THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY - EXAMINATION. PAPER l - GENERAL SURGERY. TUESDAY 27 APRIL 1999 (3 hours)

Transcription

1 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY - EXAMINATION PAPER l - GENERAL SURGERY TUESDAY 27 APRIL 1999 (3 hours) This paper is in two sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each section. Candidates are warned that illegible handwriting may result in examiners being unable to award marks for information which candidates intend to convey. Section A (1½ hours) Candidates must answer TWO of the THREE questions set. (Allow approximately 45 minutes to answer each question.) 1. Discuss the importance of the elimination of dead space during equine surgery. What techniques may be used? 2. The efficacy of achieving high target tissue concentrations of certain antibiotics in the treatment of septic conditions is being increasingly recognised. Discuss the different options, their experimental justification and your practical experiences with them. 3. Describe the processes involved in the conversion of a wound to a mature scar. Indicate how these can be affected by therapeutic intervention.

2 P.T.O. for Section B

3 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY - EXAMINATION PAPER l - GENERAL SURGERY TUESDAY 27 APRIL 1999 (3 hours) This paper is in two sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each section. Candidates are warned that illegible handwriting may result in examiners being unable to award marks for information which candidates intend to convey. Section B (1½ hours) Candidates must answer ALL TEN QUESTIONS. (Allow approximately 9 minutes to answer each question.) 1. Two days after a routine arthroscopy a horse develops signs of depression and vague discomfort. It's heart rate is 48 per minute, respiratory rate 28 per minute and temperature 38.4 o C. No abnormalities are evident on rectal examination. The PCV is 38%, total white blood cell count 3.9 x10 9 /l, 40% neutrophils, 55% lymphocytes and 5% monocytes. List your main differential diagnoses and outline how you would investigate this complication further. 2. Write brief notes on the pre-operative management of a foal with a ruptured bladder. 3. List the imaging techniques applicable to the diagnosis of abdominal disease in the horse, briefly mentioning the advantages and disadvantages of each technique. 4. Briefly list the methods of haemostasis, including their advantages and disadvantages, which may be utilised during ovariectomy in the mare.

4 5. How would you measure a horse s blood pressure during general anaesthesia? Briefly discuss techniques which may be used to raise blood pressure or prevent it from dropping, during anaesthesia. P.T.O FOR QUESTIONS 6, 7, 8, 9 AND Write notes on the use of laser surgery, giving examples of possible applications in the horse. 7. Compare and contrast loss of use insurance cover, with all risks mortality insurance cover, in the horse. 8. Write short notes on the difference in second intention wound healing between horses and ponies. 9. List the advantages and disadvantages of different methods of sterilising endoscopic equipment. 10. What is the rationale for the use of the following as wound dressings: a. Karbopad E (activated charcoal dressing)? b. Sainsbury s meat tenderiser (papain)? c. Dermisol cream (malic acid, benzoic acid, salicylic acid)? d. Preparation-H (Live Yeast cell derivative)? e. Kaltostat (calcium alginate)?

5 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY - EXAMINATION PAPER ll- ORTHOPAEDICS SURGERY TUESDAY 27 APRIL 1999 (3 hours) This paper is in two sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each section. Candidates are warned that illegible handwriting may result in examiners being unable to award marks for information which candidates intend to convey. Section A (1½ hours) Candidates must answer THREE of the FOUR questions set. (Allow approximately 30 minutes to answer each question.) 1. Discuss the advice you would give to a Thoroughbred stud farm to reduce the incidence of osteochondrosis, in relation to current concepts in the aetiopathogenesis of the condition. 2. Describe the healing of articular cartilage following a traumatic injury to a diarthrodial joint. How may we affect this repair process? 3. Discuss (with the aid of diagrams) the management and possible implications of a puncture wound to the sole of the foot in the horse.

6 4. Discuss sacroiliac sprain in the horse. P.T.O. FOR SECTION B THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY - EXAMINATION PAPER ll - ORTHOPAEDICS SURGERY TUESDAY 27 APRIL 1999 (3 hours) This paper is in two sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each section. Candidates are warned that illegible handwriting may result in examiners being unable to award marks for information which candidates intend to convey. Section B (1½ hours) Candidates must answer ALL TEN questions. (Allow approximately 9 minutes to answer each question.) 1. Write notes (using diagrams as necessary) on the treatment of a horse with palmar foot pain as a result of long toe, low heel conformation, and a brokenback hoof-pastern axis. 2. Describe the clinical signs, diagnosis and treatment of luxation of the superficial digital flexor tendon from the point of the hock. 3. Write notes on the diagnosis and treatment of Lyme s disease in the horse.

