Quiz Question

In Danielski 2025 et al., on PUO complication reduction, what was the **overall complication rate** reported with IM pin and rhBMP-2 use?

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Correct. The total complication rate was 7.4%, significantly lower than in prior studies.
Incorrect. The correct answer is 7.4%.
The total complication rate was 7.4%, significantly lower than in prior studies.

🔍 Key Findings

  • Combined intramedullary (IM) pin and rhBMP-2 use resulted in a low complication rate (7.4%) after proximal ulnar osteotomy (PUO).
  • Major complications occurred in 5.3% of cases (4 infections, 1 pin breakage with ulnar tilt requiring revision).
  • Minor complications occurred in 2.1% of cases (seroma, delayed union).
  • No cases of non-union were observed; 98.9% of limbs achieved radiographic healing by 6 weeks.
  • IM pin breakage was noted in 11.8% of limbs but did not affect healing outcomes.
  • Chondrodystrophic breeds made up 64.8% of the cohort and tolerated the procedure well.
  • Compared to prior studies, complication rates were substantially reduced with this technique (prior major: 13.9%; this study: 5.3%).
  • The use of rhBMP-2 likely enhanced early bone healing and provided biologic support, particularly important in breeds at higher risk of complications.

Danielski

Veterinary Surgery

6

2025

Impact of intramedullary pinning and recombinant human bone morphogenetic protein‐2 on postoperative complications after proximal ulnar osteotomy in dogs

2025-6-VS-danielski-2

Article Title: Impact of intramedullary pinning and recombinant human bone morphogenetic protein‐2 on postoperative complications after proximal ulnar osteotomy in dogs

Journal: Veterinary Surgery

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In Sunlight 2022 et al., on Protein C monitoring, which combination was most associated with “excellent” ultimate clinical status?

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Correct. All dogs with excellent status had normalized PC and were off shunt medications and low-protein diets.
Incorrect. The correct answer is Postoperative PC normalization and no shunt medications.
All dogs with excellent status had normalized PC and were off shunt medications and low-protein diets.

🔍 Key Findings

  • Postoperative Protein C (PC) activity increased in 78.7% of dogs, and was significantly higher in dogs with excellent clinical outcomes.
  • Complete acute shunt occlusion resulted in higher postoperative PC activity (96.3%) and better ultimate clinical outcomes than incomplete occlusion.
  • Preoperative PC was not predictive of clinical status, but postoperative PC was associated with improved outcomes.
  • Standard biochemical markers (HCT, MCV, ALB, BUN) also improved postoperatively, especially in dogs with excellent clinical outcomes.
  • Dogs requiring a second procedure had significantly lower postoperative PC (43.5%) than those not requiring further intervention (78.5%).
  • Repeat procedures improved PC and BUN values, with PC increasing significantly after second intervention (to 69.8%).
  • PC normalization (within reference interval) occurred in 87.5% of dogs with excellent clinical status, compared to only 12.5% in those with poor status.
  • Clinical outcome classification (excellent/fair/poor) correlated with biochemical normalization and lack of need for diet/medications.

Sunlight

Veterinary Surgery

1

2022

Protein C and comparative biochemical changes in dogs treated with percutaneous transvenous coil embolization of congenital intrahepatic portosystemic shunts

2022-1-VS-sunlight-5

Article Title: Protein C and comparative biochemical changes in dogs treated with percutaneous transvenous coil embolization of congenital intrahepatic portosystemic shunts

Journal: Veterinary Surgery

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In Kuvaldina 2023 et al., on axillary lymph node excision, which complication was NOT observed in any of the clinical cases following axillary lymphadenectomy?

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Correct. No cases developed lymphedema postoperatively, a complication often seen in humans.
Incorrect. The correct answer is Lymphedema.
No cases developed lymphedema postoperatively, a complication often seen in humans.

