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| Section | Weight | Objectives |
|---|---|---|
| Anesthesia | 15% | - Anesthetic Procedures
|
| Pharmacy and Pharmacology | 12% | - Medication Preparation
|
| Laboratory Procedures | 12% | - Diagnostic Testing
|
| Dentistry | 8% | - Dental Procedures
|
| Surgical Nursing | 11% | - Perioperative Procedures
|
| Diagnostic Imaging | 7% | - Imaging Techniques
|
| Emergency Medicine and Critical Care | 8% | - Emergency Procedures
|
| Animal Care and Nursing | 20% | - Patient Care
|
| Pain Management and Analgesia | 7% | - Pain Control
|
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NEW QUESTION # 1215
A 4-year-old Portuguese water dog was hospitalized for an Addisonian crisis. The patient is now stable and heading home with medication. You are discharging the patient and going over their medications, including fludrocortisone. You discuss the medication and explain that at-home monitoring is critical.
They should be on the lookout and let the vet know as soon as possible if they notice all of the following clinical signs, except:
Answer: B
Explanation:
Addison's disease, or hypoadrenocorticism, is an uncommon condition in dogs. It is caused by atrophy of the adrenal glands, resulting in a severe electrolyte imbalance and shock. Addison's disease is considered a medical emergency and often presents in animals as weakness, vomiting, loss of appetite, and altered mentation. Patients in acute crisis have elevated potassium (K) and low sodium (NA) levels, with a very low NA to K ratio of < 23.
Fludrocortisone, a synthetic steroid, has both mineralocorticoid (aldosterone) and glucocorticoid (cortisol/prednisone) activity. The drug provides the hormones a dog's body needs to restore electrolyte imbalances to normal by signaling the kidneys to retain sodium and excrete potassium. It also provides the physiological dose of glucocorticoids needed to maintain various normal physiologic processes in the body.
It is critical to monitor for signs of reoccurrence of clinical signs. Signs of Addison's disease often mimic other diseases and include increased drinking and urination, decreased appetite, vomiting or diarrhea, lethargy, exercise intolerance, and even collapse. Signs may often wax and wane and are often brought on by stressful events such as boarding, grooming, or other alterations in normal routines. If any of these signs start to reoccur, it could mean that the dose of Fludrocortisone is insufficient or another underlying disease may be present. Regardless, owners need to be educated to monitor for these signs. If they notice a slight decrease in appetite or even a single episode of vomiting, they should alert the veterinarian as soon as possible. Addison's disease can cause life-threatening crises, and any change from normal needs to be taken seriously.
Addisonian patients often have decreased or waxing and waning appetites (not polyphagia), increased drinking and urination, and intermittent GI upset that owners often pass off as the pet having a sensitive stomach.
NEW QUESTION # 1216
What is the most effective treatment for recurrent cases of feline chronic gingivostomatitis?
Answer: C
Explanation:
Feline chronic gingivostomatitis is a condition in which excessive inflammation appears in the presence of minimal and often no calculus. While the cause is not fully understood, it is believed to be a hypersensitivity reaction to plaque, potentially in combination with another immune system disorder (FeLV and FIV, for example). This condition was previously called lymphocytic plasmacytic stomatitis.
Corticosteroids, cyclosporine, and antibiotics often temporarily improve the clinical signs of inflammation and infection, but signs return once these treatments are discontinued. Treating the primary problem, the presence of plaque, is essential for long-term resolution. Even with meticulous daily home dental care, clinical signs typically persist to some extent. Full mouth extractions provide up to 80% of patients with a lifetime cure. Teeth removal alleviates chronic pain and inflammation and improves the overall quality of life.
