149 Questions
Which of the following is NOT a factor that affects the progression of gingivitis to periodontitis?
Amount of saliva produced
What is the advanced periodontal disease flora primarily composed of?
Motile Gram - Anaerobic Rods/Spirochetes
Which stage of periodontal disease is characterized by up to 25% attachment loss?
Stage 2: early PD- up to 25% AL
Which of the following is an indication for gingivectomy?
Gingival hypertrophy or hyperplasia
What is the potential sequelae of untreated endodontic disease?
Abscess formation
Which structure is at risk of injury during marsupialization of ranulas or pharyngeal sialoceles?
Facial nerve
Which nerve should be ligated at the rostral landmark for marsupialization of ranulas or pharyngeal sialoceles?
Lingual nerve
What is the purpose of making a large incision into the fluid pocket during marsupialization?
To allow drainage of saliva into the mouth
What is the expected outcome of marsupialization if the underlying pathology is still present?
Recurrence
Which of the following is the most common cause of pneumoperitoneum?
Hollow viscous rupture
Which of the following is a characteristic of hepatomegaly?
Rounded caudoventral margins
Which of the following is a cause of generalized splenomegaly on radiographs?
Infiltrative neoplasia
Which of the following is a characteristic of the spleen?
Head is fixed in the left cranial abdomen
What is the most likely diagnosis when both the liver and spleen are enlarged?
Lymphoma
Which of the following is a disadvantage of direct radiography (DR) for acquiring digital dental rads?
The sensor is only one size
Which radiographic positioning technique is good for radiographing all teeth?
Bisecting angle
What does a widened periodontal ligament, alveolar bone loss, and decreased alveolar bone density indicate in dental rads?
Periodontal disease
What does periapical lysis imply in dental rads?
The tooth is dead and needs to be extracted
Which type of tooth resorption in cats is more common?
Type 2: root replaced by bone (replacement)
Which clinical abnormality is NOT seen in evaluation of neoplasia in feline dentistry?
Tooth resorption
Which of the following is true in feline dentistry?
Canines are always X04
Which of the following is a characteristic of tooth resorption in feline dentistry?
Lesions present with defects in enamel, dentin, and/or cementum
Which of the following is true regarding feline chronic gingivostomatitis?
Often requires extraction of all premolars and molars
What is the most common surgical procedure for chronic otitis externa/media and other external/middle ear pathologies?
Total ear canal ablation and bulla osteotomy
Which structures should be cautious of during TECA-BO?
Facial nerve, caudal auricular vein, retroglenoid vein
Which surgical procedure is performed for otitis media without concurrent otitis externa, auditory polyp, or middle ear neoplasia?
Ventral bulla osteotomy
What is the most common salivary pathology characterized by the accumulation of saliva in a pocket within the subcutaneous tissue?
Sialocele
Which of the following is NOT a differential diagnosis for acquired megaesophagus?
Vascular ring anomaly
Which of the following is NOT a diagnostic tool for megaesophagus?
Ultrasound
Which of the following statements is TRUE regarding the use of prokinetics for the treatment of megaesophagus?
Prokinetics can be used in cats because they work at the distal 1/3 of the esophagus which is lined with smooth muscle.
Which of the following is a potential complication of esophageal foreign body?
All of the above
Which of the following is NOT a potential cause of vomiting?
Renal disease
Which of the following is NOT a component of the afferent pathways of the emetic center?
Central afferents
Which of the following is NOT a component of the treatment approach for vomiting?
Administering antibiotics
Which of the following is a potential consequence of chronic vomiting?
All of the above
Which of the following drugs is NOT centrally acting (EC, CRTZ)?
Anticholinergics
Which class of drugs must the patient be hydrated before use for vomiting?
Phenothiazines
Which class of drugs is NOT recommended due to their potential to cause GI stasis and ileus?
Anticholinergics
Which muscle is responsible for the failure of relaxation and acceptance of food in cricopharyngeal dysphagia?
