2024 VTNE Critical Care Exam 1

2024 VTNE Critical Care Exam 1 Latest Questions With Complete Grade A Answers

• Pre-renal azotemia is most commonly caused by which of the following?

Chronic renal failure Dehydration Urethral obstruction Acute renal failure Pyelonephritis

Answer: Dehydration

Dehydration is the most common cause of pre-renal azotemia. Azotemia is the term for elevated renal values (BUN and creatinine). When a patient is dehydrated, renal values may be elevated. When re-hydration occurs, renal values should return to normal.

Renal failure (acute or chronic) causes primary renal azotemia.

Post-renal azotemia is most often caused by obstruction either in the bladder or urethra, which prevents urine from being voided.

• You are working in the large animal ward at the hospital. You are receiving a

horse that needs immediate treatment for dehydration. The vet asks you to calculate the fluid deficit for this horse. He is a 950-pound horse that is about 7% dehydrated.What is his fluid deficit?

63 L 15 L

• L

30 L

Answer: 30 L

You can estimate the fluid deficit by the following formula:

Body weight in kg X % dehydration = Liters needed to re-establish hydration So for

this horse: 1 / 4

950 pounds/2.2 pounds per kilogram (pounds cancel out) = 431.8 kg (will round up to 432kg)

Now, multiply by percent dehydrated: 432 kg X 0.07 (which is 7%) = 30 Liters

• A client calls to schedule an appointment and tells you his male cat is straining to

urinate in his litter box but no urine is seen in the box. He wants to know if it would be okay to give him some leftover Clavamox from when he had a skin infection last month. What should you tell him?Bring the cat in immediately for an exam

Have him pick up some non-absorbable litter from the clinic so that he may collect a urine sample at home when the cat finally urinates

Give 1/2 teaspoon of cod liver oil because although it appears he is straining to urinate, he is likely constipated

Tell him to give the leftover Clavamox he has in his cabinet and come in first thing tomorrow morning so the doctor can collect a urine sample

Orally syringe water to keep him hydrated and schedule an appointment for tomorrow morning since there are no open appointments today

Answer: Bring the cat in immediately for an exam

A male cat straining to urinate is always an emergency. If the cat has a urethral obstruction, this can be immediately life-threatening. The cat needs to be examined so that the doctor can assess the cat and palpate his bladder.

• Performing an abdominocentesis involves which of the following?

Withdrawing fluid from the abdomen Removing an organ from the abdomen Obtaining a urine sample from the abdomen Making an incision into the abdomen

Answer: Withdrawing fluid from the abdomen

"Centesis" is the act of puncturing a body cavity or hollow organ in order to remove fluid; therefore, abdominocentesis implies the removal of fluid from the abdominal cavity. Similarly thoracocentesis would be removal of fluid from the chest cavity. A cystocentesis describes the removal of fluid from the urinary bladder. Terms that 2 / 4

involve the removal of an organ usually end with "-ectomy". Examples of terms would include splenectomy, nephrectomy, and lung lobectomy.

• A large canine patient that has been in the hospital developed a decubital ulcer.

What is likely causing this?

Improper nutrition Kidney function is declining Pressure from laying in one position for too long MRSA infection

Answer: Pressure from laying in one position for too long

A decubital ulcer is the proper term for a pressure sore. This is more common in patients that are not ambulatory and lay in the same position for too long; this is why patients must be turned and moved regularly.

• A Dachshund presents for back problems and the dog is ambulatory but very

unsteady in both hindlimbs. The doctor suspects an intervertebral disk protrusion that

is affecting the spinal cord. Regarding the gait, this dog has:

Vestibular syndrome Paralysis Hypermetria Plegia Paresis

Answer: Paresis

Paresis is partial loss or impaired movement; this is when motor is still present. A dog with paresis of both hindlimbs would have "paraparesis".

Paralysis and plegia are terms used to describe lack of any voluntary motor.Hypermetria is an exaggerated gait caused by cerebellar disease.Pets with vestibular syndrome often have an abnormal gait and will veer toward one side or the other and have difficulty standing, but this is not a lack of motor.

• A 12-year old flat coated retriever presents early for an appointment with a 24-

hour history of lethargy. The patient is alert and responsive, has very strong pulses, and a heart rate of 160 beats per minute. The veterinarian has just begun a new pet appointment with a long-term client. This patient should be: 3 / 4

Brought into the treatment area and be immediately examined by the veterinarian.Started on IV fluids immediately, prior to the veterinarian's examination Allowed to stay in the lobby until the patient's appointment time Transferred to the local emergency clinic immediately Brought into the treatment area and monitored until the veterinarian is finished with the current appointment

Answer: Brought into the treatment area and be immediately examined by the

veterinarian.

This patient is most likely in compensatory shock and should be examined by a veterinarian immediately. A heart rate of 160 is well over the normal range for a large dog and very strong pulses are often bounding pulses indicating hypovolemia.Sending this patient to another clinic will delay treatment, and that decision should be left to the attending veterinarian. Intravenous fluids may or may not be indicated depending on the dog's diagnosis, and the decision to administer them should also be left up to the veterinarian.

• You have a bottle of 50% Dextrose. You are asked to add it to a bag of LRS for a

pet in diabetic ketoacidosis to create a 2.5% solution. The pet has 800 mL left in his bag. How much will you add to his bag?

60 mL 40 mL 20 mL 25 mL 80 mL

Answer: 40 mL

800 mL X 0.025 = 20 mL. If this were 100% dextrose, adding 20 mL to the bag would create the 2.5% concentration. Since it is 50% dextrose, this number must be

doubled: So, 20 mL X 2 = 40 mL

Draw out 40 mL from the bag (now there are 760 mL left in the bag). Add in 40 mL of

50% Dextrose. Now, 2.5% of the total 800 mL is Dextrose. Double check the math:

40 mL/ 800mL = 0.05 (i.e. 5%) divided by 2 {because it was 50% dextrose that was added) = 0.025 = 2.5%.

• You are working in the emergency clinic and are assisting with treating a dog

that has been hit by a car. You are asked to set up for a blood transfusion, and the doctor would like you to give whole blood. A whole blood transfusion would include which of the following components?

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