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| Section | Objectives |
|---|---|
| Topic 1: Diagnostic Imaging | - Radiography positioning and safety - Image processing and interpretation basics |
| Topic 2: Dentistry | - Dental prophylaxis procedures - Oral anatomy and disease recognition |
| Topic 3: Emergency Medicine and Critical Care | - Triage and stabilization - Shock management and CPR |
| Topic 4: Laboratory Procedures | - Urinalysis and microbiology - Hematology and clinical pathology |
| Topic 5: Anesthesia | - Anesthetic protocols and equipment - Anesthetic monitoring |
| Topic 6: Surgical Nursing | - Sterile technique and instrumentation - Preoperative and postoperative care |
| Topic 7: Pharmacology | - Dosage calculations and administration - Drug classifications and uses |
| Topic 8: Animal Care and Nursing | - Nutrition and husbandry - Patient handling and restraint |
| Topic 9: Pain Management and Analgesia | - Pain assessment techniques - Analgesic drug use |
>> VTNE Certification Questions <<
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NEW QUESTION # 1153
You are visiting a farm with multiple cattle for routine preventative care. You notice that one of the cows not being evaluated today has a slight lameness. You ask the client if they would like the cow evaluated, and they say no. You ask why, in an attempt to educate the client about signs of pain in cows.
The client may give all of the following reasons not to have the cow evaluated. Which excuse is false?
Answer: A
Explanation:
You can easily explain to the owner signs of pain in cattle, including lameness, suggesting that something with the leg not appropriately used is painful, or she would be entirely putting weight on it. Yes, animals do experience pain. They have similar nervous systems, musculoskeletal systems, and more, that allow them to function as humans do. They may be less likely to show overt signs of pain and may wait until they are sicker or more injured than a human, but they still show signs of pain.
Signs of pain in cattle may include:
*Changes in appetite
*Decreased energy
*Decreased milk production in milk-producing cattle
*Restlessness
*Pawing at a body part or the ground
*Not wanting to move around
*Reluctance to stand at the milker
*Laying down more often than normal
*Abnormal gait
However, cattle, even those actively producing milk for consumption, can utilize various pain medications. There are fewer drug choices available in production animals. However, many can be safely used. Caution must be taken with several drug classes or medications, as some non-pain medications are prohibited for use in food-producing animals.
While pain medications can be used, caution will be needed as appropriate withdrawal times may be warranted. Withdrawal time means not using that cow's milk for a certain period while the drug may remain in her system. The medicine could be excreted in the milk and thus, pose a human health risk if consumed. Various drugs have different withdrawal times, but that is not a justifiable reason to withhold pain management in any species.
Just because a cow still produces milk, even at a decent volume, this doesn't mean that she isn't painful. Additionally, just because the cow is eating normally and not losing weight, doesn't mean she isn't painful. Cattle are prey species despite their size. Their instinct tells them to eat and hide illness. While the cow may have just an intermittent lameness, she could have a serious injury and still produce milk and eat well for a period of time. If it goes on too long, she likely would demonstrate additional signs of pain and may stop producing well.
Sadly, especially in food-producing animals, cost does play a role in treating an individual animal. Preventative herd health commonly supersedes that of an individual. The value of the animal may not be enough to justify a farmer paying for individual care.
NEW QUESTION # 1154
Which of the following formulas estimates hemoglobin in normal dogs?
Answer: D
Explanation:
In dogs, hemoglobin content is approximately 1/3 of the Packed Cell Volume (PCV) Percentage. For example, if the PCV = 36%, Hb is approximately 12.
Joanna M. Bassert, VMD. McCurnin's Clinical Textbook for Veterinary Technicians, 9th Edition. Pg 371.
Mosby's Comprehensive Review for Veterinary Technicians 5th Edition. Pg 39-40.
NEW QUESTION # 1155
Which of the following medications would not be beneficial in treating a post-operative patient with signs of either dysphoria or emergence delirium?
Answer: D
Explanation:
Emergence delirium occurs as patients are recovering during the post-operative period as a result of the gas anesthetic. This behavior is very transient and usually resolves within the first few minutes post anesthetic recovery, thus, requiring no intervention.
Dysphoria describes a patient demonstrating signs of anxiety, stress, agitation, depression, or unease that is not attributable to pain. The most common causes of this behavior include medication-related changes. Often, opioids are most commonly associated with dysphoric behavior in veterinary patients. Animals may act dysphoric either because the pain med dose was too high, or they can be nauseated or restless from the medication. However, other factors may play a role, which can happen with drugs other than opioids.
Deciphering whether a patient is painful vs. dysphoric can be difficult. But if evaluations of pain such as palpation at the incision site or other known previously painful areas produce no pain, the patient is not mentally appropriate or reacts inappropriately to normal stimuli, this must be considered. We do not want to administer additional pain meds until this is ruled out. Thus, the pure µ opioid agonist hydromorphone would not be an appropriate choice. Most patients already have an opioid on board, especially when hospitalized post-surgically or for a painful condition such as pancreatitis, parvovirus, or others. Pure opioid agonists commonly can lead to dysphoria, especially in older patients and patients with increased anxiety prior to surgery. Patients with underlying medical conditions may also be more prone to this reaction. Thus, it would not be an appropriate first choice.
Valium or midazolam are benzodiazepines and, as anxiolytics, may help remove any anxiety component to the behavior. However, it will not reverse the negative effects of any opioids on board. If the procedure was relatively short, it might be additive with any previously used Benzodiazepines. However, in low doses and with monitoring, it can be beneficial.