NEW QUESTION # 1217
A five-year-old MN pitbull mix presented to the hospital after receiving multiple bite wounds and punctures. He had been attacked by two smaller dogs and a large mixed-breed Mastiff. He was lucky to have survived. He was stabilized and, luckily, had mostly superficial or minor wounds. Once stabilized, he was anesthetized for wound evaluation and closure when warranted. Several punctures were left open to drain and heal by second intention. Two wounds were lacerations and repaired surgically. A third wound had significant penetration depth, and the location on the dorsal lumbar area had a lot of dead space and pocketing. The veterinarian was concerned that a drain was warranted. A drain was placed. The pet recovered without incident and was to be discharged the next morning. He was kept overnight on IV fluids and pain management. You are set to discharge the patient, and in addition to normal post-operative care instructions with incisional checks, exercise restrictions, e-collar recommendations, and related materials, you discuss at-home drain care with the owner.
All of the following are true regarding drain care, except:
Answer: D
Explanation:
Drain care is critical as it can mean the difference between infection and healing properly.
The owner must be cautioned that the drain is open and may leave discharge in the home.
The owner should use warm water soaks with gauze or a similar material several times a day and gently remove any serous discharge gathered around the drain hole and on the skin. We want to remove this regularly to prevent scalding and a potential means of egress for bacteria.
Proper drain hole care is crucial to prevent infection, skin scalding, and improving the chance of wound repair success.
In addition to normal exercise restrictions, patients living with other animals may need to be separated until the drain is removed if those pets groom them or are licking at the drain sites, which will delay healing.
Ensure that the patient is wearing an e-collar at all times to protect all the wounds, including those surgically repaired and those left open. The e-collar will prevent accidental removal if the pet can reach the drain. However, if the pet pulls out the drain, ensure the owner knows to try to find the drain pieces and to call the office or bring the pet in. We may need to take radiographs to see if any of the drain remains in the deeper tissue. If it does, this can become a nidus for immune system response or infection and may need surgical removal. Furthermore, the pet could have swallowed sufficient pieces of the drain. Depending on the patient's size and amount ingested, it could be at risk for obstruction.
We recommend applying petroleum jelly or a similar product to the area around the drain (after cleaning and drying the site). This helps to further dry and protect the skin. This lessens the risk of scalding or irritation and can help clean any discharge. We do not recommend antibiotic ointments. The pet will be on oral antibiotics, given the degree of bite wounds and risk of infection. We do not want to increase the chance of antimicrobial resistance by applying a topical antimicrobial, as it isn't warranted prophylactically.
Advise the owner that we expect serous discharge for the next one to three days or so until the drain is removed, and explain what that is and what it looks like. The owner should see a decrease in the amount of discharge or none at all. If, however, the discharge changes color, becomes thick, develops an odor, or other abnormality, this could mean the prescribed antibiotics aren't sufficient and an infection has developed. Were this to occur, the pet should be seen right away.
NEW QUESTION # 1218
Diagnostic quality radiographs typically require orthogonal views. Which of the following pairs describe orthogonal views?
Answer: C
NEW QUESTION # 1219
Mandibular mesioclusion is commonly observed in all of the following breeds except:
Answer: A
Explanation:
Class I malocclusions (neutroclusion) occur when one or more teeth are in an abnormal position (misaligned). The maxilla and mandible develop a normal relationship to each other. A Class I tooth may be pointing in the wrong direction or rotated. Common examples include rostral crossbites and linguoversion (also called base-narrow canines).
Class II-III malocclusions affect jaw length rather than tooth position alone.
Class II malocclusions (distoclusion) occur when the maxilla is forward (maxillary prognathism) and the mandible develops caudally (mandibular retrognathism). Other names include brachygnathism, overbite, and parrot mouth. These are most commonly observed in dolichocephalic dogs (long maxilla and narrow skulls).
Class III malocclusions (mesioclusion) occur when the mandible is forward (mandibular prognathism) relative to the maxilla (maxillary retrognathism). Other names include prognathism and underbite. These are commonly observed in brachycephalic dogs.
Additional malocclusions may be described, such as those created by an abnormal number of teeth in the mouth and other abnormalities that are non-specific, such as wry mouth. This simply pertains to various occlusal abnormalities that occur unilaterally.
NEW QUESTION # 1220
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