Challenging VTNE questions

Challenging VTNE questions You are asked to run an electrocardiogram (ECG) strip on a pet. There are three leads on your machine. One is white, one is black, and one is red. Where should these be placed? Answer: White: right forelimb, black: left forelimb, red: left hindlimb Explanation - White= right front Black= left front Red= left hind Green (if present)= right hind The easy ways to remember these: You read your newspaper in the morning (black and white towards front of pet), Christmas comes at the end of the year (red and green towards the rear of pet). In right lateral recumbency: snow (white) and grass (green) are on the ground so are on the right side down towards the table. White also rhymes with right. A horse with flared nostrils and a heave line from the tuber coxae towards the elbow with forced expiration likely has which of the following conditions? A.) Congestive heart failure B.) Obstructive airway disease C.) Lead poisoning D.) Laminitis Answer: Obstructive airway disease These symptoms are typical of a horse with chronic increased respiratory effort. Coughing, weight loss, lack of energy, and exercise intolerance are also signs of this condition, termed "chronic obstructive pulmonary disease" (COPD). It is more common in older horses that are stabled during winter months. It is helpful to turn these horses out to pasture to help control the disease. COPD is similar to asthma in humans. A rupture or tear in the thoracic duct would result in which of the following? A.) Chylothorax B.) Pyothorax C.) Pericardial effusion D.) Hemoabdomen Answer: Chylothorax Chyle (a fluid high in chylomicrons and lymph) effuses from the thoracic duct into the pleural space if the thoracic duct tears or ruptures (usually trauma-related). The effusion typically appears as a milky white fluid and is odorless. This is only one cause of chylothorax. Other causes include lymphangiectasia, lung lobe torsion, heartworm disease, cardiomyopathy, neoplasia, idiopathic, and others. If the triglyceride level of the effusion is greater than that of peripheral blood, this can help to determine the effusion is chylous. The necropsy on this animal reveals a chylous effusion. Note the milky appearance of the fluid. What does it mean if an animal is a paratenic host of a parasite? Answer: The parasite does not undergo development on the animal A paratenic host is also known as a transport host. This indicates a type of intermediate host on which a parasite does not undergo development into the next stage. The definitive host harbors the adult, sexual stage of a parasite. The intermediate host harbors larval, asexual, or immature forms of a parasite. A reservoir host is another vertebrate host for a parasite that serves as a source of infection for people or domestic animals. Canine parvovirus causes which of the following laboratory changes? A.) Neutrophilia B.) Neutropenia C.) Hemolytic anemia D.) Thrombocytopenia Answer: Neutropenia 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. 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? Answer: Obturator 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. Which of the following tests would be most helpful in the diagnosis of feline pancreatitis? A.) Serum glucose B.) Serum pancreatic lipase immunoreactivity (PLI) C.) Serum amylase D.) Serum lipase Answer: Serum pancreatic lipase immunoreactivity (PLI) Amylase and lipase are not sufficiently sensitive or specific in the cat to diagnose pancreatitis, but PLI has been shown to correlate very well with the presence and severity of pancreatitis in cats. What technique should be used to obtain a lateral oblique radiograph of the left tympanic bulla? Answer: Patient should be placed in lateral recumbency, left side down; the skull should be rotated 20 degrees towards the VD position Explanation - For a lateral oblique film of the tympanic bulla, the side to be imaged should be positioned down (against the table). The Patient should be placed in lateral recumbency, and the skull should be rotated 20 degrees towards the VD position. It is frequently useful to also obtain the same view for the contralateral bulla for comparison and to evaluate if it is also affected. What is most common anticoagulant used for hematology? Answer: Ethylenediaminetetracetic acid Explanation - The correct answer is Ethylenediaminetetracetic acid (EDTA). This is the anti-coagulant found in "purple top" tubes. Gray top tubes contain sodium fluoride and are most often used for accurate assessment of glucose levels. Blue top tubes contain sodium citrate and are used for coagulation testing. The veterinarian asks you to please administer an FVRCP vaccination to a cat that is boarding. Where should you administer the vaccination? Answer: Subcutaneous on the lateral aspect of a forelimb as distal as possible Explanation - Because of the risk associated with feline vaccine-associated sarcomas, it is recommended to give feline vaccines on the lateral aspect of a limb as distal as possible. The intrascapular region and nape of the neck area should be avoided. Which of the following medications requires special handling because it can cause aplastic anemia in humans? A.) Famotidine B.) Chloramphenicol C.) Phenylpropanolamine D.) Chlorpheniramine E.) Metronidazole Answer: Chloramphenicol Explanation - Chloramphenicol