VTNE random test questions

Which of the following hormones is produced by the adrenal glands? Cortisol Adrenocorticotropic hormone (ACTH) Antidiuretic hormone (ADH) Thyroid stimulating hormone (TSH) Growth hormone (GH)

Cortisol Explanation Cortisol is a steroid hormone, or glucocorticoid, produced by the adrenal glands. The other hormones listed here are all produced in the pituitary gland.

Ruminants frequently belch or burp to release gas from the forestomach. What is the term for this process known as? Eructation Apnea Casting Fermentation

Eructation Explanation Eructation is the process of belching or burping.

An 11-year old female spayed dog is diagnosed with a bladder tumor. She is still able to pass urine, but she strains towards the end of her urination and needs to go out frequently. Her bloodwork is unremarkable. What medication is sometimes prescriped specifically to alleviate symptoms from bladder tumors in dogs? Tramadol Amoxicillin-clavulanic acid Piroxicam Cranberry extract

Piroxicam Explanation Piroxicam is a non-steroidal anti-inflammatory drug that has some anti-cancer properties against transitional cell tumors and nasal adenocarcinoma in dogs. Piroxicam can cause renal papillary necrosis as a rare side-effect, so is usually reserved for cases that have no underlying renal issues.

Brachygnathism results in which of the following? Severe overbite Loose teeth Severe underbite Crooked teeth

Severe overbite Brachygnathism results in a severe overbite. Brachygnathism is a defect also called "parrot mouth" due to the appearance of an extremely overshot jaw. Severe underbite is a result of prognathism. Crooked teeth are the result of various reasons, such as irregular bone development, malformed teeth, misaligned bites, or too small of mouths. Loose teeth are mostly caused by gum disease.

Patients that have received prednisone chronically need to be tapered off slowly to avoid which of the following? Signs of exocrine pancreatic insufficiency Signs of hyperinsulinism Signs of hyperadrenocorticism Signs of hypoadrenocorticism Signs of diabetes insipidus

Signs of hypoadrenocorticism Explanation Chronic prednisone administration can lead to atrophy of the adrenal gland due to the absence of signaling to produce cortisol. If prednisone is suddenly stopped, the adrenal gland will not be capable of producing enough cortisol, and the animal may show signs of hypoadrenocorticism (Addison's disease). PowerPage Hypoadrenocorticism (Addison's Disease) Hypoadrenocorticism is a disease that can appear very differently in the clinic than the way it tends to appear on board exams. In the real world, this disease can be "The Great Imitator" and should be on the differential list for a multitude of common clinical signs. Dogs can present anywhere along the spectrum, from vague and mild clinical signs and bloodwork abnormalities to a life-threatening emergency, with severe GI signs and cardiac abnormalities. Fortunately, on board exams, you should expect to be asked about cases that display most of the "classic" signs associated with Addison's disease; these are discussed on this PowerPage. Background Caused by inability of the adrenal glands to produce cortisol (glucocorticoids and mineralocorticoids). Causes include: o Autoimmune/idiopathic factors o Granulomatous destruction of adrenal cortex o Secondary via a disruption in the adrenal-pituitary axis Commonly affected breeds include Standard Poodles, Portuguese Water Dogs, Rottweilers, and West Highland White Terriers, but any breed may be affected. Clinical signs Symptoms may include: o Weakness o Vomiting o Diarrhea (sometime vague gastrointestinal symptoms) o Finicky appetite o Dehydration o Bradycardia and low blood pressure Symptoms may be waxing and waning Addisonian crisis is a medical emergency Laboratory Findings Elevated potassium, low sodium and chloride (lack of aldosterone leads to impaired renal sodium retention and potassium excretion) o Na:K ratio usually < 27:1 Hypoglycemia Increased BUN and creatinine due to decreased renal perfusion from hypovolemia and hypotension (leading to decreased cardiac output) Diagnosis Test for diagnosis is ACTH Stimulation test Treatment Fluid of choice is 0.9% sodium chloride Supportive care with fluids and steroids are the mainstays of therapy Additional chronic treatment is life-long. Treatment of Addison's includes: o Steroids: DOCP injections (mineralocorticoid), oral prednisone (glucocorticoid) These are only started AFTER the ACTH stimulation test has been performed! The only steroid medication that can be given prior to the ACTH stim test is Dexamethasone and should be started in a crisis situation until the ACTH stim may be performed

Which type of urinary stone is lucent and does not typically show up on a radiograph? Magnesium ammonium phosphate Struvite Urate Calcium oxalate

Urate Explanation Urate and Cystine are the two types of stones that do not usually show up on radiographs and require ultrasound or contrast studies to diagnose. Calcium oxalate and struvite stones are radiodense and usually visible on a radiograph. Magnesium ammonium phosphate is another name for a struvite stone.

How many liters of 50% dextrose should be added to 5 liters of 0.9% saline to make a 5% dextrose solution? 0.5 L 0.05 L 0.25 L 0.75 L

0.5 L Explanation To answer this question, the following formula should be implemented: C(1)V(1) = C(2)V(2) C is the concentration V is the volume C(1) =0.5 V(1) = x C(2) = 0.05 V(2) = 5 L 0.5x = 0.05(5) x = 0.5 L 0.5 L of 50% dextrose should be added to one liter in order to make a 5% solution. PowerPage Medical Calculations The metric system is the most widely used system throughout the world. The system is based on powers of ten. The basic units of measurement are the meter for length, the liter for volume, and the gram for weight (mass). Prefixes are added to the basic unit to form multiples and fractions. Table 1 Numerical meaning Decimal System Metric Prefix Abbreviation Thousand 1,000 Kilo- k Hundred 100 Hecto- h Ten 10 Deka- dk Unit 1 Tenth 0.1 Deci- d Hundreth 0.01 Centi- c Thousandth 0.001 Milli- m Millionth 0.000001 Micro- Metric Conversions There are two commonly used metric unit conversion methods; the step method and proportion equations. The step method uses movement of the decimal place to the right if converting to a smaller unit, and to the right if converting to a larger unit. Example: to convert 500 milligrams (mg) to grams (g) According to Table 1 500 mg is 0.001 of a g 1 g is larger than 1 mg, therefore, the decimal must be moved 3 places to the left. Answer: 0.5 g Perform the proportion equation by cross multiplication Example: to convert 500 mg to g According to Table 1, 1 g = 1000 mg Therefore, x g/500 mg = 1 g/1000 mg (x being the unknown number) 500mg x g = 1000mg 1g 1000 mg x g = 500 mg 1 g x g = 500 mg 1 g 1000 mg x g = 0.5 g Converting Metric Mass As mentioned above, the gram is the standard unit for mass. The non-metric unit is the pound. The majority of the medication doses are mg/kg, therefore, when this is the case, the technician must always convert pounds to kilograms before performing the calculation. 1 kg = 2.2 lbs to convert pounds to kilograms: lbs 2.2 Example: 45 lbs 2.2 = 20.5 kg Dosage Calculations The dose is the amount of medication measured (mg, mL) The dosage is the amount of medication based on units per weight of the animal ( 50 mg/kg, 10 mls/kg) The concentration of the drug is calculated by the manufacturer (mg/ml, mg/tablet) A 20.5 kg mixed breed dog is scheduled for an orthopedic procedure today and the veterinarian in charge has asked you to give a Cefazolin injection at a dosage of 22 mg/ kg. The concentration of Cefazolin is 100 mg/ml. How many mLs of Cefazolin will you administer to the dog? To calculate the dose in milligrams use the following formula; weight (kg) dosage (mg/ml) = dose Example: the patient weighs 20.5 kg and the the dosage is 22 mg/kg 20.5 kg 22 mg/kg = 451 mg (the dose is 451 mg) To calculate the dose in milliliters use the following formula; dose (mg) concentration (mg/ml) = dose (ml) Example: 451 mg 100 mg/ml = 4.51 ml (you will administer 4.51 ml to the patient) The same patient will be going home with carprofen the following day. The dosage is 2.2 mg/kg twice daily. The veterinarian would like you to dispense 5 days worth. Carprofen comes in 25mg, 75mg, and 100mg chewable tablets. What is the dosage, what size tablet should be used, and how many tablets will you dispense? Example: 20.5 kg 2.2 mg/kg = 45 mg The dosage is 45 mg twice daily, you will chose 100 mg tablets and give ½ twice daily, dispensing 5 tablets. *Drugs are manufactured in a variety of concentrations, therefore, it is extremely important to always record the milligram dosage of the drug given on the patient's record. Dilutions and Solutions Solution: mixture of substances made by dissolving solids in liquids or liquids in liquids. Solvent: solution capable of dissolving other substances. Solute: substance that is dissolved in liquid Dilution: reduction of a concentration of a substance. Diluent: agent that dilutes The concentration of the substance is the amount of solute dissolved in the solvent. Concentrations are expressed as; volume per volume (v/v), weight per volume (w/v), or weight per weight (w/w). When calculating the percent strength of a solution (w/v) use the following formula; mass (g) volume (ml) = concentration (g/ml) Example: What is the strength of a solution if 1g of powder is dissolved in 200 ml of liquid? 1g 200 ml = 0.005 To find the percent multiply by 100: (0.005 100 = 0.5%) Also calculate what the concentration is per mL: *Remember that there are 1,000mg in 1g 1000 mg 200 ml = 5 mg/ml (Also since you already calculated that the percent concentration is 0.5%, you can move a decimal place to the right to know that the concentration is 5 mg/mL) Percent solution calculations are used to prepare a specific concentration of solution. Example: The veterinarian has asked you to prepare a 2.5% Dextrose solution to administer to a patient using 1000 ml of Lactated Ringers' solution (LRS). The dextrose concentration is 50%. First you will take the percent solution you want (2.5%) and multiply it by the amount of liquid you will be adding it to (1000 ml). Then you will divide that by the concentration of solution you have (50%). Remember that to multiply or divide by the %, move 2 decimals to the left (so 2.5% is equal to 0.025 and 50 % is equal to 0.5) 2.5% (which is the same as 0.025) 1000 = 25 25 50% (which is the same as 0.5) = 50 (Note: this is the same a doubling it for 50% solutions) 50 mls of 50% dextrose will need to be added to 1000 ml of LRS The concentration of a solution can also be expressed as a ratio; 1:100 = 1g / 100 ml = 1% / 10 mg/ml Example: The veterinarian asks you to give a patient 400 mg of enrofloxacin intravenously. The concentration of enrofloxacin is 2.27%. First you convert 2.27% to mg/ml ( 22.7 mg/ml). To do this easily, simply add a zero to the percentage (i.e. 20% solution has 200 mg/mL, a 10% solution has 100 mg/mL and so on; in this case, since the percent has a decimal, it is the same as moving a decimal place to the right so you get 22.7 mg. A 10% solution is the same as a 10.0 % solution, moving a place to the right will give you the 100 mg/mL you were calculating). Then you divide the concentration you want by the concentration you have. 400 mg 22.7 mg/ml = 17.6 ml 17.6 mls of enrofloxacin will need to be administered to the patient. Drip Rates The following formula is used to calculate a drip rate to deliver solutions; Drip rate = time (seconds) volumeof solution (ml)x drops / mL The volume of solution (mL) is the amount of solution to be administered. Drops per mL is the calibrated amount of the administration set usually indicated on the packaging. Time (seconds) is the amount of time that the fluids are to be administered. Example: What is the drip rate if the volume of solution is 1 L, the drops per ml are 15, and the time is 1 hour? Drip rate = 1hour 60minutes 1000ml 15drops/ml x x (there are 60 min in 1 hour) = 60minutes 15,000drops = 250 drops / min Example: What is the drip rate in seconds, if the volume of solution to be given is 250 mls, the drops per ml are 15, and the time is 1 hour? Drip rate = 1hour 3600seconds 250ml 15drops/ml x x (there are 3600 seconds in 1 hour) = 3600seconds 3750drops = 1 drop/sec Equivalents 16 fl oz = 1 pt 1 fl oz = 30 ml 32 fl oz = 1 qt 1 tsp = 5 cc 2 Tbs = 1 fl oz 2000 lb = 1 ton

A 60-kg dog needs to be sedated with dexmedetomidine and butorphanol. The doctor would like a dose of 10 ug/kg for dexmedetomidine and 0.1 mg/kg for butorphanol. Dexmedetomidine comes in a 1 mg/ml solution, and butorphanol is in a 10 mg/ml solution. How many milliliters of each medication will need to be administered for the patient's sedation? 0.6 ml of dexmedetomidine and 0.6 ml of butorphanol 0.06 ml of dexmedetomidine and 0.3 ml of butorphanol 60 ml of dexmedetomidine and 0.6 ml of butorphanol 0.6 ml of dexmedetomidine and 6 ml of butorphanol

0.6 ml of dexmedetomidine and 0.6 ml of butorphanol Explanation For dexmedetomidine, do the following math: 60 kg x (10 ug/kg) = 600 ug Note the units and convert to work with milligrams as the solution is in milligrams per milliliter. 600 ug / (1000 mg/ug) = 0.6 mg 0.6 mg / (1 mg/ml) = 0.6 ml For butorphanol, do the following math: 60 kg x 0.1 mg/kg = 6 mg 6 mg / (10 mg/ml) = 0.6 ml

You draw up a canine distemper-parvo combination vaccine. How long is the vaccine considered viable at room temperature? 8 hours 1 hour 20 minutes 24 hours

1 hour Explanation Vaccines should be discarded if they have been left out at room temperature for longer than one hour. Most references state that if they are refrigerated they can be used within 24 hours, but this is controversial. The best option is to use the vaccine shortly after it is drawn up to avoid any concerns.

What is the normal amount of gastric reflux obtained from a healthy horse via nasogastric tube placement? 1-3 liters 14-18 liters 10-12 liters 5-8 liters

1-3 liters Explanation Normally, a healthy horse will have a small amount of gastric reflux, 1-3 liters. If you get back 8-12 or more liters of reflux, the horse likely has an obstructive intestinal disease or ileus of some sort.

What is the normal temperature for a cat or dog? 97.8-98.5F 95.7-103.5F 100-102.6F 103.5-104.5F

100-102.6F Explanation Normal temperature for dogs and cats is around 100 to 102.5F. When they are stressed or excited, the temperature may increase somewhat or may remain normal for some patients. Therefore, a temperature slightly higher than the reference range should be interpreted based on clinical status of the patient.