7 4. Write brief notes on the use of isoxsuprine hydrochloride for the treatment of orthopaedic diseases in the horse. 5. What is a sequestrum? Describe the etiology, pathogenesis and treatment of bone sequestration in the horse. 6. What are the treatment options that should be considered after making a diagnosis of osteoarthritis of the small tarsal joints (bone spavin)? 7. Write notes on the interpretation of radiographs of the navicular bones of the fore feet taken at the request of a prospective purchaser. P.T.O FOR QUESTIONS 8, 9, AND Write notes on the action you would take to confirm that a horse which remains recumbent after a fall in a steeple chase has suffered a spinal fracture. 9. Write notes on maintaining radiation safety when performing scintigraphy on horses using technetium 99m. 10. What is the rationale for the use of BAPTEN in the management of a superficial flexor tendon injury?

8 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY - EXAMINATION PAPER ll SOFT TISSUE SURGERY TUESDAY 27 APRIL 1999 (3 hours) This paper is in two sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each section. Candidates are warned that illegible handwriting may result in examiners being unable to award marks for information which candidates intend to convey. Section A (1½ hours) Candidates must answer THREE of the FOUR questions set. (Allow approximately 30 minutes to answer each question.) 1. Discuss periapical dental infection in the horse. 2. Describe the pathophysiological events that occur and their subsequent treatment, following: a) a simple intestinal obstruction b) a strangulating obstruction of the intestine in the horse. 3. Six weeks after suffering oesophageal choke, a horse presents with a severe oesophageal stricture in the middle third of the cervical part of the oesophagus. During your attempt at surgical bougienage, you suspect you have caused an iatrogenic oesophageal tear. Discuss the management of this case. 4. Discuss the significance and clinical presentations of diseases of the auditory tube diverticulum (guttural pouches), in relation to the anatomy of the region. Describe, with the aid of a diagram, the surgical approaches to the guttural pouches.

9 P.T.O. FOR SECTION B

10 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY - EXAMINATION PAPER ll SOFT TISSUE SURGERY TUESDAY 27 APRIL 1999 (3 hours) This paper is in two sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each section. Candidates are warned that illegible handwriting may result in examiners being unable to award marks for information which candidates intend to convey. Section B (1½ hours) Candidates must answer ALL TEN questions. (Allow approximately 9 minutes to answer each question.) 1. List, together with any rationale for their use, the different techniques which have been tried for the treatment of dorsal displacement of the soft palate in the horse. Briefly speculate how future treatments may improve on these. 2. Describe your approach to a four year old horse, which shows stallion-like behaviour, but with no palpable testes and a scrotal scar. Briefly outline possible surgical techniques. 3. Briefly list the potential causes of abdominal adhesions in the horse. How might the incidence of adhesions be reduced following colic surgery in the horse? 4. List the pharmaceutical agents which modify bowel motility in the horse. In each case indicate their mechanism of action and clinical application. 5. List the advantages and disadvantages of loop-colostomy vs. end-colostomy for the managment of a grade 3 rectal tear in the horse.

11 6. Describe the different surgical options for the management of urine pooling in mares. P.T.O. 7, 8, 9 AND Write notes on the differential diagnosis and management of a horse with a penile prolapse of 7 days duration. 8. Briefly discuss the aetiology, diagnosis and management of two types of caecal disease in the horse. 9. Describe the different techniques available for the removal of the eye in a case of septic panophtalmitis in the horse. 10. Write short notes on the complications that may occur to a laparotomy wound in the horse, their diagnosis and management

12 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY TUESDAY 28 MARCH 2000 PAPER l - GENERAL SURGERY (3 hours) This paper is in two sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each section. Candidates are warned that illegible handwriting may result in examiners being unable to award marks for information which candidates intend to convey. Section A (1½ hours) Candidates must answer TWO of the THREE questions set. (Allow approximately 45 minutes to answer each question.) 1. Discuss the aetiopathogenesis of endotoxaemia in the horse. What methods of treatment are currently available to combat its effects? 2. Discuss the development, practical applications and drawbacks of minimallyinvasive surgical techniques in the horse. 3. You are called to advise a surgical unit which is suffering an abnormally high rate of post-operative infections. Discuss in detail the measures you would use to investigate this. Outline potential predisposing factors and methods of combating the problem.