can cause a rare reaction in people who are exposed to the drug leading to aplastic anemia. Because of this, chloramphenicol is typically used as a last resort and only in special situations. Direct contact with the drug should be avoided and therefore gloves must be worn when handling. The tablets should never by crushed to avoid inhalation of any powder. Which of the following correctly indicates where electrons are generated in an x-ray machine? A.) At the filament of the anode B.) At the target of the anode C.) At the filament of the cathode D.) At the target of the cathode Answer: 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. In normal occlusion, what is the proper position of the incisors and canine teeth when the mouth is closed? Answer: Mandibular incisors are palatal to the maxillary incisors, and the mandibular canine is mesial to the maxillary canine Explanation - In normal occlusion, the mandibular incisors are palatal (behind) the maxillary incisors, and the coronal third of the mandibular incisors rests on a smooth convex bulge on the maxillary incisors known as the cingulum. The mandibular canines should be centered between the maxillary third incisor and the maxillary canine (mesial to the maxillary canine), without touching either tooth. We have an expert-written solution to this problem! Which of the following disorders is caused by a Type IV hypersensitivity, also known as delayed type hypersensitivity, as a result of a T-cell response to an antigen? A.) Glomerulonephritis B.) Autoimmune hemolytic anemia C.) Contact allergy to plastic D.) Atopy Answer: Contact allergy to plastic Explanation - There are 4 types of hypersensitivity. Type I is known as immediate hypersensitivity and results from inflammatory mediators being released immediately after exposure to an antigen. Common examples are atopy and anaphylaxis. Type II hypersensitivity is known as antibody-mediated hypersensitivity and results from antibodies directed against one's own cells. An example is autoimmune hemolytic anemia. Type III hypersensitivity is known as immune complex disease and occurs when antibodies and antigens form complexes that collect and cause problems. Glomerulonephritis can be caused by type III hypersensitivity. Type IV hypersensitivity is a delayed hypersensitivity that results from T-lymphocytes reacting against antigens. Examples include certain contact allergies (such as poison ivy) or from plastic food dishes (in some dogs). Which of the following scenarios describes the proper care of surgical instruments? A.) Place instruments in surgical milk. Remove from surgical milk and rinse to remove and debris and residue. Place instruments in ultrasonic cleaner for 10 minutes. Let instruments dry. B.) Rinse the instruments to remove the debris and residue. Place in an ultrasonic cleaner for 30 minutes. Then place the instruments in surgical milk. After removing instruments from the surgical milk rinse them again. C.) Place instruments in ultrasonic cleaner for approximately 10 minutes. Rinse instruments with distilled water and scrub as necessary. Place instruments in surgical milk. Remove from surgical milk and let instruments dry. D.) Pre-rinse the instruments immediately after surgery to remove residues. Place in ultrasonic cleaner for approximately 10 minutes. Place in surgical milk. Remove from surgical milk and let instruments dry. Answer: Pre-rinse the instruments immediately after surgery to remove residues. Place in ultrasonic cleaner for approximately 10 minutes. Place in surgical milk. Remove from surgical milk and let instruments dry. Explanation - The correct answer is to pre-rinse the instruments (using distilled water) immediately after surgery to remove residues. Place in ultrasonic cleaner for approximately 10 minutes. Place in surgical milk. Remove from surgical milk and let instruments dry. Anemia would likely result from a heavy infection with which parasite? A.) Dipylidium B.) Ancylostoma [ Correct answer ] C.) Toxocara D.) Isospora Answer: Ancylostoma Explanation - The most significant risk to an animal with hookworms is anemia. Hookworms live in the small intestine and ingest blood. Ancylostoma and Uncinaria are the two hookworms in dogs and cats (hookworm eggs are shown in this photo). Isospora (coccidia) can cause a significant bloody diarrhea in some cases, which could lead to anemia, but this is not as likely as with hookworms. Toxocara (roundworm) and Dipylidium (tapeworm) are not as likely to cause a severe anemia. Ivermectin would not be used when treating which parasite? A.) Nematodes B.) Trematodes C.) Mites D.) Ticks Answer: Trematodes Explanation - The correct answer is trematodes (flukes). Ivermectin is ineffective against flukes. Ivermectin has activity against ticks, mites, nematodes, and even lice. Ivermectin works by stimulating GABA which is an inhibitory neurotransmitter. Which essential amino acid is critical for cats? Taurine Tyrosine Lysine Arginine Answer: Taurine Explanation - Taurine deficiency in cats is associated with dilated cardiomyopathy (DCM) and retinal degeneration (think taurine Deficiency = DCM). One of the most common incisional complications encountered in veterinary surgery is the formation of a seroma. Which of the following is a poor treatment choice for an incision diagnosed with a seroma? Antibiotics Exercise