🔍 Key Findings

  • Endoscopic excisional biopsy of axillary lymph nodes was successfully performed in cadavers and clinical dogs with minimal complications.
  • The technique used a SILS port and CO₂ insufflation through a small incision between the latissimus dorsi and superficial pectorals.
  • In 4 cadavers (6 limbs), mean time to remove axillary nodes was 33 minutes, and single nodes were found in 5/6 limbs.
  • In 3 clinical dogs, the procedure was successful in 2 cases; 1 required conversion to open surgery due to difficulty manipulating the node.
  • Accessory axillary nodes were successfully excised when present, located adherent to deep latissimus dorsi.
  • No cases developed lymphedema, pneumothorax, or major complications postoperatively.
  • Subjective benefits included better visualization, reduced dissection, and less postoperative morbidity than open techniques.
  • Study suggests MIS lymphadenectomy may improve staging accuracy and reduce complications, though larger studies are needed.

Kuvaldina

Veterinary Surgery

6

2023

Development of a minimally invasive endoscopic technique for excisional biopsy of the axillary lymph nodes in dogs

2023-6-VS-kuvaldina-3

Article Title: Development of a minimally invasive endoscopic technique for excisional biopsy of the axillary lymph nodes in dogs

Journal: Veterinary Surgery

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In Kuvaldina 2023 et al., in Minimally invasive axillary lymphadenectomy in dogs, which of the following best describes postoperative morbidity in the 3 clinical patients?

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Correct. Postoperative morbidity was minimal; all clinical cases recovered uneventfully with no major complications.
Incorrect. The correct answer is Minor seroma or lameness resolved without intervention.
Postoperative morbidity was minimal; all clinical cases recovered uneventfully with no major complications.

🔍 Key Findings

  • A minimally invasive endoscopic technique was successfully developed for excisional biopsy of axillary lymph nodes in dogs.
  • The procedure was performed on 4 cadavers (6 limbs) and 3 clinical patients, with no major complications reported.
  • Mean cadaveric time: accessory axillary node 5.1 min; axillary node 33 min. One limb had a double axillary node.
  • In clinical cases, 2/3 were completed endoscopically; one required conversion to open due to node elevation difficulty.
  • Surgical times in clinical cases ranged from 35 to 58 minutes, depending on node accessibility and number.
  • Postoperative morbidity was minimal: no lymphedema, minor seroma or lameness resolved quickly.
  • The SILS port approach enabled effective access, though precise placement was critical to visualization.
  • This is the first reported veterinary endoscopic technique for axillary lymphadenectomy; potential for improved staging and reduced morbidity.

Kuvaldina

Veterinary Surgery

7

2023

Development of a minimally invasive endoscopic technique for excisional biopsy of the axillary lymph nodes in dogs

2023-7-VS-kuvaldina-4

Article Title: Development of a minimally invasive endoscopic technique for excisional biopsy of the axillary lymph nodes in dogs

Journal: Veterinary Surgery

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In Korchek 2025 et al., on fracture gap risk, what effect did prolonged external coaptation (>1 week) have on outcomes?

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Correct. Prolonged external coaptation was associated with bandage-related complications such as skin wounds and osteopenia (OR = 5.4, p = .04).
Incorrect. The correct answer is It was significantly associated with major and minor non-implant complications.
Prolonged external coaptation was associated with bandage-related complications such as skin wounds and osteopenia (OR = 5.4, p = .04).

🔍 Key Findings

80 toy breed dogs with surgically repaired transverse radius/ulna fractures were analyzed.
Fracture gap in the caudal cortex was present in 46% of cases.
Implant failure rate:

  • 27% in cases with fracture gap
  • 2% in cases without fracture gap

Fracture gap significantly associated with implant failure:

  • OR = 23.0, 95% CI: 2.7–197.9, p = 0.004

Absence of external coaptation also associated with increased implant failure risk:

  • OR = 10.1, 95% CI: 1.1–89.6, p = 0.04

Prolonged external coaptation (>1 week) linked to non-implant complications (skin wounds, osteopenia, osteomyelitis):

  • OR = 5.4, p = 0.04

Plate thickness, type, open screw holes, and working length were not statistically significant predictors of implant failure after multivariable analysis.

Korchek

Veterinary Surgery

2

2025

Association of fracture gap with implant failure in radius and ulna fractures in toy breed dogs—A multicenter retrospective cohort study

2025-2-VS-korchek-2

Article Title: Association of fracture gap with implant failure in radius and ulna fractures in toy breed dogs—A multicenter retrospective cohort study

Journal: Veterinary Surgery

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In Thompson 2024 et al., on cyanoacrylate enterotomy sealants, what was the most common leak location in the cyanoacrylate-only (CE) group?