13 P.T.O. for Section B

14 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY - EXAMINATION TUESDAY 28 MARCH 2000 PAPER l - GENERAL SURGERY (3 hours) This paper is in two sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each section. Candidates are warned that illegible handwriting may result in examiners being unable to award marks for information which candidates intend to convey. Section B (1½ hours) Candidates must answer ALL TEN QUESTIONS. (Allow approximately 9 minutes to answer each question.) 1. Write short notes on local anaesthetic techniques that are applicable to equine standing surgery. 2. Briefly describe your preferred technique to obtain and preserve a biopsy of the following: a) liver b) lung c) ileum d) periocular mass e) rectal mucosa.

15 3. Write short notes on the therapeutic use of ionising radiation in equine surgical conditions. P.T.O. FOR QUESTIONS 4, 5, 6, 7, 8, 9 AND Write short notes on the anaesthetic induction protocols you would use for the following: a) A severely endotoxaemic horse with a large colon volvulus b) A 3-year-old racing Thoroughbred with a medial condylar fracture of the third metatarsus. c) A ten month pregnant mare with dystocia with a still viable foetus 5. What complications can occur with the use of distal limb casts in the horse? How may they be minimised? 6. What suture material and suture patterns would you use in the following?: a) Repair of a transected superficial digital flexor tendon in the midmetacarpus. b) A prosthetic laryngoplasty. c) An acute corneal laceration. d) Closure of a bladder following removal of a calculus. e) Closure of the vaginal wall following colpotomy for ovariectomy. f) End-to-end anastomosis of the small colon. g) Closure of a sinonasal flap following sinus surgery. 7. Briefly outline the potential applications of lithotripsy in equine surgery. 8. Write brief notes on three methods by which elevated local levels of antibiotics can be achieved in equine surgery. 9. What techniques can be used to decrease the incidence of post-operative myositis in the horse?

16 10. Contrast the advantages and disadvantages of skin staples vs sutures for closure of skin lacerations. ******************

17 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY - EXAMINATION TUESDAY 28 MARCH 2000 PAPER ll- ORTHOPAEDIC SURGERY (3 hours) (This Paper to be answered ONLY by those Candidates whose elective is Orthopaedic Surgery) This paper is in two sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each section. Candidates are warned that illegible handwriting may result in examiners being unable to award marks for information which candidates intend to convey. Section A (1½ hours) Candidates must answer THREE of the FOUR questions set. (Allow approximately 30 minutes to answer each question.) 1. Discuss the role of surgery in the management of Developmental Orthopaedic Disease. 2. Critically discuss therapies currently in use for the treatment of acute laminitis, in relation to current theories concerning the aetiopathogenesis of this disease. 3. Discuss your experiences with, and the scientific rationale for, the different systemic treatments for osteoarthrosis. 4. A National Hunt yard is suffering a very high rate of superficial digital flexor tendinitis. Discuss the predisposing factors, and how you would institute a regime to try and reduce the incidence of this disease.

18 P.T.O. FOR SECTION B THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY - EXAMINATION TUESDAY 28 MARCH 2000 PAPER ll - ORTHOPAEDIC SURGERY (3 hours) (This Paper to be answered ONLY by those Candidates whose elective is Orthopaedic Surgery) This paper is in two sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each section. Candidates are warned that illegible handwriting may result in examiners being unable to award marks for information which candidates intend to convey. Section B (1½ hours) Candidates must answer ALL TEN questions. (Allow approximately 9 minutes to answer each question.) 1. Make brief notes on the pathogenesis of distal interphalangeal joint flexural deformity. 2. Make short notes on the diagnosis and management of sacral fractures in the horse. 3. Briefly outline how you would assess a penetrating wound in the stifle region, in relation to the relevant anatomy of the region. 4. Write short notes on the use of physiotherapeutic techniques in the treatment of soft tissue injuries of the equine back.

