotids

Answer 145

Ultrafiltrate of blood with very few cells, little protein, and slightly less glucose than blood. - Produced by choroid plexus in ventricles, flows rostral to caudal: Lat. ventricles-> intraventricular foramina ->3rd ventricles -> mesenceph. aqueduct -> 4th ventricle -> etc. - Is in the subarachnoid space between arachnoid and pia

Answer 146

Analog of codeine In people it is metabolized to a full Mu, causes analgesia with serotonin and adrenergic receptor effects. Dogs don't metabolize that way - so weak Mu at best Cats do make it, but it's bitter so they hate it Don't mix with SSRIs or trazodone (serotonin syndrome)

Answer 147

TMS, Doxycycline, Rifampin, Metronidazole, Chloramphenicol (lipid soluble!) Fluoroquinolones (sometimes) 3rd gen cephalosporin (if inflammation) Timid DOgs Rarely MElt CHeese (For 3 Cents) You should know that cefazolin does not cross**

Answer 148

Alpha cells - glucagon Beta cells - Insulin Delta cells - somatostatin F or PP cells - Produce pancreatic polypeptide

Answer 149

Crushing: Babcock, Allis, Ochsner-Kocher Non-Crushing: Doyen intestinal, DeBakey, Satinsky, Cooley, peripheral vascular clamps (Bulldog, patent ductus clamps)

Answer 150

Metzenbaum: 1/4 overall length Mayos: 1/3 overall length

Answer 151

Ring: Stevens Spring: Wescott

Answer 152

Bone-cutters are paired, chisel-like tips and beveled on one side Osteotomes are beveled on both sides

Answer 153

Body weight in kg x percent dehydration = deficit in LITERS Fluid needs = Deficit correction + estimated ongoing losses + maintenance needs

Answer 154

YES When a screw head is moving in relation to the plate hole, or in relation to a nail, the passive layer is repeatedly destroyed and there is “fretting” and local corrosion in the area of contact.

Answer 155

The term buttress plating is reserved for a plate that negates compression and shear forces within the metaphyseal region. The plate is anchored to the main stable fragment and contoured to the smaller metaphyseal fragment to minimize displacement of the smaller fragment. Interfragmentary screw fixation is commonly used in conjunction with buttress plate fixation.

Answer 156

Calcaneus - Central (talocalcaneocentral jt) - 4th (calcaneoquartal jt) - Talus (talocalcaneal jt)

Answer 157

Cranial tibial artery (becomes dorsal pedal and dorsal MT arteries) Plantar branch of saphenous artery (medial and plantar) Tibial nerve (becomes medial and lateral plantar nerves) Common peroneal nerve Saphenous nerve (sensation to dorsomedial tarsus and MT)

Answer 158

Gastrin is normally made in the gastric endocrine cells. In gastrinoma, pancreatic islet cells (delta) that normally make somatostatin transform to secrete gastrin. -> hypersecretion of gastric acid and ulcers (Zollinger-Ellinger syndrome is a non beta-cell tumor of the panc)

Answer 159

YES and bactericidal Interfere with cell-wall synthesis Renally excreted

Answer 160

Decreased CVP

Answer 161

NO 35-40% medullary cavity

Answer 162

Alveolar type 2 cells. Surfactant increases lung compliance by lowering surface tension and reduces the amount of work needed to inflate the lungs.

Answer 163

Yes, Ketamine maintains respiratory centers sensitivity to PaCO2 and causes some bronchodilation.

Answer 164

Splenic vein -> Gastrosplenic vein -> Portal vein

Answer 165

RBC → 10-20% (Test may just say 20%) Platelets → 30 %

Answer 166

1. Hyperosmolality - Dehydrate microorganisms and have a cidal and inhibitory effect on their growth - Draws exudate and accompanying debris out of the wound - Reduce surrounding tissue edema 2. Enhanced antimicrobial effects - Presence of PHYTOCHEMICALS* and acidic pH of 3.2-4.5 - Glucose oxidase acts on glucose in honey - produces *HYDROGEN PEROXIDE (0.003%) Inhibin number = amount of dilution to which honey will retain its antibacterial activity (higher number = can be diluted more/ is more potent)

Answer 167

Hyperfibrinolysis syndrome / fibrinolytic syndrome. Use Epsilon-ACA or Tranexamic acid (antifibrinolytic agents) which block the breakdown of clots.

Answer 168

1.9mm 30 degree

Answer 169

No specific location for biologics - but it would follow that they should go in the deepest part of a pack. Bios are only run weekly due to cost.

Answer 170

methemoglobinemia +/- hepatotoxicity and renotoxicity. Cats are deficient in glucuronidation and sulfation abilities -> make NAPQI instead = badness.

Answer 171

No for linens No for aeration

Answer 172

Respirations become faster and larger, then slower, followed by an apneic pause; caused by increased intracranial pressure.

