When inducing anesthesia using the injection combination of ketamine-diazepam or ketamine-midazolam, what rate of administration is appropriate?
Correct Answer: D
Ketamine and diazepam are commonly mixed for intravenous anesthetic induction in dogs, cats, and horses. Usually, this drug mixture is pushed relatively rapidly over about 1-2 minutes; pushing too quickly can lead to a rough induction. Generally speaking, anesthetics are never pushed IV rapidly but are given slowly over a period of time to determine the effect. Often the total amount drawn up is not necessary. Ketamine and diazepam doses are calculated to be what the patient needs to induce anesthesia given the premedications used, the patient's temperament, the patient's body weight, and any underlying health conditions. Thus, unlike propofol or Alfaxalone, this drug combination is not usually just given to effect. Propofol and Alfaxalone are commonly given to effect. One calculates 1/4th of the total dose and administers that every 30 seconds for propofol and every 15 seconds for Alfaxalone to effect. If the patient is already anesthetized sufficiently to allow intubation, administration of the drug past that point is not necessary.
Question 72
Which medication is most often used in a circumferential ring block in combination with lidocaine?
Correct Answer: D
Bupivacaine is most often used in circumferential ring blocks along with lidocaine. Lidocaine has a rapid onset, but short duration, while bupivacaine has a longer onset with a long duration, so they complement each other. They are typically mixed in the same syringe prior to injection. Tetracaine and benzocaine are local anesthetics limited to topical use. Epinephrine can be purchased in the same vial as lidocaine, but this formulation can increase the risk of complications and should not be used routinely.
Question 73
What is the name of the structure that contains a tooth's blood vessels and nerves?
Correct Answer: C
The pulp is the tooth's center and contains blood vessels, nerves, and connective tissues. Enamel is the surface layer of a tooth's crown. The gingival sulcus is the space between the gingival tissue and the tooth, typically located at the free gingival margin and cementoenamel junction. The crown is the visible portion of the tooth above the gumline.
Question 74
When evaluating the head, face, and neck before a dental procedure, you assess the patient for all of the following, except:
Correct Answer: B
When evaluating the head, neck, and face of a pet prior to a dental procedure, you are assessing the muscles of the jaw and face for changes in muscle tone; note the presence of atrophy, the presence of pain on palpation, and any asymmetry, swelling, or discharge. Sometimes the asymmetry is subtle and may not be appreciated until you open the pet's mouth. Assess non-oral related muscles and structures and assess for any additional swelling, masses, or other abnormalities. While assessing cranial nerves is never wrong and may help identify any asymmetry present with atrophy, it doesn't directly pertain to a pre-dental evaluation.
Question 75
You will be going on a farm call with your veterinarian for a group of sheep you will need to evaluate, vaccinate, and deworm. The farmer doesn't have a chute system, and manual restraint will be required. All of the following are critical when considering restraint/movement of this species, except:
Correct Answer: D
Sheep can be flighty and may not always be amenable to restraint. Without a chute system, you have to manually hold/touch the sheep to be able to deliver vaccines and other care and permit the veterinarian to complete the physical exam. You want to use minimal restraint whenever possible. The more restraint you use, the more the animal will resist. You always want to keep them calm and to do so, stay just on the edge of the flight zone. Do not enter it too deeply or quickly. Since prey species instinctively move away from a threat, you need to be aware of their flight zone. This is the spatial distance an animal maintains between itself and a perceived danger before initiating movement. However, you do not want to enter the flight zone to get them to move where you want. Instead, approach its edge calmly, slowly, and deliberately. If you enter the flight zone, chances are high they will bolt. You want them to see you, but not as a threat. Using an animal's strong flocking instincts, like in sheep, camelids, and goats, can come in handy. You can often move an entire group of animals from a larger space to a smaller one by taking advantage of this instinct. This can be done using animals, such as a lead llama or alpaca or herding dogs, or with slow, calm movements directing them in a specific direction. If you want to get the animal(s) to move, prevent shadows, dead ends, or sharp corners (and people) from being directly in front of them. Ideally, have at least one sheep with you along with the animal being evaluated, as sheep are often calmer in pairs/groups.
