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Quiz Session - Attempts With Random Questions

AAVSB VTNE Exam Questions

Page 1 of 58

1.

What is a common side effect of corticosteroid administration?

  • Delayed wound healing

  • Decreased thirst and urination

  • Lowered risk of diabetes mellitus

  • Increased inflammation

Correct answer: Delayed wound healing

While glucocorticoids (corticosteroid medications) can be extremely effective at reducing inflammation, there are risks associated with long-term use and/or high doses. Side effects include delayed wound healing, polyuria (increased urination), and polydipsia (increased thirst). Steroid use is also associated with an increased risk of diabetes mellitus.

2.

"Tablespoon" is commonly used in dosing over-the-counter medications. How many milliliters are in one tablespoon?

  • 15 mL

  • 5 mL

  • 50 mL

  • 500 mL

Correct answer: 15 mL

One tablespoon is equal to 15 milliliters. To convert tablespoons into milliliters, multiply the dose in tablespoons by 15.

There are 3 teaspoons in 1 tablespoon. One teaspoon is equal to 5 milliliters.

3.

It is becoming increasingly clear that to have a healthy work-life balance, one needs to choose jobs/workplaces that support healthy living, including mental health support. Often, staff retention is low in various veterinary practices and other fields because of a hostile work environment. It is the responsibility of all staff members to communicate effectively with all staff. Further, it is also essential that we conduct ourselves professionally and appropriately in all aspects of the job, in front of clients and behind the scenes.

All of the following would constitute a hostile workplace, except:

  • Illegal comments or remarks by staff

  • Discriminatory actions or remarks

  • Inability to perform duties to the best of one’s ability due to another’s behaviors and attitudes

  • A worker feels threatened physically

Correct answer: Illegal comments or remarks by staff

Workplace harassment is too commonplace in today’s society. It is seen in both big and small companies — it can happen anywhere.

The U.S. Equal Employment Opportunity Commission (EEOC) defines harassment as "unwelcome conduct that is based on race, color, religion, sex (including sexual orientation, gender identity, or pregnancy), national origin, older age (beginning at age 40), disability, or genetic information (including family medical history)." It is not in and of itself illegal. However, it can become so when an individual must endure harassment as a condition of employment or when it creates a situation of abuse or intimidation. Suppose the harassment falls in the definition of sexual harassment, including physical threats, harm, or inappropriate contact. In that case, it can be considered illegal. While not unlawful most of the time, it negatively affects mental health, production, and overall work performance.

A hostile workplace includes:

  • When the actions or comments by anyone in any position with the company or business show discrimination of any kind. This can be against age, gender, ethnicity, disability, or sexual preferences.
  • Because of the actions of others, an employee cannot perform work duties effectively or to the best of their ability.
  • A manager or other employee purposely engages in behavior that leads to or attempts to get an employee to quit.
  • When an employee is physically threatened with violence. This is criminal in nature and, therefore, illegal, and should be reported.

A hostile work environment—while awful, traumatizing, and detrimental to a business' overall success goals—is in and of itself not considered illegal.

4.

Uterine biopsy specimens in mares and cows can easily be obtained via what method?

  • Standing and biopsy forceps

  • Ventral midline incision

  • Left flank incision

  • Paralumbar fossal incision

Correct answer: Standing and biopsy forceps

One can use biopsy forceps to obtain a uterine biopsy in standing mares and cows. Uterine biopsies are truly endometrial biopsies. In other species, the procedure requires a ventral midline incision. 

Once the sample has been collected, it can be teased out of the forceps with a small-gauge needle. This prevents the crushing of the sample. Once removed, it is placed in fixative for the lab to evaluate. Indications of severity include inflammation and fibrosis. This evaluation is done commonly as part of breeding soundness exams in the face of subfertility or infertility.

5.

The primary mechanism of general anesthesia affects the:

  • Central nervous system

  • Parasympathetic nervous system

  • Sympathetic nervous system

  • Immune system

Correct answer: Central nervous system 

General anesthesia results in loss of consciousness and the ability to feel pain, both of which are central nervous system (CNS) functions. The CNS is made up of the brain and spinal cord.