Answer 173

May improve smooth muscle contractility and sensitize to alpha-adrenergic stimulators (such as proin)

Answer 174

A second gen cephalosporin like cefoxitin plus ampicillin for enterococcus coverage. **Yes, this is in multiple spots

Answer 175

Supplied as a liquid monomer. Polymerizes when it contacts anions in moisture. Should be applied over, and not in wound (will act as FB) Breaks down into cyanoacetate and FORMALDEHYDE. Non-medical glues have more short-chains that make more formaldehyde and have less breaking strength. Don't use them.

Answer 176

Check for presence of multimers: <50% of normal is deficient Used as definitive confirmation after a BMBT is suggestive.

Answer 177

The mechanism of action is not well understood. -Thought to block voltage-gated Ca+ channels & decreases extracellular glutamate While it is structurally related to GABA, it does not appear to alter GABA binding, reuptake, or degradation.

Answer 178

oxygen —green or white (Pressure is 2,200 PSI , E cylinder is 660L / H tank is 6,900L) nitrous oxide—blue (Pressure is 745 PSI, E cylinder is 1,590L) air—yellow (pressure 2,200 PSI, E cylinder 6,550L) CO2 - Grey (pressure 838 PSI, E cylinder is 1,590L) nitrogen—black )Pressure 2,200 PSI, H tank 6,400L) helium -- brown Pin-indexed safety system (PISS) is for cylinder attachment, diameter-indexed safety system (DISS) is for central pipeline attachment.

Answer 179

After surgery, risk of PTE is up to 72hr. Cushing's causes a hypermetabolic state with hypertension and increased PCV -> pro-clotting environment. - One study found dogs had increased procoagulant factors and circulating fibrinogen - Antithrombin was also deceased and increased thrombin-antithrombin complexes were noted.

Answer 180

Caudal rectal nerve - a branch of the pudendal n.

Answer 181

Most SSIs are caused by endogenous microorganisms that appear on the patient's skin when the surgical incision is made.

Answer 182

Inherited defect in cellular ryanodine receptor (RYR1) -> Excessive and dysregulated intracellular Ca release -> muscle spasm, rigidity, hypermetabolic state First sign: Abrupt increase in ETCO2 (or PaCO2) -> elevated temperature and HR Caused by: Succinylcholine, halothane Treated with: Dantrolene (stop inhalant /use TIVA)

Answer 183

Type IV with a medial fracture/slab and a dorsal slab is the most common type of fracture. You need to rigidly fix both fragments - do the medial first to prevent joint collapse. The dorsal is articular.

Answer 184

1,2,5 degenerate 3 becomes common carotid artery 4 becomes heart/aorta - usually left 4, if right 4 persists is PRAA 6 becomes shunts between the pulmonary and systemic arteries - Left 6 becomes ductus arteriosus (PDA) - Right 6 degenerates

Answer 185

Transverse: Right colic and middle colic arteries Cranial mesenteric -> common colic trunk: Cecum: ileocolic artery Ascending: ileocolic proximally, right colic distally Transverse: Right colic and middle colic Descending: - Proximal: middle colic - Distal: left colic off the caudal mesenteric **Most distal part is - cranial rectal artery - also off cd. mesenteric

Answer 186

**Activated M1 macrophages are a major source of TNF-alpha.*** Also made by : Monocytes, macrophages, neutrophils, NK cells, and several others (T, B, fibroblasts).

Answer 187

Granulation bed is composed of: capillary bed fibroblasts macrophages a ground substance of collagen, fibronectin, and hyaluronic acid

Answer 188

Type I: present in bone, skin, ligaments, and tendons - 90% of organic matrix of bone - 80% of the dry weight of tendons - 75% of ligaments is collagen (with 85% of collagen as type I) - 80% of skin collagen is type 1 Type II: present in cartilage - 50% of cartilage is collagen (with 85-90% of the collagen as type II) Type III: present in skin(20%), around vessels, and newly formed wounds (90%)

Answer 189

In dogs, opioid-induced bradycardia is responsive to atropine, an anticholinergic agent. For treating of excessive vagal tone, the recommended dose is 0.01mg/kg to 0.04mg/kg IV or IM. It can decrease GI motility and cause sedation (BBB) It doesn't work on alpha-2 reflex bradycardia

Answer 190

29-65C (84-149F) for 120-300 minutes (2-5 hours) After this it needs to be aerated - allows desorption of the toxic ETO residual contained in exposed absorbent materials (plastics/rubber).