You are monitoring an adult cat under anesthesia. Since induction, the heart has been slowing down. What is the approximate lowest acceptable heart rate for this cat? 180 160 140 120

120 Explanation If the heart rate drops below 100-120 beats per minute in an anesthetized cat, the heart rate needs to be increased and the anesthetic depth should be evaluated. If appropriate, atropine may be administered in this situation, and anesthetic gas turned down if possible.

The gestation period for hamsters makes them a valuable research model. What is their gestation period? 30 days 15 days 21 days 56 days

15 days Explanation Hamsters have the shortest gestation period of all the rodents. Their rapid reproduction makes them valuable in the biotech field, saving on cost. In addition, it allows quick results for any reproductive study.

Which of the following suture size is the largest? 6-0 2-0 1-0 2

2 Explanation As the number to the left of the "-0" increases, the diameter of the suture decreases. If there is no "-0" following the number, then as the number increases the diameter of the suture increases. In this question, 6-0 is the smallest diameter suture listed.

Which is the dental formula for a cat? 2 (I 3/3 C 1/1 P 3/2 M 1/1)= 30 2 (I 3/3 C 1/1 P 4/4 M 2/3)= 42 2 (I 2/2 C 1/1 P 3/3 M 2/1)= 30 2 (I 3/2 C 2/2 P 3/3 M 0/1)= 32

2 (I 3/3 C 1/1 P 3/2 M 1/1)= 30 Explanation Cats have 3 incisors, 1 canine, 3 premolars, and 1 molar on one side of the upper jaw and 3 incisors, 1 canine, 2 premolars, and 1 molar on one side of the lower jaw so the dental formula for the cat is: 2 (I 3/3 C 1/1 P 3/2 M 1/1)= 30 permanent teeth Dogs have 42 teeth, so their dental formula is : 2 (I 3/3 C 1/1 P 4/4 M 2/3)= 42 PowerPage Dentistry Periodontal disease is the most common disease in veterinary medicine, as more than 70-80% of pets have it. Therefore, routine dental prophylaxis or teeth cleaning is an important part of preventative medicine and treatment in which the veterinary technician plays an important role. Dental cleanings are performed under general anesthesia. Anatomy of the Tooth and Terminology Apical - direction toward the root Attrition - wearing of the teeth from mastication or teeth rubbing together Buccal - direction toward the cheek Calculus - calcified plaque which hardens on the tooth and may not be brushed off Cementum - hard connective tissue covering the tooth root and sometimes the crown Crown - portion of the tooth that sits above the gumline and is covered in enamel Dentin - the bulk of the tooth; the hard connective tissue of the tooth made mostly of calcium and collagen Enamel -the white hard outer layer of the crown (made mostly of calcium) Endodontics - treatment involving the pulp cavity (i.e. root canal procedure) Floating -smoothing a horse's teeth with a file (called a float) to rid of sharp edges Gingiva - mucosa surrounding the teeth (gums around the teeth) Halitosis - bad breath Lingual - direction toward the tongue Malocclusion - abnormal position of the teeth Occlusal - regarding the tooth surface that meets tooth surface on the opposite jaw Periodontal ligament - collagen fiber which attaches tooth to the bone (holds tooth in place) Periodontium - supportive tissues around the tooth including bone of alveolus, periodontal ligament, cementum, and gingiva Plaque - a film which accumulates on the tooth made of food, bacteria, cells, and mucin Pulp - the soft part inside the tooth made of nerves, vessels, odontoblasts, connective tissues and lymphatics Ranula - a salivary cyst under the tongue Recession - apical gingival movement away from the tooth crown Root - lower part of the tooth that is in the alveolus Stomatitis - inflammation of the soft tissues in the mouth Sulcus - pocket under the gingiva; normal is 0-3 mm, greater than this suggests periodontal disease Types of Teeth 1) Hypsodont (radicular or aradicular): High-crowned teeth. Seen in horses, cattle, deer (radicular - continuously erupting but not growing); in rodents, lagomorphs, chinchillas (aradicular - continuously growing) 2) Brachydont: Low-crowned teeth. Seen in dogs, cats, humans. Dental Formulas for Adult Teeth Dogs: 2 (I 3/3 C 1/1 P 4/4 M 2/3) = 42 Cats: 2 (I 3/3 C 1/1 P 3/2 M 1/1) = 30 Cows/Sheep/Goats: 2 (I 0/3 C 0/1 P 3/3 M 3/3) = 32 Horses: 2 (I 3/3 C 0-1/0-1 P 3-4/4 M 3/3) = 36-42 Pigs: 2 (I 3/3 C 1/1 P 4/4 M 3/3) = 44 Lagomorphs: 2 (I 2/1 C 0/0 P 3/2 M 3/3) = 28 Rat/Mouse: 2 ( I 1/1 C 0/0 P 0/0 M 3/3) = 16 Important Dental Instruments Curette - used for subgingival removal of calculus and for root planning; can also be used supragingival; has a rounded back and tip Elevator - used for breaking down the periodontal ligament with pressure and leverage Luxator - used for breaking down/cutting the periodontal ligament; not used for leverage Extraction forceps - used to extract (pull out) the tooth after the periodontal ligament has been broken down Probe - has a blunted tip and is inserted into gingival sulcus to measure pocket depth and evaluate mobility Polisher - removes plaque and smoothes the scaled tooth surface; used with prophy paste and done on slow speed (not faster than 1000 rpm or may cause thermal damage) Scaler - used for supragingival removal of calculus (NOT subgingival due to sharp tip) http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/mvm_list_img.htm

A patient is hypoventilating and the end-tidal CO2 is rising. The doctor instructs you to give the patient a breath. The pressure on the manometer to which you ventilate the patient is: 20 cm H2O 40 cm H2O 5 cm H2O 60 cm H2O

20 cm H2O Explanation When inflating the lungs, the pressure should reach but not exceed 20 cm H2O.

What is the maximum time a fecal can be used for fecal flotation with zinc centrifugation to look for ova and parasites if kept in the refrigerator? 3 days 1 week 12 hours 2 hours

3 days Explanation Ideally, a fecal should be collected and performed within 24 hours. However, the maximum time that the feces can still be used if refrigerated is 3 days. Fresher is always better!

How many milliliters of dextrose should be added to a 60 ml syringe of 0.9% NaCl to make a 2.5% dextrose solution? The patient weighs 20 kg, and the dextrose in the hospital comes in a 50% concentration. 6 ml 120 ml 0.6 ml 3 ml 1.5 ml

3 ml Explanation To answer this question, use the following equation: C(1)V(1) = C(2)V(2) C is the concentration V is the volume C(1) =0.025 V(1) = 60 ml C(2) = 0.50 V(2) = x 0.025(60)= 0.50x x = 3 ml Note that the body weight is completely unnecessary to calculate the answer to this problem. 200 ml of 25% dextrose should be added to one liter in order to make a 5% solution.

A 60-lb patient is to go home on Clavamox after his dental cleaning. The dose is 14 mg/kg. What size tablet should the patient be sent home with? 375 mg 125 mg 250 mg 62.5 mg

375 mg Explanation After converting the body weight to kilograms the dose needs to be multiplied by the body weight. 60 lb / (2.2 lb/kg) = 27 kg (Notice the pounds cancel out) 27 kg x 14= 378 mg Many medications are available in different concentrations to accommodate different sized patients. This is particularly the case with oral medications so that owners don't have to worry about trying to halve or quarter medications.

Tramadol is to be sent home with a 27 pound Beagle following a routine ovariohysterectomy. The veterinarian wants you to fill the prescription giving 2 mg/kg every 8 hours PO for 3 days. Tramadol comes in 50 mg tablets. How many tablets will you dispense? 9 tablets 18 tablets 5 tablets Dispense as many tablets as the owner would like in case the patient is painful for more than 3 days.

5 tablets Explanation First you must convert pounds to kilograms dividing 27 by 2.2 = 12.2 kg. 12.2 kg multiplied by 2 mg/kg = 24.5 mg. This patient will get 1/2 tablet by mouth (25 mg) every 8 hours or 3 times daily. 0.5 tablet multiplied by 3 times daily is 1.5 tablets per day multiplied by 3 days is 4.5 tablets. The appropriate number of tablets to dispense is 5.

Regarding fluid types, which cannot be given subcutaneously? Isolyte 0.9% NaCl 5% Dextrose Lactated Ringers

5% Dextrose Explanation Only use isotonic fluids for subcutaneous administration. This means that the osmotic properties are equal to that of the extracellular fluid.

What is the maximum amount of oral fluids that a horse should receive at a time? 6-8 Liters 10-15 Liters 1-2 Liters 20-25 Liters

6-8 Liters Explanation The average size horse (800 to 1200 pounds) has a stomach capacity of only about 4 gallons. It is best to give smaller quantities of fluids more frequently, and no more than 6 to 8 liters should be given at one time.

When collecting blood for a blood transfusion, the maximum recommended amount that can be collected from a donor horse (500 kg) is what volume? 6-8 liters 3-6 liters 10-12 liters 12-14 liters

6-8 liters Explanation A safe amount of blood to collect from a horse is 15-16 ml/kg, equaling 6-8 liters in a 500 kg horse. Typically, blood is only collected from a donor every 30 days or longer.

A 2-ounce bottle of Dermacool spray contains how many milliliters? 15 mL 40 mL 60 mL 30 mL

60 mL Explanation There are 30 mL in one ounce. 2-ounce bottle X 30 mL/ounce = 60 mL

A 2-ounce bottle of Dermacool spray contains how many milliliters? 40 mL 15 mL 30 mL 60 mL

60 mL Explanation There are 30 mL in one ounce. 2-ounce bottle X 30 mL/ounce = 60 mL

How many cervical vertebrae do cows have? 6 9 7 13

7 Explanation Cows as well as dogs, sheep, pigs, cats, goats, horses and humans have 7 cervical vertebrae.

The heart rate of an adult dog should range between which of the following? 70-160 bpm 24-50 bpm 180-240 bpm 120-200 bpm

70-160 bpm Explanation A dog heart rate ranges between 70-160 bpm. As with the cat, there may be variation. An adult cat typically has a resting heart rate between 150-220 bpm. Keep in mind that if the cat is very excited, the heart rate might be faster. Remember that puppies and kittens will have faster heart rates.

A 4-kg puppy is in need of subcutaneous fluids due to dehydration. The doctor prescribed a dose of 20 ml/kg. How many milliliters should this patient receive? 24 ml 5 ml 200 ml 80 ml

80 ml Explanation To obtain the answer the following math should have been performed: 4 kg x (20 ml/kg) = 80 ml Notice the kilograms were canceled out.

What is colic in a horse? Abdominal pain that can be secondary to multiple etiologies Abdominal pain secondary to intestinal volvulus Abdominal pain secondary to intestinal strangulation Abdominal pain secondary to gastrointestinal gas

Abdominal pain that can be secondary to multiple etiologies Explanation The best answer choice is abdominal pain that can be secondary to multiple etiologies. It is a very broad term, and colic can be secondary to any of the other answer choices. In effect, knowing that the patient has colic does not necessarily mean the clinician knows exactly what treatment to provide until the underlying cause of colic is identified.

If a snake is undergoing "dysecdysis", what does this mean? Difficulty breathing Abnormal shedding of the skin External parasitism by mites or ticks Retention of the eye cap or "spectacle" after shedding Normal physiologic process of skin sloughing

Abnormal shedding of the skin Explanation "Ecdysis" means the shedding or sloughing of the skin and occurs in reptiles including snakes. Dysecdysis is the term used when there is abnormal or incomplete sloughing. In pet reptiles, this is most commonly due to a habitat that is not sufficiently humidified.

Which substance should never be used for prepping the digits for a declaw if a laser is going to be used? Chlorhexidine Povidone iodine Alcohol 0.9% sodium chlorid

Alcohol Explanation Alcohol is flammable and laser may ignite the area.

The doctor is trying to retrieve a foreign body out of a dog's ear and is using this tool (see image). What instrument is this? Mosquito hemostat Alligator forceps Crile clamp Allis tissue forceps

Alligator forceps Explanation The alligator forceps is a two-bladed instrument with a handle for compressing or grasping tissues. It works really well for grasping foreign bodies from the ear canal.

Gas exchange occurs between air and blood by diffusion through which structure? Alveoli Trachea Bronchi Pleura

Alveoli Explanation The alveoli are the site of gas exchange. They are tiny air sacs in the lungs that exchange carbon dioxide and oxygen and are located at the last branching of the respiratory tract. They are lined with simple squamous epithelium. The oxygen diffuses through the epithelium and the capillary endothelium in the exchange. The upper airway is lined mostly with pseudostratified columnar epithelium.

What causes cutaneous larval migration in humans? Dipylidium Toxocara Ancylostoma Echinococcus

Ancylostoma Explanation The correct answer is Ancylostoma. These are hookworms; when they come in contact with unprotected skin, the infective larvae penetrate the epidermis but generally cannot penetrate the basement membrane. They therefore migrate aimlessly, and the disease is usually self-limiting in humans.

You are opening the boxes from today's shipments and find soda lime. What is this used for? Vaccine refrigerator Suction canister Anesthesia machine Autoclave

Anesthesia machine Explanation Soda lime or ("Sodasorb") is used in the anesthesia machine. In the machine, these granules absorb carbon dioxide exhaled by the patient in a rebreathing anesthesia circuit.

A patient who has stopped breathing after administration of a short-acting anesthetic can be described as being which of the following? Eupneic Atelectic Dyspneic Apneic

Apneic Explanation This patient would be apneic, which means the patient is not breathing. Dyspnea implies difficulty breathing. Eupnea is normal respiration. Atelectasis is the description given to collapsed lungs.

The medications Mirtazapine and Cyproheptadine can both be used for which purpose? Appetite stimulation To stop epistaxis To increase hemoglobin levels Sedation for brief procedures

Appetite stimulation Explanation Mirtazapine and Cyproheptadine are both commonly used as appetite stimulants in veterinary medicine.

What is the biggest complication in patients with megaesophagus? Anemia Spinal cord compression Aspiration pneumonia Glaucoma

Aspiration pneumonia Explanation Megaesophagus patients are at a high risk of aspirating due their high incidence of regurgitation.