restriction Warm compress Placement of a drain Answer: Antibiotics Explanation - Seromas are not infections and do not need to be treated with antibiotics. They consist of serous fluid, which is usually secondary to excessive dissection or "dead-space" that was created during surgery. Excessive activity and motion at the surgical site may predispose to the formation of a seroma. A warm compress will help increase blood flow to the region and thus help the body reabsorb the fluid. Nonetheless, it may take days to weeks for a seroma to completely resolve. Placing a drain at the site of a seroma may help speed up its resolution, as this helps keep the tissues adhered to each other. You are examining a blind dog and want to know if the dog has a sense of smell. You wave a treat in front of the dog's nose, and he smells it right away. Which nerve were you testing? Cranial nerve X (ten) Cranial nerve V (five) Cranial nerve II (two) Cranial nerve I (one) Answer: Cranial nerve I (one) Explanation - The Olfactory nerve deals with the sense of smell and is Cranial nerve I. Cranial nerves: I-Olfactory nerve II-Optic nerve III-Oculomotor nerve IV-Trochlear nerve V-Trigeminal nerve VI-Abducens nerve VII-Facial nerve VIII-Vestibulocochlear nerve IX-Glossopharyngeal nerve X-Vagus nerve XI-Accessory nerve XII-Hypoglossal nerve What is the most common cause of flexural and angular deformities in horses? Excessive riding Abnormal development Laminitis Incorrect shoeing Answer: Abnormal development Explanation - Flexure and angular deformities occur as a result of musculotendinous and musculoskeletal growth deformities. These abnormalities may be present at birth or develop over the first few months to years of life. Treatment may be as simple as corrective shoeing or bandaging, but more advanced cases may require surgical intervention. The three main types of flexural deformities are carpal, distal interphalangeal (coffin joint), and metacarpophalangeal. Which of the following is an expected side effect of atropine? Cause inhibition of excessive salivation [ Correct answer ] Cause pupillary constriction Cause mild sedation Cause bradycardia Explanation - Atropine functions as a sympathetic, competitive antagonist of muscarinic cholinergic receptors. It inhibits salivary secretions, causes increased heart rate, and causes dilation of pupils. It is not a sedative. What is the test of choice for diagnosing Addison's disease in dogs? Estrogen level ACTH stimulation test [ Correct answer ] Insulin:glucose ratio Urine cortisol:creatinine ratio Pre- and post-prandial bile acids test Explanation - Addison's disease, or hypoadrenocorticism, is a condition where the adrenal glands do not produce sufficient cortisol. ACTH should stimulate cortisol secretion from the adrenal glands, but patients with Addison's disease do not have the ability to secrete normal cortisol levels, even after stimulation. Celiotomies are performed on a routine basis in veterinary medicine. Which of the following procedures is performed through a celiotomy? Lung lobectomy Ovariohysterectomy [ Correct answer ] Femoral fracture repair Tail docking Explanation - A celiotomy or laparotomy is a surgical incision into the abdominal cavity. The term celiotomy is derived from the word coelom, which means body cavity. Knowing this information, the only surgery listed which is performed through a ventral midline incision is an ovariohysterectomy. To review, an ovariohysterectomy is the removal of the ovaries and uterus. Which of the following principles will always improve radiographic image quality? Use the lowest kilovoltage (kVp) setting and the highest milliampere (mA) that adequately exposes the film as possible Use the highest milliampere (mA) setting and lowest time (s) setting possible to achieve the desired mAs [ Correct answer ] Use the highest kilovoltage (kVp) setting and the lowest milliampere (mA) that adequately exposes the film as possible Use the lowest milliampere (mA) setting and the highest time (s) setting possible to achieve the desired mAs Explanation - The product of multiplying the milliamperage (mA) and time (s) is the mAs, which determines the degree of film exposure for a given kVp. Minimizing the time of exposure decreases motion artifact that occurs from the patient moving. It is always preferable to use the highest milliamperage and lowest time setting for this reason. Depending on the type of radiographic study and the size of the animal, a certain kVp and mAs will produce a radiograph with a corresponding amount of contrast and latitude. Maximizing contrast at the expense of latitude or vice-versa may not yield the best radiograph. math Which of these animals does not have a gall bladder? Bird Rabbit Horse [ Correct answer ] Cow Cat Explanation - Horses do not have a gall bladder. The other species listed all do. Where is the best place to give an intramuscular injection in a dog? Sternohyoid muscle Any muscle will do Epaxial muscle [ Correct answer ] Semitendinosus muscle Explanation - This is a large group of muscles between the spine and the wings of the ileum. They are easy to find and use. Semitendinosus muscles on the rear legs can be used, but there is a possibility of sciatic nerve damage if not done carefully. The sternohyoid muscle is a muscle of the neck and not appropriate to use for intramuscular injection. Muscles