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Quiz Session - Attempts With Random Questions

AAVSB VTNE Exam Questions

Page 8 of 58

141.

Pulmonary edema is classified into what two categories?

  • Cardiogenic and noncardiogenic

  • Peripheral and central

  • Hypovolemic and hypervolemic

  • Invasive and noninvasive

Correct answer: Cardiogenic and noncardiogenic

Pulmonary edema is classified as either cardiogenic or noncardiogenic, based on the underlying cause. Cardiogenic pulmonary edema is caused by an increase in hydrostatic pulmonary pressure from heart failure. Noncardiogenic pulmonary edema is caused by a decrease in plasma oncotic pressure or altered capillary membrane permeability. Causes of non-cardiogenic pulmonary edema include electrocution and choking.

142.

When maintaining mechanical scalers for dental calculus removal, the oil level of the compressors should be checked how frequently and thoroughly changed how often? 

  • Checked weekly; changed biannually

  • Checked weekly; changed annually

  • Checked every 6 months; changed annually

  • Checked every month; changed biannually

Correct answer: Checked weekly; changed biannually

To maintain your scalers properly, always follow the manufacturer's guidelines for maintenance. Still, as a general rule, the oil levels should be checked weekly to ensure they are adequate and top them off as needed. The entire unit should have the oil changed every 6 months.

143.

What is the name of mineralized debris that builds up on teeth over time?

  • Calculus

  • Enamel

  • Dentin

  • Cementum

Correct answer: Calculus

Calculus is mineralized plaque that coats the tooth surface and is difficult to remove by brushing alone.

Enamel is the outer surface layer of a tooth's crown. Dentin composes the majority of the tooth and is located beneath the enamel and cementum. Cementum is the calcified substance that covers a tooth's roots.

144.

In small animal radiography, what is the most commonly used milliamperage (mA) setting?

  • 300 mA

  • 48 mA

  • 1000 mA

  • 20 mA

Correct answer: 300 mA

Milliamperage (mA) is a measure of the amount of electrons emitted from an x-ray tube-based on filament and anode activity. Most x-ray machines are set at 300 mA in small animal radiology, but can range from 25 to 400.

Large animal portable units may use settings as low as 10 mA, while some stationary units at larger veterinary hospitals can be set up to 1000 mA.

145.

To provide proper nutritional needs to cattle hospitalized with you, you must ensure that you provide mature cattle capable of drinking independently, with a minimum of how much water daily?

  • 13 gallons

  • 8 gallons

  • 25 gallons

  • 60 gallons

Correct answer: 13 gallons

The average mature adult cow requires 10 to 14 gallons of water daily.

Dairy cows need 3 to 5 gallons of water in order to produce 1 gallon of milk, equating to an estimated water requirement of 45 gallons daily during peak lactation.

In general, the amount of water needed daily (mL) is equivalent to the daily caloric requirements.

146.

During surgery, each individual in the operating room should, at a minimum, wear all of the following items except:

  • Gloves

  • Surgical cap

  • Mask

  • Booties

Correct answer: Gloves

Aseptic technique is particularly important in operating rooms, where bacteria and other sources of contamination can easily affect patient safety. To decrease contamination in the room, all individuals should wear surgical caps, masks, and booties.

Nonsterile assistants (individuals who do not have direct contact with the patient or equipment that can pass infectious agents onto the patient) are not required to wear gloves or gowns.

147.

Which of the following requires immediate surgical intervention?

  • Splenic rupture

  • Ruptured abscess

  • Luxated patella

  • Torn cranial cruciate ligament

Correct answer: Splenic rupture

A splenic rupture requires immediate surgical intervention (or humane euthanasia) due to severe blood loss and potential death.

The other options will usually benefit from surgery, but are rarely emergencies.

148.

Bexagliflozin is the new oral diabetic agent recently approved for use in cats in the U.S. What is the mechanism of action for this drug?

  • SGLT2 inhibitor

  • Suflonylurea

  • Incretin mimetic

  • DPP4 Inhibitor

Correct answer: SGLT2 inhibitor

Bexacat™ or Bexagliflozin is a new oral diabetic drug recently approved by the FDA in the U.S. It is an SGLT2 inhibitor (sodium-glucose cotransporter-2). SLGT2 is present in the kidneys and is responsible for 97% of glucose resorption that would otherwise be excreted via micturition. SGLT1 works by reabsorbing glucose from the intestinal tract.

Inhibiting this transporter causes a dumping of sugar in the urine and prevents (hopefully) hyperglycemia, thereby preventing the secondary negative effects of diabetes.