The parasympathetic nervous system controls bodily functions when at rest. The sympathetic nervous system controls the fight or flight response. The immune system is the body's defense against disease.

6.

Which of the following is an example of an objective means of monitoring a patient under anesthesia? 

  • Measurement of systolic blood pressure

  • Mucous membrane color

  • Palpation of peripheral pulse strength

  • Auscultation of heart sounds

Correct answer: Measurement of systolic blood pressure

The measurement of systolic blood pressure is an objective means of observation since it provides quantifiable data. It is not subject to opinion. Objective measurements often use mechanical devices to measure physiological signs that humans cannot easily discern, but this is not necessary. For example, counting heart rate beats per minute is verifiable and not subject to opinion.

The other options are incorrect because they are all sensory observations that are based on subjectivity.

7.

Which of the following amino acids is classified as nonessential?

  • Glycine

  • Lysine

  • Valine

  • Tryptophan

Correct answer: Glycine

Glycine is a nonessential amino acid, since animals are able to synthesize enough glycine to meet their requirements.

Lysine, valine, and tryptophan are classified as essential amino acids.

8.

You are admitting a patient to the hospital for a routine ovariohysterectomy. The owner wants to know what that actually means. He just scheduled the dog for her spay but realized he didn't fully understand what that meant.

What organs are removed when a female is spayed?

  •  Ovaries, uterus, and oviducts

  • Ovaries

  • The integumentary system

  • Ovaries, uterus, and cervix

Correct answer: Ovaries, uterus, and oviducts

While many people casually throw around the word "spay", it is a significant abdominal surgery. It is, by definition, the removal of the uterus and ovaries (to which the oviduct is connected). It is performed by safely ligating the ovarian vessels and the mesovarium (broad ligament). This creates the ovarian stump or pedicle. The ovaries are then removed, and the next step becomes the removal of the broad ligament and the uterus itself. The oviduct is the conduit for the ova from the ovaries into the uterus, also known as the fallopian tubes or uterine tubes. They are removed as well. The body of the uterus with vessels is first ligated, then cut. Then all three organs are removed.

To explain this easily to a client, you can simply say the ovaries, fallopian tubes, and uterus are all removed. She will have an incision that will take about 10-14 days to heal, and she will need to be kept quiet, leash walks only, and not allowed to run, jump, play, or lick at the incision for that time.

The procedure is recommended to prevent pregnancy and pyometra, and minimize the risk of cancer in those organs and breast cancer.

Removal of just the ovaries, or ovariectomy, may be feasible and routinely done via laparoscopy or normal incisional methods. It is more common in Europe currently than in the United States. They thus, leave in place the oviduct and uterus but remove the hormone stimulation to prevent pregnancy and minimize the risk of neoplasia. The cervix is not removed or fully exteriorized in most dogs and is normally located between the uterus' body and vagina. 

9.

Dystocia is a common obstetrical emergency in large animals. A veterinarian's dystocia supply kit should contain a fetotome that is used for which of the following?

  • Cutting a fetus into small parts

  • Holding fetus parts for removal

  • Applying traction on obstetrical chains

  • Performing vaginal examinations

Correct answer: Cutting a fetus into small parts

Dystocia is a medical term that means difficult birth. A fetotome is a device used to cut a fetus into smaller parts with wire to facilitate vaginal removal. This procedure is called a fetotomy. It is primarily used in large animal medicine.

A Krey Hook is used to hold fetus parts for removal. A calf-jack is used to apply traction on obstetrical chains placed on the limbs of the fetus for vaginal delivery. Sterile sleeves are used to perform vaginal examinations.

10.

You are managing a post-op femoral fracture repair in a 13-YO MN DSH. The patient is fractious, and you suspect it is due to poorly controlled pain. His last pain dose was buprenorphine 10 hours before your shift began. You informed the veterinarian that his pain evaluation was not performed as directed every four hours. You suspect he is behind and needs a stronger medication than buprenorphine. You find that the patient is hunched in the corner, growling at you, won’t eat, and is not putting any weight on the surgical leg. You recommend an oral dose of gabapentin and a fentanyl CRI. The veterinarian performs her assessment and agrees with you. She advises you to give 10 mg/kg PO of gabapentin and start a fentanyl CRI. She requests an initial loading dose of 2.5 mcg/kg followed by a 3 mcg/kg/hour CRI. You will be using a syringe pump. The concentration of fentanyl is 50 mcg/ml.