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Correct. 100% of leaks in the CE group originated from the incisional line.
Incorrect. The correct answer is Incisional line.
100% of leaks in the CE group originated from the incisional line.

🔍 Key Findings

  • Highest initial leak pressure (ILP) observed in the handsewn + cyanoacrylate (HS + CE) group: 83.3 ± 4.6 mmHg (p < .001 vs. others).
  • Lowest ILP: cyanoacrylate-only group (CE): 18.6 ± 3.5 mmHg.
  • No significant MIP difference between handsewn (HSE) and HS + CE groups (p = .19); CE had significantly lower MIP (22.7 mmHg).
  • Leak location:
    • HSE: 60% from suture holes
    • CE: 100% from incisional line
    • HS + CE: 60% from incisional line, 40% from suture holes
  • Authors conclude cyanoacrylate augmentation significantly increases ILP and could reduce enterotomy leakage risk.

Thompson

Veterinary Surgery

2

2024

Effects of cyanoacrylate on leakage pressures of cooled canine cadaveric jejunal enterotomies

2024-2-VS-thompson-2

Article Title: Effects of cyanoacrylate on leakage pressures of cooled canine cadaveric jejunal enterotomies

Journal: Veterinary Surgery

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In Alvarez-Sanchez 2023 et al., on SLN mapping in canine MCT, what was the histologic metastasis rate (HN2 or HN3) in excised lymph nodes?

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Correct. 27 of 41 excised lymph nodes were histologically metastatic, a high rate even though most tumors were low-to-intermediate grade.
Incorrect. The correct answer is 65.8%.
27 of 41 excised lymph nodes were histologically metastatic, a high rate even though most tumors were low-to-intermediate grade.

🔍 Key Findings

  • Combined ICTL and NIRF detected the same SLN in 80% of cases; each method alone missed sentinel lymph nodes in some dogs.
  • ICLT failed in 5% of dogs, while NIRF failed in 20%; combined use resulted in only 5% failure in SLN detection.
  • Metastatic lymph nodes were detected in 95% of dogs, despite most tumors being low or intermediate grade (95%).
  • 27 of 41 nodes (65.8%) were histologically metastatic (HN2 or HN3), many of which would have been missed using ALN alone.
  • ALN matched the SLN in only 45% of cases with ICTL and 30% with NIRF, supporting the need for SLN mapping.
  • ICLT and NIRF were complementary, often identifying different SLN, with some only fluorescent or enhanced in one modality.
  • Subcutaneous MCT had higher metastatic rates (7/8 dogs) than previously reported, challenging older assumptions about benign behavior.
  • Removing both ALN and SLN (from both methods) improved detection of metastasis to 85–95%, reducing risk of understaging.

Alvarez-Sanchez

Veterinary Surgery

3

2023

Comparison of indirect computed tomographic lymphography and near-infrared fluorescence sentinel lymph node mapping for integumentary canine mast cell tumors

2023-3-VS-alvarez-sanchez-4

Article Title: Comparison of indirect computed tomographic lymphography and near-infrared fluorescence sentinel lymph node mapping for integumentary canine mast cell tumors

Journal: Veterinary Surgery

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In Wood 2024 et al., on knot security and locking throws, which knot had the poorest performance, especially without a locking throw?

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Correct. Forwarder knot showed the lowest holding pressures, especially when unlocked.
Incorrect. The correct answer is Forwarder knot.
Forwarder knot showed the lowest holding pressures, especially when unlocked.

🔍 Key Findings

  • Adding a single locking throw significantly increased holding security for specific knots, including the surgeon's throw (p = .0001) and square throw (p = .0002).
  • For the Miller's throw (p = .166) and strangle throw (p = .808), no significant improvement was observed with a locking throw.
  • After locking throw addition, all five knots leaked at similar pressures (p = .5233), and these pressures exceeded physiologic arterial pressures.
  • Surgeon's throw without a locking throw had the lowest leak pressure (62.5 ± 46.2 mm Hg), below physiologic arterial values.
  • The square throw without locking also leaked below physiologic pressures (148.7 ± 109.4 mm Hg), though it outperformed the surgeon's throw.
  • Miller’s and strangle throws performed significantly better than square or surgeon’s throws without locking, achieving leak pressures >200 mm Hg.
  • All knots used 2-0 polyglyconate monofilament (Maxon); no comparisons across suture types or sizes were performed.
  • Authors concluded that correct tensioning and locking throw addition are key to safe vascular ligation. Miller’s, strangle, or slip knots are preferred for challenging surgical fields.

