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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Emergency Medicine / Critical Care | 7% | - Triage, shock, respiratory/cardiac emergencies - Toxicology, trauma, first aid procedures |
| Topic 2: Diagnostic Imaging | 6% | - Image quality assessment and documentation - Radiography: positioning, safety, technique - Ultrasound, other imaging modalities |
| Topic 3: Dentistry | 7% | - Dental anatomy, disease recognition - Dental cleaning, polishing, radiography - Periodontal care and patient education |
| Topic 4: Animal Care and Nursing | 20% | - Husbandry, nutrition, fluid therapy - Physical examination, patient assessment - Infection control, sanitation, isolation - Specialized care for exotic, large or neonatal patients |
| Topic 5: Surgical Nursing | 13% | - Surgical preparation, instrumentation, aseptic technique - Intraoperative and postoperative care - Wound management, suture materials and techniques |
| Topic 6: Pain Management / Analgesia | 7% | - Multimodal analgesia protocols - Pain assessment, pharmacologic and non-pharmacologic control |
| Topic 7: Pharmacy and Pharmacology | 13% | - Controlled substance management - Drug classification, dosage calculation, administration routes - Preparation, dispensing, storage, safety and disposal - Anatomy, physiology, pathophysiology related to agents |
| Topic 8: Laboratory Procedures | 9% | - Sample collection, handling and processing - Parasitology, microbiology, cytology - Hematology, clinical chemistry, urinalysis |
| Topic 9: Anesthesia | 13% | - Recovery and emergency management - Pre-anesthetic assessment and preparation - Anesthetic agents, equipment, monitoring |
| Topic 10: Communication and Veterinary Professional Support Services | 5% | - Practice management, team collaboration - Medical records, ethics, legal and regulatory compliance - Client education, communication techniques |
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NEW QUESTION # 885
Before using steroids for chronic disease, you need to provide your client with appropriate client education as to the possible long-term side effects. A dog with intervertebral disc disease (IVDD) has neurologic deficits that warrant surgery. However, the owner declines surgery due to financial concerns. The pet receives prednisone, gabapentin, and amantadine daily for pain management among non-medical modalities to support him.
Which of the following would not occur with long-term steroid use in a dog with intervertebral disc disease?
Answer: C
Explanation:
Addison's or hypoadrenocorticism is the lack of steroid production by the adrenal glands. Typically, this is the immune-mediated destruction of some or all of the adrenal glands. This can cause increased drinking, urination, waxing and waning GI signs, weakness, exercise intolerance, collapse, etc. However, there is no need for the adrenal glands to produce more steroids when we administer steroids exogenously. Therefore, the body's natural production slows or stops. Thus, we would not induce this by giving steroids daily. However, we would induce this iatrogenically if we abruptly stopped the steroids in this dog without weaning them slowly to allow the adrenals time to start producing the hormones again in sufficient amounts.
When vets discuss pain management, steroids aren't the first type of drug to come to mind. We think of opioids, NSAIDs (non-steroidal anti-inflammatory drugs), gabapentin, tramadol, amantadine, and non-drug modalities. However, we often forget that steroids do provide pain relief. They provide pain relief similar to an NSAID by inhibiting phospholipase action. However, corticosteroids mimic natural glucocorticoid hormones produced by the body. As a result, many adverse effects may occur, making steroids poor choices in most pain management cases. Given these negative effects, one has to pause before reaching for them.
Steroids cause immunosuppression, making a pet more susceptible to infection the longer they remain on the drug. Delayed wound healing occurs due to the inhibition of scar tissue-producing fibroblasts preventing healing. Steroids exert a catabolic effect. This causes protein breakdown resulting in the thinning of the skin, hair loss, and generalized muscle mass decrease.
NEW QUESTION # 886
Many opioid pain medications can cause ileus with routine administration. Ileus disrupts which bodily function?
Answer: A
Explanation:
Ileus represents decreased to stopped bowel motility and contractility, leading to constipation.
Dyspnea describes abnormal breathing. Micturition disorders involve disrupted urination. An abnormal heart rhythm is called arrhythmia or dysrhythmia.
NEW QUESTION # 887
Which of the following x-ray machine settings affects image radiodensity the most?
Answer: D
Explanation:
Radiodensity refers to how dark or light different structures appear on radiographs. It is influenced by several factors:
*Milliamperes and seconds (mAs) have the greatest influence, with mAs being directly proportional to the density.
