European College of Veterinary Surgeons
Certifying Examination
Large Animal Case-based Examination
MOCK EXAM EQUINE SOFT TISSUE
100 POINTS TOTAL
Total time: 30 minutes
Page 13 Minutes
You are presented with a 3 year old Arab colt for castration. At the time of your preliminary clinical examination you can only palpate the left testicle.
1. Give 3 reasons why the right testicle may not be palpable.
1.
2.
3.
Question Maximum[3 pts_____]
2. What 4 further diagnostic tests would you perform before surgery?
1.
2.
3.
4.
Question Maximum[8 pts_____]
Total:[11 pts_____]
Page 2 2.5 Minutes
As a result of further examination you suspect that the right testicle is abdominally retained.
Is it more common for the left or right testicle to be abdominally retained and why?
[2 pts_____]
List 6 different surgical approaches that can be used for cryptorchidectomy.
1.
2.
3.
4.
5.
6.
Question Maximum[6 pts_____]
Total:[8 pts_____]
Page 3 3 Minutes
You elect to anaesthetise the horse and use an inguinal approach to perform the cryptorchid castration.
1. Which 4 structures border the deep inguinal ring?
1.
2.
3.
4.
Question Maximum[8 pts_____]
2. Fill in the steps when performing an inguinal cryptorchid castration
1. Make a 10-15cm skin incision over the superficial inguinal ring
2. Bluntly dissect the inguinal fascia to expose the superficial ring
3.
4.
5.
6. Testis is pulled through vaginal ring and exteriorised for removal.
Question Maximum[6 pts_____]
Total:[14 pts_____]
Page 43.5 Minutes
At surgery the left testicle is removed using a closed technique. On the right side an inguinal approach was made, the vaginal process incised and the epididymis located. However traction on the proper ligament fails to exteriorise the testicle.
1. List 3 techniques that you might use to facilitate finding the retained testicle.
1.
2.
3.
Question Maximum[6 pts_____]
2. At this time the anaesthetist tells you that the mean arterial pressure (MAP) is 55mmHg.
Interpret this finding
[1 pt_____]
3. List three methods for correction of the MAP in this horse.
1.
2.
3.
Question Maximum[6 pts_____]
Total:[13 pts_____]
Page 55 Minutes
In view of the anaesthetist’s concerns, you elect to terminate the surgery and, recover the horse and to perform a standing laparoscopic procedure the following day.
Describe where you would make your scope portal.
[3 pts_____]
What technique is being usedin the pictureto facilitate removal?
[1 pt_____]
What do you observe about the retained testicle?
[2 pts_____]
What are the two most likely causes of this?
[2 pts_____]
What 3 other techniques might be used to facilitate removal of the testicle?
1.
2.
3.
Question Maximum[3 pts_____]
Total:[11 pts_____]
Page 63 Minutes
The slide shows the laparoscopic appearance of the caudal aspect of the right side of the abdomen following removal of the enlarged testicle.
What are the labelled structures?
A.
B.
C.
D.
Question Maximum[4 pts_____]
What technique has been used to free the testicle?
[2 pts_____]
The horse is given intramuscular penicillin and intravenous gentamicin for 5 days post operatively and flunixin meglumine is provided for analgesia.
What is the mode of action of gentamicin?
[2 pts_____]
What is it’s spectrum of activity?
[2 pts_____]
What is the mode of action of penicillin?
[2 pts_____]
What is it’s spectrum of activity?
[2 pts_____]
Total:[14 pts_____]
Page 72 Minutes
Initially the horse made good progress. However, 4 days post operatively he develops signs of severe oedema and discharge from the flank wound. The next day the horse is dull and pyrexic (temperature 39.3oC) and begins to show signs of colic.
What further diagnostic techniques would you perform?
1.
2.
3.
4.
5.
Question Maximum[5 pts_____]
Total:[5 pts_____]
Page 82 Minutes
You do an abdominocentesis and a blood cell count. The results are presented in this slide.
How would you interpret these findings?
[2 pts_____]
The horse shows signs of increased discomfort over the next few hours. What would you do next?
[2 pts_____]
Total:[4 pts_____]
Page 92 Minutes
You elect to debride the abscess and to do an exploratory laparotomy via a right flank laparotomy. At surgery you find a large abscess in the body wall and intestine adhered to the abscess. The adhesions are broken down and the affected portion of intestine is exteriorised.
What portion of intestine is involved?
[1 pt_____]
What procedure would you perform next?
[2 pts_____]
Total:[3 pts_____]
Page 102 Minutes
You elect to perform a partial resection of the large colon and an end-to-end anastomosis.
How many taenial bands are present on the following parts of the large colon?
1. Right ventral colon
2. Left ventral colon
3. Pelvic flexure
4. Left dorsal colon
5. Right dorsal colon
Question Maximum[5 pts_____]
Draw lines on the diagram below to show how you would transect the right ventral and dorsal colon when performing a resection of the large colon and an end-to-end anastomosis.
[3 pts_____]
Total:[8 pts_____]
Page 112 Minutes
The slide shows two staplers that can be used to perform a large colon resection.
Fill in the following details for each stapler:
Stapler 1
Name the instrument
What size(s) of staples would you use with this stapler?
Describe the staple pattern.
How long is the row of staples that is placed?
Maximum thickness of tissue in which instrument will properly close?
Question maximum[5 pts_____]
Stapler 2
Name the instrument
What size staples does this stapler use?
Describe the staple pattern.
How long is the row of staples that is placed?
Question maximum[4 pts_____]
Total:[9 pts_____]
March, 15