Wood

Veterinary Surgery

4

2024

Influence of a single locking throw on the in vitro holding security of five friction knots using two monofilament suture materials in a canine model

2024-4-VS-wood-5

Article Title: Influence of a single locking throw on the in vitro holding security of five friction knots using two monofilament suture materials in a canine model

Journal: Veterinary Surgery

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In Poggi 2025 et al., on laparoscopic cholecystectomy in cats, what was the reported median postoperative hospitalization duration?

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Correct. The median hospitalization time following surgery was 3 days (range 2–4 days).
Incorrect. The correct answer is 3 days.
The median hospitalization time following surgery was 3 days (range 2–4 days).

🔍 Key Findings

  • Laparoscopic cholecystectomy (LC) was successfully performed in all 22 cats without conversion to open surgery.
  • Complication rate was low: 3 cats had postoperative complications (1 seroma, 1 vomiting, 1 EHBDO and death).
  • Median operating time was 41 minutes; median hospitalization was 3 days.
  • No cases required conversion to open laparotomy, even in cats as small as 2.5 kg.
  • Common devices used: Hemoclips or Hem-o-lok for cystic duct ligation; Ligasure, harmonic scalpel, or j-hook for dissection.
  • Most common indications: cholelithiasis (9/22) and cholecystitis (10/22), with one biliary mucocele and one adenoma.
  • Histopathology confirmed diagnosis in all cases; concurrent liver or intestinal biopsies were performed in some cats.
  • Postoperative AUS and bloodwork were routine and important for detecting early signs of EHBDO.

Poggi

Veterinary Surgery

5

2025

Laparoscopic cholecystectomy in 22 cats (2018–2024)

2025-5-VS-poggi-5

Article Title: Laparoscopic cholecystectomy in 22 cats (2018–2024)

Journal: Veterinary Surgery

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In Duffy 2022 et al., on crotch suture techniques, which statement best describes leakage location outcomes with SCCS?

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Correct. No leakage was observed at the crotch with SCCS; all leakage occurred at the longitudinal staple line.
Incorrect. The correct answer is Leakage occurred only at the longitudinal staple line.
No leakage was observed at the crotch with SCCS; all leakage occurred at the longitudinal staple line.

🔍 Key Findings

  • Augmenting FEESA with two simple interrupted crotch sutures (TCS) or simple continuous crotch suture (SCCS) significantly increased initial leakage pressure (ILP) compared to no suture or a single suture (NCS, SICS).
  • SCCS had the highest ILP (47.6 mm Hg), followed by TCS (37.8 mm Hg), SICS (33.0 mm Hg), and NCS (27.1 mm Hg).
  • All crotch suture types increased maximal leakage pressure (MLP) compared to no crotch suture.
  • Leakage from the crotch occurred most commonly in NCS (67%) and SICS (50%), but only 8% with TCS and 0% with SCCS.
  • SCCS was the only technique where leakage never occurred at the crotch site.
  • SCCS had the highest MLP (100.6 mm Hg), supporting its use in clinical settings with high-risk patients.
  • Intraluminal pressures during leakage in NCS constructs were sometimes below normal physiologic pressures, emphasizing risk of leakage without crotch suture.
  • The transverse staple line never leaked in any group, indicating the crotch is the primary weak point.

Duffy

Veterinary Surgery

4

2022

Influence of crotch suture augmentation on leakage pressure and leakage location during functional end-to-end stapled anastomoses in dogs

2022-4-VS-duffy-2

Article Title: Influence of crotch suture augmentation on leakage pressure and leakage location during functional end-to-end stapled anastomoses in dogs

Journal: Veterinary Surgery

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Quiz Results

Topic: Healing & Complications
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