193.122 Past Exam 2017 PDF

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This is the exam paper for the year 2017 which I used to practice for my final exam in 2018. I have written my answers on the paper for study purposes....

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1702/193.122 MTU Internal

CP1 2HR

MASSEY UNIVERSITY MANAWATU CAMPUS EXAMINATION FOR 193.122 PRINCIPLES AND PRACTICE OF VETERINARY NURSING Semester Two 2017 Time allowed: TWO (2) hours. Answer EACH in a SEPARATE blue answer book. SECTION A: ALL FIFTEEN (15) questions are COMPULSORY. The value of each question in SECTION A is indicated. Total: ONE HUNDRED (100) marks. SECTION B: ALL FOUR (4) questions are COMPULSORY. The value of each question in SECTION B is indicated. Total: TWENTY (20) marks. TOTAL: ONE HUNDRED AND TWENTY (120) MARKS. Non-programmable calculators only are permitted. Students are NOT permitted to remove question papers from the exam room The exam paper will be made available on the Massey University Library website

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SECTION A ALL questions are COMPULSORY. Start this section in a NEW BLUE ANSWER BOOK.

A1.

What is the correct medical term for the following: a) b) c) d) e) f) g) h)

A2.

State of fast breathing.Tachypnoea Enlarged or dilated oesophagus Mega-oesophagus Straining to defecate. Tenesmus (straining to urinate = stanuria An extremely short onset, within hours Per-acute (acute is within days) An irregular heart rate. Arrhythmia Procedure of looking into a joint with a camera. Arthroscopy Sterile removal of fluid from the abdomen. Abdominocentesis (from thorax = thoracocentesis Lack of Red blood cells Anemia (4 marks)

Define the following terms: a) b) c) d) e) f) g) h) i) j)

Haematuria Blood in the urine Uroabdomen Urine in the abdomen Bradycardia Decreased or slower than normal heart rate Dyspnoeic Having difficulty breathing Laryngitis Inflammation of the larynx (back of the throat Abduction of a limb Movement of the limb away from the midline of the body (outwards Polyphagia Increased eating/appetite Disinfection Destruction or inhibition of pathogenic organisms, reducing to a safe level (sterilising = fully removing Flexion Movement of a joint to bring the distal bone closer to the body, decreasing the angle of the joi Pyrexia Fever, increased temperature (5 marks)

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Complete the following table on commonly-used blood tubes Anticoagulant Plain

Colour code a) Red

b) EDTA Heparin Oxalate f) Citrate

Purple green e)Grey Blue

Purpose Biochemistry, serology, drugs hormones c) Complete blood counts (CBC) d) Avian blood sampling, some biochemistry Glucose Coagulation profile (3 marks)

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A4.

List THREE (3) ways to collect a urine sample from a cat, and state whether each is a sterile or non-sterile sample. (3 marks) Free catch /voided sample= non-sterile sample (pink pottle) Urinary Catheterisation = non-sterile (pink pottle) Cystocentesis = sterile sample, sterile needle into bladder to collect urine, can send to lab to do a culture (yellow pottl

A5.

List FOUR (4) reasons why disinfection procedures can fail to be effective. (4 marks)

The disinfectant was diluted too much Inadequate contact time of the disinfectant Not enough physical cleaning was done prior to disinfection Poor coverage Expired product Inadequate temperature or mixing of product Persence of organic material

A6. Calculate the Resting Energy Rate (RER) for a 15kg dog? (Include working) (2 marks) RER = BW^0.75 x 293 15^0.75 x 293 = 2233.24 KJ/day

A7.

You receive a phone call from a client who is thinking of purchasing an 8-week-old female Border Collie and she would like to know what general health care the puppy requires for its first 12 months. The client would also like any specific information (such as temperament, exercise requirements) that you would have on the breed that she is thinking of purchasing.