What would the dose of gabapentin and the initial fentanyl bolus dose be for this patient if the cat weighs 12.1 lb?

  • 55 mg gabapentin and 13.75 mcg fentanyl

  • 120 mg gabapentin and 30.25 mcg fentanyl

  • 27.5 mg gabapentin and 0.28 mcg fentanyl

  • 55 mcg gabapentin and 13.75 mg fentanyl

Correct answer: 55 mg gabapentin and 13.75 mcg fentanyl

Make sure you recognize the correct units for the drugs being dispensed. Gabapentin is dispensed in mg, and fentanyl is dispensed in mcg. Further, make sure to perform calculations using the right weight unit. You are given the weight in pounds but must convert it to kg to complete the math.

A patient weighing 12.1 lb is 5.5 kg (12.1 divided by 2.2 lb/kg).

5.5 kg x 2.5 mcg/kg fentanyl = 13.75 mcg of fentanyl

If you were to determine the volume of fentanyl, you would then divide 13.75 mcg by 50 mcg/ml, which results in 0.275 ml or 0.28 ml. However, this was not asked in this problem.

11.

A veterinarian prescribes amphotericin B to treat a patient’s severe Histoplasma fungal infection. Which organ is at the highest risk of serious adverse effects?

  • Kidney (nephrotoxicity)

  • Liver (hepatotoxicity)

  • Blood cells (bone marrow failure)

  • Eye (vision loss)

Correct answer: Kidney (nephrotoxicity)

Amphotericin B carries life threatening risks of nephrotoxicity to the kidneys.

Toxicity to the liver, bone marrow, or eyes is not recognized with this medication.

12.

A stray dog is brought in by a good samaritan with respiratory distress and neurologic signs. We are concerned the dog may have distemper. He looks cachectic, and the people say they have seen him around on and off for a few years. They do not know of any owner. This was the first time they could get near him to even bring him to a vet because he was so debilitated.

What increases a dog's chance of contracting the distemper virus?

  • Exposure to wildlife

  • An adult dog with multiple previous distemper virus vaccines (DHPP) is a few months late with the booster

  • Getting a blood transfusion

  • Exposure to an indoor-outdoor cat

Correct answer: Exposure to wildlife

Exposure to wildlife can increase a dog's chance of contracting the distemper virus. Distemper is most commonly associated with domestic canines, but it may also affect other species. Distemper may be carried and spread by wild animals in the families Canidae, Mustelidae, Mephitidae, Hyaenidae, Ailuridae, Procyonidae, and Pinnipedia. The mode of transmission for canine distemper is the inhalation of the airborne virus or contact with urine, feces, or mucosal secretions.

Blood purchased from a blood bank is screened for various diseases and is unlikely to have the distemper virus. 

An adult dog with multiple previous distemper virus vaccines (DHPP) a few months late with the booster will not increase the risk of disease. Distemper and parvovirus vaccinations have been shown with repeat bolstering, to last potentially well beyond the three-year booster window. Thus, being a few days or months late is only a theoretical concern. 

Exposure to an indoor-outdoor cat will not increase a dog's risk of distemper. Distemper isn't transmissible to felids. 

Note that distemper patients can mimic those with rabies, and vice versa, especially depending on what phase of rabies' clinical course manifests on presentation. Thus, even though one suspects distemper, all precautions should be taken and it should be treated as if the dog has rabies until proven otherwise. 

13.

When preparing for a surgical anesthetic procedure, you want to ensure you have all you need well before you need it. Additionally, you want to ensure that all parts are in working order. You should have a standard checklist and operating procedure that goes over testing the anesthetic machine before each use. An anesthetic machine consists of four key systems. 