Answer 191

Monocryl (poliglecaprone 25): Approximately 50% of its original tensile strength in 1 week and 20-30% at 2 weeks BUT has higher initial breaking strength. Vicryl (polyglactin 910): Approximately 50% of its original tensile strength at 2-3 weeks

Answer 192

Iso: 1.3% dog / 1.7% cat Sevo: 2.1% dog / 3.1% cat NO: 188% dog / 255% cat

Answer 193

Topoisomerase inhibitor that prevents gyrase from cutting double stranded DNA -> DNA replication can’t continue. Bacteriocidal

Answer 194

The relative lipid solubility of morphine is set at 1 (it is the index) and it has LOW solubility. High lipid solubility facilitates opioid transport into the biophase or site of action. -> High lipid solubility confers a more rapid onset of action. Fentanyl is 580x as lipid soluble as morphine (much more rapid)

Answer 195

Brachial plexus block (C6, C7, C8, T1) Puncture point is cranial to acromion and medial to subscapularis Use nerve stimulator to locate needle placement Once there is flexion of the elbow (musculocutaneous nerve) If there is just extension of the elbow, needle has gone too caudal and stimulating just the radial nerve. Bupivacaine 4mg/kg

Answer 196

Vasopressin (also called antidiuretic hormone or ADH) Vasopressor on non-adrenergic V1 receptors (0.5-5mU/kg/min) Synthesized in the hypothalamus. In normal conditions, it acts in the collecting duct of the kidney to retain water -> increasing urine osmolality and decreasing urine flow. During hypovolemia, vasopressin not only increases water retention, but exerts a powerful vasoconstrictor effect especially on smaller vessels.

Answer 197

Cardiac output= HR x SV CO= (MAP-CVP)/total peripheral resistance (another factor for CO) SV = end-diastolic volume - end-systolic volume

Answer 198

Dia. of thread 3.5mm Thread pitch 1.25mm Dia. of core 2.4mm Dia. of head 6.0mm

Answer 199

Cephalosporins Three MOAs: - beta-lactamase inhibitors - mecA gene encodes a mutation that causes reduced affinity for beta-lactam ring 🡪 resistance - change in porin size

Answer 200

"A Gentleman Halstead, Always Observes The Principles" Aseptic technique Gentle tissue handling Hemostasis Apposition Obliteration of dead space Tension minimizing Preserve blood supply

Answer 201

IM pin should be 70% of medullary cavity (diameter) IM pin with plate should be 35-40% medullary cavity (diameter)

Answer 202

Dogs: Staph intermedius, Staph aureus, and beta-hemolytic Strep most common. Staph canis is most common from congenital or neonatal exposure Cats: Pasteurella multocida and Bacteroides spp. Reflects oral flora of the feline mouth and the frequency of penetrating cat bites.

Answer 203

Biosynthesis of proteoglycans and glycosaminoglycans (GAGs) involves transcription and translation of the core protein gene, addition and sulfonation of glycosaminoglycan side-chains within the ENDOPLASMIC RETICULUM, and packaging within the GOLGI apparatus in preparation for secretion. Chondroitin sulfate is the most prevalent GAG Hyaluronic acid is an unsulfated "backbone" for making other GAGs

Answer 204

I- cribriform plate II- optic canal III, IV, VI- orbital fissure/canal V- ophthalmic (orbital fissure), maxillary (round foramen-> alar canal-> rostral alar foramen), mandibular (oval foramen) VII- stylomastoid foramen / internal auditory meatus(?) IX, X, XI- jugular foramen and, then, through the tympano-occipital fissure XII-hypoglossal canal

Answer 205

Vitamin B12 is released from dietary proteins in the stomach by acid gastric secretions It is then bound to R protein and passes into the small intestine, in which pancreatic proteases (trypsin) digest the R Protein, thereby releasing Vitamin B12. The free Vitamin B12 than binds to intrinsic factor (a mucoprotein), which is produced by the gastric mucosa in humans but appears to be produced primarily in the pancreas in dogs and cats. The Vitamin B12-intrinsic factor complex is absorbed by the distal small intestines, especially the ileum.

Answer 206

Leiomyomas represent 90% in dogs Cats get endometrial adenocarcinomas that like to met

Answer 207

Prostaglandins are synthesized by both the COX-1 and COX-2 enzymes in the healthy kidney and influence renal blood flow, glomerular filtration rate, renin release, and Na excretion PGE2 and prostacyclin (PGI2) increase renal blood flow and glomerular filtration rate in normal conditions, resulting in greater tubular flow and secretion of potassium. Under conditions of decreased renal perfusion, the production of renal PGs serves as an important compensatory mechanism. PGI2 (and possibly PGE2) increases potassium secretion mainly by stimulating secretion of renin -> increased secretion of aldosterone. PGE2 acts as a counterregulatory factor under conditions of increased sodium reabsorption. PGE2 decreases sodium reabsorption at the thick ascending limb of the loop of Henle.

Answer 208

CNS stimulant which causes an increased respiratory rate and tidal volume. Used in laryngoscopy if respiration is weak/anesthesia too deep and need to verify normal function/lack thereof. Dose: 1.1mg/kg

Answer 209

Lower pH, BE and bicarbonate concentrations were found in GDV dogs with gastric necrosis.

Answer 210

Most common acid/base abnormality in GDV patients is metabolic acidosis (base deficit) and lactic acid is a major contributor. Lactate concentrations in dogs with gastric necrosis ( >6.6mmol/L) were significantly higher than that of dogs without gastric necrosis (<3.3 mmol/L) Specificity and sensitivity of using plasma lactate concentration (cutoff of 6 mmol/L) to predict which dogs had gastric necrosis were 88 and 61%, respectively.