19 5. List the relative advantages and disadvantages of treatment methods that can be used for the management of a deep dorsal hoof crack, that runs from the coronary band to the solar surface. 6. Make brief notes on the diagnosis and current thoughts of the aetiology of motor neurone disease in the horse. P.T.O. FOR QUESTIONS 7, 8, 9 AND Briefly outline the options for the management of a severely comminuted fracture of the proximal phalanx of a forelimb in a Thoroughbred colt. What complications may develop and what prognosis would you give for subsequent stud duties? 8. List the conditions that may cause distension of the digital tendon sheath in the absence of a penetrating wound. Briefly outline how you would further investigate this problem. 9. Briefly outline your approach to the interpretation of a positive response to intraarticular analgesia of the distal interphalangeal joint, with reference to the relevant literature. 10. How do the feet of Thoroughbreds and Warmbloods differ?

20 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY - EXAMINATION TUESDAY 28 MARCH 2000 PAPER ll SOFT TISSUE SURGERY (3 hours) (This Paper to be answered ONLY by those Candidates whose elective is Soft Tissue Surgery) This paper is in two sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each section. Candidates are warned that illegible handwriting may result in examiners being unable to award marks for information which candidates intend to convey. Section A (1½ hours) Candidates must answer THREE of the FOUR questions set. (Allow approximately 30 minutes to answer each question.)

21 1. Discuss current concepts of the aetiology, epidemiology and diagnosis of equine dysautonomia (Grass sickness). 2. Using illustrations as necessary, describe the anatomy of the inguinal canal in the horse with reference to the descent of the testicle. How might we use these anatomical structures to our benefit during cryptorchidectomy? 3. Using experimental justification where available, what is the rationale of treatments available to the veterinary surgeon that may influence small intestinal motility following resection of 2 metres of infarcted mid-jejunum? 4. Discuss critically, the methods that are currently available for the diagnosis and management of infection associated with the 3rd mandibular cheek tooth. P.T.O. FOR SECTION B THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY - EXAMINATION TUESDAY 28 MARCH 2000 PAPER ll SOFT TISSUE SURGERY (3 hours) (This Paper to be answered ONLY by those Candidates whose elective is Soft Tissue Surgery) This paper is in two sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each section. Candidates are warned that illegible handwriting may result in examiners being unable to award marks for information which candidates intend to convey.

22 Section B (1½ hours) Candidates must answer ALL TEN questions. (Allow approximately 9 minutes to answer each question.) 1. List the complications that may be seen following balloon catheterisation of the internal carotid artery for acute haemorrhage from the gutteral pouch in a horse. Briefly state how you would manage such complications. 2. Make brief notes listing the pathological changes that may occur subsequent to penetration of the lateral chest wall of a horse by a wooden stake. In each case, note how this particular disease may be managed. 3. Briefly describe the complications which can occur subsequent to prosthetic laryngoplasty ( tie-back ) surgery. In each case, comment on how these complications may be managed. 4. Write brief notes on current concepts of the aetiology and management of equine sarcoids. P.T.O. FOR QUESTIONS 5, 6, 7, 8, 9, AND Discuss techniques that you may use for the management of a recurrent squamous cell carcinoma on the vulval lips of an aged riding mare. 6. Outline the different methods of non-surgical correction of left dorsal displacement of the colon. 7. Discuss, with reference to the literature, the closure of the uterine wall following caesarian section in the mare. 8. Briefly outline your preferred method of penile amputation, and list the advantages over other techniques.

23 9. Make short notes on the removal of a parotid duct sialolith in an 18-year-old mare. 10. Make short notes on the methods available for the prevention of adhesion formation following exploratory laparotomy

24 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY WEDNESDAY 8 AUGUST 2001 PAPER l - GENERAL SURGERY (3 hours) This paper is in two sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each section. Illegible handwriting may result in examiners being unable to award marks for information which candidates intend to convey. If insufficient time is available to answer a question fully, it will be acceptable to complete in note form. PAPER l SECTION A (1½ hours) Candidates must answer TWO of the THREE questions set. (Allow approximately 45 minutes to answer each question.) 1. Why is exuberant granulation tissue a problem in horses? Review the prevention and treatment of this phenomenon. 2. Discuss the rationale for the use of antimicrobial agents in equine surgery. Include their pre-operative, intra-operative and post-operative uses. 3. Discuss critically the techniques available to treat the common forms of external neoplasia in the horse

25 P.T.O. for Section B THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY WEDNESDAY 8 AUGUST 2001 PAPER l - GENERAL SURGERY (3 hours) This paper is in two sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each section. Illegible handwriting may result in examiners being unable to award marks for information which candidates intend to convey. If insufficient time is available to answer a question fully, it will be acceptable to complete in note form. Section B (1½ hours) Candidates must answer ALL TEN QUESTIONS. (Allow approximately 9 minutes to answer each question.) 1. Make brief notes on post-operative equine salmonellosis. 2. Indicate, giving reasons for your choice, the optimum surgical draping techniques for: a. Transmaxillary repulsion of a septic molar tooth b. Standing repair of a rectovaginal fistula c. Standing flank laparoscopy d. Metacarpophalangeal joint arthroscopy e. Ventral midline laparotomy.