However, the drug can only be used in cats who are not yet on insulin (and have never been on insulin). It will only work in cats who still produce their own insulin (type 2 diabetics). Usually, cats who are recently diagnosed as diabetic and are not ketotic are considered most likely to respond.

All other options are possible diabetic medications currently available in people but have either not been shown effective in cats or not yet been utilized/studied in cats. These other options include sulfonylureas, e.g., glipizide, incretin mimetics (glucagon-like peptide 1 or GLP-1 receptor agonist), e.g., Byetta® and Victoza®, or a DPP4 (dipeptidyl peptidase 4) inhibitor, e.g., Ozempic®. While sulfonylureas are oral, the other options are currently injectable. Thus, even if cats responded, it isn't as beneficial as an oral option. However, the frequency of administration may be less than with insulin.

149.

A veterinarian's protocol is to administer Euthasol at 2 mL per 10 pounds for the first 10 pounds, then 1 mL per 10 pounds of body weight thereafter.

How much Euthasol should be drawn for a 25-pound patient?

  • 3.5 mL

  • 2.5 mL

  • 5 mL

  • 3 mL

Correct answer: 3.5 mL

The veterinarian wants 2 mL for the first 10 pounds of body weight.

The veterinarian wants 1 mL per 10 pounds for the remaining body weight (25 pounds - 10 pounds = 15 pounds). 1 mL per 10 pounds, extrapolated to 15 pounds = 1.5 mL

To cover the 25 pounds of patient weight, 3.5 mL of Euthasol should be drawn.

150.

All of the following are correct upon extubation of a ruminant patient except:

  • Ensure the neck is elevated away from the neutral position and not fully extended

  • Place in sternal recumbency until awake

  • Offer food as soon as able and willing to eat

  • Keep the endotracheal tube inflated or only partly deflated until absolutely necessary

Correct answer: Ensure the neck is elevated away from the neutral position and not fully extended

Actually, in ruminants, because of the risk of bloating and aspiration, we keep the endotracheal tube inflated or only partly deflated until absolutely necessary. When the patient is coughing or has strong swallowing movements, we can remove the tube slowly and steadily, ensuring the neck is kept in a natural but extended position to protect the airway from aspiration of any pharyngeal particulate matter. In small ruminants, the tube can often be left fully inflated. Still, in larger species, you may need to release a bit of air very slowly and try to remove the tube again.

Additionally, we want to ensure that ruminants recover even once extubated in the sternal recumbent position to ensure they do not bloat. After about 15 to 20 minutes, they can be left alone. However, they should still be monitored frequently to ensure they have not taken up the lateral position. If they have, return them to sternal until they can stand. Note if sternal recumbency isn’t initially possible, place the animal in right lateral recumbency to have the rumen on the upside.

Finally, with ruminants, we do not need to withhold water or food for any period of time after anesthesia, so they can be offered food and water as soon as they are standing and interested.

151.

Hydromorphone is an opioid analgesic which is widely used in the veterinary industry for the management of pain. This medication is said to have a high potential for abuse. It also has an accepted medical purpose with severe restrictions.

Hydromorphone falls into what schedule of controlled drugs?

  • Schedule II

  • Schedule I

  • Schedule III

  • Schedule V

Correct answer: Schedule II

Hydromorphone is a Schedule II drug. The DEA assigns drugs to Schedule II because they have the potential for severe psychological and physical dependence when abused by humans. These medications are very effective for pain control, so are permitted for medicinal use with severe restrictions.

Other drugs included in Schedule II include fentanyl, morphine, and some hydrocodone cough preparations.

152.

Which of the following drug combinations is administered concurrently to provide both pain relief and sedation?

  • Acepromazine and hydromorphone

  • Lidocaine and bupivacaine

  • Dexmedetomidine and atipamezole

  • Carprofen and PSGAG (polysulfated glycosaminoglycan)

Correct answer: Acepromazine and hydromorphone

Neuroleptanalgesia medication combinations typically contain an opioid and a tranquilizer, such as acepromazine and hydromorphone. They are useful for mild to moderate sedation, especially when a procedure may cause pain. A common indication is sedation for the radiographic positioning of an injured limb.

Lidocaine and bupivacaine are both local anesthetics. When combined, they provide short onset and long duration local anesthesia.

Dexmedetomidine and atipamezole both act at the alpha-2 adrenergic receptors. Dexmedetomidine provides mild analgesia with moderate to marked sedation. Dexmedetomidine is an agonist, while atipamezole is an antagonist. They should not be given at the same time but staggered.