Which of the following is not one of those parts?

  • The anesthetic chamber

  • The carrier gas supply

  • The vaporizer

  • The scavenging system

Correct answer: The anesthetic chamber

The four components of an anesthetic machine include:

1. The carrier gas supply allows the delivery of oxygen and carrier gases to the patient using a controlled flow rate. This includes the:

  • Compressed gas cylinder
  • Pressure-reducing valve
  • Tank and line pressure gauges
  • Flowmeters
  • Oxygen flush valve

2.  The anesthetic vaporizer takes a precise concentration of the liquid inhalant, vaporizes it, and then mixes it with the carrier gases.

3.  The breathing circuit functions to deliver the anesthetic and oxygen mixture by way of the endotracheal tube, chamber, or mask to the patient. It also removes expired gases away from the patient. These circuits are either rebreathing or non-rebreathing, depending on patient size.

4.  Finally, the scavenging system takes the waste gases and excess vaporized anesthetic and disposes of it safely.

An anesthetic chamber, a solid box, is uncommonly used in small animal medicine for feral, intractable, or otherwise unmanageable patients to induce anesthesia. Two ports facilitate this induction, one for the fresh gas source and the other providing an exit for waste gas. The use of this method of induction is highly recommended against. It goes against Fear Free practices but may be necessary in extreme cases. However, this is not a part of the anesthesia machine itself.

14.

Surgery involving an incision into the urinary bladder is referred to as what?

  • Cystotomy

  • Urethrostomy

  • Gastropexy

  • Orchidectomy 

Correct answer: Cystotomy

Surgery involving an incision into the urinary bladder is referred to as a cystotomy. The prefix cysto is derived from the Greek word, kustis, meaning bladder. The suffix otomy is a term used to describe the act of cutting into something. Cystotomies are often used to remove bladder stones, place a cystostomy tube, and remove tumors.

A urethrostomy is the process of cutting into the urethra. A gastropexy is the tacking of the stomach to the body wall to prevent rotation (volvulus). An orchidectomy is the removal of a male animal's testicles, also known as castration.

15.

A client receives a recommendation for her dog to receive Apoquel daily for treatment of atopic dermatitis. She wants to price check what she should expect to spend for three months (90-day supply) of treatment. The 16 mg tablets cost $1.17 each for the hospital. The business marks up products 2.5 fold for the price charged to the client. The dog's prescription is for 1/2 tablet by mouth once daily.  

How much is the financial estimate to the client for this course of therapy?

  • $131.62

  • $52.65

  • $105.30

  • $263.24

Correct answer: $131.62

Calculate number of tablets needed: (1/2 tablet per day) x (90 day supply) = 45 tablets

Calculate cost to practice: 45 tablets x ($1.17/tablet) = $52.65 cost to practice

Markup cost to client:  $52.65 x 2.5 mark up = $131.62

16.

You have treated a dog for acute collapse and diagnosed a hemoabdomen. You have reviewed surgery, complications, risks, cost, and post-op prognosis with and without adjunct care. Ultimately, due to cost concerns and declining quality of life, the owners elect humane euthanasia. They have young children with them and are so upset that they aren’t even sure how to address it with them.

When talking to children about death, all of the following are true, except:

  • Use euphemisms like “put to sleep”

  • Be honest

  • Provide children with books on pet loss

  • Permit kids to be present for euthanasias, but have the freedom to leave the room if they change their minds

Correct answer: Use euphemisms like “put to sleep”

We need to be straightforward, honest, and accurate in our descriptions with kids. Do not be vague, as this could lead to confusion and misunderstanding. Do not use euphemisms like “put to sleep”. Kids may fear going to sleep themselves, fearing they may never wake up. Or they may think the pet is taking a nap and will wake up and be with them again.

In addition to being honest, we want to use accurate terms such as "death" and "dying". We do not want to sugarcoat reality or lie, but we want to make our explanations simple and easy to understand. Ensure that the child comprehends the meaning of dying: that the pet will not be coming back.

