Surgery

Question 1

Correction of pneumovagina in the mare when it is too severe for successful correction with a Caslick vulvoplasty is possible using:

• A. Buhner’s technique
• B. Caudal relocation of the transverse fold
• C. Perineal body reconstruction (Gadd procedure)
• D. Urethral extension

Answer 1

C. Perineal body reconstruction (Gadd procedure)

Question 2

What is the primary force counteracted by the presence of an intramedullary pin in a transverse femoral fracture?

Answer 2

Bending

Question 3

What is flail chest?

Answer 3

A segment of the chest wall created by ≥ two fractures of ≥ two adjacent ribs

Segment paradoxically moves into the chest during inspiration and outward during expiration.

Question 4

At which sites in the canine stifle does osteochondritis dissecans (OCD) occur most commonly?

Answer 4

• Lateral femoral condyles
• Medial femoral condyles

Question 5

Other than hemorrhage, what is the major consideration, in terms of patient management, if you are contemplating percutaneous fine needle aspiration or biopsy of an adrenal mass?

Answer 5

If the mass is a pheochromocytoma, catecholamine release may lead to a hypertensive or paradoxical hypotensive crisis

Question 6

Which intestinal layer has the greatest tensile strength and should be included when suturing the intestine?

Answer 6

The submucosa

Question 7

What is the most common post-operative complication associated with unilateral arytenoid lateralization for treatment of idiopathic laryngeal paralysis in dogs and cats?

Answer 7

Aspiration pneumonia

Surgical failures (larynx fracture, suture breakdown) also are well-recognized adverse consequences.

Question 8

Tibial plateau leveling osteotomy (TPLO) is most likely indicated for treatment of:

• A. Patellar luxation
• B. Cranial cruciate ligament injury
• C. Fragmented medial coronoid process

Answer 8

B. Cranial cruciate ligament injury

Question 9

During a routine ventral midline celiotomy in mammals, the aim is to incise this structure, thus avoiding the highly vascular rectus abdominis muscles on either side.

Answer 9

Linea alba

Question 10

Surgical reduction of a pelvic fracture typically may no longer be possible after how many days?

• A. 2
• B. 4
• C. 7

Answer 10

C. 7

This is when early callus formation and soft-tissue contraction begin to stabilize the fracture fragments. At that point, it is not possible to realign the pelvis without excessive force or additional damage.

Question 11

During cranial cruciate ligament repair, the meniscal attachments often are deliberately transected. This procedure is known as:

Answer 11

Meniscal release

This offers greater meniscal mobility to reduce the likelihood of meniscal injury.

Question 12

What are the most common sites for intussusception in a small animal?

Answer 12

• Ileocolic
• Jejunojejunal

However, they can occur anywhere in the gastrointestinal tract.

Question 13

At which part of the small intestine does a linear foreign body usually perforate?

Answer 13

The mesenteric border

Here, the bowel becomes tightly pleated and the mesenteric vessels create fixed points of tension. As the intestine attempts to move, this tension saws through the mesenteric edge, leading to perforation.

Question 14

When performing a thoracocentesis, should the needle be advanced into the thorax off the cranial or caudal aspect of the rib?

Answer 14

Off the cranial aspect of the rib

This avoids the intercostal vessels and nerves located (protected) caudal to each rib.

Question 15

Is a peritoneopericardial diaphragmatic hernia (PPDH) more likely to be congenital or acquired?

Answer 15

A PPDH is always congenital

Due to developmental failure of separation of pericardial and peritoneal cavities.

By contrast, a true diaphragmatic hernia is usually trauma-induced.

Question 16

Define:

Comminuted fracture

Answer 16

Fracture with ≥ two fracture lines

It can range from three-piece fractures to highly comminuted fractures with ≥ five pieces.

Question 17

Fill in the blank:

Tissue transplanted from one site to another in the same patient is called a/an ______.

Answer 17

Autograft

Tissue transplanted from one patient to another patient of the same species is an allograft, and from one species to another is a xenograft.

Question 18

When performing definitive closure of wounds, waiting until the appearance of healthy granulation tissue before closing the wound is known as:

Answer 18

Secondary closure

(or closure by second intention)

Question 19

A fracture line perpendicular to the long axis of the bone characterizes which type of fracture?

Answer 19

Transverse fracture

Question 20

Which suture material remains in the body the longest: polypropylene, polydioxanone or chromic gut?

Answer 20

Polypropylene

(which is non-absorbable)

Question 21

In addition to 2- to 3-cm margins, what other surgical recommendation is paramount when resecting a mast cell tumor?

Answer 21

Excision should include ≥ one fascial plane beyond the apparent extent of the tumor

Also: minimal manipulation of the tumor to avoid degranulation.

Question 22

Fluid accumulation, tissue damage, and bacterial contamination in a wound necessitate the use of which principle of wound management?

Answer 22

Establishment of wound drainage

Also decontamination and debridement if compromised tissues are present.

Question 23

During cervical exploratory surgery, your absent-minded colleague is about to excise four thyroid “nodules” when you step in and prevent the removal of which normal structures?

