What does the minimum inhibitory concentration (MIC) refer to when discussing antimicrobial susceptibility testing?
Correct Answer: A
For each antibiotic and each organism, there exists a breakpoint. This breakpoint is a number that either describes the MIC or the diameter of the zone of inhibition. This zone of inhibition is created by measuring the diameter of the area inhibited by the antibiotic on antibiotic colony growing disks. The MIC refers to the actual concentration at which bacterial growth will not occur. They both represent a value at which an organism is susceptible to or resistant to a specific antimicrobial. The serial dilution of a bacterial isolate growing in broth describes how the Kirby-Bauer Disk Diffusion susceptibility test is achieved to determine the MIC of certain antibiotics for a specific bacterium. Fastidious organisms are those that need particular growing conditions and nutrients to grow. Often, these organisms are difficult to culture and require the use of incubators and carbon dioxide gas to help increase the proliferative ability of the bacteria in the media.
Question 202
If a veterinarian was performing a routine dissection of fibrous tissue (for example, the linea alba), which type of scissors would most likely be used?
Correct Answer: C
Mayo scissors are most often used for routine dissections. Mayo scissors are heavy-duty scissors, used to cut fascia tissue and other dense tissues. Metzenbaum scissors are used for delicate dissections, such as cutting through thin muscle and fat tissue. Iris scissors are used for fine detailed ophthalmic work. Lister scissors are used for cutting bandages.
Question 203
When providing pressure-assisted ventilation in a small animal patient, your manometer should not exceed what pressure?
Correct Answer: D
When providing assisted ventilation, a pressure monometer helps guide you to ensure you do not overinflate the lungs. The gauge reflects the amount of pressure being applied to the patient's lungs and airways. They can measure pressure in millimeters of mercury or centimeters of water. When a patient is breathing independently, the pressure should remain at zero (0 to 2 cm H2O). The manometer is usually calibrated from - 20 to + 50 cm of H2O. The pressure is affected by oxygen flow and any pop-off valve adjustments. The maximum reading of the manometer should never go above 20 cm H2O in a small animal (15 to 20 cm H2O, the acceptable range) and never above 40 cm of H2O in a large animal patient.
Question 204
Which of the following pain medications is a non-steroidal anti-inflammatory drug (NSAID)?
Correct Answer: A
Meloxicam belongs to the non-steroidal anti-inflammatory drug class. Other drugs include carprofen, robenacoxib, grapriprant, firocoxib, phenylbutazone, flunixin meglumine, and diclofenac sodium. Butorphanol is commonly used for sedation in combination with other drugs. It is a partial mu agonist opioid with weak pain management properties. Nocita (active ingredient, bupivacaine) is a long-acting local anesthetic. It provides 72 hours of relief. It is injected intra-operatively and requires training before one is qualified to administer it. Gabapentin is an anticonvulsant that is rather ineffective for seizure control as a sole agent. However, it is beneficial for neuropathic pain, wind-up (central sensitization), and chronic pain, and is found commonly as part of multimodal pain therapy in small animal medicine.
Question 205
A preanesthetic patient assessment includes many factors. It starts with admitting the patient into the hospital. Owners need to be properly prepared for what is to come. This includes financial expectations, wishes in the case of adverse events, and post-op plans. Failing to present this information to your owners upfront, the staff and hospital fail to provide what to their client?
Correct Answer: D
Informed consent allows pet parents to understand what will occur with their pet and any potential risks of diagnostics, anesthesia, or surgical procedures. Additionally, providing an estimate upfront permits owners to be prepared for the financial aspect prior to picking up the pet and prepare accordingly. Another key component of informed consent involves limiting legal liability. By providing your clients with upfront information about cost, procedural, anesthetic, and other risks, recovery, and more, you are doing your due diligence and keeping with the standard of veterinary care. However, informed consent doesn't stop when the patient enters the building; it continues through to treatment and includes discharge. Providing discharge instructions both verbally and in writing and having owners sign a copy you keep at the hospital ensures that all parties are on the same page regarding findings on diagnostics, surgical procedures, and on post-op care, restrictions, and recheck evaluation recommendations. Explicit consent is a form of consent related to personal information data collection and providing permission for this type of collection. Implied consent, sadly, is what many people assume. The act of participating in an event or dropping a pet off for a procedure suggests implied consent. However, unless they sign a document discussing what will/may be done while the pet is under your care, including financial authorization and other forms, then it was not informed consent. We can not assume the client understands what we have verbally discussed with them and if it wasn't in writing, there is no legal standing to demonstrate the owner knew what was going to happen and the risks. Active consent is similar to explicit consent and is more of a verbal acknowledgment. However, it is not considered sufficient in veterinary medicine.
