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66 Cards in this Set

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What are the stages of wound healing?
Inflammatory
Debridement
Repair
Maturation
What is the "golden period" of wound healing?
4-6hrs post injury
What is the difference between delayed primary and secondary wound healing?
NO GRANULATION TISSUE for delayed primary (2-5d); there IS granulation tissue present for secondary (>5d post injury)
What are some methods of neurovascular assessment?
cut toenail
check for deep pain
prick the skin
How are wounds assessed (4 ways)?
Open/closed
Type
Duration (acute/chronic)
Degree of contamination
Which of the following are correct regarding wound cleaning?
a) NEVER allow scrub solution to contact the wound
b) Bruised skin does not need to be prepped if there are no open wounds
c) the best way to remove clipped hair from wounds is lavage
d) sterile instruments are unnecessary for contaminated wounds
a) NEVER allow scrub solution to contact the wound
(clip PAST bruises; use sterile lube in the wound to trap hair; use sterile instruments!!)
What is the appropriate wound lavage pressure? How is this attained?
8psi attained using a 35cc syringe + 18ga needle
Which of the following are appropriate wound lavage solutions?
a) tap water
b) 5% chlorhexidine
c) 1% iodine
d) 3% hydrogen peroxide
3) Dakin's Solution
a) tap water
c) 1% iodine
(should be 0.05% chlorhex; don't use H2O2 or bleach)
What is the goal of wound debridement?
Convert accidental wound into a surgical wound
What is the most common form of wound dressing bandage?
Wet to dry
Which of the following is BEST for preventing debridement of granulation tissue?
a) dry to dry
b) wet to dry
c) wet to wet
d) wet to dry to wet
d) wet to dry to wet
What is the indication to remove a drain?
When serous fluid is being produced or when the amount of fluid removed plateaus
What are the indications for drains?
Eliminate dead space
Evacuate fluid
Prevent formation of fluid/gas
Which of the following can inhibit wound contraction?
a) Silver sulfadiazine
b) Gentamicin sulfate
c) Aloe vera
d) Honey
a) Silver sulfadiazine
b) Gentamicin sulfate
Which of the following delays epithelialization?
a) Silver sulfadiazine
b) Nitrofurazone
c) Aloe vera
d) honey
b) Nitrofurazone
Which of the following has broad antimicrobial activity?
a) Silver sulfadiazine
b) Nitrofurazone
c) Aloe vera
d) Gentamicin sulfate
a) Silver sulfadiazine
b) Nitrofurazone
(both are G+ and G-)
Which of the following has anti-pseudomonas activity?
a) Silver sulfadiazine
b) Nitrofurazone
c) Aloe vera
d) honey
c) Aloe vera
What are some rad things about honey?
antioxidant
reduces inflammation
attracts macrophages
promotes granulation and epithelization
has antibacterial activity
When should a non-adherent contact layer be placed on a wound?
When granulation tissue is present
T or F:
Feline hyperthyroidism most commonly presents bilaterally.
True (80% do)
How should a hyperthyroid cat be prepared for surgery?
Administer methimazole to get cat euthyroid and check renal function. Also use beta blocker if have heart issues.
What is the surgery of choice for feline thyroidectomy? What structure must be preserved?
Modified extracapsular (preserve external parathyroid gland and cranial thyroid artery)
T or F:
All parathyroid tissue is commonly removed along with thyroid in cats since hypoparathyroidism is easy to manage.
False!
You can implant parathyroid tissue in the neck meat to preserve parathyroid function.
What are possible complications of feline thyroidectomy?
Hypothyroidism
Lar par
Horner's
Recurrence
Worsening of renal dz
Iatrogenic hypoparathyroidism
When performing a canine thyroidectomy, what are some considerations that should be made?
GET READY FOR A TRANSFUSION (they're highly vascular)
80-90% malignancy; 33% metastasis
What is the calcium cutoff for peri-operative Ca and vitamin D supplementation?
Above 14 mg/dl, higher risk of postop hypocalcemia (start supplementation)
What is the fastest acting type of vitamin D?
Calcitriol
Which adrenal tumor more commonly invades the caudal vena cava? Which side?
Pheochromocytoma (equal chance for both sides)
What are some screening tests for Cushing's?
90-95% of dogs have increased ALP
ACTH and LDDS
What are some screening tests for pheochromocytoma?
None!
What pharmaceutical can be given post adrenalectomy to prevent dehiscence due to cortisol?
Vitamin A
(or the Canadian version, Vitamin Eh)
What pharmaceutical greatly reduces mortality in pheochromocytoma excision? How is it administered?
Alpha blockers!
Start phenoxybenzamine 10-14d pre-surgery.
Use beta blockers (altenolol) on surgery day
What procedure is often associated with removal of the right limb of the pancreas and why?
partial duodenectomy due to shared cranial pancreatico-duodenal artery
Where do insulinomas commonly metastasize?
