Small animal abdominal surgery and diagnostics quiz

WIKIQUIZ

Questions reviewed by:

Tony Sarma BVM&S CertSAS MRCVS

1

What is the recurrence rate of intussusception post surgery? 41-50% 1-10% 11-20% 31-40% 21-30% Please select an option Incorrect. The correct answer is 11-20% of cases that go to surgery will recur within 1-5 days of surgery, as cited by the American College of Veterinary Surgeons. Link to ACVS site Incorrect. The correct answer is 11-20% of cases that go to surgery will recur within 1-5 days of surgery, as cited by the American College of Veterinary Surgeons. Link to ACVS site Correct! 11-20% of cases that go to surgery will recur within 1-5 days of surgery, as cited by the American College of Veterinary Surgeons. Link to ACVS site Incorrect. The correct answer is 11-20% of cases that go to surgery will recur within 1-5 days of surgery, as cited by the American College of Veterinary Surgeons. Link to ACVS site Incorrect. The correct answer is 11-20% of cases that go to surgery will recur within 1-5 days of surgery, as cited by the American College of Veterinary Surgeons. Link to ACVS site

2

In relation to positional changes of the intestine, what is a torsion? Telescoping or invagination of one section of intestine into the lumen of an adjacent section of intestine. A twisting of the intestine around its longitudinal axis. A state of intestinal stasis Displacement of intestine through a defect in the wall of the abdominal cavity. A twisting of the intestines causing obstruction of blood flow. Please select an option Incorrect. This is an intussusception, which is defined as telescoping of one section of intestine into the lumen of an adjacent section. The part of the intestine which passes into the lumen of the next section is referred to as the intussusceptum; the intestine into which the intussusceptum enters (and often becomes stuck) is known as the intussuscipiens. Intussusception occurs in all species particularly in young dogs and can involve the small intestine, caecum or colon. Intestinal torsion is a twisting of the intestine around its longitudinal axis. This is most common in the colon of the pig and the horse. Some people use the term intestinal torsion to refer to twists around the root of the mesentery; strictly, this is in fact mesenteric torsion which may lead to intestinal volvulus. Necrosis of the affected gut may follow. When assessing viability of gut, it is important to remember that the mucosa is more sensitive to ischaemic damage than the serosa, so at surgery, it is possible to look at the intestines and assume that they are ok when in fact the mucosa has sustained significant damage, and may not be viable. As a rule of thumb, if in doubt about viability, it is safer to remove intestine (as long as you don't remove too much to allow the remainder to function!!!) WikiVet Article: Positional changes. Correct! This is most common in the colon of the pig and the horse. Some people use the term intestinal torsion to refer to twists around the root of the mesentery; strictly, this is in fact mesenteric torsion which may lead to intestinal volvulus. When assessing viability of gut, it is important to remember that the mucosa is more sensitive to ischaemic damage than the serosa, so at surgery, it is possible to look at the intestines and assume that they are ok when in fact the mucosa has sustained significant damage, and may not be viable. As a rule of thumb, if in doubt about viability, it is safer to remove intestine (as long as you don't remove too much to allow the remainder to function!!!) WikiVet Article: Positional changes. Incorrect. This is ileus, which is described as a state of intestinal stasis. The intestine is usually flaccid or distended with gas; ileus is most commonly seen in horses and rabbits. Intestinal torsion is a twisting of the intestine around its longitudinal axis. This is most common in the colon of the pig and the horse. Some people use the term intestinal torsion to refer to twists around the root of the mesentery; strictly, this is in fact mesenteric torsion which may lead to intestinal volvulus. Necrosis of the affected gut may follow. When assessing viability of gut, it is important to remember that the mucosa is more sensitive to ischaemic damage than the serosa, so at surgery, it is possible to look at the intestines and assume that they are ok when in fact the mucosa has sustained significant damage, and may not be viable. As a rule of thumb, if in doubt about viability, it is safer to remove intestine (as long as you don't remove too much to allow the remainder to function!!!) WikiVet Article: Positional changes. Incorrect. This is a hernia, which is the displacement of intestine through a defect in the wall of the abdominal cavity; technically, in a true hernia, the defect through which the intestine passes is a normal opening in the abdominal cavity (e.g. umbilical hernias in young animals), whereas a rupture is where the normal body wall has been disrupted (e.g. diaphragmatic rupture; technically, the common perineal hernia should be referred to as perineal rupture). Intestine may become trapped in the abdominal wall defect, and if blood flow becomes disrupted, this is referred to as strangulation. Intestinal torsion is a twisting of the intestine around its longitudinal axis. This is most common in the colon of the pig and the horse. Some people use the term intestinal torsion to refer to twists around the root of the mesentery; strictly, this is in fact mesenteric torsion which may lead to intestinal volvulus. Necrosis of the affected gut may follow. When assessing viability of gut, it is important to remember that the mucosa is more sensitive to ischaemic damage than the serosa, so at surgery, it is possible to look at the intestines and assume that they are ok when in fact the mucosa has sustained significant damage, and may not be viable. As a rule of thumb, if in doubt about viability, it is safer to remove intestine (as long as you don't remove too much to allow the remainder to function!!!) WikiVet Article: Positional changes. Incorrect. This is volvulus. Volvulus is defined as a twisting of a viscus causing obstruction of blood flow. This generally occurs in the stomach (as in GDV) or small intestine, and leads to an intense, almost black, congestion as a result of haemostasis. Necrosis of the affected gut may follow. Intestinal torsion is a twisting of the intestine around its longitudinal axis. This is most common in the colon of the pig and the horse. Some people use the term intestinal torsion to refer to twists around the root of the mesentery; strictly, this is in fact mesenteric torsion which may lead to intestinal volvulus. When assessing viability of gut, it is important to remember that the mucosa is more sensitive to ischaemic damage than the serosa, so at surgery, it is possible to look at the intestines and assume that they are ok when in fact the mucosa has sustained significant damage, and may not be viable. As a rule of thumb, if in doubt about viability, it is safer to remove intestine (as long as you don't remove too much to allow the remainder to function!!!) WikiVet Article: Positional changes.