When is generally considered the optimal time to spay a dog? At approximately 6 months of age Anytime after the third estrus Anytime after the second estrus, but before the third At 2 years of age

At approximately 6 months of age Explanation Spaying before the first estrus dramatically reduces the lifetime likelihood of developing mammary neoplasia. Dogs that are spayed after the first estrus have an 8% chance of developing mammary neoplasia. Dogs spayed after the second estrus have a 24% chance of developing mammary neoplasia. Performing a spay at the time of estrus can be done but is not recommended, as the uterus is highly vascularized at this time, and the chances of complications or excessive bleeding may be greater. It is usually recommended to perform a spay 3-4 months after estrus (if the dog went into estrus).

Which of the following correctly indicates where electrons are generated in an x-ray machine? At the target of the cathode At the target of the anode At the filament of the cathode At the filament of the anode

At the filament of the cathode Explanation The cathode flament of the x-ray machine is where electrons are generated. The kVp applied directs those electrons to the anode, where they hit a tungsten target to produce x-rays.

A canine hospitalized following a TPLO surgery unexpectedly cardiac arrests. Endotracheal intubation and chest compressions have been initiated. What two drugs are usually administered FIRST during CPCR? Propofol and diazepam Atropine and epinephrine Dexamethasone sodium phosphate and methylprednisolone Mannitol and hypertonic saline Dextrose and intravenous fluids

Atropine and epinephrine Explanation Atropine is used in CPCR because it blocks signals from the vagus nerve and is used to treat bradycardia. Epinephrine is used because it increases cardiac output by causing peripheral vasoconstriction and causes bronchodilation. Mannitol and hypertonic saline are used to decrease intracranial pressure and are not the first drugs to be administered during CPCR. Dex SP and methylprednisolone are both steroids and do not increase cardiac function or output. Propofol and diazepam are drugs that might be given during status epilepticus, not during CPCR. Dextrose and fluids may be administered during CPCR but are not usually the first drugs of choice.

Agglutination of blood and spherocytes seen on a blood smear are indicative of which type of disease? Auto-immune Viral Bacterial Rickettsial

Auto-immune Explanation Agglutination occurs in immune-mediated disorders due to antibodies coating the red blood cells. This results in clumping of the erythrocytes. Spherocytes are often seen with Immune Mediated Hemolytic Anemia (IMHA).

A 5-year-old domestic short hair cat presents with some lesions on his chin. The doctor diagnoses feline acne and prescribes some antibiotics and ointment. Which of the following is a good suggestion a technician could make to the owner? Avoid plastic food and water dishes Apply hydrocortisone cream to the chin twice a day Allow the cat to go outside as the air will help the chin to dry out Gently pop the pimples on the chin twice a day

Avoid plastic food and water dishes Explanation In some cats, a hypersensitivity to plastic can cause feline acne. This is a good suggestion to make to the owner of any cat with this condition. You cannot make recommendations for medications other than what the doctor prescribed during the visit. Popping the pimples can further irritate the skin and should not be performed by the owner. Taking the cat outside will not likely help this condition.

Which of the following is the most mature neutrophil precursor? Band Prorubricyte Metamyelocyte Myeloblast Promyelocyte

Band neutrophil Explanation The neutrophil lineage, from most immature to mature, proceeds as follows: Myeloblast, promyelocyte, neutrophilic myelocyte, neutrophilic metamyelocyte, neutrophilic band, neutrophil. A prorubricyte is an erythrocyte precursor.and neutrophil

The menace test will elicit which response? Which two nerves is this testing? Smell, Cranial nerves I and IV Blink, Cranial nerves II and VII Gag reflex, Cranial nerves XII and VIII Ear twitch, Cranial nerves V and III

Blink, Cranial nerves II and VII Explanation The menace is when you wave your hand to the eye to try and elicit a blinking response. This is testing vision via the Optic nerve (Cranial nerve II). I-Olfactory nerve (smell) II-Optic nerve III-Oculomotor nerve IV-Trochlear nerve V-Trigeminal nerve (sensory to the face) VI-Abducens nerve VII-Facial nerve VIII-Vestibulocochlear nerve IX-Glossopharyngeal nerve (sensory for gag reflex) X-Vagus nerve (motor for gag reflex) XI-Accessory nerve XII-Hypoglossal nerve

All of the following are typically included in a complete blood count EXCEPT for which of the following? Plasma protein concentration Blood urea nitrogen levels Platelet count and/or estimate Erythrocyte indices Hemoglobin concentration Differential white blood cell count

Blood urea nitrogen levels Explanation A complete blood count provides a total red blood cell count, white blood cell count, and platelet count and/or estimate in addition to a packed cell volume or hematocrit and plasma protein concentration. It includes a blood smear evaluation to assess the differential white blood cell count as well as blood cell morphology. Hemoglobin concentration and erythrocyte indices of size are included. For anemic patients, a complete blood count should also include a reticulocyte count. Blood urea nitrogen is not part of a complete blood count and is considered a chemistry value.

Which of following typically appear hyperechoic (bright white) on ultrasound imaging? Spleen and lung Renal medulla and gas Bone and gas Bone and fluid Colon and liver Liver and spleen

Bone and gas Explanation Sound is strongly reflected by mineral and gas, resulting in a hyperechoic appearance of bone and gas in the gastrointestinal tract or air in lungs. Fluid such as urine in the bladder typically appears hypoechoic or anechoic (black), and most soft tissues such as spleen, liver, and kidney have varying echogenicities in between the two. In addition to a hyperechoic appearance, mineral and gas also typically create a shadow that obscures deeper structures because the sound is unable to penetrate.

A 3-year old female Doberman presents for a routine spay. The owner states that she has not recently been in heat and has been healthy her entire life. The veterinarian is concerned that Doberman Pinchers are predisposed to having von Willebrand's Disease (vWD). Which of the following diagnostic tests would give the best indication of whether the dog has an increased risk of bleeding due to this disorder? Total protein level Abdominal ultrasound Buccal mucosal bleeding test Chest radiographs

Buccal mucosal bleeding test Explanation Doberman Pinschers are predisposed to having von Willebrand's Disease (vWD). Specifically, Dobermans have increased incidence of Type 1 vWD. In this type, there is a reduced presence of the functional von Willebrand factor. This factor is crucial in initial clot formation; it attracts platelets and allows them to bind to exposed subendothelium after injury. A buccal mucosal bleeding test should result in a clot in less than 4 minutes in normal dogs. An abnormal result warrants further investigation to confirm the presence of vWD in order to take the appropriate measures prior to surgery.

Mineralized debris on the tooth surface is known as which of the following? Cementum Calculus Dentin Plaque

Calculus Explanation Calculus is mineralization of plaque on the teeth. Plaque is a mixture of bacteria, saliva, and food parts that cover the tooth in a thin film. Plaque can turn into calculus in as early as a week. Dentin is the hard, white portion of the tooth. Cementum is calcified connective tissue.

An emasculator tool is used in which procedure? Enucleation Castration Teeth floating Hoof testing

Castration Explanation An emasculator is a tool used in the castration of livestock. It functions to simultaneously crush and cut the spermatic cord, preventing hemorrhaging.

A rabbit is brought in for skin problems. Upon exam, you notice large flakes of dead skin over the dorsum. Some of these flakes appear to move. What might you be seeing? Psoroptes Cheyletiella Notoedres Sarcoptes Demodex Otodectes

Cheyletiella Explanation Cheyletiella is also known as "walking dandruff". It is a 8 legged mite that can live on the skin of rabbits, dogs, cats and humans. They do not bury in the skin but live in the keratin layer. They have a 21 day life cycle and cannot live more than 10 days off the host.

Which of the following small mammals has the longest life expectancy? Hamster Guinea pig Chinchilla Rabbit Rat

Chinchilla Explanation The life expectancy of a chinchilla is 10 to 15 years. This exceeds the life expectancy of most other small mammals including rabbits (5 to 8 years depending on species), rats (3 years), guinea pigs (4 to 7 years) and hamsters (1.5 to 2 years). Other small mammals with relatively long life expectancies are ferrets (8 to 10 years) and sugar gliders (8 to 10 years). PowerPage Vital Parameters and Life Expectancies for Small Mammal Species You must know what is normal in order to recognize what is abnormal. This PowerPage shows the normal lifespan, weight, temperature, heart rate and respiratory rate of the small mammal species that are most frequently encountered in veterinary practice. It is not necessary to memorize all of these values, but it will be helpful to have a sense of what the typical lifespan, weight, and vital signs should be for these species. Weight, Temperature, Pulse and Respiratory Rates Species Weight (metric) Weight (oz/lb) Body Temperature (C/F) Pulse Rate (beats/min) Resp. Rate (breaths/min) Mouse 20 - 40 grams 0.7 - 1.4 oz 37 - 38 C 99 - 100 F 400 700 80 - 200 Rat 400 - 800 grams 1 - 2 lbs 37.5 - 38.5 C 100 - 101 F 300 - 500 75 - 150 Ferret 600 - 1200 grams (females smaller than males) 1.5 - 2.5 lbs 38 - 40 C 100 - 104 F 180 - 250 30 - 40 Rabbit 1 - 10 kg (Varies widely by breed) 2 - 20 lbs (Varies widely by breed) 38.5 - 40 C 101 - 104 F 150 - 300 30 - 60 Chinchilla 400 - 500 grams 1 lb 37 - 38 C 99 - 100 F 100 - 150 40 - 80 Hamster 20 - 40 grams 0.5 - 1.5 oz 36 - 37.5 C 97 - 100 F 300 - 500 40 - 100 Guinea Pig 750 - 1000 grams 1.5 - 2 lbs 37 - 39.5 C 99 - 103 F 250 - 300 50 - 125 Gerbil 70 - 130 grams 2.5 - 5 oz 37 - 38.5 C 99 - 101 F 250 - 600 80 - 140 Hedgehogs 300 - 600 grams 0.5 - 1.25 lbs 33 - 36 C 91 - 96 F 200 - 300 25 - 50 Sugar Gliders 80 - 200 grams 3 - 7 oz (0.2 - 0.5 lb) 31 - 32 C 88 - 90 F 200 - 300 15 - 40 Species Lifespan Litter Size Recommended Ambient Temperature (F) Mouse 1 to 2.5 years 7 - 11 70 - 77 Rat 3 years 6 -13 70 - 75 Ferret 8 to 10 years 2 - 17 (average 8) 60 - 75 Rabbit 5 to 8 years 4 - 10 40 - 80 Chinchilla 10 to 15 years 1 - 6 (average 2-3) 50 - 70 Hamster 1.5 to 2 years 5 - 10 70 - 75 Guinea Pig 4 to 7 years 1 - 10 (average 2-4) 65 - 80 Gerbil 1.5 to 2.5 years 3 - 7 65 - 75 Hedgehogs 5 to 7 years 1 - 7 (average 3-4) 75 - 85 Sugar Gliders 8 - 10 years 1 - 2 70 - 80

While the surgeon is focused on the task at hand, it is the anesthetist's job to make sure the patient's vitals are maintained at a normal plane. Which of the following is not suggestive of significant blood loss? Weak pulses Rapid respiratory rate Cyanotic mucous membranes Rapid heart rate

Cyanotic mucous membranes Explanation Patients suffering from substantial blood loss can be expected to have tachycardia, tachypnea, and weak pulses. In addition, pale/white mucous membranes as opposed to cyanotic mucous membranes would be noted. Cyanotic mucous membranes are seen when the patient lacks oxygen.

You are performing a urinalysis and identify this six-sided crystal (see image). What type of crystal is this? Cystine Struvite Calcium oxalate Urate

Cystine Explanation You will know cystine crystals by their hexagon shape. They are caused by a renal tubular amino acid reabsorption defect which appears to occur due to a genetic abnormality.

It is the beginning of the day and you are getting together the anesthetic and pre-anesthetic drugs for all of patients for the day. Which of the following drugs should not be drawn up into a disposable plastic syringe, labeled, and stored in a lockbox unless they are going to be used promptly? Medetomidine and ketamine Acepromazine and etomidate Diazepam and propofol Atropine and thiopental

Diazepam and propofol Explanation Propofol should not be stored in a lockbox at room temperature because the vehicle for propofol is a liquid emulsion that serves as an excellent growth medium for bacteria. It should be used promptly or discarded. Diazepam should not be stored in a plastic syringe because the drug will bind to the plastic, and the proper dose will not be dispensed when injected. There is no similar contraindication to the storage of the other drugs listed.

Which parasite would be flat and segmented in appearance? Toxocara Cystoisospora Dipylidium Trichuris

Dipylidium Explanation The tapeworm of Dipylidium is usually 6 or more inches in length. It is a flat, segmented worm. It attaches to the intestine via the rostellum which has hooks on it. It has 6 rows of teeth. The segments from the tail end of the worm are dropped off and passed in the feces (look like rice granules). These segments contain the eggs which are then shed into the environment.