Answer 211

A Tuohy needle is a hollow hypodermic needle for inserting epidural catheters. The needle features an anti-coring curve at its tip designed to cause a catheter passing through the needle's lumen to exit laterally at a 45 degree angle.

Answer 212

For every additional hour of operating time 2x infection 30% per person

Answer 213

LigaSure Can seal up to 7mm diameter vessels LDS can occlude vessels > 2/3 the width or <1/3 width the staple size **should be several mm from cut edge LDS comes in two sizes: 5.8mm and 8mm

Answer 214

1. Hypovolemic- reduction in circulating intravascular volume 2. Distributive- impairment of the mechanisms regulating vascular tone with maldistribution of the vascular volume and massive systemic vasodilation (sepsis) 3. Cardiogenic- myocardial dysfunction, severe arhythmia, mechanical defects, drugs 4. Hypoxic- adequate tissue perfusion but inadequate arterial oxygen content or cellular oxygen utilization

Answer 215

Dermis: Superficial/Subpapillary plexus Middle/Cutaneous plexus Hypodermis: Deep/subdermal/subcutaneous plexus **Connections between plexuses allow for collateral flow to adjacent areas of the skin

Answer 216

MAXILLA: Infraorbital nerve block: 1-inch needle either intra- or extraorally about 1 cm cranial to the bony lip of the infraorbital foramen. Maxillary PM3 is a landmark Maxillary nerve block: 1-inch needle ventral to the border of the zygomatic process and about 0.5 cm caudal to the lateral canthus of the eye. Direct the needle perpendicular to the skin and medially. Maxillary last molar is a landmark. MANDIBLE: Mental nerve block: 1-inch needle over the mental nerve, rostral to the middle mental foramen. Mandibular PM2 is a landmark. Mandibular alveolar nerve block: 1 inch needle at the lower angle of the mandible about 1.5 cm rostral to the angular process. Direct and advance the needle 1.5 cm dorsally against the medial surface of the ramus of the mandible to the palpable lip of the mandibular foramen.

Answer 217

Left: - Left cranial (subdivided into cranial and caudal) - Left caudal Right: - Cranial - Middle - Caudal - Accessory

Answer 218

In the thorax, the thoracic duct travels dorsolateral to the aorta on the RIGHT in dogs and LEFT in cats 10th ICS for thoracotomy In dogs, at the level at the 5th or 6th thoracic vertebrae, the duct travels to the left. Both species terminate at the left external jugular vein or jugulosubclavian angle

Answer 219

1. NSAIDs (carprofen) have been shown to cause sloughing of cells and erosion of the colonic mucosa, thus compromising the integrity and barrier function of the mucosa. 2. Anemia (as low as 15%) does not seem to affect healing, and administration of blood transfusion may actually inhibit colonic wound healing. 3. Tension should be minimal to avoid induced local ischemia - obstructions/stretch is not good. - PaO2 less than 40mmHg will prevent collagen formation - PaO2 less than 10mmHg will cause failure of angiogenesis and epithelial hyperplasia 4. When fully healed, colon has a higher tensile strength (% of original strength) than skin

Answer 220

Increased risk of surgical site infection. (possibly by re-contimination, consider covering skin if procedure is next day)

Answer 221

TEG (but if you don't have it D-dimers)

Answer 222

As a source of preformed cytokines / later as a aggregator. Platelets adhere to the exposed endothelial collagen, which activates them to release granules and start the cascade. Thrombin is the most potent activator of platelets.

Answer 223

CVP is determined by interaction of cardiac function and venous return, these are influenced by: Total blood volume Vascular tone Cardiac output Right ventricular compliance Intrathoracic pressure (using a ventilator) Normal CVP: 0-8cmH2O or 0-5mmHg

Answer 224

Mucosa - 3 days Submucosa is 30% at 48hr and 75% at 4 months (slower than SI)

Answer 225

At a pH of 7.15 and HCO3− of 24 mEq/L, the base deficit will be 6. (metabolic acidosis) At a pH of 7.47 with the same HCO3− of 24, the base deficit will be −1 (base excess, i.e., negative base deficit = metabolic alkalosis).

Answer 226

1. Celiac artery gives off the splenic and hepatic arteries: - The splenic artery supplies the left limb of the pancreas. - The hepatic artery -> cranial pancreaticoduodenal artery and supplies the cranial right limb and duodenum. 2. Cranial mesenteric artery -> caudal pancreaticoduodenal artery supplies distal right limb and anastomoses to the cranial.