Discuss what you would tell the client about general health care. You must include information on nutrition, preventative medicine, exercise, transportation, grooming and any other pertinent information. Nutrition = high energy diet if this dog will be a working dog, puppy food (10 marks) Preventative medicine = de-fleaing every 6 weeks depending on the product, de-worming every 2 weeks until 12 weeks old then every 3 months, vaccines such as DHPP distemper/hepaitis/parainfluenza/parvovirus, Leptoguard for leptospirosis, Nobivac for kennel cough, cleaning carpet, vacuum, wash bedding, regularly groom, dental care such as soft chews for puppies, no bones, desensitise to tooth brushing, annual checkup De-sexing = should be done at 6 months of age if you are planning to do this, make sure that animal is healthy if ths will be done earlier than 6 months old Exercise = high energy breed due to being bred as sheep dogs, dog will need a lot of exercise and room to do this (apartment not appropriate), aviod big long runs as bones are still developing, short frequent walks good, need mental stimulation to prevent boredom and undesirable behaviours, needs 1-2 walks a day when mature Transportation = harness or dog seatbelt which is attached to the seatbelt to keep the dog safe and keep him from distracting the driver, can transport in a crate, desensitise the puppy to the car (socialisation period) Grooming = medium to long hair so can be predisposed to matting, prone to shedding, brush at least 2-3 times a week but ideally daily

A8. While working in an equine clinic a client calls you to ask about vaccinating their horses. a)

Name the TWO (2) diseases we vaccinate for in New Zealand. (2 marks) Strangles and Tetanus

b)

While vaccinating the horse you notice it has a skin condition, name three possible causes of this skin condition? (3 marks)

Skin allergy, inadequate nutrition, ringworm, lice, infection, rain scald due to excessive exposure to rain, mud fever due to excessive exposure to muddy groun

A9.

You have collected a urine sample from a dog via urinary catheterisation. List the diagnostic tests you typically run during a urinalysis and state whether this sample is sterile or not. (3 marks)

Look at the sample and assess colour and turbidity (amber and clear), should smell like normal urine. Dipstick to check for blodd, glocose, and other abnormal parameters. USG by dropping urine onto refractometer. Sediment exam to assess for cells, crystals, and microorganisms.

This is a non-sterile sample as there could be contamination from the catherter, outside of the vagina as the catheter went in, inner walls of the vagina as the catheter went in, or peoples hands on the catheter preinsertion. A culture can not be run with this urinary sample. The diagnostic tests that can be run include USG, dipstick and sedimen

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A10. A 3-year-old Poodle weighing 7 kgs has been suffering from vomiting and diarrhoea for the last three days. You estimate it to be 6% dehydrated when it is admitted to the hospital. It is estimated that the volume of diarrhoea and vomit each day equates to 800mls. a)

What clinical assessments did you perform to determine this level of dehydration, and how did you interpret these assessments? You can answer this question in Table form. (5 marks)

Tachy mucous membranes, subtle loss of skin turgor by skin elasticity, normal CRT, normal extremety temperature, sunken appearance of eyes, and concentrated urine (high USG). MM colour, skin tent, CRT, temperature of extremeties, sunken eyes, urinalysis.

b)

Calculate the volume of fluid this dog must be given over the next 24 hours. Show all your calculations. Maintenance = 2.5ml/kg/hr or 60ml/kg/day Maintenance fluid rate = 7kg x 2.5ml/hr = 17.5ml/hr = 420ml over 24 hrs = 17.5ml/hr (4 marks) Deficit fluid rate = 0.06 x 7 kg = 0.42L/day = 420ml over 24 hrs = 17.5ml/hr (to replace deficit) Ongoing losses fluid rate = 800ml/day = 800ml over 24hrs = 33.33ml/hr Woudl reassess dehydration after the first 24 hours and if the deficit is replaced then no more deficit fluid rate is needed

420ml + 420ml + 800ml = 1,640ml over 24 hours 17.5ml + 17.5ml + 33.33ml = 68.33ml/hr

c)

By what route will this fluid be delivered? Give reasons why you made this choice. Small dog losing a lot of fluid. (2 marks) Intravenous fluids will be the fastest and okay for a small dog. Preferred method for hypovolaemia and dehydration as it is the fastest method to getting into the vascular space. IV catheter relatively cheap and easy to place and dog is not said to be in shock so IV can be used (not IO).

d)

What fluid would you choose for this dog? Give reasons why you made this choice. (2 marks) Iostonic crystalliod fluid. This type of fluid is good for correcting dehydration and is always used first and chages if it is not working (Hartmann's). Can cross the cell membrane so will hydrate cells and increase volume of fluid in vascular space.

e)

In note form, give a rehydration plan for the next 48 hours.