On a CBC on a 5-year old Basenji at a routine wellness exam, you identify the microfilaria shown below. There are two species of microfilariae that can be seen in the peripheral blood in dogs. What are they? Acanthocheilonema (Dipetalonema) reconditum and Filaroides osleri Dirofilaria immitis and Acanthocheilonema (Dipetalonema) reconditum Dirofilaria immitis and Uncinaria stenocephala Uncinaria stenocephala and Filaroides osleri

Dirofilaria immitis and Acanthocheilonema (Dipetalonema) reconditum Explanation The correct answer is Dirofilaria immitis and Acanthocheilonema (Dipetalonema) reconditum. Dipetalonema reconditum is a blood parasite that looks similar to the microfilariae of Dirofilaria immitis, the agent of heartworm disease. The two parasites must be differentiated because Dipetalonema reconditum is not pathogenic and is therefore not treated. Uncinaria stenocephala and Filaroides osleri would not be found in the blood. Incidentally, the organism in this blood smear is D. immitis PowerPage Heartworm Disease Heartworm disease in dogs is a common disease that is likely to appear on boards. It is less common in cats but has some important differences to know about. This PowerPage discusses the life cycle of Dirofilaria immitis, the signs it causes in dogs and cats, and treatment and prevention methods. Key Points • Lifecycle of Dirofilaria and transmission depend on mosquito • Heartworm antigen test is effective in dogs but not in all cats • Treatment with melarsomine in dogs must be done carefully to avoid complications • Prevention with monthly ivermectin (or other comparable product) is recommended Pathophysiology Adult Dirofilaria worms can be 15-30 cm long and can live 3-5 years. They reside in the pulmonary artery and right ventricle. This results in right ventricular hypertrophy. The worms are transmitted as L3 larvae through mosquito bites. Dogs develop much higher worm burdens than cats. In recent years, the bacterium Wohlbachia has been identified in heartworms (a bacterium that infects the heartworm itself). Doxycycline is often given in conjunction to prevent a secondary bacterial infection. Clinical Signs Dogs • Signs may be consistent with right heart failure. o Exercise intolerance o Cough o Dyspnea o Ascites Cats • Signs may be acute, severe, and include salivation, tachycardia, shock, neurologic symptoms, or even sudden death. • Signs may be more chronic, leading to HARD (Heartworm-associated respiratory disease). This is a syndrome in cats that appears similar to asthma (coughing, wheezing) but occurs secondary to heartworm infestation. Vomiting and weight loss are also common chronic symptoms. Diagnosis Dogs • Heartworm antigen test is the test of choice o Detects Ag from adult female worms • Modified Knott's test may detect microfilaria (less sensitive than antigen test) • Other diagnostic findings may include o Right sided cardiac enlargement on thoracic radiographs (reverse D appearance) o Enlarged pulmonary arteries • Heartworm infection may cause proteinuria or an increased eosinophil count Cats • Heartworm antigen test has false negatives from low worm burden or all male infections • Heartworm antibody test indicates exposure but not necessarily infection • In some cases, thoracic radiographs and/or echocardiography can provide a diagnosis Treatment Dogs The treatment of choice for dogs with heartworm is melarsomine. Currently, no matter the disease stage, the American Heartworm Society recommends a split protocol for these injections (a single injection followed in 4-6 weeks by 2 injections 24 hours apart) Confinement after treatment with melarsomine helps to decrease the chance of thromboembolism (throwing a clot or dead worm to the lungs) Wohlbachia, the bacteria found in heartworm, can be readily treated with doxycyline, azithromycin, or rifampin, which may enhance effectiveness of heartworm treatment An alternative to treatment with melarsomine is the use of monthly heartworm preventative and waiting for adults to die; this is not currently recommended by the American Heartworm Society Cats • Cats do not tolerate melarsomine (immiticide) • Treatment is usually symptomatic with a heartworm preventative, bronchodilators and/or corticosteroids until the worms die (2-3 year life span of worms in cats) Prevention Several options are available and effective for heartworm prevention in dogs and cats including: • Oral o Ivermectin (Heartgard™) o Milbemycin (Sentinel™) • Topical o Selamectin (Revolution™) o Moxidectin and imidacloprid (Advantage Multi™)

Which of the following correctly lists the species in order from shortest to longest gestation length? Pig, Sheep, Horse, Cow, Llama Dog, Pig, Sheep, Horse, Llama Ferret, Dog, Sheep, Pig, Horse Cat, Ferret, Sheep, Cow, Horse

Dog, Pig, Sheep, Horse, Llama Explanation This list of gestations should be committed to memory: Llama 1 year (350 days), Horse 11 months (330 days), Cow 9 months (280 days), Sheep/Goat 5 months (150 days), Pig 4 months (114 days), Dog/Cat 2 months (63 days), Ferret 1.5 months (42 days)

Which instrument is specifically designed for atraumatically clamping across the intestine? Halted mosquito forceps Rochester-Carmalt Kelly forceps Doyen forceps Crile forceps

Doyen forceps Explanation Doyen forceps are the only forceps used in veterinary medicine for atraumatically occluding a loop of bowel. All the other forceps mentioned will result in trauma to the intestine and are not recommended for use on either the intestine or any other delicate structure that the surgeon is trying to preserve.

The pancreas connects to which part of the intestine? Jejunum Duodenum Ileum Cecum

Duodenum Explanation The pancreas connects to the duodenum (the first segment of the small intestine). It secretes digestive enzymes into the duodenum via the pancreatic duct.

What is cerumen? A mucoid substance secreted by the stomach The oily part of the tear film Oil produced by sebaceous glands Ear wax

Ear wax Explanation Cerumen is the proper term for ear wax. It is the yellowish waxy hydrophobic protective substance that is secreted in the ear canal. Sebum is an oily substance that is produced by the sebaceous glands.

Which of these therapies would prevent weight-bearing of a limb? Ehmer sling Schroeder-Thomas splint Mason-Meta splint Fiberglass cast

Ehmer sling Explanation Two common examples of slings which prevent weight-bearing are: 1) Ehmer sling- used for coxofemoral luxations (dislocated hips) to hold hip in place 2) Velpeau Sling- used for shoulder luxation or after shoulder surgery Splints provide rigid support and do not prevent weight bearing on the limb. They do not go around the entire limb. Casts provide support and go all the way around the limb.

What is the purpose of a Potter-Bucky diaphragm on an X-ray machine (sometimes called a "Bucky tray")? Increase contrast of the film Prevent patient movement Eliminate grid lines on the film Decrease exposure time that is necessary to produce a diagnostic image

Eliminate grid lines on the film Explanation A Potter-Bucky diaphragm is a moving grid. A grid is a series of short strips of lead that is placed over the cassette, absorbing all radiation that does not go between the strips. The strips are geometrically arranged to allow the primary radiation through but to absorb any radiation that is scattered in other directions. This results in increasing the resolution of structures on the film. However, using a grid results in the appearance of grid lines on the film unless a Potter-Bucky diaphragm is used. Using a Potter-Bucky diaphragm requires increased exposure time and/or kilovoltage.

Administration of which antimicrobial is MOST LIKELY to result in diarrhea in the adult horse? Ceftiofur Penicillin Enrofloxacin Erythromycin Gentacin

Erythromycin Explanation Many antimicrobials can result in diarrhea in horses because of disruption of the normal intestinal flora. Of the drugs listed, erythromycin has the highest likelihood of contributing to the development of diarrhea. Erythromycin is administered to foals with Rhodococcus equi pneumonia but is rarely used in adult horses because of its common association with the development of diarrhea. All the other listed drugs can be administered to horses.

On average, cows have their estrous cycle how often? Every 30 days Every 21 days Every 6 months Every 60 days

Every 21 days Explanation Cows are non-seasonal polyestrous (have estrous cycles year-round). The average estrous cycle in the cow is 21 days (every 18-24 days).

What instrument is being used to temporarily appose the skin edges of this tail wound in a cat?

Explanation Although the Backhaus towel clamp is typically used to clamp towels or drapes to the patient when creating a sterile field they are occasionally used in reconstructive surgery. The surgeon will use them temporarily to plan a difficult skin closure and assess the tension that would result along the incision line. Halsted mosquito forceps are used for blunt dissection. Brown-Adson forceps are used to pick up tissues. Allis tissue forceps are occasionally used to grasp masses that are going to be excised. This forceps are considered traumatic.

Which of the following species have teeth that only grow for a limited time during development and do not continually erupt or grow throughout the life of the animal? Pigs Horses Rats Rabbits

Explanation Cats, pigs, humans and other carnivores have all brachyodont teeth. This means that they have a small crown relative to the size of the roots, and the apex of the each tooth root is only open for a brief period during development and does not continue to erupt. Horses, rodents, and lagomorphs have hypsodont teeth, which means that they have a relatively large amount of crown that is beneath the gingival margin as well as a root structure that allows for continued eruption during most of the animala's lifetime. Hypsodont teeth can be further categorized as radicular hypsodont teeth, such as the cheek teeth of horses. These have apices that eventually close and stop growing, but continued eruption offsets attrition from occlusion. Aradicular hypsodont teeth (such as the incisors of rabbits) lack a true root structure, allowing for lifelong growth of the tooth itself.

An owner brings a box of rat poison to your hospital and says her dog ingested it. You help the doctor induce vomiting. Which of the following would be an appropriate treatment for an animal that has ingested an anticoagulant rodenticide? Give diazepam Give IV vodka Give atropine Give vitamin K

Explanation It takes at least a few days for anticoagulant rodenticides to cause prolonged bleeding times and clinical hemorrhage. This could likely be prevented with early intervention with decontamination and Vitamin K1 administration. In patients that have prolonged bleeding times, plasma is also indicated. The bright green vomit confirms the owners suspicion of rodenticide ingestion because many rat poison contains a bright green dye. Dogs that ingest these products may have bright green vomit or stool.

Where would you find the Loop of Henle? Liver Heart Ear Kidney

Explanation The Loop of Henle is located in the kidney and is part of the nephron. The nephron is the functional unit of the kidney. PowerPage Renal Anatomy and Physiology

Abdominal radiographs should be taken at which of the following times? Systole Full inspiration Diastole Full expiration

Full expiration Explanation Abdominal radiographs are best taken at full expiration because this is when the diaphragm is pushed cranially, which increases the amount of space in the peritoneum and minimizes the overlap of abdominal organs on the radiograph. It is usually not possible to time a radiographic exposure based on the cardiac cycle.

Which of the following could be used for hemostasis at the site of a liver punch biopsy? Styptic powder Gelfoam Silver nitrate Bone wax

Gelfoam Explanation Gelfoam is a sterile compressed sponge that is intended to aid in hemostasis; it allows for absorption of blood and formation of a clot at the bleeding site. It has a very useful application in liver biopsies. Bone wax controls bleeding from bone and functions as a mechanical plug that is pressed into the bleeding bone surface. Silver nitrate applicators are used to stop small superficial bleeders such as a snipped skin tag or a bleeding toenail. These are not sterile. Styptic powder is used to stop bleeding toenails and would never be used on tissues.

This retractor is being used to hold open a laryngotomy incision in a horse. Which instrument is this? Balfour Senn Gelpi Deaver

Gelpi Explanation The gelpi retractor is a self-retaining spreader suitable for small surgical sites. The blades separate as the handles are closed and are held open by a rachet. The blades turn down at right angles at their tips, and bow towards each other so the edges of the incision are pushed apart. Senn and Deaver retractors are hand-held retractors. Balfours are self-retaining retractors used in abdominal surgery to allow visualization of internal organs.

If you take the total protein measurement and subtract the albumin, what measurement is left? Calcium Amylase Potassium Globulins

Globulins Explanation Albumin and globulins are combined for the total protein level. Globulins are the protein that plays an important role in the immune system. Calcium binds to albumin so if the albumin is low, the calcium level can appear falsely decreased. This is not measured in the total protein level.

Which food consumed by humans can be highly toxic to dogs and cats? Bananas Tomatoes Carrots Grapes Spinach

Grapes Explanation Grapes and raisins can cause severe kidney problems/failure in some cats and dogs. This may be due to the high levels of oxalates they contain. Other toxic foods include macadamia nuts, onions, and chocolate. Coffee, alcohol, yeast dough, nutmeg, and sugarless gum containing xylitol can also cause severe toxicities.

Linear artifacts on a film are usually due to which of the following? Film Processing machine Grid Collimator Cassette Intensifying screen

Grid Explanation Linear artifacts can be normal gridlines or may be due to the beam not being appropriately centered on the grid. Alternatively, they may occur if the grid is otherwise out of position, upside-down, or damaged. Processing machine errors may cause streaks on the film which should not be confused with linear artifacts. Errors with the other components listed should not cause linear artifacts.

Some x-ray machines have the option of using 2 different sized filaments at the cathode. Which of the following is an advantage of using a larger filament? Increased penumbra effect Improved image definition Higher exposures can be used Decreased penumbra effect

Higher exposures can be used Explanation A larger filament produces a broader electron beam with a larger focal spot. This spreads out the area of the target where heat is generated and allows higher exposures to be used. However, the wider focal spot leads to decreased image definition and increased penumbra effect, both of which are disadvantages. The penumbra effect is the blurring of margins that occurs as a result of the geometry of the x-ray beam.

The veterinarian is performing an orthopedic exam and says a dog has positive Ortolani sign. What corresponds with this? Luxating patella Cervical instability Hip dysplasia Cranial cruciate rupture

Hip dysplasia Explanation Ortolani is the palpable sensation of gliding the femoral head in and out of the acetabulum and suggests joint laxity, most often seen in hip dysplasia. A "drawer sign" would correspond with a cranial cruciate rupture.

What purpose does this instrument serve? (see image) Holds the scalpel blade Probes pockets under the gingiva Helps to locate the uterine horns Cuts suture material

Holds the scalpel blade Explanation The image shows a scalpel blade handle. The most commonly used blades are the #10, #11 and #15.

The viscosity of synovial fluid is directly related to which component in the fluid? Hyaluronic acid Cartilage Acetic acid Erythrocytes

Hyaluronic acid Explanation Hyaluronic acid is found in all connective tissues. It is highest in the joints where it acts as a cushion. In inflammatory conditions, the fluid gets thinner, and thus the overall quality of the joint fluid decreases. To test the viscosity or "stickiness" of the fluid, take a drop of synovial fluid between two fingers, press and pull your fingers apart. The stringy component (viscosity) of the fluid is related to the hyaluronic acid component.

What is an expected finding in a patient with Hypervitaminosis D, or Vitamin D toxicity? Hypokalemia Hypocalcemia Hypoglycemia Hyperkalemia Hypercalcemia

Hypercalcemia Explanation Vitamin D is the building block of calcitriol, which works with parathyroid hormone. Calcitriol increases absorption of calcium and phosphorus from the intestines and decreases their excretion in the urine. In so doing, calcium levels in the blood rise and PTH levels drop. So, when vitamin D is too high from intake, calcium is too high (there is no negative feedback mechanism with PTH).

Phenylpropanolamine is used to treat urinary incontinence in dogs. It can commonly cause which side effect that should be discussed with the owner? Renal failure Hypocalcemia Profound hyperglycemia Hypertension

Hypertension Explanation Phenylpropanolamine (Proin) can cause a high blood pressure (hypertension). If this occurs with the drug, a different treatment should be considered.