Answer 23

The parathyroid glands

Question 24

Which two surgical goals must be achieved for successful arthrodesis of a joint?

Answer 24

• Complete removal of articular cartilage
• Rigid stabilization of the joint

Question 25

A **parotid duct transposition** is used for surgical correction of **which disease**?

Answer 25

Keratoconjunctivitis sicca | (KCS)

Question 26

Other than surgical ligation, what are **two** methods for surgical correction of a **portosystemic shunt**?

Answer 26

* Ameroid constrictor * Cellophane banding * Hydraulic occluder * Intravascular coils

Question 27

In a **dog or cat**, in which direction should the hindlimb be manipulated to minimize the **risk of sciatic nerve damage** when placing an intraosseous needle in the **proximal femur**?

Answer 27

Rotate the hindlimb internally and adduct it | (this widens access to the trochanteric fossa)

Question 28

Which paired vessel can safely be **ligated** bilaterally to treat **canine** patients that have **intractable epistaxis**?

Answer 28

Common carotid arteries ## Footnote Vertebral arteries provide collateral supply to the head.

Question 29

What is the **difference** between **torsion** and **volvulus**?

Answer 29

* Torsion: twisting along the long axis of the organ * Volvulus: twisting perpendicular to the long axis of the organ (usually around the mesenteric attachment)

Question 30

Name **three** key treatments used for **initial stabilization** of a dog with gastric dilatation/volvulus (**GDV**) prior to surgery.

Answer 30

1. IV fluids 2. Oxygen supplementation 3. Gastric decompression 4. Management of any cardiac arrhythmias 5. Analgesia 6. Antimicrobials

Question 31

The following techniques are used for rectovaginal fistula repair, except: * A. Conversion to 3rd degree perineal laceration; repair * B. Laparotomy; perineal body reconstruction * C. Perineal body dissection; closure of rectal and vestibular mucosa * D. Mucosal flap in dorsal vestibular wall; suture to rectal mucosa

Answer 31

B. Laparotomy, perineal body reconstruction ## Footnote There is no indication for laparotomy during repair of this caudal reproductive tract injury. The other answer choices are all possible techniques to repair rectovaginal fistulae.

Question 32

**Suture material** with which characteristics should be used in **infected wounds**?

Answer 32

* Sterile * Monofilament * Absorbable | (to reduce risk of persistent infection) ## Footnote e.g., Polydioxanone (PDS®), Poliglecaprone 25 (Monocryl®), or Polyglyconate (Maxon®)

Question 33

# Define: Tension pneumothorax

Answer 33

Continuous entrance of air into the pleural space, which cannot exit | ("one-way valve" effect of lesion causes pneumothorax) ## Footnote Ultimately this results in lung collapse as air builds up.

Question 34

Which **synthetic absorbable suture** material retains tensile strength for the **longest** period of time? * A. Polydioxanone (PDS®) * B. Polyglycolic acid (Dexon®) * C. Silk

Answer 34

A. Polydioxanone (PDS®)

Question 35

Name the **four** stages involved in the **healing** process of a **skin graft**.

Answer 35

1. Adherence (starts within the first eight hours post-op) 2. Plasmatic imbibition (maximum about 48 to 72 hours after grafting) 3. Inosculation (revascularization) 4. Remodeling

Question 36

What are mechanisms of benefit from **bone grafting** at a fracture site?

Answer 36

* Osteogenesis * Osteoinduction * Osteoconduction

Question 37

What is the preferred surgical approach for an exploratory celiotomy in cattle? * A. Left paralumbar fossa * B. Right paralumbar fossa * C. Ventral midline * D. Right paramedian

Answer 37

B. Right paralumbar fossa ## Footnote Performed standing, the right flank provides broad access to most abdominal organs while avoiding the rumen on the left side.

Question 38

Which **suture pattern** is recommended for **skin closure** in a standing flank **rumenotomy** in cattle?

Answer 38

The Ford interlocking pattern (with nonabsorbable suture) provides strong skin edge apposition and is suitable for tough bovine hide in standing flank surgery.

Question 39

In **horses** with left laryngeal hemiplegia, the **prosthetic laryngoplasty** (“tie‑back”) surgery aims to mimic the action of **which laryngeal muscle**?

Answer 39

The cricoarytenoideus dorsalis ## Footnote It is the sole abductor of the arytenoid cartilage; the tie‑back procedure mimics its action to open the rima glottidis and restore airflow.

Question 40

What **age** should a **dog** be before performing surgery to correct **entropion**?

Answer 40

Five to six months of age | (because head is closer to more mature size)

Question 41

Why are **ocular nerve blocks** necessary for **enucleation**, even when the patient is under general anesthesia?

Answer 41

To prevent the oculocardiac reflex ## Footnote This reflex can cause severe bradycardia or cardiac arrest when the optic nerve is manipulated (during globe traction), even under anesthesia.