Butorphanol is an opioid agonist-antagonist with sedative properties. We commonly use this to help with anxiety and calm patients down, for example, those in respiratory distress. It has mild pain management properties, though short-lived vs. sedative properties. It may partially reverse any pure µ opioid agonists on board, thus, minimizing the dysphoria while maintaining some pain management.
Finally, if an opioid was used intraoperatively and one is concerned that the patient is not adequately metabolizing it, the patient is not responding to other treatments, or as a first-line, naloxone is the true reversal (antagonist) for pure µ opioid agonists such as fentanyl, hydromorphone, and morphine. Thus, it should be considered. Even patients who had no surgical procedure but received opioids may benefit from this medication. However, note that while it will immediately remove the drug, it is short-acting. We commonly see patients "re-narc," meaning that the opioid will reattach to the receptors once naloxone is out of the system. So care must be taken, and patients should be monitored closely. Often, giving one dose is sufficient to remove the dysphoria. Because enough drug remains, they then have adequate pain management once it is metabolized.
NEW QUESTION # 1156
A 3-year-old MN pug presents with stertorous breathing and an episode of collapse a few hours earlier. The temperature outside was only in the 50s yesterday but spiked to the 80s with high humidity today. He was out for about a 1-mile walk today and usually does fine with that distance.
On presentation, he has a loud, low-pitched sound to his breathing, almost a snorting sound, his gums are slightly pale bluish, he's weak, and his respiratory rate is in the high 60s. He is not yet overtly dyspneic, but you provide flow-by oxygen while finishing your triage and getting the veterinarian for evaluation.
Given the history, breed, and breathing patterns, all of the following could be present in this patient, except?
Answer: A
Explanation:
Pugs represent one of the classic breeds with Brachycephalic Airway Syndrome (BAS). These dogs, while adorable, have significant anatomical abnormalities that lead to complex breathing problems and can also lead to chronic GI and other diseases. They are often obese, have stenotic nares, elongated soft palates, and many have tracheal hypoplasia, not hyperplasia. Nasal turbinates also tend to be hypoplastic or at least abnormal in composition.
The chronically increased resistance to airflow created from these malformed structures causes laryngeal saccule eversion, tonsillar eversion, tracheal and laryngeal collapse, and even syncope.
These dogs often present with clinical signs of upper airway obstructive signs by about four years of age. Signs may include stertor, heat intolerance, exercise tolerance problems, and dyspnea. Suppose there is an underlying upper laryngeal disease. In that case, they may also demonstrate stridor, a more musical, high-pitched wheeze-like sound associated with laryngeal vibrations. Some owners may even witness collapse or cyanotic gums intermittently. These dogs are at a higher risk of aspiration pneumonia than other breeds. They are also prone to obesity which, when present, only further worsens respiratory disease and complications associated with their anatomical malformations.
NEW QUESTION # 1157
When monitoring vital signs, the American College of Veterinary Anesthesia and Analgesia's (ACVAA) Recommendations for Monitoring Anesthetized Veterinary Patients group vital signs into three classifications, including all of the following except:
Answer: C
Explanation:
The ACVAA's group on monitoring anesthesia discusses vital signs as only loosely correlated with anesthetic depth. However, knowing when a patient's heart rate, rhythm, respiratory rate and depth, capillary refill time, temperature, blood pressure, and mucous membrane colors are abnormal may help you determine what surgical plane of anesthesia you should be in time. Various factors affect the surgical plane and the body's response to surgery, anesthesia, pain, and other stimuli. Thus, we cannot solely rely on the classic vital signs to determine if a patient is stable and in the correct surgical anesthetic plane.
The ACVAA classifies vital signs into 3 groups.
Indicators of circulation. These include:
*Heart rate
*Blood pressure (Indirect measure via Doppler or oscillometric monitor or directly via an arterial catheter)
*Capillary refill time
*Mucous membrane color
*Pulse strength (determined by palpation of a peripheral artery such as the femoral, carotid, lingual, or in small animals, the dorsal pedal, and in large animals, the facial, digital, dorsal pedal, or auricular arteries) Indicators of oxygenation. These include:
*Pulse oximetry
*Measuring dissolved blood oxygen via a blood gas
*Mucous membrane color, the only physical indicator of oxygenation, will change, but once the change is visibly evident (cyanosis), intervention is often too late, and it is not accurate in the presence of anemia; thus, just a crude indicator of oxygenation.
Indicators of ventilation. These include:
*Respiratory rate
*Respiratory effort
*Tidal Volume
*Capnography
*Blood gas analysis
The first of these three is visually monitoring the expansion and contraction of the reservoir bag, unidirectional flow through the valves, via monitoring equipment, or simply by watching the chest wall rise and fall.
Ideally, you will have evaluated the animal's normal quality and depth of respiration when awake to determine if there is a significant change from normal once anesthetized.
The above three indicators are what the ACVAA classifies as the three key vital sign classifications. However, there are other indicators of anesthetic depth, including reflexes. Reflexes, involuntary, protective responses by the body can further assess anesthetic depth based on the procedure being performed. These include:
*Palpebral reflex
*Swallowing reflex
*Pedal reflex
*Corneal reflex
*Muscle jaw tone
*Eye position and pupil size
Most patients' eye position and pupil size for a proper surgical anesthetic plane will have ventromedial deviation. For some horses, the eyes may change from ventromedial to central and revert back. On the other hand, nystagmus often signifies a light plane of anesthesia.
Finally, a response to surgical stimuli can also help determine the anesthetic depth, and monitoring key parameters at times when you know there will be an increase in noxious stimuli is paramount and part of your job as a technician monitoring anesthesia and the patient's overall well-being and safety during the procedure.
NEW QUESTION # 1158
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