Which of the following is not a common cause of dystocia? Hypokalemia Decreased pelvic diameter Uterine inertia Oversize fetus

Hypokalemia Explanation Hypokalemia is not considered a cause of dystocia. Hypocalcemia, on the other hand, can result in decreased ability to contract and will be a cause for dystocia. Oxytocin release will lead to contraction and depletion of calcium stores; inadequate release of oxytocin may result in uterine inertia. An oversized fetus, as is common in small breed dogs, may necessitate a planned cesarean delivery. Animals that have a decreased pelvic diameter will also be at risk of developing dystocia. A common cause of decreased pelvic diameter is previous trauma.

Which of the following is not considered part of the large intestine? Cecum Ileum Colon Rectum

Ileum Explanation The cecum, colon, and rectum are all part of the large intestine. The duodenum, jejunum, and ileum are all part of the small intestine.

What is the effect of administering a diuretic, such as furosemide? Increased blood pressure Water retention Sodium retention Increased urine production

Increased urine production Explanation Diuretics work to flush out excess water and sodium from the body (which would decrease blood pressure) and thus increase urine output. They are most commonly used in treating congestive heart failure as the goal is to control pulmonary edema. An example of a medication that increases blood pressure is dopamine.

Which of the following is most appropriate when placing a urinary catheter in a dog or cat? Insert the catheter until urine flows, then advance 1 cm further and secure Insert the catheter until resistance is met Insert the catheter no more than 3 inches in any pet, whether urine flows or not Do not use lubrication, as this can irritate the inside of the urethra

Insert the catheter until urine flows, then advance 1 cm further and secure Explanation A sterile urinary catheter should always be used and coated in sterile lube. Sterile gloves should also be worn. Contaminants around the prepuce should be cleaned away with a gentle scrub. The catheter should be advanced until urine flows then 1 additional centimeter before securing in place. Placing the catheter until resistance is met can cause damage or irritation to the bladder wall, as well as cause bleeding, and can cause the catheter to loop back on itself.

A 2-year old male Golden Retriever has been brought to your facility in cardiac arrest. Obtaining intravenous access will be extremely difficult due to degloving injuries on all legs and additional trauma to the head and neck. What alternate route would be the first choice for atropine and epinephrine administration? Intramuscular Intracardiac Rectal Subcutaneous Intratracheal

Intratracheal Explanation Both atropine and epinephrine can be administered via the endotracheal tube (intratracheal). Three times the intravenous dose must be administered. Intracardiac administration can be used; however, it would not be the first alternate choice as significant cardiac trauma can be caused. Subcutaneous and intramuscular administration both are too slow for resuscitation drugs as it can take up to 30 minutes for drugs to reach the blood stream via these routes. Rectal administration of these medications is not beneficial.

A 6-month old puppy has presented to the hospital with a history of severe straining to defecate. A fecal float identifies a severe parasitic infection. An abdominal ultrasound was performed, and the doctor identified that one of the loops of intestine was telescoping into another segment of intestine. What is this called? Evisceration Intussusception Hydrometra Strangulation

Intussusception Explanation This question is describing an envagination of intestine into an adjacent segment of intestine. The part which prolapses into the other is called the intussusceptum, and the part which receives it is called the intussuscipiens. Evisceration refers to the removal of organs from body, usually from the abdomen. A hydrometra is the word used to describe fluid in the uterus. If the uterus were filled with pus, it would be referred to as a pyometra. Strangulation of a loop of intestine results in a point of constriction which then impedes circulation.

When performing orthopedic surgery, it is sometimes necessary to advance a pin into the medullary canal of a bone. Which of the following instruments should the surgeon be provided to advance a pin? Jacobs chuck Mallet Periosteal Freer elevator Osteotome

Jacobs chuck Explanation A chuck key is used to tighten the Jacobs chuck around the pin. Once the pin is secured, a back-and-forth twisting motion at the wrist is used to drive the pin through the medullary canal of bone. An osteotome is the orthopedic version of a chisel. A mallet is the orthopedic version of a hammer. A periosteal Freer elevator is used to elevate muscle and periosteum off the bone.

Which of the following sedative or anesthetic drugs would NOT frequently cause hypotension (low blood pressure)? Ketamine Acepromazine Propofol Isoflurane

Ketamine Explanation Ketamine's effects on the cardiovascular system include increased cardiac output, increased heart rate, and increased blood pressure. These cardiovascular effects are secondary to increased sympathetic tone. Isoflurane and other inhalant gases can cause profound hypotension. Acepromazine and propofol also very commonly cause hypotension.

In dogs, which of the following are all permanent teeth with 2 roots? Maxillary premolars 2, 3, and 4, and molar 1 Mandibular premolar 1 and molars 2 and 3 Mandibular premolars 2, 3, and 4, and molar 1 Maxillary molars 1 and 2

Mandibular premolars 2, 3, and 4, and molar 1 Explanation While exceptions do occur, the following are generally accepted and true. In dogs, all of the permanent incisors and canine teeth have 1 root. In the mandible, premolar (PM) 1 has one root. PM 2, 3, and 4 all have two roots. M 1 and 2 have two roots. M3 can have one or two roots. In the maxilla, PM 1 has one root. PM 2 and 3 have two roots, although PM 3 can sometimes have 3 roots. PM 4 and M1 and 2 all have 3 roots.

Which antibiotic often used for diarrhea has potential to cause a neurologic side effect? Tylosin Bismuth subsalicylate Amoxicillin Metronidazole

Metronidazole Explanation Metronidazole is used frequently for treating diarrhea. It can cause neurologic symptoms in some sensitive patients or at higher dosages. The treatment for metronidazole toxicity is supportive care, including Diazepam as a main treatment. Owners with pets on higher dosages of this medication should be advised of this potential side effect. The most common use for higher doses is treatment of Giardia. Fenbendazole is often a safer option for this parasite.

A degenerative left shift implies which of the following? Less monocytes than lymphocytes More eosinophils than lymphocytes More neutrophilic bands than normal neutrophils More lymphocytes than neutrophils

More neutrophilic bands than normal neutrophils Explanation A degenerative left shift specifically refers to the neutrophil count. In this case, there are more neutrophilic bands present than neutrophils. In a regenerative shift there are more normal neutrophils present than neutrophilic bands. Bands have a smooth nucleus with parallel sides, while mature neutrophils have a twisted nucleus.

What is the vector for transmission of heartworm disease? Tick Flea Mosquito Fly

Mosquito Explanation The heartworm, Dirofilaria immitis, is transmitted by infected mosquitoes (the mosquito is the intermediate host). The mosquito ingests microfilariae from the blood of an infected dog (an L1). Then the microfilariae mature in the mosquito to an infective state (L3). The mosquito punctures the skin, and the L3 enter into the new host where they begin migrating and maturing. The adults arrive in the heart about 110 days after infection. The females begin to produce the microfilariae about 6 months after infection, at which time the cycle can begin again via a mosquito bite. PowerPage Heartworm Disease

You are helping the neurologist with a Tensilon test in a dog. Tensilon is the trade name for edrophonium chloride. By administering this drug, you are testing for which disease? Old dog vestibular disease Meningitis Hydrocephalus Diskospondylitis Myasthenia gravis

Myasthenia gravis Explanation Myasthenia gravis can sometimes be diagnosed with a Tensilon test. With this disease, there are not many acetylcholine receptor sites on the muscles, and acetylcholine is broken down before it can fully cause muscle stimulus. This results in muscle weakness. By blocking the action of acetylcholinesterase, Tensilon prolongs stimulation to the muscles, thus temporarily improving strength. Results are usually seen within a minute of administering the drug IV. A blood test that can also help to aid in diagnosis of Myasthenia gravis is the acetylcholine receptor antibody test.

Johne's disease is an intestinal infection that can lead to clinical signs of diarrhea and weight loss. It affects cattle, sheep, goats, and other species. What is the Genus of the causative agent of Johne's disease? Brucella Mycobacterium Fusobacterium Listeria

Mycobacterium Explanation The correct answer is Mycobacterium. Mycobacterium avium subsp. paratuberculosis is the cause of Johne's disease and is known to affect cattle, goats, and sheep, as well as many exotic hoof-stock. Infection usually occurs when the animals are young, but clinical signs do not show up until the animal becomes stressed, often around 2 to 3 years of age. Clinical signs are essentially chronic intermittent diarrhea and weight loss. Listeria monocytogenes causes a disease of the central nervous system. Fusobacterium necrophorum is a bacteria often isolated from footrot in cattle. Brucella abortus is a bacterium which causes abortion in cattle (known as "Bang's disease") and also causes a disease in humans known as undulant fever.

Canine parvovirus causes which of the following laboratory changes? Hemolytic anemia Neutropenia Neutrophilia Thrombocytopenia

Neutropenia Explanation Parvoviral enteritis causes severe vomiting and diarrhea, which leads to dehydration and often sepsis and fever. The sepsis (overwhelming infection) leads to a low neutrophil count.

Canine parvovirus causes which of the following laboratory changes? Neutropenia Hemolytic anemia Thrombocytopenia Neutrophilia

Neutropenia Explanation Parvoviral enteritis causes severe vomiting and diarrhea, which leads to dehydration and often sepsis and fever. The sepsis (overwhelming infection) leads to a low neutrophil count.

What is the preferred stain to identify reticulocytes and Heinz bodies in erythrocytes? New methylene blue Wright's-Giemsa stain Romanowsky stain Wright's stain

New methylene blue Explanation Reticulocytes and Heinz bodies are most reliably identified using a new methylene blue stain. Since this is not routine on a CBC, a separate new methylene blue stain should be performed when a reticulocyte count is indicated or when oxidative damage is suspected. Brilliant cresyl blue stain is another option for visualizing Heinz bodies.

Which of the following blades is the most commonly used when incising the skin of an animal? No. 20 No. 12 No. 11 No. 10

No. 10 Explanation The No. 10 blade is the most commonly used blade, and the technician needs to be familiar with this blade size. The No. 15 blade is also commonly used. This blade is smaller and will be used for more delicate incisions. The No. 11 blade is pointed at the tip and will be used to transect structures such as ligaments. The No. 12 blade is not commonly used but some may use it to lance abscesses.

In a cow that is having difficulty calving and seems to have her legs splaying out from underneath her, you are most concerned about damage to which nerve? Tibial Femoral Peroneal Obturator

Obturator Explanation Obturator nerve paralysis (ONP) is most common. This nerve is responsible for adducting the hind limbs and runs from the spinal cord into the birth canal before it innervates the inner thighs. During birthing, this nerve can become crushed and lead to this problem.

You are restraining a horse with a halter while the veterinarian is examining a sore on the lateral side of the left pelvic limb. Where should you stand while holding this horse? On the left side, hold lead rope and leave enough slack so that the horse may turn his head around to see what the veterinarian is doing The horse should be tied up and you should stand to the right of the veterinarian at the hind end of the horse to prevent the horse from kicking On the right side, hold lead rope with little slack On the left side, hold lead rope with little slack