3

Which is the best diagnostic technique for definitively diagnosing an oesophageal stricture? Fluoroscopy Barium contrast radiography Ultrasonography Survey radiographs of the thorax Oesophagoscopy Please select an option Incorrect. Fluoroscopy may be unremarkable in animals with benign oesophageal strictures. Oesophagoscopy should be used to provide a definitive diagnosis, confirming the site and severity of a stricture and also to exclude the presence of an intraluminal mass. WikiVet Article: oesophageal stricture. Incorrect. Although barium contrast radiography is normally diagnostic of the disorder, demonstrating narrowing of the oesophagus, it may not exclude intraluminal masses. Oesophagoscopy is required for definitive diagnosis. It should be used to confirm the site and severity of the stricture and also to exclude the presence of an intraluminal mass. WikiVet Article: oesophageal stricture. Incorrect. Although ultrasonography may visualise a stricture caused by extramural mass compression, it is not usually useful in diagnosing small benign strictures. Oesophagoscopy should be used to provide a definitive diagnosis, confirming the site and severity of a stricture and also to exclude the presence of an intraluminal mass. WikiVet Article: oesophageal stricture. Incorrect. Survey radiographs are usually unremarkable in animals with benign oesophageal strictures. Oesophagoscopy should be used to confirm the site and severity of a stricture and also to exclude the presence of an intraluminal mass. WikiVet Article: oesophageal stricture. Correct! Oesophagoscopy should be used to confirm the site and severity of a stricture and also to exclude the presence of an intraluminal mass. WikiVet Article: oesophageal stricture.

4

What are the two most important first line emergency treatments for gastric dilatation and volvulus? Lidocaine (for cardiac arrhythmias) and gastric decompression. Administration of a pure opioid drug and broad spectrum antibiotics. Fluid therapy and gastric decompression Administration of Lidocaine (for cardiac arrythmias) and fluid therapy. Administration of a pure opioid and non-steroidal anti-inflammatory drug. Please select an option Incorrect. The administration of lidocaine is not considered a first line emergency treatment. It may be required to once the dog is stabilized in order to treat a cardiac arrhythmia. The two most important first line emergency treatments are gastric decompression and fluid therapy. Gastric decompression is essential as gastric dilatation can cause caudal vena cava obstruction and impair venous return to the heart. Fluid therapy should be administered in shock doses in order to treat the hypovolaemic shock. Incorrect. Although these drugs may be required once the animal is more stable, they are not considered a part of the first line emergency treatment. Pure opioids such as morphine can be given to provide analgesia. Broad spectrum antibiotics should be given at surgical induction due to the possibility of endotoxaemia and bacterial translocation at surgery. The two most important first line emergency treatments are gastric decompression and fluid therapy. Gastric decompression is essential as gastric dilatation can cause caudal vena cava obstruction and impair venous return to the heart. Fluid therapy should be administered in shock doses in order to treat the hypovolaemic shock. Correct! Fluid therapy and gastric decompression will stabilize the animal. Gastric decompression must be carried out as soon as possible as gastric dilatation can cause caudal vena cava obstruction and impair venous return to the heart. The gastric wall can also become devitalised. Fluid therapy should be administered in shock doses in order to treat the hypovolaemic shock. Incorrect. Although fluid therapy is regarded as one of the first line emergency treatments to treat hypovolaemic shock, lidocaine is not. Lidocaine may be administered once the animal is stabilize in order to treat a cardiac arrhythmia. The two most important first line emergency treatments are gastric decompression and fluid therapy. Gastric decompression is essential as gastric dilatation can cause caudal vena caval obstruction and impair venous return to the heart. Fluid therapy should be administered in shock doses in order to treat the hypovolaemic shock. Incorrect. Pure opioids may be administered to provide analgesia once the animal has been stabilised by gastric decompression and fluid therapy. Non-steroidal anti-inflammatory drugs should be avoided due to their adverse effects on the gastric mucosa. The two most important first line emergency treatments are gastric decompression and fluid therapy. Gastric decompression is essential as gastric dilatation can cause caudal vena caval obstruction and impair venous return to the heart. Fluid therapy should be administered in shock doses in order to treat the hypovolaemic shock.

