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74 Cards in this Set
- Front
- Back
A cleft lip is a(n)...
a) congenital defect of the soft palate b) traumatic injury of the upper lip c) congenital defect of the primary palate d) more than one of the above is correct |
c) congenital defect of the primary palate
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T or F:
Both dogs and cats handle major glossectomy quite well. |
False!
Dogs do but not cats (no grooming behavior) |
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What artery needs to be avoided when performing tongue surgery?
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Lingual artery
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What are differentials for mandibular/maxillary neoplasia in the dog? In the cat?
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Dog (SCC, Fibrosarcoma, Malignant Melanoma, Osteosarc)
Cat (SCC, SCC, SCC, Fibrosarcoma) |
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What is the prognosis for maxillectomy in the cat? In the dog?
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Dog is very good!
Cat you gotta wait....depends on the tumor (SCC is way invasive) |
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What are the types of epulids and which is bad news???
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Fibromatous
Ossifying Acanthomatous (invasive) |
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What are clinical signs of a palatial defect? When do signs manifest typically?
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Sneezing and nasal discharge manifest post-weaning
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T or F:
Surgery of congenital palate defects should be performed as soon as possible. |
False!
Delay until at least 16 wks to wait for facial bones to stabilize. |
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What are the 4 goals when fixing palatial defects?
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1) double layer closure
2) don't close directly over defect 3) avoid cautery 4) avoid tension on suture lines |
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What is the most common indication for salivary gland surgery?
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Sialocoele (salivary mucocoele)
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What are the 2 most common salivary glands affected in dogs?
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Mandibular #1; sublingual #2
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T or F:
Xerostoma is a common sequel following sialodenectomy in dogs. |
False! Dogs do fine, even if they lose BOTH mandibular salivary glands
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What procedure allows saliva to leak-out into the oral cavity? What conditions are indications for this procedure?
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Salivary marsupialization;
For ranulas and pharyngeal mucocoeles |
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What are indications for tonsillectomy in small animals? What are the prognoses for these?
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Neoplasia!
If lymphoma, may not need surgery. If SCC, BAD NEWZ!!! Perform bilateral tonsillectomy |
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Describe the muscular layers of the esophagus...or DIE!
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Inner circumferential
Outer longitudinal |
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Why doesn't the esophagus heal well?
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Incomplete serosal layer
Lots of contamination Lots of motion No omentum Maybe poor blood supply?? |
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Just to prove you're a bad ass....recite Halstead's Principles of surgury WHILE STANDING ON YOUR HEAD!!!
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Gentle tissue handling
Closure of dead space Accurate hemostasis Preservation of blood supply Strict asepsis Careful approximation of tissue planes No tension on sutures |
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What is the holding layer in the GI tract?
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submucosa!
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Your patient has a foreign body lodged cranial to the thoracic inlet. Describe the surgical approach.
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Likely a cervical approach
Move trachea to R to visualize the esophagus |
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Describe surgical approaches for the thoracic esophagus and indications for each.
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Always do L thoracotomy via an intercostal space.
However, if at heart base, must do a R thoracotomy since the aorta won't move outta the way |
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What structures should be avoided when performing a thoracic esophagotomy?
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Vagal nerves (start on L and R and move dorsal and ventral)
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How can tension be relieved when performing an esophagectomy?
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Cut more of the outer (longitudinal) layer.
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What are two ways to strengthen an esophageal suture line?
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Harvest sternohyoideus/thyroideus for a patch
Pull omentum through diaphragm for a patch |
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What are the main clinical signs of esophageal disease?
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Regurgitation
Coughing Dysphagia Dyspnea Ptyalism Pyrexia Altered appetite Weight loss |
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What are the 4 common locations for an esophageal foreign body in dogs?
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Upper esophageal sphincter (oropharyngeal)
Thoracic inlet Heart base Stomach cardia |
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What neoplasms are associated with esophageal disease? Which has the best and worst prognosis?
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SCC
Leiomyosarcoma (BAD) Fibrosarcoma Leomyoma (great prognosis) Osteosarcoma |
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Esophageal sarcomas in the dog are associated with what parasite?
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Spirocerca lupi
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What are the 3 types of hiatal hernias?
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Sliding hernia
Paraesophagal hernia Gastroesophageal intussusception |
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What are the 3 treatments for a hiatal hernia?
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Hiatal reduction (suture hiatus tighter)
Esophagopexy Bilateral gastropexy |
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Regurgitation in young animals is associated with:
a) Vascular ring anomalies b) Cricopharyngeal achalasia c) Both A and B d) none of the above |
a) Vascular ring anomalies
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What are possible complications to placing an esophageal tube?
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Skin irritation
Mediasteinitis Hemorrhage (poking the jugggg) |
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T or F:
Treatment of a PRAA is best corrected with surgery as early as possible. |
Tru dat!
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What is the treatment for a PRAA? The prognosis?
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Tx - ligate and cut ligamentum arteriosum
Prognosis - EXCELLENT! |
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What are the "4 P's" of GI surgery?
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Pink
Peristalsis Perfusion Palpation |
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T or F:
Like esophageal surgery, GI surgical closure should always be a 2-layer closure. |
False! Picky questions! Yes, GI sx should be 2 layer but esophageal can be 1 or 2.
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What are the more common causes of gastric ulceration?
