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small animal surgery 2006



                     JUNE/JULY 2006


                           PAPER 1

                     Perusal time: 15 minutes

           Time allowed: TWO (2) Hours after perusal

       Answer FOUR (4) from the six questions ONLY.

                 All questions are of equal value

Subsections of Questions are of equal value unless stated otherwise
Answer FOUR (4) from the six questions ONLY.

1.   Discuss the pathophysiology of septic peritonitis caused by a ruptured small
     intestine in the dog.                                       (25 marks)

2.   Describe the phases of wound healing that will occur as a 5cm diameter full
     thickness skin defect on the flank of a cat progresses from the initial injury to full
     closure of the defect by second intention healing.                  (25 marks)

3.   a.     Describe the blood supply to a normal long bone.              (7 marks)

     b.     The blood supply to a long bone can be extensively damaged if the bone is
            fractured. Describe how blood supply is re-established to the callus of a
            healing fracture.                                        (8 marks)

     c.     Describe the effects that different types of surgical implants can have on
            the re-establishment of blood supply to a healing long bone.   (10 marks)

4.   Discuss the aetiology and pathophysiology of hip dysplasia in the dog. (25 marks)

5.   The local wound environment can greatly influence the risk of a surgical wound
     infection. Describe what factors can contribute to this risk and discuss what the
     surgeon can do to minimise the risk of a wound infection developing. (25 marks)

6.   a.     Describe how a pin and tension band wire causes compression at a fracture
            site.                                                   (5 marks)

     b.     Discuss the mechanical differences between the use of a plate in
            compression, neutralisation and buttress modes.    (5 marks)

     c.     Explain how the application of a cancellous bone graft can assist fracture
            healing.                                                 (15 marks)

                                      END OF PAPER

                     JUNE/JULY 2006


                           PAPER 2

                     Perusal time: 15 minutes

           Time allowed: TWO (2) Hours after perusal

       Answer FOUR (4) from the six questions ONLY.

                 All questions are of equal value

Subsections of Questions are of equal value unless stated otherwise
Answer FOUR (4) from the six questions ONLY.

1.   A 5 year old cattle dog presents with a rapidly growing 4cm diameter subcutaneous mass
     on the lateral aspect of the stifle. Cytological examination of a fine needle aspirate of the
     mass identifies large numbers of mast cells.

     a.      Describe what pre-operative investigations you would perform. (5 marks)
     b.      Describe your surgical management of this case.               (15 marks)
     c.      Discuss the prognosis for this case.                          (5 marks)

2.   A nine year old, desexed, male Great Dane presents at your clinic with a three month
     history of inspiratory dyspnoea. The condition has worsened noticeably over the past
     month and the dog’s tolerance to exercise and high ambient temperature is poor. The
     owner has noted that the dog often coughs after drinking water.

     Clinical examination of the dog is essentially normal but there is a significant inspiratory
     stridor which is loudest in the laryngeal region.

     a.      List your differential diagnoses for this case.                   (2 marks)
     b.      Describe how you would investigate this case.                     (8 marks)
     c.      If laryngeal paralysis was diagnosed, what treatment would you recommend to the
             owner? Include a description of a surgery that you may propose and the post-
             operative care required, the prognosis, and any complications that might arise.
                                                                               15 marks)

3.   a.      Describe how you would assess viability of stomach and small intestine during an
             exploratory laparotomy.                                       (9 marks)

     b.      Discuss and describe the options for the management of an area of gastric necrosis
             that has occurred during an episode of gastric dilatation and volvulus. (8 marks)

     c.      Describe the ideal suture pattern and the desirable properties of a suture material
             for performing an end to end anastomosis in the small intestine. (8 marks)

4.   a.      Many surgeons recommend that a release of the medial meniscus be performed if
             a normal meniscus is found during a stifle arthrotomy performed in conjunction
             with a stifle stabilisation procedure for a ruptured cranial cruciate ligament.
             Discuss the advantages and disadvantages of this procedure.   (10 marks)

     b.      The stabilisation of the canine stifle after rupture of the cranial cruciate ligament is
             commonly performed using extracapsular prosthetic ligaments. This has been
             described as “a very crude method of stabilising a complex joint”. Discuss the
             limitations of this technique.                                        (15 marks)

                                         Continued over/Small Animal Surgery Paper 2/2006
Continued/Small Animal Surgery Paper 2/2006

5.    A Hansen type 1 intervertebral disc prolapse in the thoracolumbar spine can cause
      varying degrees of spinal cord injury.

      a.     Describe how you would identify the site of the prolapse and assess the
             severity of the spinal cord injury.                     (10 marks)

      b.     Discuss what criteria you would use to determine if you would recommend
             decompressive surgery and discuss the varying factors that can affect the
             prognosis for this condition.                             (15 marks)

6.    A 2 year old 30kg male Boxer presents to you for a second opinion. The dog
      sustained a comminuted fracture of the tibia that involved the middle third of the
      shaft. Six weeks ago the leg was placed in a fibreglass cast. On removal of the
      cast the leg was obviously atrophied and the fracture unstable. Radiographs show
      resorption of some of the fracture fragments, atrophy of the proximal and distal
      fragments and no callus formation. Describe your management of this case.
      Include in your answer a description of the preoperative assessment, surgical
      treatment and post operative management of the case.              (25 marks)

                                  END OF PAPER

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