5

Which is the best diagnostic technique for definitively diagnosing chronic gastritis? Gastroscopy alone Haematology and biochemistry Contrast abdominal radiography Plain abdominal radiography Biopsy of the stomach Please select an option Incorrect. Varying degrees of hyperaemia, hypertrophy and haemorrhage due to chronic gastritis may be evident. However, if no endoscopic lesions are visualised, chronic gastritis cannot be ruled out. Biopsy of the stomach followed by histological examination should always be performed and is mandatory for definitive diagnosis. Biopsies may be taken via endoscopy as this is less invasive than via surgery, but may provide less detail of the deeper tissue layers than full-thickness surgical biopsy, e.g. in gastric tumours. For chronic gastritis, endoscopic biopsy is sufficient. WikiVet Article: chronic gastritis Incorrect. Haematology and biochemistry may reveal possible effects of chronic gastritis such as anaemia due to chronic blood loss, however, the findings are not diagnostic. Biopsy of the stomach followed by histological examination should always be performed and is mandatory for definitive diagnosis. Biopsies may be taken via endoscopy as this is less invasive than via surgery, but may provide less detail of the deeper tissue layers than full-thickness surgical biopsy, e.g. in gastric tumours. For chronic gastritis, endoscopic biopsy is sufficient. WikiVet Article: chronic gastritis Incorrect. Contrast abdominal radiography may reveal thickening or irregularity of the gastric rugae but does not provide a definitive diagnosis. Biopsy of the stomach followed by histological examination should always be performed and is mandatory for definitive diagnosis. Biopsies may be taken via endoscopy as this is less invasive than via surgery, but may provide less detail of the deeper tissue layers than full-thickness surgical biopsy, e.g. in gastric tumours. For chronic gastritis, endoscopic biopsy is sufficient. WikiVet Article: chronic gastritis Incorrect. Plain abdominal radiography is usually unremarkable. Biopsy of the stomach followed by histological examination should always be performed and is mandatory for definitive diagnosis. Biopsies may be taken via endoscopy as this is less invasive than via surgery, but may provide less detail of the deeper tissue layers than full-thickness surgical biopsy, e.g. in gastric tumours. For chronic gastritis, endoscopic biopsy is sufficient. WikiVet Article: chronic gastritis Correct! Biopsy of the stomach followed by histological examination should always be performed and is mandatory for definitive diagnosis. Biopsies may be taken via endoscopy as this is less invasive than via surgery, but may provide less detail of the deeper tissue layers than full-thickness surgical biopsy, e.g. in gastric tumours. For chronic gastritis, endoscopic biopsy is sufficient. WikiVet Article: chronic gastritis.

6

Which breed of dog has been associated with a congenital form of oesophageal fistulas? Labradors German Shepherd Dogs Collie Cairn Terrier Miniature Schnauzers Please select an option Incorrect. It is reported that Cairn Terriers suffer from a congenital form of oesophageal fistulas. WikiVet Article: oesophageal fistulas. Incorrect. It is reported that Cairn Terriers suffer from a congenital form of oesophageal fistulas. WikiVet Article: oesophageal fistulas. Incorrect. It is reported that Cairn Terriers suffer from a congenital form of oesophageal fistulas. WikiVet Article: oesophageal fistulas. Correct! It is reported that Cairn Terriers suffer from a congenital form of oesophageal fistulas. WikiVet Article: oesophageal fistulas. Incorrect. It is reported that Cairn Terriers suffer from a congenital form of oesophageal fistulas. WikiVet Article: oesophageal fistulas.