Cricopharyngeus muscle
How is cricopharyngeal dysphagia distinguished from other causes of dysphagia?
Fluoroscopy
Which condition can cause symptoms like regurgitation, weight loss, hypertrophy osteopathy, and blood in saliva/vomit?
Esophageal neoplasia
What is the most common cause of esophageal stricture?
Reflux under anesthesia
Which type of anomaly encircles the esophagus, causing focal constriction?
Vascular ring anomalies
Which procedure is commonly used to bypass the oral cavity and pharynx for feeding and to monitor regional anatomy?
Esophagostomy tube placement
Which procedure involves the use of autologous tissues or artificial materials to either buttress a closure or replace a portion of the esophageal wall?
Esophageal patching
What is a hallmark symptom of esophageal disease?
Regurgitation
Which of the following is NOT a common location for esophageal foreign bodies?
Upper esophageal sphincter
Which liver enzyme is relatively liver specific in small animals and also elevated with regeneration?
ALT
Which liver enzyme is cholestatic and often has a latency of 2-3 days before an increase is seen?
ALP and GGT
Which breed is NOT commonly associated with copper associated chronic hepatitis?
Golden Retriever
What is the treatment of choice for copper associated chronic hepatitis?
Chelation therapy
Which of the following is NOT a risk factor for pancreatitis in cats?
Hepatic encephalopathy
The level of rise parallels the degree of injury in this liver enzyme:
ALT
What does a rise in liver enzyme levels indicate about liver function?
Does not correlate with liver function
Which of the following is NOT one of the three most common clinical signs of hepatic disease in cats?
Anorexia
Which of the following liver enzymes would you expect to be the MOST elevated in an animal with a portosystemic shunt?
ALT
Which of the following is the most common dental disease in ferrets?
Periodontal disease
Which of the following statements is FALSE regarding Helicobacteriosis in ferrets?
Gastric biopsies are commonly performed to diagnosis Helicobacteriosis
Which of the following is a potential cause of oral ulceration in ferrets?
Dental disease
Which of the following is a con to using percutaneous decompression using U/S or tympany in GDV cases?
All of the above
How is the stomach assessed during an abdominal explore following decompression de-rotation?
By assessing the omentum covering the stomach
Which procedure may be performed in cases of splenic thrombosis/necrosis?
Splenectomy
Which of the following is NOT a potential consequence of gastric dilatation-volvulus (GDV) in dogs?
Increased ventilatory capacity
What is the purpose of gastric decompression in the treatment of GDV?
To improve venous return and cardiac output
Which of the following is NOT a potential cause of splenomegaly on radiographs in dogs?
Pancreatitis
Which surgical procedure is recommended for cases of hypertrophic pyloric gastropathy with mucosal hypertrophy?
Y-U pyloroplasty
Which imaging modality allows for concurrent biopsy and aids in surgical planning for gastric neoplasia?
Gastroscopy
Which type of gastric neoplasia in dogs is most commonly located in the pyloric antrum and has an aggressive behavior with early metastasis?
Adenocarcinoma
Which congenital anomaly of the esophagus is most commonly associated with young German Shepherd Dogs and is typically considered a surgical emergency?
Gastroesophageal intussusception
Which surgical procedure is recommended for cases of gastroesophageal intussusception in young German Shepherd Dogs?
Left sided gastropexy
Which type of gastric neoplasia in cats is typically high grade and has a poor prognosis?
Lymphoma
Which of the following statement describes the radiographic appearance of a mechanical ileus?
Segmental dilation is seen unless the obstruction is in the distal small intestine
What is the normal size of the small intestine in dogs, expressed as the maximal serosa-serosa diameter divided by the height of L5?
Less than 1.6
Which of the following is the top differential for reduced kidney size radiographically?
Chronic renal disease
Which of the following is the most common cause of increased kidney size in a unilateral manner radiographically?
Hydronephrosis
Which of the following is NOT a potential cause of altered kidney size with large and irregular margins in a bilateral manner?