Use 1,640ml for the first 24 hours. For the next 24 hours we wont need deficit fluid rates as the deficit is corrected. Maintenance fluid rate = 420ml/day Ongoing losses fluid rate = 800ml/day 420ml + 800ml = 1,220ml/day Assuming that the ongoing losses have not changed.

A11. a)

(2 marks)

When caring for a sick rabbit with a poor appetite in the veterinary hospital, describe TWO (2) ways you could provide nutritional support and/or encourage the rabbit to eat. (2 marks) Offer a critical care diet which does not need to be chewed. Offer weet-bix or shredded wheat biscuits. Keep hay available.

b)

Name the gland in rats that produce red tears. Harderian gland, behind the eyes, secretes porforin

c)

What do red tears indicate? Explain. (1½ marks)

Respiratory disease, stress, or other illness

d)

(1 mark)

Name the vitamin which guinea pigs require daily. (½ mark) Vitamin C, as they can not make it themselves

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A12. A farmer calls and asks for help. He has a lot of 4-day-old calves who are extremely sick, they have diarrhoea and they are dying in large groups. He estimates at least 20% of his calves in the past week have died. Tests have confirmed that they have salmonella and campylobacter. Both are highly infectious, zoonotic and this outbreak is due to a break down in calf intensive housing management. a)

Explain why calves are at high risk of infectious diseases

Their immunity is lower than that of a cow, they may not have had enough colostrum yet which is their only source of passive immunity from their mother and must be obtained in the first 24 hours. Their navel can become infected if it is left wet and dirty after birth. They have no resistance to infections other than the passiv immunity from their mother, but their immune system is still developing so are more susceptible.

b)

(3 marks)

Describe in detail a calf management protocol that you would suggest to the farmer to reduce further spread of disease. (7 marks)

Feed each calf enough colostrum within 24 hours of birth, keep calf rearing pens clean and dry, spray calves navels when born and in high risk periods, ensure that all calves are fed their daily requirements, keep ill calves seperate from the others to prevent spreading of disease, treat ill calves as soon as possible and with appropriate treatments then keep them isolated until they are better, vaccinate cow and calves against vaccine preventable diseases, keep birthing paddocks clean and as dry as possible.

A13. Mrs Trump has returned to the surgery for the test results for her pet monkey, Donald. This monkey has been dull, lethargic, anorexic and losing weight for the past three weeks. You are the senior veterinary technologist at the practice and have to tell Mrs Trump that the blood and biopsy results indicate that Donald has a gastrointestinal lymphoma and now needs to be euthanized on humane grounds. Briefly (in point form) discuss what methods you would use to try and deal with a grief-stricken client. Your answer should include employing aspects of the Calgary Cambridge guide which would include the four core skills of communication. (6 marks) Non verbal communication, open ended questions, reflective listening, empathy. Provide support and empathy, be understanding, allow the client to process this hard informatio "I understand this is hard for you and not the outcome you were hoping for" "You have made the right choice for Donald, this will prevent him from living a painful life" "Remember all the fun times you have had with Donald, you've given him a great enjoyable life"

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A14. An older gentleman has recently bought himself a companion bird. It is a 10year-old cockatoo. He is wondering if he can bring in the bird for a health check and also talk to someone about how to care for his new friend. He doesn’t have a lot of money to spend. a)

What type of diet would you recommend and why? This is an older bird so a seed and pellet diet made specifically for older birds would be ideal. Fresh fruit and vegetables as well as plenty of fresh water shoulf be provided. An older birds digestive system may be weakened or less functional than it used to be so having an older bird diet would be beneficial to prevent gastrointestinal tract harm and allow easy digestion.

b)

(3 marks)

A cockatoo is an intelligent and destructive bird by nature. What would you recommend this gentleman do for enrichment? Making the bird work to get food by means of puzzles such as putting pellets in a ball with holes. (2 marks) Providing bells, string, baths or dangling toys to play with. Changing the toys in the cage every few days to provide novelty. Allowing some flight time around the house or a set room.

c)

A new bird exam is part of this consult, which is a physical exam, crop wash and faecal. What type of head hold would you use for this cockatoo? (1 mark) Three finger head hold to keep the birds head still and the sharp beak away from your face or hands. The other hand may be needed to stabilize the bird as he is bigger than many smaller bird breeds such as a budgie which can be restrained in one hand only.

d)