Question 42

A performance horse presents with exercise intolerance and a loud gurgling noise during expiration. Endoscopy confirms the soft palate displaces dorsally over the epiglottis. **What is the surgical treatment of choice?**

Answer 42

Laryngeal tie‑forward surgery ## Footnote This repositions the larynx rostrally and dorsally to prevent the soft palate from displacing and causing airway obstruction.

Question 43

Which of the following is the most appropriate **indication** for performing a **perineal urethrostomy** in a **male cat**? * A. Acute first-time urethral obstruction that resolves with catheterization * B. Recurrent urethral obstruction or obstruction that cannot be relieved by catheterization * C. Feline idiopathic cystitis without urethral involvement * D. Presence of bladder uroliths without urethral obstruction

Answer 43

B. Recurrent urethral obstruction or obstruction that cannot be relieved with catheterization ## Footnote Perineal urethrostomy is a salvage procedure, not a first-line treatment for initial or uncomplicated urinary disease.

Question 44

During a **feline perineal urethrostomy**, extend the incision proximally to which **anatomic landmark** to ensure an adequate urethral diameter?

Answer 44

The cranial extent of the bulbourethral glands (where the pelvic urethra is wider) ## Footnote Stopping too distally leaves the narrow penile urethra and predisposes to post-operative stricture.

Question 45

Which of the following factors is most critical when **selecting an appropriate suture material** for a surgical procedure? * A. Cost and color of the suture * B. Healing properties of the tissue and patient wound-healing capability * C. Surgeon’s preference * D. Length of the surgical procedure

Answer 45

B. Healing properties of the tissue and patient wound-healing capability

Question 46

What slow-to-heal tissue type requires **suture support** for the **longest duration**?

Answer 46

Tendon | (relies heavily on mechanical support from sutures for weeks to months) ## Footnote Tendons heal slowly due to limited blood supply and require prolonged suture support to maintain alignment during repair.

Question 47

# True or False: **Tissue infection** has no impact on **suture selection**.

Answer 47

FALSE ## Footnote Monofilament, absorbable, or antimicrobial-coated sutures are preferred in infected sites to reduce risk of persistent infection or suture-related complications.

Question 48

Which suture characteristic is **MOST responsible** for increased risk of bacterial wicking and infection in contaminated wounds?

Answer 48

Capillarity of braided suture ## Footnote Monofilament sutures are preferred in contaminated or infected tissues because they minimize bacterial wicking.

Question 49

What is the primary purpose of placing **subcutaneous sutures**?

Answer 49

Eliminate dead space and reduce tension on skin sutures

Question 50

Which **suture pattern** is preferred in areas of **skin tension** because it provides strength with less compromise to blood supply?

Answer 50

Vertical mattress

Question 51

What is the **Gambee suture pattern** most often used for?

Answer 51

Intestinal surgery to reduce mucosal eversion

Question 52

Which **suture pattern** is adequate and preferred for routine closure of the **urinary bladder** in most patients?

Answer 52

Single-layer appositional pattern | (using absorbable suture)

Question 53

How long does it take for **complete healing** of the urinary bladder following surgical injury?

Answer 53

The bladder regains normal tissue strength within approximately 14 to 21 days

Question 54

What are the most common **complications** associated with **urethral surgery**?

Answer 54

Urethral stricture or urinary incontinence

Question 55

What is the primary purpose of **Doyen intestinal forceps**?

Answer 55

To atraumatically occlude the intestinal lumen and prevent spillage of contents | (allowing safe resection or anastomosis) ## Footnote Their longitudinal, fenestrated design distributes pressure evenly, minimizing ischemic injury.

Question 56

**Fecal incontinence** is a risk with rectal surgery. Name **two** things that increase this **risk**.

Answer 56

* Resection of > 4 cm or the final 1.5 cm of the terminal rectum * Perineal nerve damage * Damage to > half the external anal sphincter

Question 57

What are the normal **phases** of **wound healing**?

Answer 57

Hemostasis → inflammation → proliferation → maturation (remodeling)

Question 58

During which phase of **wound healing** do **fibroblast multiplication** and **collagen** deposition primarily occur?

Answer 58

Proliferation phase | (they provide structural strength and support new tissue formation) ## Footnote This phase follows the inflammatory phase and precedes the remodeling/maturation phase in normal wound healing.

Question 59

Which **cell type **plays the MOST important role in early wound **debridement** and **bacterial control**?

Answer 59

Neutrophils

Question 60

Which of the following is currently considered the treatment of choice for **drainage of prostatic abscesse**s? * A. Marsupialization * B. Placement of multiple passive drains * C. Prostatic omentalization * D. Subtotal prostatectomy

Answer 60

Prostatic omentalization (provides continuous drainage and promotes healing of prostatic abscesses while preserving gland function) ## Footnote Marsupialization and subtotal prostatectomy carry higher morbidity and have fallen out of favor.

Question 61

Pyometra most commonly develops during which phase of the **estrous cycle** in dogs?

Answer 61

Diestrus | (when progesterone levels are high)

Question 62

How does **progesterone** contribute to the development of pyometra?

Answer 62

Promotes endometrial gland secretion, decreases endometrial immunity, and reduces myometrial activity