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NSAIDS
Steroids Shock Gastrinomas |
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What are the most common gastric neoplasms in...
...cats? Dogs? |
Cats - lymphoma
Dogs - adenocarcenoma |
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Plugging a loop of bowel into the stomach is better known as...
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...Gastroenterostomy
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Rerouting the biliary tract is known as...
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...Cholecystoenterostomy
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What is the common signalment for a dog w/GDV?
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Middle-aged to older deep chested, large breed
OR Shar pei, Bassett, Cocker Spaniel |
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Describe the pathogenesis of GDV?
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Pylorus rotates dorsally while fundus rotates ventrally (usually in a clockwise fashion)
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Describe how a GDV can lead to a V/Q mismatch.
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Diaphragmatic impingement leads to decreased tidal volume
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What are the major sequelae to the decrease in perfusion caused by GDV?
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Obstructive and hypovolemic shock
Arrhythmia and myocardial depression |
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What are some possible pre-surgical stabilization techniques used in patients w/GDV?
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Antiarrthymics (maybe)
Analgesia/premeds Give O2 (and free radical scavengers) ET tube + gastric tube Maybe trocharization |
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Once the abdomen is open and you are standing on the dogs right, how is a GDV de-torsed? How can positioning be verified afterwards?
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Push fundus dorsal and away from you
Pull pylorus ventral and toward you Palpate @ esophageal hiatus to verify positioning |
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During GDV repair, what are indications for splenectomy? Gastrectomy?
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Splenectomy if spleen is thrombosed or vascularly devitalized
Partial gastrectomy if stomach wall is thin or is excessively dark or pale |
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How is a gastropexy performed in a GDV repair?
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on right side...
Cut into serosa muscularis of pylorus and cut into abdominal muscles; suture the 2 together! |
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When does the greatest possibility for dehiscence occur post surgury?
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Between days 3 and 5
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Why is perfusion important in intestinal healing?
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Need adequate oxygen for hydroxylation of proline and lysine and for crosslinking of collagen
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What fancy-ass intestinal suture pattern ensures that you grab the submucosa?
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Gambee
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In an enterotomy for foreign body removal, where is the cut made?
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In the anti-mesenteric border in a healthy portion of bowel
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Non-crushing forceps used for intestinal surgery are better known as...
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Doyen forceps
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When anastomosing an intestinal resection, what portions are sutured first?
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Mesenteric and antimesenteric sites are pegged first
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Which is tougher...a colopexy or a gastropexy?
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Colopexy is HARRRRRRRD
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What is the max intestinal diameter on a lateral radiograph?
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2x L5
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Which has a better prognosis for linear foreign body, cat or dog?
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cat!
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You see a double donut on an ultrasound. Which is the "inner donut"?
a) intussusceptum b) intussusection c) intussuscipiens d) intussussussusizzle |
a) intussusceptum
('septum invades into the 'scipiens" |
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What is the intussusception recurrence rate?
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Between 6 and 27%
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What are indications for surgery to remove a colonic foreign body?
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NONE...it'll pass...
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Megacolon is relatively common in ...
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...CATS
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What is the most common cause of megacolon in cats? How is it usually treated?
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IDIOPATHIC is 62%; treat by resection and anastomosis of colon (subtotal colectomy)
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How much jejunum can be removed with no effect?
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70-85%
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What are signs and diagnostic test results of post operative intestinal dehiscence?
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Anorexia, depression, pain, vomiting
Abdominal tap shows sepsis, toxic and/or degenerate neutrophils |
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Which of the following is/are associated with apocrine gland carcinomas?
a) Anal sac adenocarcinoma b) Almost always in intact male dogs c) Hepatoid tumors d) Highly malignant tumor e) Poor prognosis |
a) Anal sac adenocarcinoma
d) Highly malignant tumor e) Poor prognosis |
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Which of the following is/are associated with perianal gland tumors?
a) Hepatoid tumor b) No sex predisposition c) Metastasizes to the sublumbar lymph nodes d) Excellent prognosis for cure e) Associated with intact male dogs |
a) Hepatoid tumor
d) Excellent prognosis for cure e) Associated with intact male dogs |
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What are your top two differentials for a dog with low PTH and hypercalcemia?
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Lymphoma
Apocrine gland carcinoma |
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When should perianal fistulae be treated surgically? How are these commonly treated medically?
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Pretty much NEVA treated surgically; use cyclosporin for immunosuppression.
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What is a major complication to anal sacculectomy?
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Fecal incontinence
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Which type of anal sacculectomy should be used when treating a tumor, open or closed?
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Closed! Don't wanna seed those nasty tumor cells!
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How does testosterone lead to perineal hernias?
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Testosterone causes progressive atrophy of the pelvic diaphragm (coccygeus and levator ani), allowing the rectum to dilate and herniate.
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How can perineal hernias be diagnosed?
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Look at the ass of the dog
Rectal palpation Ultrasound for bladder involvement |
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What surgical procedure repairs a perineal hernia? How is this repair achieved?
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Herniorrhaphy; pexy anal sphincter to sacrotuberal ligament or elevated external obturator m.
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What is a major complication to herniorraphy using a pexy to the sacrotuberal ligament?
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Sciatic nerve entrapment!!!
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What are some overarching complications to perianal surgery?
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Fecal incontinence
Tenesmus Anal stenosis Recurrence of problem Urethral damage |