Metastatic neoplasia
All of the following statements describe hepatic vascular anomalies EXCEPT:
Acute ligation is the surgery of choice
Which of the following breeds is NOT commonly associated with gallbladder mucocele?
German Shepherds
Which of the following is false regarding splenic disease?
During a splenectomy, you should complete your explore first and then control active bleeding
Which of the following is NOT a life threatening complication of acute pancreatitis?
Biliary obstruction
Which of the following liver enzymes will have the highest increase with cholestasis?
ALP
What is the main function of the common bile duct in cats?
To transport bile acids from the gallbladder to the duodenum
What is the main purpose of gastric decompression in the treatment of GDV?
Improve venous return and cardiac output
What is the most common cause of esophageal stricture?
Doxycycline
Which of the following is the most common clinical sign of gastric foreign bodies?
Profuse vomiting
What is a common bloodwork finding in cases of gastric foreign bodies?
Hypochloremic metabolic alkalosis
What is the displacement of the stomach or other organs through the esophageal hiatus into the chest called?
Hiatal hernia
Which artery supplies the majority of blood to the spleen?
Splenic artery
Which of the following is the most common cause of atraumatic abdomen?
Neoplasia
Which of the following is a con associated with autotransfusion?
Risk of infection
What is the first line therapy for ventricular arrhythmias associated with GDV and splenic disease?
Lidocaine
Which splenectomy approach is faster, best for critical cases, and requires identification of pancreatic branches?
Ligation of splenic artery and vein upstream of hilar branches plus short gastrics/gastroepiploics as needed
Which of the following is NOT a negative prognostic indicator for GI stasis in small mammals?
Hyperglycemia: > 200 mg/dl
Which of the following is NOT of the most common bacteria that cause dysbiosis in rabbits
Helicobacter
Which of the following small mammals is NOT a hind gut fermenter?
Hamster
Which of the following is NOT one of the most common clinical signs of feline hepatic diseases?
Anorexia
What is the most common cause of jaundice in cats with hepatic lipidosis?
Hepatic lipidosis
What can prolonged retention of ingesta in the cecum lead to?
All of the above
Which of the following is the most common cause of septic peritonitis in cats and dogs?
Ruptured GI viscus
Which of the following diagnostic tests should be avoided in patients with suspected peritonitis?
Radiographs with contrast (barium)
What is the most common cause of pancreatitis?
Idiopathic
Which of the following is NOT a risk factor for pancreatitis in cats?
Hypertriglyceridemia
Which of the following is false regarding the diagnosis of pancreatitis?
Increased pancreatic lipase is indicative of pancreatitis
Which of the following liver enzymes is relatively liver specific in cats, but is non-specific in dogs?
A and B
Which of the following clinical signs is NOT seen in the progressed form of chronic hepatitis?
PU/PD
Which of the following hepatic diseases is NOT properly matched to its treatment?
Hepatic encephalopathy: High protein diet
Which of the following is FALSE regarding ferret diets?
A ferret's diet should be high in carbs and low in fiber
Which of the following disorders is incorrectly matched with its surgical approach?
All are correctly matched
A SI max/L5 > or = to _____ indicates a likely obstruction.
2.4
Radiographically, plication and hairpin turns are indicative of:
Linear foreign body
Which of these stones can be seen radiographically?
A and B
Which of the following is not a contributor to the blood supply of the spleen?
Right gastroepiploic artery
Which of the following statements is false regarding splenic torsions?
Derotate the spleen prior to preforming a splenectomy to ensure that important blood supply is not compromised
Which of the following statements is correct?
A and C
Which view is best for identifying pyloric outflow obstructions?
LLAT
A gravel sign on radiographs is seen with which disorder?
Chronic/partial pyloric outflow obstruction
Fetal mineralization is visible on radiographs after ___ days.
45
Cystic endometrial hyperplasia pyometra complex is associated with ______ stimulation during diestrus/luteal phase.
Progesterone
Which of the following GI disorders will have a kiwi fruit appearance of abdominal ultrasound?