26 3. List the potential complications that may be encountered during the administration of a whole blood transfusion in the horse. Briefly indicate how these may be minimised. 4. Briefly discuss the indications and methods of total intravenous anaesthesia in the horse. P.T.O. for Questions List the common uses for mechanical stapling devices in equine surgery. For each use indicate the advantage of the device over more conventional techniques. 6. List the basic essentials for a start-up internal fixation kit for general equine practice. 7. Review the techniques available for cleaning and sterilisation of fibreoptic equipment prior to diagnostic or surgical use. 8. Write short notes on the use of surgical drains in equine surgery. 9. List FIVE different types of wound dressing available for use in the horse, and briefly discuss the indication for each type of dressing. 10. A horse on which you are about to perform elective surgery under general anaesthesia suffers a sudden cardiac arrest straight after anaesthetic induction. Briefly discuss the actions that you would take to both diagnose and treat this problem.

27 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY WEDNESDAY 8 AUGUST 2001 PAPER ll- ORTHOPAEDIC SURGERY (3 hours) (This Paper to be answered ONLY by those Candidates whose elective is Orthopaedic Surgery) This paper is in two sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each section. Illegible handwriting may result in examiners being unable to award marks for information which candidates intend to convey. If insufficient time is available to answer a question fully, it will be acceptable to complete in note form. Section A (1½ hours) Candidates must answer THREE of the FOUR questions set. (Allow approximately 30 minutes to answer each question.) 1. A dressage horse working at Grand Prix level shows a unilateral hindlimb lameness that is abolished by injection of local anaesthetic into the metatarsophalangeal digital flexor sheath. Provide your differential diagnosis of this problem and, with reference to the anatomy, describe how you would investigate the case in order to arrive at a definite diagnosis. For each condition, briefly list any useful treatment and the likely prognosis. 2. Discuss critically the use of corrective farriery in the treatment of orthopaedic conditions that do not relate to the foot. 3. Describe the potential complications that may occur following internal fracture fixation in the horse. Indicate the risk factors for each complication and describe the methods that may be employed to minimise their occurrence. State how you would manage each complication.

28 4. From your own experience, discuss the use of arthrodesis techniques in equine practice, giving details of your preferred techniques for individual joints and the prognoses you give to your clients. P.T.O. FOR SECTION B THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY WEDNESDAY 8 AUGUST 2001 PAPER ll - ORTHOPAEDIC SURGERY (3 hours) (This Paper to be answered ONLY by those Candidates whose elective is Orthopaedic Surgery) This paper is in two sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each section. Illegible handwriting may result in examiners being unable to award marks for information which candidates intend to convey. If insufficient time is available to answer a question fully, it will be acceptable to complete in note form. Section B (1½ hours) Candidates must answer ALL TEN questions. (Allow approximately 9 minutes to answer each question.) 1. Summarise the problems of extensor tendon rupture in foals. 2. Briefly review the syndrome of acute thrombosis of limb arteries in horses. 3. With the aid of a diagram describe the approaches that may be used to collect a synovial sample from the elbow joint of a horse. 4. LIST the reasons for the wide range of outcomes in the treatment of fractures of the accessory carpal bone.

29 5. You are asked to examine a 7 year old National Hunt steeplechaser which had a surgical (lag screw) repair of a lateral condylar fracture of the third metacarpus 10 months previously, and is still moderately lame with pain localised to the level of the metacarpophalangeal joint by perineural local anaesthesia. Briefly discuss the reasons why such a horse may still be lame. P.T.O. FOR QUESTIONS Briefly describe your approach to the management of a six-week-old foal with a unilateral carpal valgus angular limb deformity. 7. Make notes on the treatment of sepsis of the sustentaculum tali in an adult riding horse. 8. Discuss the complications that may be seen in a horse that is being treated using a full hind limb cast up to the level of the proximal tibial crest. 9. List the advantages and disadvantages of local anaesthetic techniques for the diagnosis of foot pain in the horse. 10. Outline the use of ultrasonographic imaging techniques for the investigation of chronic back pain in the horse.