Carprofen and PSGAG (polysulfated glycosaminoglycan, such as Adequan) combine an NSAID (anti-inflammatory and analgesic) with a chondroprotectant (joint support). Neither has sedative effects.

153.

The identification of immune-mediated hemolytic anemia (IMHA) includes evidence of the destruction of red blood cells (RBCs). This may lead to what RBC morphology?

  • Spherocytes

  • Eccentrocytes

  • Heinz bodies 

  • Howell-Jolly bodies

Correct answer: Spherocytes

Spherocytes are small red blood cells lacking an area of central pallor. They are usually circular when compared to normal RBCs. They are most often found in canine smears in the presence of IMHA, but they can be seen in other species. They may have dark red staining and appear smaller than average RBCs. These cells occur due to antibody binding to the RBC's surface, which removes a part of the membrane via splenic macrophages. Recognizing these cells on a blood smear may be pivotal to a correct diagnosis of IMHA. But note that they cannot be identified correctly in thicker smear areas and may be falsely present on the feathered edge. Ensure care when evaluating these cells.

Eccentrocytes represent one possible change to the RBCs that occurs with oxidative damage. Here, the hemoglobin shifts to one side of the RBC, creating a transparent region outlined by a thin membrane rim.

Heinz bodies also occur when oxidative damage occurs to the hemoglobin, causing a pale area that may protrude from the membrane's surface. They appear blue when stained with methylene blue. They are commonly found in sick cats but must be interpreted relative to total RBC numbers.

Howell-Jolly bodies represent nuclear remnants. These manifest as basophilic, round, tiny structures within the RBC. They can be seen with regenerative anemias of any kind.

154.

A client with a five-year-old Shih Tzu calls because the pet has no change in blepharospasm or epiphora since starting the medications less than 24 hours ago. The patient was sent home on topical medications, including atropine, an antibiotic, and an e-collar. She reports that she is not using the cone provided. The owner is concerned that the current therapy for a superficial corneal ulcer is failing. She wants to know what else she can do for the pet.

You talk with the veterinarian and advise her to do all of the following, except:

  • Decrease the frequency of medication administration

  • Keep an e-collar on at all times

  • Make an appointment with the ophthalmologist

  • Pick up oral pain medication to assist with the care 

Correct answer: Decrease the frequency of medication administration

The patient has not been on the medications for a significant enough amount of time to determine if they will be effective. The client admits to not using the e-collar as prescribed. Thus, the patient is likely rubbing their eyes/face on furniture/paws and may be causing irritation. The most ideal plan would be to ensure 24-hour use of the e-collar to prevent self-trauma and see if the medications work.

Medications are prescribed based on the duration of action and mode of action. Thus, decreasing the frequency would not improve the patient's condition unless an allergic reaction to them has developed. While this can happen, it is uncommon.

It is never wrong to make an appointment with an ophthalmologist. However, getting an appointment with a specialist, especially post-COVID-19, can be difficult, and wait times may be upwards of one to three months. Thus, the owner needs to ensure that she continues to treat the dog as prescribed. If the dog is not improving or worsening, the owners should recheck at an emergency clinic or by appointment with the primary care veterinarian as soon as possible.

The dog may not be thoroughly improving because they are in pain. Blepharospasm is a sign of pain, and the dog would definitely benefit from oral pain medications. Though they should have been included from the beginning, it is never wrong to start them now. Treating pain will allow for improved healing. If the dog doesn't start to improve after a day or so of pain management, they should recheck as soon as possible. It could be that the medications are not sufficient or that the disease has progressed and additional treatment may be warranted.

155.

What is the purpose of maintaining asepsis in surgery?

  • Decrease microbial contamination 

  • Reduce surgical procedure time

  • Control bleeding

  • Decrease pain during the procedure

Correct answer: Decrease microbial contamination

Asepsis is the state in which no living organisms survive. Thus, no infectious particulates exist. 

Asepsis (also called aseptic technique) minimizes microbial contamination, decreasing surgical site infections. These principles apply to the surgeon (for example, scrubbing hands before gloving), the patient (clipping and scrubbing the surgical site), and supplies/equipment (using a designated room for surgery exclusively).

Using aseptic techniques increases preparation time before and after surgical procedures, but does not affect the actual procedure time and is not the purpose of asepsis. Hemostasis describes the control of bleeding. Analgesia and anesthesia are methods to decrease pain.

156.

The canine blood group acronym "DEA" stands for which of the following?