Answer 227

Cortex: Steroids (GFR / sugar, salt, sex) Medulla: Catecholamines (normally don't make a lot of sex hormones)

Answer 228

Erythromycin (macrolide) inhibited Beta-lactams less activity (penicillins inactivated at (<6.0) Aminoglycosides and fluoroquine less effective

Answer 229

Applicable ONLY in skeletally immature animals - Best younger than 5-6 months Relies on the use of long, thin, compliant plates that span entire length of bone between distal and proximal physes Secured to bone with as few diverging screws as possible (typically 2 - four cortices proximal and distal) No less than 3 open holes / 2.0/2.7 plate in med-large breeds How it works: Increases working length of plate (distance btwn the inner most screws) Which increases the compliance of the construct [compliance = L^3 / (I x E) ] Which allows plate deformation within its elastic limit Indirectly spares bone-screw interfaces from excess shear stresses Also contributes to preservation of periosteum and blood supply

Answer 230

Eccentric = gold, 1mm off center for compression Concentric = green (neutral) 0.1mm off center so small amount of compression

Answer 231

Made of myofibrils that are tandem arrays of contractile functional units called sarcomeres. Sarcomeres are made of parallel arrays of overlapping actin and myosin filaments. Myosin is thicker than actin. - M line / I band contains myosin (myosin in middle) - Actin binds to the Z band at the end of sarcomere - A band all overlap (actin and myosin) The sarcolemma is the cell membrane of the myofiber. If it is intact, they regenerate rapidly.

Answer 232

Fibroblasts make collagen. (and smooth muscle cells in GIT) Made from amino acids in diet. Pathway: mRNA -> pre-pro-collagen Pre-pro-collagen -> triple helix procollagen -> ECM In ECM Procollagen ->tropocollagen Fibrilogenesis assembles tropocollagen into macromolecular fibrillar complexes within the extracellular matrix = collagen

Answer 233

COX1- housekeeping isoform that are typically found in GI mucosa, kidney, platelets, endothelial cells - Predominant role in protection of the GI tract - Decreases HCl secretion, increases mucosal bicarb and mucosal production, increase epithelial cell proliferation and mucosal blood flow COX2- constitutively expressed in the kidney and brain - major role is inducible in inflammation - has cytoprotective effects in damaged or inflamed GI mucosa

Answer 234

Sarcomas metastasize via hematogenous spread Carcinomas and round cell tumors metastasize via lymphatics

Answer 235

1. Cell detaches from primary tumor 2. Migrates through surrounding tissues 3. Intravasation into a microvessel 4. Survival in circulation 5. attachment to distant endothelial cell 6. extravasation 7. angiogenesis 8. Proliferation

Answer 236

They help with invasion past the basement membrane by tumor cells.

Answer 237

1. Aponeuroses - flattened structures that connect muscles to bones or other fascial elements (fascia of biceps femoris, rectus abdominis) 2. Positional tendons - discrete and stiff structures that transfer muscular forces to bones (infraspinatus, DDF) CAN wrap around as they traverse joints. 3. Energy storing tendons - have a greater elastic content to respond to weight bearing by elastic recoil (common calcanean tendon) - canNOT wrap around to connect to joints**

Answer 238

Connective tissue bands that connect bone to bone. Yes, the transverse humeral ligament is an example that has origin and insertion on same bone. A capsular ligament.

Answer 239

Chromium, in the presence of air (oxygen), forms a thin film of chromium oxide which covers the surface of stainless steel implants. The stainless steel passivation process chemically removes any free irons and forms a passive oxide “film” layer which further improves corrosion resistance.

Answer 240

Viable: - Hypertrophic: motion - Oligotrophic: loose implants --> poor vascularity --> lack of cellular activity Non-Viable: - Dystrophic: compromise of vasculature - Necrotic: infected - Atrophic: dead bone removed without replacement (defect: big gap)

Answer 241

Resorptive modeling Occurs on the periosteal surface as well as in the region previously occupied by epiphyseal cortex.

Answer 242

Primary: Mechanical damage (contusion, etc) Secondary: A series of metabolic and biomechanical changes that cause neuronal and glial cell death. (increased intracellular Na, Cl, Ca -> cytotoxic edema; decreased astrocyte uptake of glutamate -> more extracellular glutamate -> increased excitation ->excitotixicity)

Answer 243

The non-dominant hand Latex are more resistant to perforation than vinyl gloves Single: 12.7 - 31% perforations Double: 3.8 - 13% perf for inner gloves (less holes, similar contamination rates)

Answer 244

Clinical signs (pupil position, jaw tone, palpebral, PLR) ETCO2 Brainwave activity - electroencephalogram - not good for dogs or cats *For surgery goal is "Stage III, Plane 2" (light-medium, loss of palpebral), but Stage III plane 3 is acceptable (deep medium, loss of PLR)

Answer 245

Positive pressure ventilation (manual) Reservoir bag size = 5-10x Tidal Volume (large enough to provide reasonable reservoir but not so big that it is difficult to see breathing Big dogs should be minimum 6x TV

Answer 246

- Gelatin (Gelfoam) - Bovine collagen - Better than gelatin but more expensive - Cellulose (Surgicel)- acidic properties denature blood proteins stimulating hemostasis (However, acidity inactivates thrombin, which makes it the least effective hemostat) - Polysaccharide spheres (Hemablock)- hydrophilic and concentrates solid components of blood by dehydrating it / Volume can expand 500% - Bone wax/Ostene- blocks the surface and allows clot formation