On the left side, hold lead rope with little slack Explanation When handling a horse, the holder and the person working on the horse should be standing on the same side. If the exam starts on the left, stand on the left; as the examiner moves to the right side, you should also move to the right side. There should be little slack in the lead rope to prevent the horse from moving. PowerPage Equine Restraint Capture and Restraint of Horses When working with equine patients it is important to not only know how to properly capture, perform restraint, and distraction techniques for these animals, but also to understand the potential dangers and practice proper technique when approaching a horse. Potential Dangers The rear feet of an adult horse can have a kicking range of up to 8 feet. To pass by a horse safely the technician should stay at least 10 to 12 feet behind or to the side of the animal. Alternatively the technician can stay in physical contact with the horse. If a horse rears it can use its front feet to knock a person down. The front feet can also be used to strike out without rearing up. Approaching a Horse Horses are trained to be approached from the near or left side. The right side is termed the far side. When approaching the horse the technician should move slowly and talk softly without sudden movements or loud noises. If the horse moves away, stop, or the horse may think it is being chased and flee. Capturing a Horse Slip the lead rope around the horse's neck and tie a single overhand knot to prevent the rope from slipping off. To place the halter hold the neck strap of the halter in the left hand, reach under the horse's neck, and hold the head still so the right hand can bring the halter over the horse's neck. Slide the nose band of the halter onto the nose and buckle the neck strap behind the ears. Check to be sure the halter is sitting on the horse's face correctly. Attach the lead rope to the center ring of the halter under the chin. Untie the lead rope from around the neck. The left hand should hold the loose end of the rope in neat loops with the entire rope held in front of you. * Never wrap the loose end of the lead rope tightly around your hand or any part of your body. * Never have the rope loose behind you. Leading a Horse Gather the lead rope in your left hand. Always walk on the near side of the horse with your right hand on the lead rope approximately 5 to 6 inches below the halter ring. Stay close to the shoulder and when stopping, stand facing the same direction as the horse. Restraint for General Examinations Stand on the same side of the horse as the person who is working on the animal. By standing on the same side, the horse has an opportunity to move away from both of you. If there are barriers on both sides the horse may decide to move over a smaller object. This could mean moving over someone bending or kneeling, causing serious injury. When tying a horse it should always be tied to a sturdy, vertical object. The knot used to tie the lead rope should always be a quick release knot so the horse can be freed quickly if there is an emergency. Allow 2 to 3 feet of lead rope so the horse can move its head comfortably. The lead rope should not be any longer than 2 to 3 feet or the horse may get its front feet tangled. If the rope is left shorter it may frustrate the horse and cause it to try to escape. Check the area for hazards that could injure the horse. Never pass under the neck of a tied horse; this can result in serious injuries. Cross tying is used to prevent a horse from rearing and from moving it's forequarters from side to side. It should be noted however, that the horse can still strike with its front feet and move its hindquarters. Snap a lead rope onto the cheek piece ring on each side of the halter. Tie each lead rope to the side of the stanchion, to stocks, or beams. Cross tying will allow you access to the entire body but does not prevent the rear from swinging. Stocks are narrow stalls with removable or semi open sides and a gate at both ends. To place the horse in the stocks you should lead the animal through the back gate and close the front after it is all of the way in. Never go into the stocks with the horse, instead, pass the rope around the bars as needed to keep the horse moving forward. Stocks are usually used for rectal and uterine examinations or procedures on the head. Blindfolds can be used to control a stubborn or a fearful horse. The horse will normally calm down and allow you to lead it wherever you want it to go. Work slowly and talk constantly to reassure the horse. Hobbles are rarely used since being replaced by chemical restraint. However, breeding hobbles are still used commonly and effectively prevent the mare from kicking. They are fitted around the hocks with web or leather straps and then tied to a neck strap or rope after being passed between the forelegs. Restraint for Dental Procedures Place your left hand on the bridge of the horse's nose with your thumb under the noseband of the halter, and place your right hand on the nape of the neck; pushing the head down. To hold the tongue, reach in at the commissure of the lips, grasp the tongue, and slowly pull it out to the side through the diastema of the lower jaw. Distraction Techniques Twitches are used on stubborn horses that will not allow procedures to be performed. Twitches distract the horse from other procedures by applying a mild pain to the upper muzzle. The chain, humane, and rope are the three types of twitches. Of these three, the chain is the most commonly used. To apply the twitch, place the loop of chain over your left hand catching one side of the loop between your little finger and ring finger. Grasp as much of the horse's upper lip with your left hand as possible, pressing the bottom edges together to protect the delicate inner surface, and quickly slide the handle up so the chain loop rests high up around the lip. Tighten the chain by twisting the handle until the twitch is fitted snugly on the lip so that it curls upward. Tighten and loosen the chain on the muzzle to keep the twitch effective. If steady pressure is applied, the muzzle would lose circulation, reducing sensitivity of the muzzle, making the twitch ineffective. After the twitch is removed, massage the muzzle to restore circulation. The eyelid press is a distraction technique involving placement of the fingers on the upper eyelids and lightly applying pressure. This is a gentle technique that can be used when giving injections or to keep the horse still. The shoulder roll is done by grasping a large fold of skin just over the shoulder with both hands and wiggling it from side to side or up and down. This technique works well when giving intravenous injections. Heavy swats or grasping the base of the ear with the heel of your hand touching the head and squeezing or rotating the ear in a small circle are both alternative and effective ways to distract a horse. Picking up the Feet For the front feet stand lateral to the shoulder and parallel to the horse, facing the caudal end of the animal. Place your closest hand on the horse's shoulder; gently but firmly run it down to the fetlock. Grasp the fetlock by placing your palm on the underside of the fetlock and wrapping your fingers around the joint. Squeeze and lift the foot; at the same time lean into the horse to make it shift it's weight to the other three legs. After raising the foot up, bring it slightly out to the side. Place your body close to the animal's body so that your knees are slightly bent. Place the foot between your knees. This allows both of your hands to be free. Flex the fetlock and hoof towards yourself. For the rear feet approach in the same manner as for the front feet. After you have lifted the food, extend the leg out to the rear and place it on top of your bent knee closest to the horse. Capture and Restraint of a Foal Keep the foal in sight of the mare. Place the mother in a stall so she can see the foal but is unable to get to you. Grasp the foal around the front of the chest with one arm, and around the rump with the other arm, or grasp the tail. Quickly move the foal clear of the mare. Use your arms to form a "mini corral" to keep the foal within the circle of your arms. Lifting the foal off its feet will make it nervous and cause it to struggle. Always talk to a foal and comfort it. References and Links McCurnin, D. & Bassert, J. (2006) Clinical Textbook for Veterinary Technicians. St. Louis, Missouri. Elsevier Saunders. p 34-50 Tying a horse video http://www.youtube.com/watch?v=LhIy0Oc6wQg&feature=related Picking up a horse's foot video http://www.youtube.com/watch?v=_yY5UCEpwn0

If a pulmonary metastatic lesion is visible on a right lateral radiograph but not on a left lateral radiograph, where is the lesion most likely to be? One of the left lung lobes One of the caudal lung lobes One of the dorsal lung lobes One of the ventral lung lobes One of the cranial lung lobes One of the right lung lobes

One of the left lung lobes Explanation When a patient is placed into left lateral recumbency for a left lateral radiograph, the left lung fields are compressed and do not inflate fully. This can prevent resolution of small metastatic lung lesions in the left lung lobes due to the lack of contrast with air in the left lung. The same is true of the right lung fields with a right lateral radiograph. Therefore, for evaluation of pulmonary metastasis, both a left and right lateral radiograph should be taken. In this case, a lesion that can be seen on a right lateral but not a left lateral projection is most likely in the left lung lobe because, as explained above, the lesion may be obscured on the left lateral projection due to a lack of contrast in the uninflated lung.

Regarding sterilization in reptiles, which is true? Sterilization of female pet reptiles is recommended so that they do not develop estrogen toxicity Reptiles should not be sterilized due to sensitivity to anesthetics Only the oviducts should be removed and ovaries should be left intact Ovaries should always be removed during sterilization

Ovaries should always be removed during sterilization Explanation When sterilizing a reptile, the ovaries should always be removed. Removal of only the oviducts puts the patient at risk for egg binding. With just the oviducts removed, the ovaries are still active and yolks can be released into the coelomic cavity. In ferrets, spaying is recommended due to the risk of bone marrow toxicity from the high levels of circulating estrogen during prolonged heat cycles.

Several Heinz bodies have been identified on a blood smear of a sick dog. What is this an indication of? Cyanide poisoning Viral hemolysis Oxidative damage Carbon monoxide exposure

Oxidate damage Explanation Heinz bodies are seen whenever oxidative damage occurs to the red blood cell. They can be seen with immune mediated hemolytic anemia or ingestion of certain toxins. For example, consumption of onions results in Heinz body anemia. Another example is the administration of methylene blue, which also causes oxidative damage to red blood cells. If a large enough amount is given, this can cause anemia.

What hormone stimulates uterine contraction? Oxytocin Luteinizing hormone Antidiuretic hormone Prolactin

Oxytocin Explanation Oxytocin is the hormone responsible for uterine contraction and is sometimes administered to animals with dystocia to help expel the fetus.

What is another common name for herpes infection in psittacine birds? Pacheco's disease Newcastle disease West Nile Chlamydiosis

Pacheco's disease Explanation Pacheco's disease is a highly fatal and contagious virus of psittacine birds. It is mostly transmitted through contaminated food, water, or feces. Less commonly, airborne transmission can occur. The most common sign is sudden death, as many birds do not show symptoms of disease. Pacheco's disease is generally considered untreatable because of its acute onset and rapid mortality. Antiviral drugs such as acyclovir may be of benefit to suppress the virus. PowerPage Avian Diseases A thorough evaluation of a bird's lifestyle is one of the most important components of the examination and medical care of avian species. It is important to understand the unique housing and nutritional requirements of each species, as improper husbandry can lead to many medical problems including infectious diseases, malnutrition, cage-mate aggression, or traumatic injuries. The following is a brief overview of the husbandry, restraint, and diseases of avian patients. Housing Provide a large cage or aviary for multi-bird housing to minimize territorial stress and maximize space for flight Single birds should be housed in a large indoor cage based on weight and size Offer nest boxes for breeding birds All birds require a large variety of perching surfaces; variation in texture and diameter allow for grasping, chewing, exercising the feet and subsequently decreasing the risk of bumblefoot (large birds, raptors) A variety of toys provides environmental enrichment and stress reduction. Always select toys appropriate to the size of the bird. Toys that are too small may be broken and ingested, which may lead to GI foreign body obstructions Food and water dishes should be made of stainless steel or ceramic material Food and water should be changed daily Clean cage every 2-3 days using dilute sodium hypochlorite (bleach) Utilize indoor lighting (UVA & UVB) I.D. birds with leg bands or microchips Nutrition - Unique to each species Parrots - free feed pelleted diet Canaries & Finches - free feed seed-based diet Offer a variety of vegetables and fruits in addition to base diet Most birds do not require grit Calcium supplementation (bone, mineral block, crushed oyster shell, baked eggshell) is important, especially for breeders and layers Toxic foods: Avocados - cardiac toxin that causes heart failure and death Chocolate - even small amounts of may cause seizures, vomiting, diarrhea, cardiac arrhythmias, and death Comfrey - causes liver damage Avoid all foods that are high in sugar or salt Handling/Restraint Restraint: Birds should be brought to the clinic in a cage or animal carrier Handle only stable avian patients; unstable patients may be too weak to endure the stress of handling Small birds: briefly turn off light, grasp bird with towel; gently place head between middle and index finger, hold body with thumb and pinky finger (dominant hand) Large birds: ask owner to hand bird to you (if patient is trained to do so), then capture with towel; form Elizabethan grip with thumb and index finger under mandible (dominant hand), hold legs in place with opposite hand Avian restraint boards are also effective, especially for radiographs The restraint of large birds can be very challenging, and bites from their powerful beaks may result in severe injuries Do not attempt to restrain these animals unless you have had training or have a professional to assist you Clinical signs of illness/critical condition: Open-beak breathing Wings out Tail bobbing Depression Feathers fluffed at bottom of cage (notify doctor) Venipuncture sites: right jugular vein, basilic (wing) vein, median tarsometatarsal vein Diseases Dermatologic: Flies (hippoboscids) in aviary birds may transmit blood parasites Lice, ticks, mites Ulceration or folliculitis associated with bacterial infection Stress bars in feathers could indicate poor husbandry, infections or self-mutilation *Remember: feather picking is not always a psychological problem; disease must be ruled out disease Gastrointestinal: Normal droppings contain both feces and urine, which comes from the cloaca; fecal part should be dark/well formed; urinary portion should have white crystals (uric acid) & small amount of liquid urine; varies with diet Swollen crop, may be infectious: trichomonas (parasite), candida (fungus), or bacterial Viral, proventricular dilatation disease (PDD) associated with avian bornavirus: infection causes nervous system inflammation leading to neurologic signs and gastrointestinal dysfunction Tapeworm, giardia, roundworms Respiratory: Aspergillosis: fungal infection of the respiratory tract; may lead to fungal granulomas in the upper or lower respiratory tract Reproductive: Egg binding: most common, obstruction of egg(s) in reproductive tract. Many factors may result in this condition: poor nutrition, hypocalcemia, large eggs, obesity, tumors or infection of oviduct, stress, and genetics Egg Yolk Peritonitis: occurs when ovulation occurs outside of the oviduct into the abdomen Chronic egg laying: may be modified by dietary and behavioral changes Viral: Psittacine beak and feather disease Polyoma virus Pacheco's disease: parrot herpesvirus, often fatal Zoonotic diseases: Chlamydophila psittaci (Psittacosis): one of most common bacterial respiratory diseases in pet birds; may cause severe illness in humans. Transmission through inhalation or ingestion of spore-like phase of organism Exotic Newcastle disease: transmission through direct contact with viral particles from aerosolized bodily fluids; may result in systemic clinical signs in birds. In humans, can result in sinusitis, lethargy, and conjunctivitis West Nile virus: transmission through infected mosquitoes; causes neurologic disease in animals and people Avian influenza: wild birds are the natural hosts of Influenza A; different subtypes of influenza A have infected people. Dangerous subtypes identified = H5 & H7. Infection can result in flu-like symptoms and death in animals and people

Which organ(s) in the body is (are) responsible for producing insulin? Pancreas Liver Pituitary gland Adrenals

Pancreas Explanation The two main functions of the pancreas are endocrine or production of hormones (insulin and glucagon) and exocrine or production of digestive enzymes. The pancreatic beta cells are responsible for secreting insulin. The adrenal glands produce several hormones including aldosterone, cortisone, testosterone, and catecholamines. The pituitary gland produces ACTH, growth hormone, thyroid stimulating hormone, prolactin, and others.

A dog owner is considering having a scheduled cesarean section for her dog and would like some more information regarding the risks associated with the procedure. Which of the following statements is TRUE? Performing a cesarean delivery will result in the dog being unable to have another pregnancy Performing a cesarean delivery will result in decreased milk production Performing a spay at the time of surgery is not recommended as there is a risk that the female will not display maternal instincts Performing a spay at the time of surgery does not affect milk production

Performing a spay at the time of surgery does not affect milk production Explanation It is important to be aware that performing a spay at the time of surgery does not have a detrimental effect on the female. There are no adverse effects on milk production or predictable unwanted behaviors. Similarly, there are no long-term negative effects of performing a cesarean delivery; however, there is a possibility of development of scar tissue at the site of a cesarean which may hinder the ability of a future embryo to attach at that specific location.

Which of the following lymph nodes are not palpated peripherally? Perihilar Popliteal Mandibular Prescapular

Perihilar Explanation Above the heart is a triangular depression named the hilum, near which the perihilar lymph nodes are located. They are inside the chest and therefore not palpated peripherally.

You are assisting with a bone marrow aspirate on a dog with suspected neoplasia. You are asked to make slides to send to the laboratory with the samples the veterinarian is collecting. Which describes proper technique for this? Place a drop on the slide but do not make a pull smear or press the cells, just let air dry as-is Place a drop on the slide and place another slide on top in an up-and-down motion to press the cells firmly onto the slide Place a drop on the slide and place 1 drop of 0.9% saline onto the drop to dilute and let dry Place a drop on one end of the slide, tilt slightly and make a pull smear

Place a drop on one end of the slide, tilt slightly and make a pull smear Explanation Pull smears should be made of bone marrow samples. The pull smear should be in a light fashion as to spread the fluid but not to crush the samples. The sample should be dried immediately to preserve integrity of the cells. A blow dryer can assist by quickening drying time. A stain of one of the slides should be performed to make sure the sample appears adequate before submission.

What is the biggest risk when giving an animal fluids or medications via an orogastric or a nasogastric tube? Perforation of the esophagus Regurgitation through the nares Placing tube into the lungs GI foreign body from animal biting off the tube

Placing tube into the lungs Explanation Sometimes animals require medications through a tube. Horses that are having colic symptoms often receive fluids and mineral oil through a nasogastric tube. Sometimes small animals need to receive activated charcoal or barium through an orogastric tube. The biggest risk when tubing a patient is accidentally placing the tube into the lungs, so the tube goes down the trachea instead of the esophagus. This leads to compromise of the lungs and can lead to subsequent pneumonia and can have fatal consequences.