*kV changes affect contrast (grayscale), not density.
*Focal-film distance: With greater distance, the beam intensity reaching the film or sensor plate decreases, but these changes have a lesser effect than changes in mAs.
*With tighter collimation, there will be less scatter. This does affect density to a degree, but not as significantly as mAs.
NEW QUESTION # 888
Which of the following is a potential complication of tooth extraction?
Answer: A
Explanation:
Iatrogenic jaw fractures can occur with extraction of any mandibular teeth and in any dog. However, it is more common with small dogs, especially those with extensive periodontal disease and alveolar bone loss.
Other common complications of tooth extraction include infection, dehiscence, prolonged bleeding, swelling, bruising, sinus exposure, nerve injury, bone fragments, and osteonecrosis.
Enamel dysplasia is a developmental abnormality that can be hereditary, traumatic, or secondary to systemic disease (distemper, for example).
Wry bite is a malocclusion of the upper and lower incisors due to unilateral asymmetry of the maxilla and mandible. It is caused by one side of the jaw growing more than the other side, often due to trauma during development, but hereditary causes are possible.
Dilaceration is a developmental abnormality resulting in a sharp bend in either the crown or root.
NEW QUESTION # 889
You have a three-YO FS DLH who presented with stranguria and urinating out of the box. For the past two weeks, there have been construction workers in and outside around the home. The construction stopped five days ago, but the signs started about two days ago. Today, the owner noticed blood and insists the cat has a urinary tract infection. The veterinarian discusses the most likely diagnosis of FIC and recommends confirming that there is no infection with a urinary culture. The owner declines diagnostics, including a routine urinalysis, due to financial costs but wants to do something. She says, "Can't you just give an antibiotic shot?" Your veterinarian appropriately replies that < 1% of cats this age have infections and that, given the history and clinical signs, it is most likely a stress response and subsequent inflammation/irritation in the bladder. The vet explains to the owner that it will resolve on its own, but that providing pain relief is paramount to shortening the course of the disease and improving patient comfort. The owner cannot medicate at home but agrees to pain medication. Wanting to provide pain management as the disease takes its course, the veterinarian prescribes Zorbium. You are asked to apply this in the hospital.
How do you administer the medication to your patient?
Answer: D
Explanation:
Feline interstitial cystitis (FIC) is a common disorder in cats associated with stressful situations in which the stress goes to the bladder, causing a cascade of events, including inflammation and irritation to the bladder, straining to urinate, urinary accidents (going out of the box), and sometimes hematuria. It is painful and stressful for the cat. Still, in < 1% of healthy patients, it does not indicate a urinary tract infection. Patients with diabetes, geriatrics, or renal disease may have an infection, and urine cultures should be performed before administering antibiotics to any of these patients to ensure appropriate antimicrobial stewardship.
Treatment consists of pain management and time. While it will usually abate on its own in five to seven days, we want to ensure animals are comfortable and shorten clinical signs as much as possible.
Zorbium, a new transdermal buprenorphine product by Elanco, is labeled for post-operative pain, providing four days of "reliable pain relief from a single in-clinic dose." It is FDA-approved for post-op pain but used off-label for numerous conditions. It comes in pre-dosed aliquots that permit easy dispensing and controlled drug log monitoring/recording.
Ideally, it is applied transdermally on the patient in an area where they cannot reach with grooming and allowed to dry before sending the patient home with the owner. It is a great option for cats that cannot be orally medicated. Ideally, FIC patients would also be sent home with oral gabapentin to help provide a more complete pain management spectrum and address some of the anxiety associated with the disease. Since this owner cannot medicate the cat, however, this is a reliable option.
Zorbium is generally well-tolerated, but, as with short-acting buprenorphine, it will cause pupil dilation, may cause sleepiness at first, and an elevated temperature.
When used for surgery, it is applied one to two hours pre-operatively or a pre-op opioid is used and applied one to two hours before that pain med has fully worn off, but when the patient is alert, awake, and maintaining body temperature.
Do not clip the fur, and wear gloves while applying. The onset of action is approximately one to two hours, and it takes about 30 minutes to dry, so the pet will need to remain in the hospital for that duration.
Proper client education and handout materials on FIC should be sent home with the owner, including websites for additional information and modifications and steps to take in the home to lessen the risk of recurrence.
NEW QUESTION # 890
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