The bird seems stressed while waiting for its exam. What could you do in order to make the exam go as quick as possible? Do as much of the exam as a distance exam as possible as handling the bird may stress it out further. (1 mark) When needing to hold the bird, make sure ou use quick skilled movements to restrain and examine teh bird. Placing a towel over the birds head or doing the physcial exam in the birds cage may keep his stress levels low also.

e)

The owner has heard of feather picking and is worried his bird might develop it. What are THREE (3) of the causes of feather picking? (1½) marks Overcrowding, plucking of nestlings by parents, plucking of females by males (breeding season). Self inflicted feather plucking = boredom, hunger, stress,attention seeking, reproductive frustration, seperation anxiety,

f)

Environmental stimulation is an effective way to prevent behavioural issues such as feather picking and provide a good quality of life. List THREE (3) examples of enrichment – ie toys and puzzles. (1½) marks Baths to play and wash in. Exercise and space to move around and possibly fly. Toys that can be chewed, rolled, swinging, or climbed Diversity in the diet. Social interactions with the owner.

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A15. An 8-week-old, 12 kg male Rottweiler named “Hank” has been brought into the clinic with vomiting and diarrhoea. You are required to assess the puppy’s hydration status. He is lethargic, has tacky mucous membranes. However, due to the excess skin and the fact he is a puppy, skin tenting is not accurate . You are therefore required to perform diagnostic tests. You need to collect blood (4 mls) and urine for the diagnostic tests. a)

List the vessels available for obtaining blood and choose which one you would use in this patient. You need to include justification for your answer. Jugular vein = large volumes of blood and easiest to sample from so would be the vein of choice, less time to be restrained easier to find than smaller vessels when dehydrated, collecting blood faster has less chance of it clotting. (3 marks) Cephalic vein = best for IV catheters and smaller volumes of blood or when jugular not available Saphenous vein = best for aggressive patients and IV catherters if cephalic is not available, last choice for blood sample - lateral saphenous in dogs - lateral or medial saphenous in cats

b)

What blood tube (vacutainer) would you select and why?

Purple tube with EDTA as an anticoagulation solution so blood can be tested by means of a complete blood count (CBC Red tube with no anticoagulation solution for a biochemistry.

(1 mark)

c)

What type of urine sample and which test you would need to assess hydration status? Justify your choice. (2 marks) A USG test needs to be done to assess hydration status and can be done on urine sampled from any of the 4 methods of collection including free catch/voided, manual compression, urinary catheterisation or cystocentesis. A cystocentesis would be most sterile and accurate but is the most invasive. Free catch is the least invasive and should be used when appropriate as it causes the least stress and damage to the animal. Also visual assess the urine for amber colour and clearness.

d)

Hank has been prescribed oral codeine (dose rate 2.5mg/kg for pain management. You are required to: i)

Calculate the dosage for Hank per administration. 2.5mg/kg x 12kg = 30mg per dose

(2 marks)

ii)

Calculate how many tablets (including the size (mg) of the tablet) he will need for THREE (3) days. He is to receive codeine QID. They come in 15mg, 30mg and 60mg tablets. Use 30mg tablets for each administration, he is given one dose 4 times per day. (2 marks) 1 tablet x 4 administrations per day x 3 days = 12 tablets

iii)

Because your printer is broken you will be required to manually write the label for “Hanks” medication. Your labels have the clinic name and contact details already on them but you will need to fill in the rest of the legal requirements. Draw a label and fill in the required information for dispensing “Boss’s” drugs. (5 marks)

Hank, (insert owners last name here). Number of tablets = 12 tablets. Type of medication = 30mg oral codine tablets. Administration protocol = oral. Date dispenced to owner = 24/10/2018. Prescribing vet = Joe Bloggs Safety precautions = not for humen consumption, commonly causes constipation, contact the clinic if problems arise. Administration instructions = give one tablet prally every 8 hours until tablets are all used. Medication can cause constipation. COntact clinic is problems arise. Storage instructions = (insert storage requirements here). FOR ANIMAL TREATMENT ONLY KEEP OUT OF REACH OF CHILDREN

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SECTION B Start this section in a NEW BLUE ANSWER BOOK. B1.

Describe the difference between active and passive immunisation and indicate how long immunity derived by the two processes might be expected to last. Provide an example of both types. Active immunity is that ...