A 3-year old male neutered Maltese presents to your clinic because the owner saw "some white rice-looking things" around his anus. They were small and flat and seemed to be moving. Some of them were dried up. Which of the following drugs is effective against this organism? Fipronil (Frontline) Fenbendazole (Panacur) Pyrantel (Strongid) Praziquantel (Droncit) Selamectin (Revolution)

Praziquantel (Droncit) Explanation This dog likely has a tapeworm infection. Tapeworm segments are typically flat and white and small, resembling a grain of rice. The most common tapeworms in cats are Taenia taeniaeformis and Dipylidium caninum. The only medication that will treat both types is praziquantel. Praziquantel is in the products Drontal Plus and Profender, approved for the use in cats. Drontal Plus also contains pyrantel. Profender also contains emodepside. Both are also effective against roundworm and hookworm. Pyrantel is not effective against tapeworms and treats hookworm and roundworm infection. Fenbendazole (or Panacur), treats Taenia but not Dipylidium, and also treats hookworm, roundworm, and whipworm infection. Revolution treats and prevents hookworm, roundworm, heartworm, fleas, and ear mites in cats. Frontline treats and prevents fleas and ticks. A flea control should be recommended, since Dipylidium is transmitted by ingestion of an infected flea. Taenia is transmitted through eating an infected prey.

Chronic exposure to which hormone leads to a pyometra? Luteinizing hormone Estrogen Progesterone Testosterone

Progesterone Explanation Pyometra is often related to increased progesterone levels and their effect on the lining of the uterus. Prolonged exposure to estrogen can cause bone marrow suppression.

A 5-year old female spayed Yorkie presents with a history of decreased vision. The doctor asks you to perform tonometry on this dog. Which of the following may be used as a topical anesthetic to the eyes so that you may check the intraocular pressures with your Tonopen? Bupivacaine Benzocaine Lidocaine Proparacaine

Proparacaine Explanation Proparacaine is a topical anesthetic for the eyes. The other choices should not be used in the eyes. The other options are local anesthetic agents but are likely to cause irritation and/or corneal ulceration.

A 10-year old male intact Rottweiler is currently undergoing surgery for removal of a prostatic mass. Which term best describes the procedure? Cholecystectomy Prostatitis Onychectomy Orchidectomy Prostatectomy

Prostatectomy Explanation There are a few basic rules that will allow you to comprehend a majority of the medical terms. Any term that ends with "-ectomy" infers to removal of that organ. Onychectomy is another word declawing or removal of the distal phalanx. Orchidectomy is the removal of a testicle. A cholecystectomy is removal of the gall bladder. The ending "-itis" means inflammation. In this case, prostatitis would be inflammation of the prostate.

Newborn mice are often called which of the following? Colts Kits Squabs Pups

Pups Explanation Newborn mice are also referred to as pups or sometimes pinkies. They are pink and hairless and blind and deaf when born. Newborn rabbits are called kits and are also blind, deaf, and hairless when born. Ferrets are also called kits. Guinea pigs are also referred to as pups and are "precocious" when born. This means their eyes are open and they are aware and can see and hear and walk from birth.

The sacculus rotundus is part of the intestinal anatomy of which species? Rabbit Camel Horse Psittacine bird

Rabbit Explanation Just proximal to the cecum is a gastrointestinal structure containing a large amount of lymphoid tissue called the sacculus rotundus which has some immune function. It is present only in lagomorphs.

Which bone is adjacent to the ulna? Scapula Tibia Femur Radius

Radius Explanation The radius is adjacent to the ulna. The femur and tibia are bones of the hind limb.

When performing a major cross-match when a blood transfusion is necessary, which of the following samples are mixed? Recipient serum and donor platelets Recipient serum with donor erythrocytes Recipient erythrocytes with donor serum Recipient platelets with donor serum Recipient serum with donor neutrophils

Recipient serum with donor erythrocytes Explanation In a major cross-match, the recipient's serum is combined with the donor erythrocytes, and the sample is examined for agglutination or hemolysis, indicating incompatibility. A minor cross-match combines recipient erythrocytes with donor serum.

Microbiology materials or media that are not in use should be stored where? Refrigerator In a lighted cabinet at room temperature Freezer In the dark room at room temperature

Refrigerator Explanation Microbiology media are best kept in the refrigerator and then brought to room temperature just before use.

Phenylbutazone (bute) is often used for pain relief in horses. What side effect has been associated with this drug? Esophageal stricture Right dorsal colitis Laminitis Colonic impaction

Right dorsal colitis Explanation Phenylbutazone is an injectable non-steroidal anti-inflammatory drug commonly used for the relief of inflammatory conditions associated with the musculoskeletal system in horses. This drug may cause right dorsal colitis associated with ulcerations in this specific region of the bowel.

The veterinarian has asked you to fill a prescription that she has written in a patient's file. The directions read as follows: Apply O.D. TID x 7days. Where is this medication being applied? Left ear Right ear Both eyes Right eye Left eye

Right eye Explanation O.D. (oculus dexter) is the abbreviation for right eye. Left eye O.S.(oculus sinister). Right ear A.D. (auris dextra). Left ear A.S. (auris sinistra). Both eyes O.U. (oculus uterque).

You are taking thoracic radiographs to evaluate for lung metastasis in a dog with splenic hemangiosarcoma. What radiographic views should be taken? Dorsoventral, ventrodorsal, and either a right lateral or left lateral projection A left lateral and a dorsoventral projection A right lateral and a ventrodorsal projection Right lateral, left lateral, and either a dorsoventral or ventrodorsal projection Either a dorsoventral or a ventrodorsal projection AND either a right lateral or left lateral

Right lateral, left lateral, and either a dorsoventral or ventrodorsal projection Explanation When a patient is placed into left lateral recumbency for a left lateral radiograph, the left lung fields are compressed and do not inflate fully. This can prevent resolution of small metastatic lung lesions due to the lack of contrast with air in the left lung. The same is true of the right lung fields with a right lateral radiograph. Therefore, for evaluation of pulmonary metastasis, both a left and right lateral radiograph should be taken. Either a ventrodorsal (VD) or dorsoventral (DV) view is acceptable for visualizing the lung fields in this case.

A wound in front of the eye in a dog (toward the front of the nose) may be described as being which of the following? Ventral to the eye Rostral to the eye Dorsal to the eye Caudal to the eye

Rostral to the eye Explanation Rostral is a term that indicates a structure is towards the front of an animal; the term comes from the latin term rostrum indicating the beak or snout. In veterinary medicine, anterior and posterior are often used only to describe distal extremities but may sometimes be used to describe positions on the head. Cranial is toward the head; caudal is toward the tail. Ventral is toward the abdomen; dorsal is toward the backbone. Lateral is away from midline; medial is toward midline. Proximal is close to the spine or body while distal is away; these are typically used when describing limbs (e.g. fracture of the proximal femur vs. fracture of the distal femur). Palmar is the bottom of the paw of the forelimb; plantar is the bottom of the paw of the hind limb.

Choose in order the corresponding acronyms for: once daily, twice daily, three times daily, and four times daily BID, SID, QID, TID TID, BID, SID QID QID, SID, TID, BID SID, BID, QID, TID SID, BID, TID, QID

SID, BID, TID, QID Explanation These acronyms are often used when prescribing medications: SID - once daily BID - twice daily TID - three times daily QID - four times daily It is best to write: every 24 hours, every 12 hours, every 8 hours, or every 6 hours when possible to avoid confusion.

Which of the following arrhythmias is common in horses and can be alleviated by exercise? Third degree AV block Ventricular Fibrillation Second degree AV block Atrial Fibrillation

Second degree AV block Explanation Second degree AV block is a very common arrhythmia in adult horses as a result of high vagal tone. This arrhythmia is "regularly irregular" and often alleviates with exercise. It is more common in athletic horses. Atrial fibrillation is an irregular arrhythmia and a more serious condition that occurs when the SA node isn't firing properly. Electrocardiogram is the best way to determine atrial fibrillation by identifying a lack of p waves. It is treated with Quinidine, an antiarrhythmic. Ventricular fibrillation is a severely abnormal heart rhythm that is most often identified in patients that have undergone cardiac arrest. Third degree AV block, or complete heart block, is rare in horses and usually associated with degenerative or inflammatory changes in the heart. Horses with this condition usually have exercise intolerance or syncope.

A 4-month-old Angus calf in a beef herd in Northern California has died. Symptoms before death included lethargy and coughing. You assist with a necropsy and find pale areas in the cardiac muscles (see image). The veterinarian diagnoses white muscle disease. He asks you to assist with collecting blood samples from the herd to test for what deficiency? Selenium Potassium Copper Vitamin A

Selenium Explanation Nutritional myodegeneration (white muscle disease) is associated with low dietary selenium levels and compounded by low dietary vitamin E. Unsupplemented cattle grazing soils of volcanic origin are at high risk, and calves born in these herds may show skeletal or cardiac muscle syndromes. Measurement of whole blood selenium in some of the cows from the herd will indicate if the herd needs supplementation with selenium.

Which breed should not receive ivermectin for treating Demodex? Chihuahua Pit Bull Boxer Sheltie

Sheltie Explanation Ivermectin should not be given to collie-type breeds due to a possible MDR1 gene mutation that could cause the drug to be toxic. Breeds included for possible ivermectin toxicity include Collies, Shelties, and Australian Shepherds. The saying is "white feet, don't treat".

The California Mastitis Test (CMT) is an assay that gives a score that corresponds to which of the following? Presence of contagious bacteria in milk Fat content of milk Presence of environmental bacteria in milk Somatic cell count in milk

Somatic cell count in milk Explanation A CMT involves adding a test reagent that reacts with the DNA in somatic cells to cause a gelling reaction. The score of this test corresponds to the somatic cell count in the milk. A higher score indicates the presence of more somatic cells and is indicative of mastitis.

Which of the following is an important safety feature that one must follow when using biomedical lasers for surgery? The operator must hold his breath while the laser is being activated The patient must be maintained on oxygen only Special safety glasses must be worn The patient's incision site may only be scrubbed with 0.05% dilute chlorhexadine solution

Special safety glasses must be worn Explanation Special safety glasses that are specific to the laser wavelength should be worn by anyone present in the room during biomedical laser use. There are no specific requirements regarding the gas the patient is breathing, but one must keep in mind that oxygen is flammable. If you are working near the mouth while the patient is receiving oxygen, make sure there are no leaks in the system. The incision site may be scrubbed with any commonly used pre-operative scrubbing agent. If alcohol is used, make sure the excess alcohol is removed or has evaporated prior to applying the laser. There is no need for the operator to hold his/her breath while activating the laser.

Mannitol Salt Agar, or MSA, selects for growth of which species of organism? Escherichia coli Clostridium Campylobacter Streptococcus Staphylococcus

Staphylococcus Explanation This media contains a high concentration of salt, making it mostly selective for Staphylococci, since this level of NaCl inhibits most other bacteria. This media contains the indicator phenol red.

A dog is having his teeth cleaned and has a discolored upper right third premolar. The doctor would like you to take an x-ray of this tooth. Which patient position would make the radiograph easiest to take? Right lateral recumbency Sternal recumbency Left lateral recumbency Dorsal recumbency

Sternal recumbency Explanation Sternal recumbency is best for the maxilla (upper jaws). Dorsal recumbency is easiest for the anterior mandible. Lateral is best for the premolars and molars of the mandible.

Which of the following is a clinical sign you would see in a dog with chocolate toxicosis? Hyperpigmentation Tachycardia Paralysis Bradycardia Swollen tongue

Tachycardia Explanation The toxic principles of chocolate are methylxanthines (specifically theobromine and caffeine). Methylxanthines can cause CNS excitation tachycardia, and vasoconstriction. Signs include vomiting, diarrhea, hyperactivity, polyuria, polydipsia, lethargy, tachycardia, cardiac arrhythmias, seizures, and death.

What is the name of the reflective layer behind the retina that allows animals to have improved night vision? Lens Cornea Tapetum Optic nerve

Tapetum Explanation Domestic animals have a tapetum to help them see in dim light. Pigs do not have a tapetum. The tapetum reflects light back through the retina, increasing the light available to photoreceptors. This is a photo of a normal canine fundus. Note the reflective green tapetum. ta·pe·tum təˈpēdəm/Submit nounZOOLOGY a reflective layer of the choroid in the eyes of many animals, causing them to shine in the dark.

Telazol is commonly used in veterinary anesthetic immobilizations. Telazol is a combination of which two drugs? Ketamine and xylazine Acepromazine and butorphanol Ketamine and diazepam Teletamine and zolazepam

Teletamine and zolazepam Explanation Telazol is an injectable anesthetic/tranquilizer used for restraint or anesthesia. It is a controlled substance made of teletamine and zolazepam. Teletamine is a classified as a dissociative while zolazepam is a benzodiazepine

Which of the following drugs can cause discoloration of puppy teeth? Enrofloxacin Metronidazole Tetracycline Amoxicillin

Tetracycline Explanation Tetracyclines can cause a discoloration of puppy teeth. Tetracycline binds to calcified tissues (bone, cementum, dentin), gets incorporated into the hydroxyapatite crystals with the calcium, and causes the discoloration. This occurs with puppy teeth because the teeth are still being actively formed. After the adult teeth are present, this should no longer occur. PowerPage Antimicrobials (Chart)

You take a series of chest radiographs and notice that all of the films appear darker (more exposed) towards one side of the film. Which of the following is the most likely explanation? The processor is running low on developer The radiograph cassette is not closing fully The processor is running low on fixative The X-ray beam is usually more intense on one side of the field

The X-ray beam is usually more intense on one side of the field Explanation This phenomenon is known as the "Heel effect". X-ray distribution in diagnostic X-ray units is uneven, with the beam being most intense at the cathode side of the machine and weakest at the anode side. This effect is frequently minor but can be noticeable. It is advantageous to radiograph patients of uneven thickness (i.e. the body of a deep-chested dog) by orienting the thickest part toward the cathode side of the x-ray tube. The other choices listed could cause artifacts but should not cause such a gradient on the film.