  • Dog erythrocyte antigen

  • Dog erythrocytic antibody

  • Dog erythropoietin antibody

  • Dog erythropoietin antigen

Correct answer: Dog erythrocyte antigen

Dog erythrocyte antigen (DEA) refers to the identification system for canine blood groups. DEA 4 is the most common type and is considered a universal donor.

The canine blood group acronym DEA does not represent dog erythrocytic antibody or dog erythropoietin antibody or antigen. 

157.

What is ethylene oxide?

  • A colorless gas used for sterilization

  • An odorless gas used for sterilization

  • A gas that appears blue in color and is used for sterilization

  • A gas that smells like sulfur and is used for inhalant anesthesia

Correct answer: A colorless gas used for sterilization

Ethylene oxide is a toxic, flammable, explosive, colorless gas used for sterilization. It is capable of killing all microorganisms, making it an effective chemical to use for sterilization. However, because of its high toxicity, ethylene oxide is being replaced with hydrogen peroxide gas plasma, which is less toxic to humans, not considered carcinogenic, and safer for the environment.

Ethylene oxide is not an odorless gas, a gas that appears blue in color, or a gas that smells like sulfur.

158.

You have been asked to obtain a blood sample for an ELISA snap test to evaluate a dog for heartworm and a few tickborne diseases. The dog has no clinical signs of disease. Still, the owner did lapse on the flea/tick prevention and heartworm preventative and wants to restart the heartworm medication as soon as possible. You obtain the sample, run the test, and find that the dog is positive for heartworm and Borrelia burgdorferi (Lyme disease). 

However, what does the positive finding mean for the organism that causes Lyme when interpreting these results?

  • Exposure to the organism

  • Infection with the organism

  • Will develop clinical disease

  • False-positive

Correct answer: Exposure to the organism

ELISA tests can quantify either the amount of antigen of an organism or antibodies to an organism. With the SNAP4DX, the test measures antibodies against the different organisms for four tickborne diseases. When present (positive test result), antibodies show exposure to the organism. However, the body may have cleared the organism, had insufficient quantities to cause disease, or been exposed in the past. (How long a test remains positive for antibodies varies with the organism being evaluated). Antibodies simply tell us that the body’s immune system responded to exposure. This dog without clinical signs may never develop signs of Lyme disease. The positive test does tell us that the dog is exposed to ticks that carry Lyme and should be started back on flea/tick prevention as soon as possible.

Thus, the heartworm component of the test measures antigen, not antibodies, and suggests active infection with the organism. However, an additional confirmatory test and an evaluation for microfilariae are warranted because we can see false positives. 

No test can tell us if clinical signs are not present or if they will develop, per se. However, suppose no intervention is taken with heartworm disease. In that case, we know from the natural course of disease that the pet could eventually die from the disease.

False positives and negatives are always possible in any test, hence, the need for confirmatory tests when warranted.

159.

Which of the following statements is not correct regarding the use of fluorescein stain?

  • Fluorescein staining should be performed prior to a Schirmer tear test

  • The stain should be flushed from the corneal surface with an ophthalmic irrigating solution

  • Fluorescein stain is useful for the diagnosis of corneal lesions

  • A dark area and an ophthalmoscope are necessary for the examination of the stained area

Correct answer: Fluorescein staining should be performed prior to a Schirmer tear test

Fluorescein stain is a bright yellow-green dye that is applied to the corneal surface to highlight corneal lesions such as abrasions and ulcers. After the stain is applied to the corneal surface, the residual stain is flushed with an ophthalmic irrigating solution to remove excess dye. This is needed to verify there are no lesions along the lower lid edge. Any residual stain will fluoresce with light from an ophthalmoscope in a dark room.

Since a Schirmer tear test measures eye wetness, it must be performed before solutions are applied to the eye with fluorescein staining.

160.

A 20-kg patient received 3 mL of hydromorphone. The stock vial label indicates the concentration is 2 mg/mL. There is concern that this was an overdose, so you are asked to calculate what dosage this patient received. 

Which of the following doses administered is correct?

  • 0.3 mg/kg

  • 0.1 mg/kg

  • 2 mg/kg

  • 3 mg/kg

Correct answer: 0.3 mg/kg

Dosage is the quantity (either mL or mg) per body weight (kg).

3 mL of hydromorphone at 2 mg/mL concentration = 3 mL x 2 mg/mL = 6 mg

The patient weighs 20 kg, so the dosage would be: 6 mg/20 kg = 0.3 mg/kg

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