Gallbladder mucocele
Which of the following statements is false regarding cholangitis complex in cats?
The neutrophilic form typically affects cats < 4 years old
Which liver enzyme will have the highest increase with hepatic lipidosis?
ALP
Which of the following acute diarrhea disease mechanism is associated with malabsorption/maldigestion?
Osmotic diarrhea
Which of the following disease mechanisms of acute diarrhea is associated with components already apart of the body are being lost into the intestinal lumen?
Permeability diarrhea
Which of the following disease mechanisms of acute diarrhea is associated with the triggering of enterocytes to release sodium into the lumen of the gut?
Secretory diarrhea
Which of the following lab abnormalities is seen with acute hemorrhagic diarrhea syndrome (AHDS)?
High PCV with a low TP
What is the hallmark sign seen on CBC in dogs with parvoviral enteritis?
Leukopenia
What is the most common clinical sign seen in canine chronic enteropathy?
Diarrhea
What is the most common clinical sign seen with protein losing enteropathy?
Chronic weight loss
Which of the following is NOT a comorbidity associated with feline chronic enteropathy?
Hepatic lipidosis
The most common chemistry finding associated with chronic enteropathy is:
Panhypoproteinemia
What is the first line treatment for uncomplicated chronic enteropathy?
Dietary change
What is the treatment of choice for stable protein losing enteropathy patients?
Low protein diet
What is the best radiographic view for a foreign body stuck in the pylorus?
LLAT
What is the thickest layer of skin?
Subcutis (hypodermis)
Which dermatologic lesion is < 1 cm and flat circumscribed lesion associated w/ color change?
Macule
Which of the following lesions is a flat topped elevation greater than 1 cm, formed of coalescing papules or dermal infiltration?
Plaque
Which of the following lesions is known as an accumulation of dried exudate, keratin, serum, blood, cells, scales, or medication adherent to skin surfaces?
Crust
Which lesion is a circular scale w/ erythema. Remanent of pustule or vesicle?
Epidermal collarette
What is the difference between erosion and ulceration in dermatology?
Erosion does not penetrate the dermis, whereas ulceration does.
What is the holding layer of the small intestine?
Submucosa
Which statement regarding an enterotomy is false?
Enterotomy incision is made on the antimesenteric surface oral to the foreign body
Which of the following is not a predictor of septic peritonitis post-op?
Hypokalemia
Which of the following statements regarding sarcoptic mange (scabies) is false?
No zoonotic potential
Where does Demodex canis live?
Follicles
Which Demodex is the only contagious species, is often pruritic, and lives on the surface?
Demodex gatoi
Which dermatologic parasite is very pruritic, has hook like mouthparts, and is known as "walking dandruff"?
Cheyletiellosis
Which type of perianal tumor is most common in intact male dogs (testosterone driven)?
Perianal adenoma
Which perianal neoplasm may be associated with hypercalcemia?
AGASACA
What is the most common malignant rectal tumor in dogs?
Adenocarcinoma
Study Notes
Surgical Procedures for Ear and Salivary Gland Pathologies
- Aural hematoma is a common condition caused by excessive head shaking/scratching/rubbing, resulting in the rupture of blood vessels in the pinna.
- Treatment options for aural hematoma include addressing the underlying cause, ear cytology and culture, otoscopy, and conservative or surgical management.
- Surgical treatment of aural hematoma involves creating an S-shaped incision to drain the hematoma and using stent sutures to tack the skin and cartilage together.
- Pannectomy is a surgical procedure performed for neoplasia affecting the ear, commonly mast cell tumors (MCT) in dogs and squamous cell carcinoma (SCC) in cats.
- Total ear canal ablation and bulla osteotomy (TECA-BO) is the most common surgical procedure for chronic otitis externa/media and other ear pathologies.
- TECA-BO involves removing the lateral wall of the ear canal, completely removing the canal epithelium, widening the external acoustic meatus, and performing bulla osteotomy.