Answer 247

- Thrombin - actively converting endogenous fibrinogen to fibrin and creating a clot - Alginates- seaweed derived protein that can be combined with calcium or sodium ion On contact, calcium ions are released 🡪 clotting cascade **Cannot be used intracavitary (only on wound surfaces) since they cause FB reaction

Answer 248

Intracellular = 40% weight Extracellular = 20% weight

Answer 249

25% intravascular 75% interstitial

Answer 250

Type 1 (68%)

Answer 251

1,3 in the Skin 1,3,5 collagen in GIT

Answer 252

Type 1: 80% Type 3: 20%

Answer 253

Type 1: Wound < 1cm (sharp fragments make wound, then often retract below level of skin) Type 2: Wound >1cm without extensive soft tissue damage, flaps or avulsions (often wound was caused by outside forces) Type 3: Extensive soft tissue damage (avulsion, degloving, bone loss) fractures with neurovascular injury, gunshots, traumatic partial amputations There are 3 subtypes of Type 3: IIIa: Adequate soft tissue available IIIb: extensive loss of soft tissue, periosteal stripping, massive contamination IIIc: arterial injury that will require repair (often we amputate in vet med)

Answer 254

Type I: Same as for closed fracture of the same type Type II: Can sometimes treat same as closed - use your judgement Type III: You may not be able to do internal fixation ** benefits of stability outweigh the potential harm of implants or need for future explant

Answer 255

Inflammatory (early 24-48hr, late 48-72hr) Proliferative (day 4-12) - Contraction (soon after the granulation bed is established (dog day 4.5? cat later) - Epithelization (on the edge of wounds it begins within hours) Maturation (6wk collagen laid down / 12-18 months of organizing)

Answer 256

- Totipotent: can form ectoderm, endoderm, mesoderm AND extraembryonic tissues (trophectoderm) - From Zygote - Pluripotent: can form ectoderm, endoderm, and mesoderm - Embryonic stem cells and induced pluripotent stem cells - Multipotent: can only form the germ layer from which they originated from - Adult stem cells

Answer 257

hypotension decreased myocardial contractility acute renal failure coagulopathies GI hemorrhage delayed wound healing

Answer 258

Local anesthetics block the voltage-gated sodium channels of C- and A-type nociceptive fibers. Nerve cell depolarization is prevented -> blocking the conduction/transmission of nerve impulses to higher brain centers. They all inhibit at the dorsal horn.

Answer 259

2.5-4.8% (other sources 2-5%)

Answer 260

No, not all dogs have them. They are in the visceral group of resp. nodes Parietal nodes (sternal, etc) drain that side of things.

Answer 261

Chondroitin sulfate is the most prevalent GAG Hyaluronic acid is an unsulfated "backbone" for making other GAGs

Answer 262

Arises cranially toward left as aortic arch and ascending aorta Curves dorsocaudally to form descending aorta First branch is brachiocephalic trunk - gives off common carotid and right subclavian aa. Second branch is left subclavian a.

Answer 263

Synovium, endothelium, chondrocytes, osteoblasts, monocytes, macrophages

Answer 264

Nuclei are collections of neuronal bodies in the CNS Ganglia are OUTSIDE CNS Caudate nucleus.

Answer 265

Olfactory Frontal Parietal Temporal Occipital Limbic system

Answer 266

Grey matter (basal nuclei) is superficial White matter (tracts and fibers) is deep

Answer 267

**121C for 30 min and 15-30 drying or 132C for 15 min and 15-30 drying

Answer 268

For certain sharp instruments, powders, and glassware that may be damaged by steam

Answer 269

135C for 3 minutes, with 1 minute drying

Answer 270

The net external WORK of the ventricle

Answer 271

Respond: hypoventilation, low FiO2, Diffusion impairment, high V/Q (PTE) Poor response: Low V/Q (pneumonia, atelectasis, alveolar collapse, edema) No response: Right to left shunting

Answer 272

parietal -> out into pleural space -> absorbed by visceral

Answer 273

TNM staging: Stage 1: T1N0M0 (tumor < 3cm diameter) Stage 2: T2N0M0 (Tumor 3-5 cm) Stage 3: T3N0M0 (Tumor >5cm) Stage 4: TxN1M0 (met to ipsilateral node, independent of T size) Stage 5: TxNxM1 (distant mets)

Answer 274

24-48: Neutrophils 48-96: Macrophages Lymphocytes arrive at 3-5 days

Answer 275

Paratenon = has a vascular supply that can help heal with vascular buds (gastroc, triceps) Sheathed = avascular, more difficult to heal (DDF)

Answer 276

Non-selective COX Phenylbutazone binds to and inactivates prostaglandin H synthase and prostacyclin synthase through peroxide (H2O2) mediated deactivation. Can cause blood dyscrasias, renal failure and biliary stasis DON'T use in cats

Answer 277

The coronary ligament attaches the liver to the diaphragm and is a continuation of the hepatic peritoneal covering, which is present over the entire surface of the organ except for the region of the porta hepatis. Emanating from the coronary ligament are two right-sided triangular ligaments. In most cases, a single left-sided triangular ligament attaches to the left lobe of the liver. The hepatorenal ligament attaches the caudate lobe of the liver to the right kidney.