Capnography is a means of measuring what? Continuous blood pressure monitoring The amount of carbon dioxide in the blood The amount of carbon dioxide in respiratory gases The amount of oxygen in exhaled gas The amount of oxygen in the blood

The amount of carbon dioxide in respiratory gases Explanation Capnography is a means by which carbon dioxide is measured in gas such as inhaled or exhaled respiratory gases. Capnography measures CO2 tension by passing an infrared light beam across a measuring chamber in which a stream of exhaled gas passes. A photodetector on the other side of the chamber measures the intensity of light that is transmitted. The intensity of light transmission is inversely related to the concentration of CO2 in the exhaled gas sample. PowerPage Anesthetic Monitoring The majority of an anesthetic episode is devoted to monitoring the patient. The ability to evaluate physiologic values and respond to them appropriately will ensure the safest anesthesia possible with minimal decrement to organ function. Monitoring Equipment There are two types of anesthetic monitoring equipment, invasive and non-invasive. Invasive monitoring refers to any equipment that has to be placed in the body and non-invasive refers to any equipment that read variables that are readily apparent. Non-invasive equipment is simple and easy to use but not always as accurate when compared to invasive equipment. Advanced technical skill and knowledge is needed to place invasive equipment and there is a chance for complications, such as hemorrhage, and/or infection. Non-invasive monitoring equipment: ECG (Electrocardiogram) A visual representation of heart conduction and provides a heart rate. Allows you to assess heart rhythm, electrical conduction though the heart, and identify arrhythmia's Normal heart rate: Dogs 70-100 BPM, Cats 100-200 BPM. Disadvantage: Does not indicate cardiac function and can look normal even though peripheral blood pressure is compromised. SpO2 - (Pulse Oximetry) Measures the oxygen saturation in blood and gives a pulse rate. Provides a visual pulse waveform. Disadvantage: Has to be moved frequently due to capillary's being crushed under the compression caused by the monitoring device. Unreliable at low saturation levels and difficult to get a reading if tissue has dark pigmentation. Blood Pressure (Doppler/sphygmomanometer, oscillometric) Dopplers monitor systolic blood pressure using an ultrasonic doppler, sphygmomanometer, and inflatable cuff. The Doppler method also gives an audible representation of pulse rate. Oscillometric devices provide systolic, mean, and diastolic pressures using an inflatable cuff. Normal blood pressure range: Systolic: 100-160 mm Hg, Mean: 80-110 mm Hg, Diastolic: 70-90 mm Hg. Disadvantage: Accuracy depends on correct cuff size. Capnography Measures the endtidal and inspiratory carbon dioxide and anesthetic gas concentration. The capnograph also provides a respiratory rate and waveform. Endtidal CO2 readings are 5-10 mm Hg lower than actual alveolar concentrations. Allows you to access systematic metabolism, cardiac output, pulmonary perfusion, and the adequacy of patient ventilation. Temperature probe Used to monitor the core temperature of the animal. Normal Temperature Range: Dogs 101-102.5OF, Cats 100.5 102.5OF, (anesthesia causes hypothermia) Invasive Monitoring Equipment: CVP (Central Venous Pressure) Indicates fluid status and assesses cardiac output. Normal range: 0-4 cm H2O - standing awake, 2-7 cm H2O anesthetized. Higher readings than normal indicate hypervolemia or myocardial depression/heart failure and lower readings indicate hypovolemia. Blood Pressure (arterial catheter) Gives a constant systolic, mean, and diastolic blood pressure values along with a visual waveform. The waveform can be used to evaluate whether cardiac arrhythmias may be causing poor pressures or when pulse deficits become detrimental to the patient. The waveform can also indicate the presence of vasodilation or vasoconstriction. Blood Gas Blood Gas - (pH, Lactate, partial pressure of oxygen and carbon dioxide, bicarbonate) Gives and accurate representation of the respiratory function and acid-base balance Must be taken from an artery to evaluate respiratory function. Normal values for an arterial blood gas: PH - 7.35 - 7.45 PaCO2 - 35-45 mm Hg, PsO2 90-115 mm Hg on room air, if the patient is on 100% oxygen the PsO2 = 500 mm Hg, SaO2 - >95%, HCO3 - 18-26 mEq/L, BE- -2 to +2. Hands - On Monitoring Sophisticated monitoring equipment is not the only way to assess the status of an anesthetized patient. There is a variety of information that can be acquired using hands-on monitoring. Anesthetic Depth: Eye position - During a surgical plane of anesthesia eyes roll ventrally. The eye will be central during light and deep planes of anesthesia. Dissociative anesthetics will keep the eye central during all planes of anesthesia. Palpebral Reflex - Only present during a light plane of anesthesia. Tapping the medial/lateral canthus elicits a response. Withdrawal Reflex - Only present during a light plane of anesthesia. Preformed by pinching a toe and is often used to access whether an animal is deep enough for endotracheal intubation during a masked induction. Jaw Tone - Indicates muscle relaxation that varies with anesthetic depth. Respiratory and Cardiovascular: Mucus Membrane Color - Ascertained at the gingiva, vulva, and eyelids. Pale mucus membranes may indicate vasoconstriction, decreased cardiac output, hypoxia, and anemia. Dark pink mucus membranes may indicate vasodilation, sludging of blood in the capillaries, and high CO2 levels. Cyanotic mucus membranes indicate severe hypoxemia and a yellowish hue indicates high serum bilirubin from hemolysis or hepatic disease. Capillary Refill Time - Normal capillary refill time is less than 2 seconds and can be assessed at the gingiva, vulva, and eyelids. A capillary refill time of more than 3 seconds is significant and is indication of a low cardiac output and poor tissue perfusion. Palpation of arteries - An arterial pulse can be felt at the femoral, lingual, dorsal pedal, digital, and buccal artery. Pulse rate, rhythm, and pulse pressure can be assessed. It is important to note that pulse pressure does not indicate perfusion pressure. Common complications during maintenance anesthesia Tachypnea Tachypnea can be caused by a light anesthetic plane, pain, hypercarbia, hypovolemia, hypoxemia, drugs, and cerebral spinal fluid acidosis. Apnea Apnea can be caused by a deep anesthetic plane, hypothermia, recent hyperventilation, musculoskeletal paralysis, and drugs. Tachycardia Tachycardia can be caused by a light anesthetic plane, pain, hypotension, hypoxemia, hypercarbia, ischemia, acute anaphylactic reaction, anemia, and drugs. Bradycardia Bradycardia can be caused by a deep anesthetic plane, hypertension, increased intracranial pressure, surgical vagal reflex, hypothermia, hyperkalemia, myocardial ischemia, and drugs. Hypertension Hypertension can be caused by a light of an anesthetic plane, pain, hypercarbia, fever, and drugs. Hypotension Hypotension can be caused a deep anesthetic plane, hypovolemia, sepis, shock, and drugs. One cause of a low SPO2 is if the endotracheal tube has been inserted too far. This can easily happen in a small dog or cat. If you induce a patient and the SPO2 is immediately low and the animal is not oxygenating properly, double check the endotracheal tube and measure it again; it may need to be pulled out a little. This is why it is so important to measure the tube prior to intubation. (see Power Page on Anesthetic Induction and Recovery) Maintenance anesthesia guidelines Being prepared is the first step in preventing complications from arising. A thorough monitoring plan made before animal is anesthetized based on the patients history, health status, specific procedure, and anticipated duration of anesthesia will allow the anesthetist to prepare for and/or prevent complications. The key to anesthetic monitoring is making the correct assessment when a complication arises. Always evaluate more than one body system and more than one variable per system. Never totally depend on just one piece of monitoring equipment and double check values against different techniques and compare. For example, check the heart rate by counting it off the audible sound of the Doppler and compare it to the read out from the ECG, or by auscultation the chest to confirm accuracy. It is also important to check machine calibrations frequently. Inaccurate information can be confusing, misleading, and dangerous. A detailed anesthetic record is also helpful in determining the cause of a complication. A history of trends of physiologic variables and events will increase the likelihood of a correct diagnosis. Records are also helpful for future anesthetic episodes by providing a history of the patient's performance.

Meningoencephalomyelitis is an inflammatory neurologic condition that affects the central nervous system. What comprises the central nervous system? The cerebellum alone The peripheral nerves The brain and spinal cord The lower motor neurons The vagus nerve

The brain and spinal cord Explanation The central nervous system is comprised of the brain and spinal cord. In most cases, when a neurologic disease is said to be a "central" problem, it is suspected to involve the brain. The peripheral nerves are part of the peripheral nervous system (PNS). Sensory and motor neurons make up the PNS. Lower motor neurons are what connect the spinal cord to the muscles and relay the signals. The vagus nerve (cranial nerve 10) is an important peripheral nerve in the PNS. The cerebellum is part of the brain and is located just above the brainstem. It is responsible for coordination of voluntary movement.

Which is true regarding umbilical hernias? They usually consist of a small piece of fat protruding through the body wall and are not life-threatening They should not be repaired at the same time as a spay or neuter procedure They usually progress until a loop of bowel is strangulated through the defect and should be repaired as an emergency procedure The best treatment for all umbilical hernias is benign neglect

They usually consist of a small piece of fat protruding through the body wall and are not life-threatening Explanation MOST umbilical hernias are stable and consist of a small piece of fat protruding through a body wall defect. Many small dogs with stable hernias do not require repair since they are not life-threatening. Larger dogs with hernias require repair more often since the weight of their abdominal contents on the defect can enlarge it and increase the risk that abdominal contents (such as intestine) could protrude through. The best time to repair these is when they are already under anesthesia for their spay or neuter. The course of action for repair or monitoring depends upon the risk factors (size of hernia, size of dog, etc.).

A 9-year old Greyhound presents to your clinic with an ulcerating mast cell tumor, located subcutaneously over the left scapula. You immediately schedule the dog for a wide surgical excision after no evidence of metastatic disease is identified on a complete blood count, serum chemistry, thoracic radiographs, and abdominal ultrasound. Which drug is contraindicated in this patient? Atropine Propofol Ivermectin Thiopental Acepromazine

Thiopental Explanation In this case, thiopental is contraindicated because the patient is a sighthound. Thiopental is an ultra-short acting barbiturate. Recovery depends on redistribution to tissues, including fat. Because sighthounds have very little fat, they have prolonged recoveries and greater complications with these drugs.

What is the purpose of the rheostat of the light source on a microscope? To focus light on the object To raise and lower the light source relative to the stage To adjust light intensity To adjust the wavelength of light

To adjust light intensity Explanation The rheostat controls the intensity of the light source on a microscope. The condenser focuses light on the object and can be raised and lowered relative to the stage. The wavelength of light is not usually manipulated in a routine veterinary lab, but filters can be used to allow a certain wavelength of light through in particular applications such as immunofluorescence.

What is the purpose of the rheostat of the light source on a microscope? To adjust the wavelength of light To raise and lower the light source relative to the stage To adjust light intensity To focus light on the object

To adjust light intensity Explanation The rheostat controls the intensity of the light source on a microscope. The condenser focuses light on the object and can be raised and lowered relative to the stage. The wavelength of light is not usually manipulated in a routine veterinary lab, but filters can be used to allow a certain wavelength of light through in particular applications such as immunofluorescence.

If a disease is zoonotic, what does this imply? Not contagious Transmissible between animals but not to people Transmissible from animals to people Host-specific

Transmissible from animals to people Explanation A zoonotic disease is an infectious disease in animals that can be transmitted to people.

Which of the following is another term for the type of parasite known as a fluke? Cestode Ascarid Trematode Protozoan Nematode

Trematode Explanation Trematodes, or flukes, are leaf-shaped flatworms with unsegmented bodies. Adults are hermaphrodites. They primarily are found in the intestinal tract, liver, and lungs. Examples include the liver fluke of cattle (Fasciola hepatica) and the lungworm of cats (Paragonimus kellicotti). Nematodes are roundworms, ascarids are a type of nematode (roundworm), cestodes are tapeworms, and protozoans are single-celled organisms that may be parasitic. PowerPage Gastrointestinal Parasites (Small Animal)

You are in the clinic parking lot when you are approached by 2 large dogs who are about to attack you. They are about 25 yards away. You should immediately do which of the following? Tuck yourself into a ball on the ground and protect your face and neck Flail your arms and hit at them when they approach Run towards them and yell in a loud voice Stand completely still Run as fast as you can

Tuck yourself into a ball on the ground and protect your face and neck Explanation If you do not have a way of defending yourself and cannot get away, the best thing to do is to crouch into a ball and protect your face and neck. By taking this stance, you are not a threat to them and they are most likely to back away or not be as aggressive. If you run, the dogs are likely to chase you and will likely catch up to you causing more bodily harm. They will likely be more aggressive if you are standing there or hitting at them because they may view you as a threat.

The olecranon is a structure of which bone? Humerus Ischium Tibia Ulna Fibula

Ulna Explanation The olecranon is found at the proximal portion of the ulna and forms the point of the elbow. The triceps attaches there. It is bent forward at the summit so as to present a prominent lip which is received into the olecranon fossa of the humerus in extension of the forearm. Its base is contracted where it joins the body and the narrowest part of the upper end of the ulna

Which of these forms of chocolate contains the highest concentration of theobromine? Semi-sweet chocolate Unsweetened baking chocolate Milk chocolate White chocolate

Unsweetened baking chocolate Explanation The correct answer is unsweetened baking chocolate. This contains about 7 times more theobromine than milk chocolate. White chocolate has very little methylxanthines. Semi-sweet chocolate rates in between. Theobromine per oz. of milk chocolate= 44-60 mg/oz Baker's chocolate has 390-450 mg/oz, Semi-sweet chocolate has about half as much as Baker's or dark chocolate.

The broad ligament attaches which structure to the body? Spleen Uterus Intestines Bladder

Uterus Explanation The broad ligament is attaches the uterus to the pelvis

The somatic nervous system is responsible for which of the following functions? Contraction of the intestines Regulation of heart rate Secretion of saliva Voluntary motor movement

Voluntary motor movement Explanation Secretion of saliva, contraction of the intestines, and regulation of the heart rate falls under the responsibility of the autonomic nervous system. More specifically, the heart rate is influenced by the parasympathetic and sympathetic nervous systems, both of which are branches of the autonomic nervous system.

What is a symptom of myasthenia gravis? Hyperesthesia to touch Weakness and muscle fatigue Papules on the dermis Muscle rigidity

Weakness and muscle fatigue Explanation In Myasthenia gravis, there are few acetylcholine receptor sites (AChR) on the muscles, and acetylcholine is broken down before it can fully cause muscle stimulus. This results in muscle weakness, and with this condition, animals experience severe muscle fatigue.