Liver and lymph nodes
T or F:
Partial pancreatectomy often results in exocrine pancreatic insufficiency in the dog.
False!
Dogs have 2 pancreatic ducts; if you can keep one, they won't get EPI.
What drug can be useful for metastatic insulinomas? What is a side effect?
Streptozocin
Nephrotoxic!
Which of the following is NOT a goal associated with surgical oncology?
a) prevention of cancer
b) diagnosis of cancer
c) cure cancer
d) palliative
ALL are goals of surgical oncology! Also cytoreductive and ancillary surgical procedures
What is the risk of developing mammary tumors if spayed before the 1st heat? 2nd heat? 3rd heat?
1st (0.5%)
2nd (8%)
3rd (26%)
By how much does castration reduce testicular cancer? Prostatic cancer?
100% reduction to testicular cancer; no reduction to prostatic cancer.
How much does a peri-pubertal OVH decrease mammary tumors in cats?
around 7 fold reduction
Insulinoma surgery describes which aspect of surgical oncology?
a) curative
b) cytoreductive
c) diagnostic
d) preventive
e) palliative
b) cytoreductive
How is the surgical bed marked in an insilunoma surgery for radiation?
hemoclips
Osteosarcoma amputation falls under which category of surgical oncology?
a) curative
b) cytoreductive
c) diagnostic
d) preventive
e) palliative
e) palliative
What are some ancillary procedures associated with surgical oncology?
placement of vascular access ports, feeding tubes, etc
T or F:
Surgery is the single treatment modality that cures more cancer than any other.
TRUE DAT YO!!!
What are the 4 types of metastases?
Sattelite
Skip
Regional
Distant
Which describes inflammatory cells around the tumor?
a) reactive zone
b) pseudocapsule
c) peritumoral cells
d) Fladermaus cells
a) reactive zone
Metastases that get beyond the inflammatory cells surrounding the tumor are called...
...skip metastases
Which of the following are NOT true when it comes to surgery for a curative intent?
a) ligate vein before artery
b) use monofilament and sterile saline
c) use separate instruments, drapes, and gloves for closure
d) use omental bandaging to stimulate healing of the surgical site
e) lavage the body cavity after surgery
d) use omental bandaging to stimulate healing of the surgical site (NO - remove omentum if it is stuck to the tumor)
What is a good deep margin structure?
Fascial layer!
Go UNDER THIS SUCKER when removing a mass...
What is the 50/50 rule for canine mammary tumors?
50% benign; 50% malignant; 50% will metatasize (sounds more like 50/50/50 to me though...)
T or F:
Mammary tumors should be treated as early as possible.
TRUUUUUUUUUUUUUUUu
Spaying a cat before 6 months has what effect on mammary carcinoma development? Before 1 year?
6 months (91% reduction)
1 year (86% reduction)
T or F:
Dogs spayed within 2 years of mammary carcinoma development live longer than unspayed dogs.
True!!!
Choose the incorrect statement:
a) unspayed females are more likely go get less aggressive mammary tumors
b) spayed females are more likely to get estrogen/progesterone receptor negative tumors
c) dogs with estrogen/progesterone receptor positive tumors have a shorter survival time
d) mesenchymal tumors are normally estrogen receptor negative
c) dogs with estrogen/progesterone receptor positive tumors have a shorter survival time (should be receptor NEGATIVE)
Describe the mammary gland lymphatic drainage in most dogs.
1 and 2 go to axillary
4 and 5 to inguinal
3 can go either way
T or F:
The inguinal lymph node is always removed with mammary glands 3, 4, and 5.
True
T or F:
The axillary lymph node is always removed with mammary glands 1, 2, and 3.
False! Only if FnA is positive for metastasis or it is enlarged
T or F:
Based on current data, the bitch should not be spayed concurrently with mastectomy due to seeding issues.
False!
Current data recommends concurrent spay!
Which works better on bitch mammary tumors, radiotherapy or chemotherapy?
Neither has proven efficacy
T or F:
Mammary tumors in male dogs are usually malignant.
False! They're benign.
Which shitty-ass mammary carcinoma is often misdiagnosed as mastitis in dogs?
Inflammatory carcinoma
What is the 50/50 rule for cat mammary tumors?
Yup, there is no 50/50 rule! 85% of them are MALIGNANT!!!
Where do cat mammary tumors like to metastasize to?
Lung, liver, lymph nodes, pleura
Describe the lymphatic mammary drainage in the cat.
(1) axillary and sternal lnn
(2) axillary and sternal; maybe superficial inguinal
(3) superficial inguinal; possibly axillary and sternal
(4) superficial inguinal
T or F:
If you see a mammary lump in a cat, you should take out ALL the mammaries!
Looks true to me! Bilateral mastectomy has the longest MST.