Providing kids permission to be present but letting them know if they cannot be in the room and want to leave, they may do so. If the kids are young, have a staff member waiting outside in case they become uncomfortable or too emotional to remain in the room. In that case, someone is out there to watch them for the parents.

Have either books or a list of resources online to provide the pet owners that review pet loss for kids. Providing access to resources or options can help the family grieve, and help the children understand what has happened and how to move forward.

17.

Which of the following describes adaptive pain? 

  • Normal physiological response to tissue damage or inflammation

  • Pain secondary to a stimulus not normally painful

  • Pain above and beyond the protective response levels

  • Pain that functions as a protective mechanism

Correct answer: Normal physiological response to tissue damage or inflammation

We can see an array of pain types in veterinary medicine, from acute to chronic pain to wind-up or central sensitization and more.

Adaptive pain refers to the body’s normal physiological response to a stimulus that leads to inflammation or tissue damage.

Allodynia refers to pain that arises from a stimulus not normally considered painful (as we can see with wind-up/central sensitization) and some medical conditions.

Pathologic pain is characterized by an amplified reaction that surpasses its intended protective function. This phenomenon is often linked to tissue damage due to trauma or after surgical intervention.

Physiologic pain refers to the sensation of pain that serves as a protective mechanism, prompting an animal to distance itself from possible harm to their tissues or to refrain from engaging in movements or contact with external stimuli during tissue repair.

Understanding the various types of pain in conjunction with the various types of pain medications and how they play a role in modifying the pain pathway will help in drug selection and keeping ahead of a patient’s pain.

18.

When monitoring a patient under anesthesia, we can use vital signs to help gauge anesthetic depth. Which of the following would represent a patient that is too light? 

  • Elevated heart rate and respiratory rate with normal mucous membranes and steady pulse

  • Variable heart rate and respiration, normal to somewhat paler mucous membranes, and a still easily palpable pulse

  • Decreased heart rate, possibly reduced respiratory rate, pulses weak or not readily appreciated, prolonged capillary refill time

  • Normal heart rate and respiration, weak pulses, pale gums

Correct answer: Elevated heart rate and respiratory rate with normal mucous membranes and steady pulse

Patients who are too light:

  • Heart rate: Generally elevated
  • RR: Generally elevated
  • Pulses: Strong
  • MM/CRT: Normal

Patients who are on an appropriate surgical plane:

  • Heart rate: Variable
  • RR:  Variable
  • Pulses: Palpable, though less readily apparent
  • MM/CRT:  Normal to slightly paler with normal CRT

Patients who are too deep:

  • Heart rate: Often decreased
  • RR: Often decreased
  • Pulses: Weak, unpalpable
  • MM/CRT: Pale/delayed

19.

Which of the following may indicate obstruction of the airways in an anesthetized patient? 

  • Stridor

  • Pleural effusion

  • Hemoptysis

  • Hypoxemia

Correct answer: Stridor

Stridor is a high-pitched vibrating sound caused by an obstruction of airflow in the pharynx or larynx. If stridor is present in an anesthetized patient, the upper airways should be inspected, and anesthesia should be stopped if necessary. When an endotracheal tube is properly placed and functioning, there will be no stridor present.

Pleural effusion is fluid accumulation within the thoracic cavity. Hemoptysis is coughing up blood. Hypoxemia is low oxygen concentration in the bloodstream.

20.

Patients with diabetic ketoacidosis are frequently placed on insulin continuous rate infusions. The veterinarian's orders are for 2.2 U/kg of regular insulin (U-100) to be added to a 250 mL bag of 0.9% NaCl, beginning administration at 10 mL/hr. The patient weighs 25 pounds.  

What is the volume of insulin to add to the fluid bag?

  • 0.25 mL

  • 1 mL

  • 0.5 mL

  • 2.5 mL

Correct answer: 0.25 mL

Convert the patient's weight from pounds to kilograms: 25 pounds / (2.2 pounds per kilogram) = 11.4 kg

Calculate the dose in units: 11.4 kg x (2.2 U/kg) = 25 units

Convert units to volume: U-100 insulin is 100 units per ml concentration. 25 units / (100 units/ml) = 0.25 mL

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