30 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY WEDNESDAY 8 AUGUST 2001 PAPER ll SOFT TISSUE SURGERY (3 hours) (This Paper to be answered ONLY by those Candidates whose elective is Soft Tissue Surgery) This paper is in two sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each section. Illegible handwriting may result in examiners being unable to award marks for information which candidates intend to convey. If insufficient time is available to answer a question fully, it will be acceptable to complete in note form. Section A (1½ hours) Candidates must answer THREE of the FOUR questions set. (Allow approximately 30 minutes to answer each question.) 1. Despite a course of antibiotics given by the stud manager, a ten day old filly foal shows signs of persistent purulent discharge from a thickened umbilicus. The filly also has a diffusely swollen left forelimb carpus. Explain in detail how would you investigate this case and the surgical techniques that may be required to resolve the problem. 2. Discuss the problem of peritoneal and serosal adhesions following colic surgery in the horse. By referring to your knowledge of tissue healing and pharmacology, suggest surgical and medical procedures to reduce the incidence of adhesions. 3. Discuss the various options available for the management of dorsal displacement of the soft palate (DDSP) in a racehorse. For each option indicate its advantages and disadvantages and, where appropriate describe the surgical

31 technique that would be used. Briefly state the rationale for each technique in view of the current opinions on the aetiology of DDSP. 4. A nine year old event horse gelding is admitted as an emergency to your clinic because earlier that day it has been involved in a stable fire, resulting in full thickness burns to 10% of the total body surface area. The burns are all on the neck and thorax. Describe in detail your monitoring and management of this case, both in the short and medium term. Discuss the possible complications of such an injury and the steps you would take to deal with them. P.T.O. FOR SECTION B THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY WEDNESDAY 8 AUGUST 2001 PAPER ll SOFT TISSUE SURGERY (3 hours) (This Paper to be answered ONLY by those Candidates whose elective is Soft Tissue Surgery) This paper is in two sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each section. Illegible handwriting may result in examiners being unable to award marks for information which candidates intend to convey. If insufficient time is available to answer a question fully, it will be acceptable to complete in note form. Section B (1½ hours) Candidates must answer ALL TEN questions. (Allow approximately 9 minutes to answer each question.) 1. Describe the management of oesophageal strictures in horses 2. Briefly discuss the following statement. Does radiography have any place in the diagnosis of upper respiratory tract disorders in the horse? 3. Make short notes on the techniques of:

32 a. testicular biopsy in the mature stallion b. vasectomy in the mature stallion. 4. Outline the differential diagnosis, investigation and treatment of unilateral mammary gland enlargement in a mature mare. 5. Reviewing the relevant anatomy where necessary, briefly list the techniques that can be used to aid the equine surgeon in the localisation of a retained testicle in a cryptorchid horse. P.T.O. FOR QUESTIONS An aged mare suffers a rectal prolapse after foaling. How would you manage this case? 7. List the nerves that may be affected by mycotic infection of a guttural pouch. For each nerve state the clinical signs that would be observed when the nerve function is compromised by a guttural pouch mycosis. 8. Describe the methods available for closure of a hysterotomy incision following caesarean section in a mare. Comment on the advantages and disadvantages of each method. 9. Briefly list the steps that may be employed to minimise the risk of post-operative ileus (POI) developing following abdominal surgery in the horse. List the options available to treat a horse with POI following abdominal surgery indicating those that appear to offer a practical advantage in the treatment of this condition. 10. A 15 year old gelding is presented with an advanced squamous cell carcinoma that involves both the body of the penis and the prepuce. List, giving brief details, the possible surgical treatments of this case, and possible complications