Answer 278

1. Vasodilation (erythema/increased temp) first 2. Loss of sensation of temperature - C fibers, 0.3-1 μm diameter, unmyelinated 3. Loss of sensation to sharp pain - A-delta fibers, 1-4 μm diameter, myelinated 4. Loss of sensation to light touch - A-beta fibers, 5-12 μm diameter, myelinated 5. Loss of motor activity - A-alpha fibers, 12-20 μm diameter, myelinated Erlanger and Gasser classified nerve fibers into three major groups (ABC)- the larger the nerve fiber, the more resistant it will be to local anesthetic blockade.

Answer 279

Midazolam - it's metabolite has minimal residual activity. (Diazepam's metabolites are active).

Answer 280

Fascia, bone, or cartilage

Answer 281

Bone in a healthy animal will adapt to the loads under which it is placed (why bone remodels with loading/use).

Answer 282

Hypertrophic zone

Answer 283

Yes. The Fibrosa of the joint capsule is continuous with the interosseous membrane and cranially forms the radioulnar ligament.

Answer 284

A hyperosmotic agent: -Honey -Sugar -Hypertonic saline Inflammatory/repair stage: hydrophilic/moisture retentive Maturation stage: non-adherent semi-occlusive like a telfa Adherent (wet to dry or dry to dry) NOT RECOMMENDED ANYMORE

Answer 285

Segmental: Cervical= cranial and caudal thyroid aa. (common carotid) Cranial 2/3 = bronchoesophageal a. (aorta) Caudal 1/3 thoracic = esoph. branches of aorta or dorsal intercostals Terminal portion= Left gastric a.

Answer 286

In response to prolonged starvation, the body lowers its metabolic rate to decrease nutrient needs. - Initially glycogen is used for glucose, to conserve fatty acids and protein. - Once glycogen is depleted -> use fatty acids as primary source of energy. - Hepatic gluconeogenesis using proteins supports organs that need glucose. Death takes weeks, and is due to respiratory or cardiac failure.

Answer 287

Secretin -> stimulates secretion of large amounts of HCO3 to neutralize gastric acid Cholecystokinin -> stimulates secretion of digestive enzymes and bile

Answer 288

Filiform and Conical papillae have no taste buds. They are innervated by the hypoglossal nerve (XII). (Taste is CN VII, IX, X)

Answer 289

Hypovolemia (duh) Zinc or iron deficiency Blood transfusions Medications (cisplatin) Immunodeficiencies Poorly controlled diabetes Icterus

Answer 290

They depolarize the WHOLE heart. If the heart can't create it's own electrical pulse, then a defib shock will not help return to rhythm. Vfib is the shockable rhythm

Answer 291

Glandular hyperplasia in younger dogs (<4-5 years) - symmetric, secretory cell driven Complex hyperplasia in older dogs - asymmetric, stromal elements (some glandular)

Answer 292

8.5 - 10.5 cm with a distinct preprostatic urethra (2mm dia).

Answer 293

Staph. intermedius or pseudintermedius Others: P. aeruginosa, Proteus, E. coli etc.

Answer 294

All that acute inflammation may increase penetration by beta-lactam antibiotics. It's high binding to plasma protein will also help bind it to inflammatory proteins to get there.

Answer 295

Sucralfate

Answer 296

Meperidine and Morphine The other major CV effect is bradycardia (centrally mediated/ vagus) *a practice q said buprenorphine given IV?

Answer 297

A double lumen tube (DLT) Next best is a bronchial blocker (long catheter with balloon to occlude) LEAST desirable is just a long standard ET tube

Answer 298

- Can reduce effort of respiration as it has less resistance to flow than air or O2. (heliox increases tendency to laminar flow) - Can prevent fire caused by ignition of gas during laser surgery (use at a 70:30 ratio)

Answer 299

2x as potent as morphine Also NMDA receptor antagonist -> fewer excitatory responses in cats

Answer 300

yes. higher doses just last longer 40x morphine potency

Answer 301

Spinothalamic tract - cord to thalamus Spinoreticular - cord to reticular formation Spinomesencephalic - to midbrain Thalamus -> to midbrain

Answer 302

Phase 1: Baseline Phase 2: Rise Phase 3: Plateau

Answer 303

Cardiovascular stuff (long, thin shaft looks like a bird face)

Answer 304

3 minutes (no different than 5 min) but you should really just use alcohol Under the nails is most common residual site.