- Facial nerve, caudal auricular vein, retroglenoid vein, external carotid artery, maxillary vein, and internal carotid artery are important structures to be cautious of during TECA-BO.
- Ventral bulla osteotomy is performed for otitis media without concurrent otitis externa, auditory polyp, or middle ear neoplasia, especially in cats.
- Major salivary glands include the mandibular, sublingual, parotid, and zygomatic glands, and cats have an additional molar gland.
- Sialocele is the most common salivary pathology, characterized by the accumulation of saliva in a pocket within the subcutaneous tissue.
- Sialocele can present in various locations, including the submandibular, sublingual, zygomatic, and pharyngeal regions.
- Surgical excision of the involved salivary glands with concurrent drainage is the treatment of choice for sialocele. Salivary gland neoplasia, sialolithiasis, and salivary gland carcinomas are other salivary gland pathologies that may require surgical intervention.
Esophageal Disorders: Causes, Symptoms, and Treatment
- The esophagus is divided into the nasopharynx, oropharynx, and laryngopharynx.
- Cricopharyngeal dysphagia is a congenital swallowing disorder caused by the failure of the cricopharyngeus muscle to relax and accept food.
- Achalasia is a condition characterized by asynchrony and repeated attempts to swallow.
- Esophageal foreign bodies are fairly common, with bones being common in dogs and fish hooks and needles in cats. Symptoms include regurgitation, hypersalivation, and gagging.
- Esophageal neoplasia, such as SCC and sarcomas, is rare but can cause symptoms like regurgitation, weight loss, and blood in saliva/vomit.
- Esophageal stricture is a narrowing of the esophagus that causes obstruction, most commonly caused by reflux under anesthesia.
- Esophageal fistulas are very rare and result in the development of a fibrous tract connecting the esophagus to the bronchus, trachea, or lung.
- Vascular ring anomalies are abnormal developments of fetal vessels that encircle the esophagus, causing focal constriction. The most common type is PRAA with a left ligamentum arteriosum.
- Esophageal surgery carries a higher risk of complications compared to other GI surgeries and requires gentle handling to avoid impacting the blood supply.
- Esophagostomy tube placement is a common procedure used to bypass the oral cavity and pharynx for feeding and to monitor regional anatomy.
- Esophagotomy is commonly performed for foreign body removal, and closure can be done with a single or double layer interrupted pattern.
- Esophageal patching involves the use of autologous tissues or artificial materials to either buttress a closure or replace a portion of the esophageal wall.
- Swallowing involves several phases, including the oropharyngeal phase, pharyngeal subphase, cricopharyngeal subphase, esophageal phase, and gastroesophageal propulsion. Regurgitation is a hallmark symptom of esophageal disease.
Lecture 18: The Stomach Anatomy and Surgical Diseases
- Anatomy of the stomach includes four major divisions: cardia, body, fundus, and pylorus.
- Surgical diseases of the stomach include gastric foreign body (FB), hiatal hernia, gastroesophageal intussusception, hypertrophic pyloric gastropathy, and gastric neoplasia.
- Gastric foreign bodies are common and present with clinical signs such as vomiting, dehydration, abdominal pain, and melena.
- Diagnosis of gastric foreign bodies can be made using plain films, contrast studies, or ultrasound.
- Hypochloremic metabolic alkalosis is a common bloodwork finding in cases of gastric foreign bodies.
- Treatment for gastric foreign bodies includes rehydration, endoscopic removal, or surgery.
- Hiatal hernia is the displacement of the stomach or other organs through the esophageal hiatus into the chest.
- Hiatal hernias can be congenital or acquired and present with symptoms such as regurgitation, vomiting, dysphagia, and weight loss.
- Diagnosis of hiatal hernias can be made using radiographs, contrast studies, or endoscopy.
- Treatment for hiatal hernias may include medical management with gastroprotectants and prokinetics, or surgical procedures such as gastropexy or esophagopexy.