7

What is the most common signalment for perineal hernias? Castrated cats Castrated dogs Young entire male dogs Older entire male dogs Older entire male cats Please select an option Incorrect. Perineal hernias occur less frequently in bitches. 93% of perineal hernias occur in intact dogs. The median age is 10 years old and breeds with short tails are predisposed. Incorrect, perineal hernias occur less frequently in neutered dogs. 93% of perineal hernias occur in intact dogs. The median age is 10 years old and breeds with short tails are predisposed. Incorrect. The median age is 10 years old and breeds with short tails are predisposed. 93% of perineal hernias occur in intact dogs. Correct! 93% of perineal hernias occur in intact dogs. The median age is 10 years old and breeds with short tails are predisposed. Incorrect. Perineal hernias are rare in cats. 93% of perineal hernias occur in intact dogs. The median age is 10 years old and breeds with short tails are predisposed.

8

What are the 3 most common sites for oesophageal foreign bodies? Thoracic inlet; Cervical oesophagus; Immediately in front of the diaphragm Thoracic inlet; Base of the heart; Immediately in front of the diaphragm Base of the heart; Cervical oesophagus; Immediately in front of the diaphragm Thoracic inlet; Base of the heart; Cervical oesophagus Base of the heart; Thoracic inlet; Immediately caudal to the larynx Please select an option Incorrect. The cervical oesophagus is not a common site of oesophageal obstruction. The three most common sites of oesophageal obstruction are the thoracic inlet; base of the heart; immediately in front of the diaphragm. Correct! The three most common sites of oesophageal obstruction are the thoracic inlet; base of the heart; immediately in front of the diaphragm. Incorrect. The cervical oesophagus is not a common site of oesophageal obstruction. The three most common sites of oesophageal obstruction are the thoracic inlet; base of the heart; immediately in front of the diaphragm. Incorrect. The cervical oesophagus is not a common site of oesophageal obstruction. The three most common sites of oesophageal obstruction are the thoracic inlet; base of the heart; immediately in front of the diaphragm. Incorrect. Immediately caudal to the larynx is not a common site of oesophageal obstruction. The three most common sites of oesophageal obstruction are the thoracic inlet; base of the heart; immediately in front of the diaphragm.

9

What are the two types of acquired oesophageal diverticula? Traction; Sliding Traction; Para-oesophageal Sliding; Para-oesophageal Traction; Pulsion Pulsion; Sliding Please select an option Incorrect. Sliding refers to one of the types of hiatal hernias. The correct answers are traction and pulsion. Traction forms consist of all the oesophageal layers. These result from peri-oesophageal inflammation and fibrosis, and develop mainly in the cranial and mid-oesophageal body. Sacculations are created by adhesions to adjacent tissues. Pulsion forms include the epithelium and connective tissue, and have many possible causes. Incorrect. Para-oesophageal refers to one of the types of hiatal hernias. The correct answers are traction and pulsion. Traction forms consist of all the oesophageal layers. These result from peri-oesophageal inflammation and fibrosis, and develop mainly in the cranial and mid-oesophageal body. Sacculations are created by adhesions to adjacent tissues. Pulsion forms include the epithelium and connective tissue, and have many possible causes. Incorrect. These two forms refer to hiatal hernias. The correct answers are traction and pulsion. Traction forms consist of all the oesophageal layers. These result from peri-oesophageal inflammation and fibrosis, and develop mainly in the cranial and mid-oesophageal body. Sacculations are created by adhesions to adjacent tissues. Pulsion forms include the epithelium and connective tissue, and have many possible causes. Correct! Traction forms consists of all the oesophageal layers and results from peri-oesophageal inflammation and fibrosis and develop mainly in the cranial and mid-oesophageal body. Sacculations are created by adhesions to adjacent tissues. Pulsion forms includes the epithelium and connective tissue and have many causes. Incorrect. Sliding refers to one of the types of hiatal hernias. The correct answers are traction and pulsion. Traction forms consist of all the oesophageal layers. These result from peri-oesophageal inflammation and fibrosis, and develop mainly in the cranial and mid-oesophageal body. Sacculations are created by adhesions to adjacent tissues. Pulsion forms include the epithelium and connective tissue, and have many possible causes.