used for intramuscular injection need to be large, vascular, and easy to find and use. Not all muscles are appropriate. Stopping a blood vessel from bleeding is known as what? Incision Coagulopathy Hemostasis [ Correct answer ] Hemolysis Explanation - Hemostasis is the arrest of blood flow from a bleeding vessel. In which situation would perioperative antibiotics be strongly indicated? Ovariohysterectomy Orchidectomy 3.5 cm lipoma excision Arthroscopy [ Correct answer ] Explanation - Procedures that are considered uncomplicated and clean typically do not require perioperative antibiotic therapy unless there is a break in sterility. Performing arthroscopy carries a very low likelihood of infection; however, because an infection of the joint can be catastrophic, it is recommended that perioperative antibiotics be administered. An 11-year old male German shepherd dog with previously diagnosed dilated cardiomyopathy (DCM) presents to your clinic following a dog fight. The dog is significantly aggressive and resistant to handling. What medication should NOT be used to sedate this patient? Midazolam Buprenorphine Dexmedetomidine [ Correct answer ] Butorphanol Atropine Explanation - Dexmedetomidine should only be used in patients with normal cardiac function as it can cause a significant reduction in cardiac output due to reduced heart rate. It should be avoided whenever possible in patients that have compromised cardiac function. Butorphanol and buprenorphine would be better options for sedation as these drugs would not have as much effect on cardiac output and would provide some pain relief. Midazolam can be used to sedate the patient via IM administration and, although it would not provide any pain control, it would allow for safer handling of the patient. Atropine is not a sedative, but an anticholinergic used most commonly to increase heart rate. After performing a blood smear in a patient it is determined that macrocytosis is present. Which value would be expected to be elevated based on this observation on a complete blood count? Hemoglobin Red blood cell number Red cell distribution width Mean corpuscular volume [ Correct answer ] Explanation - Macrocytosis is expected to result in an increase in mean corpuscular volume. Mean corpuscular volume is a measurement of the mean volume in a group of red blood cells. If there is a higher volume, then one can deduce that the cell is larger (macrocytosis). Red blood cell number as well as hemoglobin content should remain unaffected. Red cell distribution is a value that helps the interpreter determine if there is anisocytosis present. How is a bull tested for Trichomonas foetus? Culture of smegma [ Correct answer ] Microscopic exam of sperm Wet mount of feces Blood culture Blood smear Explanation - Trichomonas is a venereal disease of cattle caused by the flagellated protozoan Trichomonas foetus. The prepucial hairs are shaved and the prepuce cleansed and dried. A dry plastic insemination pipette is placed into the prepuce and used to suction and scrape the prepucial membrane and penis to collect approximately 1 mL of smegma for culture. The culture is placed into a vial with 2 mL of saline and then placed on Diamond's medium for culture. A 285-gram guinea pig weighs: 1.2 pounds 2.85 kg 2.8 pounds 0.285 kg [ Correct answer ] Explanation - 1 kilogram equals 1,000 g 285 g/ 1,000 g/kg = 0.285 kg If you want to convert into pounds, multiply kg X 2.2 pounds/kg. 0.285 kg x 2.2 pounds/kg = 0.627 pounds The veterinarian is performing an orthopedic exam and says a dog has positive Ortolani sign. What corresponds with this? Luxating patella Cranial cruciate rupture Hip dysplasia [ Correct answer ] Cervical instability 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. A patient has sustained a burn to the skin corresponding to the area where the electrocautery ground plate had been placed. What is the most likely reason this occurred? The electrocautery unit was inadvertently switched to bipolar mode The surgeon used the cut mode for over 30 seconds The power level was too high The ground plate had poor contact with the patient's skin [ Correct answer ] Explanation - Poor contact between the ground plate and the skin can result in a burn to the patient. To reduce this risk, conductive gel is spread along the ground plate to help improve the level of contact with the patient's skin. Switching to bipolar mode by accident will result in an inability to use the monopolar hand piece but should not cause a burn. Setting the power level too high may cause excessive tissue trauma to the region where the electrocautery is being used, but this will not affect the interface between the skin and the ground plate. Keeping the cut mode activated for more than the given period of time has no impact on the ground plate-skin interface. You run a CBC on a dog that is heartworm positive. Which blood cell is commonly elevated in dogs with heartworm disease or other parasitic infections? Red blood cells Eosinophils [ Correct answer ] Bands Monocytes Platelets Explanation - Parasitic infections (such as heartworm, intestinal parasites, and fleas) often cause an elevated eosinophil count. Other diseases which may cause an elevation of eosinophils include allergies, chronic dermatitis, and feline asthma. A Jamshidi needle is used for which of the following procedures?