- Gastroesophageal intussusception is the invagination of the stomach into the distal esophagus and is more common in young German Shepherds.
- Treatment for gastroesophageal intussusception may require a ventral abdominal approach, reduction of the stomach back into the abdomen, and left-sided gastropexy.
- Hypertrophic pyloric gastropathy is a pyloric outflow obstruction caused by benign hypertrophy of the muscularis or mucosa, and can be congenital or acquired. Treatment options include medical management or surgical techniques such as pyloromyotomy or gastroduodenostomy.
Lecture 19: Abdominal Radiography and Common Gastric Pathologies
- Abdominal radiography can be used to assess the gastrointestinal tract, with the descending colon always on the left side in a ventrodorsal view.
- The stomach anatomy differs between dogs and cats, with the entire stomach lying more left of midline in cats.
- Gas and fluid patterns in the stomach can vary depending on the position of the patient, with gas in the pylorus and fluid in the fundus in a left lateral view.
- Gastrography, using positive contrast agents such as barium, can be used to identify the location of the stomach, evaluate mucosal margins, and assess gastric emptying.
- Common gastric pathologies include gastric dilatation-volvulus (GDV), food bloat, gastric foreign bodies, and pyloric outflow obstruction.
- GDV is a surgical emergency and can be diagnosed using radiographs that
Diagnosis and Management of Peritonitis and Pancreatitis in Cats and Dogs
- Peritonitis is a serious condition that can lead to death, with a 3x greater risk of death if the patient has a 7 mg/dl increase in blood urea nitrogen.
- Stabilization of peritonitis patients should include immediate attention to heart rate, body temperature, and abdominal distension.
- Medical management should be attempted before surgery, with treatment including fluid administration, feeding, critical care, and analgesia.
- The most common and easiest at-home treatment for peritonitis is the administration of meloxicam, buprenorphine, oxymorphone/hydromorphone, and lidocaine.
- Peritonitis is often associated with a severe inflammatory response, fibrin deposition in the abdomen, ileus, and reflex rigidity.
- Common causes of peritonitis include primary and secondary types, as well as mechanical, chemical, and septic causes.
- Septic peritonitis is the most common type and can be caused by various factors, including ruptured GI viscus, foreign bodies, neoplasia, and urosepsis.
- Clinical presentation of peritonitis includes lethargy, inappetence, vomiting, diarrhea, hypotension, and possible arrhythmias.
- Diagnostic tests for peritonitis include complete blood count, chemistry panel, radiographs, ultrasound, and abdominocentesis/fluid analysis.
- Stabilization of peritonitis patients requires intravenous fluid resuscitation, correction of acidemia and electrolyte disturbances, and broad-spectrum antibiotics.
- Surgical treatment of peritonitis involves abdominal exploration, decontamination, and lavage, as well as the placement of a closed suction drain.
- Post-operative care for peritonitis patients is critical, with days 3-5 being the most worrisome. The prognosis for peritonitis patients is guarded, even with aggressive treatment.
- Pancreatitis can be acute or chronic, with idiopathic being the most common cause. It can lead to life-threatening complications such as systemic inflammatory response syndrome (SIRS) and necrotizing pancreatitis.
- Diagnosis of pancreatitis is challenging, with criteria including compatible clinical signs, increased serum concentrations of pancreatic lipase, exclusion of competing differential diagnoses, and compatible imaging findings.
- Treatment for pancreatitis involves supportive care, including IV fluids, analgesia, anti-emetics, early enteral nutrition, and specific therapies for chronic cases.
- Common complications of pancreatitis include SIRS, DIC, multiple organ dysfunction syndrome, acute respiratory distress syndrome, biliary tract obstruction, and gastroparesis.
Test your knowledge of surgical procedures for ear and salivary gland pathologies with this quiz. Learn about treatment options for aural hematoma, neoplasia affecting the ear, chronic otitis externa/media, and more. Explore important structures to be cautious of during surgery and discover common salivary gland pathologies that may require surgical intervention.
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