Exam Block 2 Bonus

Wounded

100

What is the goal of wound debridement?

To obtain fresh wound margins and wound bed for primary or delayed closure.

200

A patient presented with a day old dog bite wound that looks dirty and gross. You decide to do surgical debridement to start. What is it important that you do first when starting the debridement?

• May be necessary to enlarge the wound to assess the extent of injury and allow debridement

300

At what time period of wound healing would you use honey?

• Early in the course of wound healing and discontinued once a healthy granulation bed is present

400

What is the goal of each of these tissues during surgical debridement: muscle, subcutaneous tissue, contaminated fat, and cutaneous vessels?

• Muscle: debrided until it bleeds and contracts with appropriate stimuli
• Subcutaneous tissue: extensive debridement should be avoided as it may delay wound healing
• Contaminated fat: liberally excised because it harbors bacteria and is easily de-vascularized
• Cutaneous vessels: must be spared to maintain viability of overlying skin

500

An infected wound was cultured and came back to be contaminated with several gram negative bacteria types such as Psedomonas and Proteus spp, what antimicrobial would you use to treat it?

• Gentamicin Sulfate
• (often used before and after grafting and for wounds that have not responded to triple antibiotic ointment)

We can fix it yes we can!

100

What type of tumors do you want to have a greater margin distance for and what are 3 examples?

-greater for aggressive, infiltrative tumors

-melanomas, mast cell, SCC, soft tissue sarcoma, feline mammary adenocarcinoma, hemangiopericytoma, infiltrating lipomas

200

During the removal of aggressive tumors, it is recommended to excise at least one fascial layer below the detectable tumor margins. What tissue can you leave in the body while excising an aggressive tumor?

• Cartilage, tendon, ligaments, fascia, and other collagen-dense, vascular poor tissues (they are resistant to neoplastic invasion)

300

What is preferred over skin stretching techniques to recruit skin and what are they?

• Axial pattern flaps; include a direct cutaneous artery and vein at the base of the flap; have better perfusion than pedicle flaps with a circulation from the subdermal plexus alone

400

What are the requirements for casting that you should take a radiograph after casting to confirm?

• Must have at least 50% overlap of fracture ends in each of two radiographic views

500

What are the different types of the primary bandage layer and what are their purposes/when would you use them?

• 
  
• Used when wound debridement is required
• May be wet or dry
• Nonadherent
• During repair phase if no necrotic debris
• Retains moisture to promote epithelialization and prevent dehydration
• Drains excess fluid and prevents maceration
• Occlusive
• Impermeable to air
• Use on nonexudative wounds to keep moist
• Speeds rate and quality of healing compared to dressings allowing desiccation
• Use in partial thickness wounds without necrosis or infection
• Semi occlusive
• Allows air to penetrate
• Allows exudate to escape
• Most commonly used primary layer

Pls Don't Die

100

What location of a wound would generally be a compressive hemorrhage?

• Wound of an extremity where direct pressure can be applied to it

Cant fix hemorrhage of the vena cava from out side the body!!

200

What are the top 3 killers of anesthesia machine?

• Closed pop off valve
• Too little o2
• Too high vaporizer setting

300

What could happen if you don't do a pressure check before you start anesthesia and there is a leak in your machine?

-pollution to environment and personnel

-patient may wake up because they are not getting enough inhalant or may become hypoxemic

400

What are the most common sources of SSIs?

• Endogenous microbial flora
• Staphylococcus aureus
• Streptococcus spp

500

What happens if you do not change out your soda lime when it is exhausted?

CO2 will accumulate in the circuit--> rebreathing of CO2--> respiratory acidosis

Breathe, do it.

100

At what psi should you get a new oxygen tank?

500 or lower

200

What animals should use a non re breathing system?

• Patients less than 3 kg should always use one
• Patients 3-7 kg are in grey zone- anesthetists preference

300

What are the most common non re-breathing systems used in vet med. What should you never do when using a non-rebreathing system?

-mapleson D and mapleson F

-NEVER push the oxygen flush valve

400

Calculate the oxygen flow rate for a 10 kg dog immediately after induction of anesthesia, and after 15 minutes of anesthesia. What size reservoir bag would you use?

• 10 kg x 60 ml/kg/min= 600 mL/ min
• 10 kg x 30 ml/kg/min= 300 mL/min
• Don't ever set the O flow rate less than 500 mL/min!!! So actually 500 ml/min
• 0.5 L 

500

It is stated that active scavenging is the preferred method. Why are some reasons you would/would not want to use charcoal absorption?

-it absorbs halogenated anesthetic gases (ex. iso, sevo, des) but noes NOT absorb CO2 or N2O

-it is mobile, low cost, and easy to set up BUT

-it must be replaced after gaining 50 grams in weight (8-12 hours); can only use with lower oxygen flow rates; adds resistance; and has an environmental impact

Stitch er up

100

What are the basic components of a needle?

needle point, needle body, swaged end

200

What is the most common non-synthetic absorbable suture material that elicits a notable inflammatory response?

Catgut (surgical gut)

300

What type of suture would you use to close the rectus fascia?

-standard absorbable monofilament with good knot security

-polydioxanone or polyglyconate (absorbable)

400

What are the inverting patterns used to close hollow organs and what differentiates them?

Connel and Cushing

Connel- enters the lumen

Cushing- extends only to submucosal layer

500

What suture would you choose off the shelf to close skin, fascia, and delicate tissues in LA? (common name and brand name)

Skin: non absorbable--> polypropylene (prolene) or nylon

Fascia: Polyglactin 910 (vicryl), Polydioxanone (PDS), Catgut in cattle

Delicate tissue: PDS, vicryl, monocryl (poliglecaprone)