Time flies. It has been three years since my first monthly surgery column in Veterinary Practice News. To celebrate this anniversary, I will ask some simple questions to test your surgical knowledge of past Surgical Insights. Circle “true” or “false” for each question. 1. Incisions heal end to end, not side to side. Therefore, a good surgeon should strive to make the shortest possible incision to speed up healing. True or false? 2. To be exact, a laparotomy is a flank incision. A celiotomy is a ventral midline incision in the linea. However, a laparotomy is considered an accepted synonym of celiotomy. True or false? 3. Surgery on a ruptured bowel or gallbladder is considered clean contaminated. True or false? 4. We should minimize the duration of anesthesia and surgery because each additional hour under anesthesia increases the risk of infection by 30 percent. True or false? Grade Yourself Odd-numbered statements (1, 3, etc.) are false. Even-numbered (2, 4, etc.) statements are true. 0-9 correct answers: Don’t feel bad, you probably would have aced a quiz on Cushing’s disease or chronic renal failure. That said, you might want to read our past surgery columns, pencil in hand. 10-19 correct answers: Not bad. You would benefit from reading the columns that correspond to the questions you did not ace. 20-29 correct answers: Excellent! You are the master blaster of the 10 blade. 30-33 correct answers: You are a true surgical asset to your practice, and your clients and patients are lucky to have found you. 5. The best treatment for redundant vulvar skin folds is a vulvoplasty rather than an episioplasty. True or false? 6. Deep pain sensation is not the same as the withdrawal reflex. Deep pain is tested by pinching a toe with a hemostat, which should cause a voluntary reaction, such as whining, trying to bite or moving away from the painful stimulus. True or false? 7. Efficiency is key in surgery. Therefore, formalin jars should be opened at the beginning of surgery and kept open until all biopsies have been harvested. True or false? 8. There is no definitive advantage for removing the uterus in addition to the ovaries during routine neutering of a young, healthy female. Ovariectomy is quicker and less invasive than ovariohysterectomy. True or false? 9. Throwing a SQ mass in the trash without a biopsy is perfectly acceptable. As the classic surgeon’s saying goes, “If it bothers the client, it should be removed and tossed.” True or false? 10. The omentum is a versatile organ that can act as a natural or physiological drain in multiple locations. True or false? 11. According to PLIT, consultations should be short to maximize exam room use and money making abilities. Documenting everything discussed with the client is a waste of time. True or false? 12. A patient with “horrible hips” on X-rays may be functional, while another dog with mild hip dysplasia may be very painful. True or false? 13. A partial ACL tear is very likely to heal on its own with strict rest and aspirin. True or false? 14. Catgut is a reactive suture. It is a “twisted” suture, which is prone to fraying and/or breaking. Its absorption profile is unpredictable. True or false? 15. To make them more affordable, declaws should be routinely included in kitten spay and neuter [packages]. True or false? 16. Approximately 25 percent of patients with anal sac apocrine gland adenocarcinoma are affected by paraneoplastic hypercalcemia. True or false? 17. After finding a small mass in your patient, your main recommendation should be for the client to “just watch it” and let you know once the mass reaches the size of a pineapple. True or false? 18. Soft tissue biopsies should be taken from the periphery of the mass, since the center may be necrotic. True or false? 19. A negative exploratory laparotomy is perfectly acceptable on a vomiting patient as long as an excisional biopsy of the gallbladder is submitted to the lab. True or false? 20. Follow-up treatment after surgical excision of a malignant mass includes chemotherapy and/or radiotherapy. True or false? 21. Corticosteroids are a safe, long-term treatment for osteoarthritis, since they are true anti-inflammatory medications with few side effects in the real world. True or false? 22. Osteosarcoma is a manageable condition since we can provide comfort and quality of life to most patients. True or false? 23. A bandage can be safely left on a leg for up to four weeks, as long as the patient is strictly confined. True or false? 24. Calcification of the entire ear canal is a sign of irreversible changes that warrant a total ear canal ablation. True or false? 25. A regular culturette can be used for aerobic and/or anaerobic cultures. True or false? 26. Untreated megacolon can lead to irreversible colonic distension, pain, dehydration and anorexia. True or false? 27. Laryngeal paralysis is a reversible condition with strict rest and low-dose steroids. True or false? 28. Observe strict asepsis and control hemorrhage carefully are two of Halsted’s seven surgical principles. True or false? 29. The four facets of surgical asepsis are surgical instruments sterility, operating room sterility, patient vaccination and patient scrubbing. True or false? 30. Studies show that human surgeons accused of malpractice spend less time with their patients than surgeons who are never sued. True or false? 31. A will, a durable power of attorney, disability insurance and long-term care insurance are only recommended for the rich. True or false? 32. Because fluids follow gravity to flow along a Penrose drain, they should exit ventrally. Letting a drain exit through a dorsal incision serves no purpose. True or false? 33. It is critical to harvest the biopsy samples from the periphery of a bony lesion, since the center may be necrotic. True or false? Phil Zeltzman is a mobile board-certified surgeon near Allentown, Pa. His website is DrPhilZeltzman.com.