Answer 305

Nd:YAG can be used for endoscopic procedures or for OVE - can coagulate vessels and has a deeper tissue effect Ho:YAG is good for arthroscopy (joints!) and lithotripsy - it is highly absorbed by water DON'T use a CO2 in a joint Er:YAG Bone

Answer 306

Can cut and coag at lower temps (50-100C) Vibration-induced heat is cause of coag (no electric current) Ultrasonic coaptive coagulation Can only seal 3mm

Answer 307

GIA has four staggered rows of staples - 2 on each side of blade. 3.5 height -> closed 1.5 EEA is circular, double staggered (4 rows all around) and a stoma is created inside the rows. The EEA anastomosis is INVERTED. It should not be used on tissue < 1mm thick or >2.5

Answer 308

Hepatic artery and portal vein (and CBD) Can be occluded 10-15 min

Answer 309

Base excess/deficit equals the amount of acid or base that is required to restore the total buffer base of ECF to a pH of 7.40 A normal BE is -4 to +4 Positive BE = metabolic alkalosis Negative BE(base deficit) = nonrespiratory = metabolic acidosis

Answer 310

Resp Acidosis = hypoventilation -> hypercapnia (PaCO2 high) - compensation is elevation of HCO3 Resp alkalosis = hyperventilation -> hypocapnia (PaCO2 low) - compensation is decreased bicarb Metabolic acidosis = decreased bicarb - compensation is hyperventilation (decreased PaCO2) Metabolic alkalosis = increased bicarb - compensation is hypoventilation (increased PaCO2)

Answer 311

Embryonic mesoderm They're anti-inflammatory and immunosuppressive

Answer 312

True! See chart: Bladder > Stomach > Colon > Skin

Answer 313

60-80% At 2wk 20% / 1 month 50%

Answer 314

Fibroblasts (and others) it turns fibroblasts into myofibroblasts

Answer 315

Paradoxical Jugular distention on inspiration. In cardiac tamponade the negative pressure of inspiration can’t distend the atrium due to external pressure and instead pulls the ventricular septum to the lower pressure side (right) pushing volume back into the jugulars.

Answer 316

Celiac a. -> splenic artery -> left gastroepiploic artery -> greater curvature and anastomoses with the right gastroepiploic artery. Celiac a. -> hepatic artery -> right gastric artery -> pylorus and pyloric antrum and anastomoses with the left gastric artery -> lesser curvature Hepatic artery continues as the gastroduodenal artery -> the right gastroepiploic artery-> greater curvature of the stomach Celiac a. -> left gastric artery -> fundus and caudal esophagus before joining the right gastric artery -> lesser curvature ** The short gastric arteries originate from splenic branches of the splenic artery and anastomose with the gastric branches of the left gastric artery to supply the fundic area of the stomach

Answer 317

51% of the forelimb weight-bearing force is carried by the proximal radial articular surface at the level of the elbow; the remaining force is thus born by the ulna.

Answer 318

NO The proximal ulna possesses a physis that is responsible for olecranon elongation only.

Answer 319

Yes, you can remove and reorient/replace a self tapping Add 2mm to ensure there is good purchase in the far cortex

Answer 320

Hyperalgesia is an increased sensitivity to feeling pain and an extreme response to pain. Allodynia is pain due to a stimulus that does not normally provoke pain (light touch).

Answer 321

1. Extracellular matrix degrades, water content increased, size of aggregan molecules decreased and structure of collagen network is damaged leading to reduced stiffness 2. Chondrocytes try to compensate through enhanced proliferation and metabolic activity. Cell clusters appear surrounded by newly synthesized matrix molecules. 3. Chondrocytes are no longer able to keep up, resulting in complete loss of cartilage tissue Phase 1/2 - thickness, swelling as proliferate -> phase 3 loses the battle and thins away

Answer 322

The poodle. Strain is deformation / total length.... so x/100 is definitely greater than x/300

Answer 323

Caudal to the renal arteries and cranial to the deep circumflex iliac arteries. - Right ovarian vein drains into the caudal vena cava - Left ovarian vein drains into the renal vein

Answer 324

- Type I: Idiopathic (50%) - Type II: reactive IMPA with infection remote from joint (25%) - Type III: IMPA associated with GI disease (15%) - Type IV: IMPA associated with neoplasia (paraneoplastic) "I Remember Grades of Polyarthritis"

Answer 325

5% (same as complication rate) Uroabdomen is 1.5%

Answer 326

Retroglenoid vein. It sits rostral to the osseous ear canal/meatus.

Answer 327

An activator for Factor 12 (kaolin, glass beads etc.)

Answer 328

Sensory: Vagus Motor: Facial**

Answer 329

NO Tourniquet injury can cause significant postop edema and swelling and you should evaluate the limb / change the bandage at 24 hours to avoid further bandage complications.

Answer 330

Embryonic (ESCs) Adult (ASCs) Fetal/Perinatal (PSCs) Artificial = induced pluripotent (IPSCs)

The Tune-Up (high-value topics) Flashcards

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