33

34 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY (SOFT TISSUE) WEDNESDAY 31 JULY 2002 PAPER I (2 hours) This Paper is in two Sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each Section Illegible handwriting may result in examiners being unable to award marks for information which candidates intended to convey. SECTION A GENERAL SURGERY (1 hour) Candidates are required to answer ALL of the following EIGHT questions. Write short notes and use clear diagrams where applicable. Allow 7½ minutes per question 1 List TEN the practical measures that can be taken to reduce the risk of post-anaesthetic myopathy. 2 List EIGHT benefits of bandaging in the treatment of open wounds on the lower limb. 3 Write notes on the prophylactic use of systemic antimicrobials in clean or clean/contaminated procedures. 4 Prepare a table to compare chlorhexidine and povidone-iodine in their use as antiseptic agents, indicating where one has an advantage over the other. 5 Write short notes on the different types of tissue retractors that are commonly used in equine surgery. 6 With the aid of diagrams describe the following suture patterns, giving an example of one application for each. a) Lembert b) Gambee c) Triple loop pulley. P.T.O. for Questions 7 and 8

35 7 Give an acceptable normal range (with units) for the following parameters in a healthy and uncompromised anaesthetised horse. a) PaO2 b) HCO3 - c) Base excess d) Mean arterial pressure e) Na + f) K + 8 Write brief notes on the important practical considerations of whole blood transfusions in horses.

36 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY (SOFT TISSUE) WEDNESDAY 31 JULY 2002 PAPER I SECTION B SOFT TISSUE (1 hour) Candidates are required to answer ALL of the following FOUR questions. Write short notes and use clear diagrams where applicable. Allow 15 minutes per question 1 Describe how you would investigate a fresh laceration on the palmar and medial aspect of the distal pastern region, involving the coronary band. 2 Describe and justify your technique for managing a complete, unstable fracture across the mid-diastema of a mandible in an adult horse. 3 Use a cross sectional diagram to explain grade 3a rectal tears. Describe briefly how such tears generally arise and how they might be assessed and managed. 4 Outline the pathophysiological events that follow the onset of an uncorrected strangulating intestinal obstruction in a horse.

37 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY (SOFT TISSUE) WEDNESDAY 31 JULY 2002 PAPER II SOFT TISSUE (2 hours) This Paper is in two Sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each Section Illegible handwriting may result in examiners being unable to award marks for information which candidates intended to convey. SECTION A (l hour) Candidates are required to answer ALL of the following EIGHT questions. Write short notes and use clear diagrams where applicable. Allow 7½ minutes per question. 1 With the aid of a diagram illustrate the anatomic structures visible within the normal left guttural pouch, as seen endoscopically. 2 List the risk factors for incisional herniation following colic surgery by midline laparotomy. Write short notes on the management of such herniae. 3 Write short notes on the diagnosis of uroperitoneum in the equine neonate. List the possible causes. 4 State and briefly explain your preferred choices of suture material and technique for the following purposes. a) end to end small colon anastomosis b) repair of a cystotomy c) creation of a new rectovaginal shelf in a rectovaginal laceration repair.

38 P.T.O. for Questions List the possible complications following repulsion of the first molar tooth from a maxillary arcade. Indicate how each might be managed. 6 Describe your preferred method for performing a distal phallectomy. 7 Write short notes on your criteria for selecting an analgesic when treating a horse with colic. 8 Write short notes on the prophylaxis for ileus following small intestinal enterectomy. P.T.O. For Section B

39 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY (SOFT TISSUE) WEDNESDAY 31 JULY 2002 PAPER II SOFT TISSUE (2 hours) SECTION B (l hour) Candidates are required to answer TWO of the following THREE essay questions. Allow 30 minutes per question. Illegible handwriting may result in examiners being unable to award marks for information which candidates intended to convey. If insufficient time is available to answer a question fully, it will be acceptable to complete in note form. 1 Describe your clinical rationale in deciding how to manage cases of dystocia in the mare. 2 Describe the diagnosis and treatment of cases of large colon volvulus. How can you assess the prognosis for such cases? 3 Briefly describe the factors that might lead you to advise skin grafting in horses using full-thickness, island autografts. Describe the physiological principles that govern the acceptance or failure of such grafts.

40 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY (ORTHOPAEDICS) WEDNESDAY 30 JULY 2003 PAPER I (2 hours) This Paper is in two Sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each Section Illegible handwriting may result in examiners being unable to award marks for information which candidates intended to convey. SECTION A GENERAL SURGERY (1 hour) Candidates are required to answer ALL of the following EIGHT questions. Write short notes and use clear diagrams where applicable. Allow 7½ minutes per question 1. List THREE potential complications, which may be associated with intravenous fluid therapy in the horse, and describe how the risks of such complications may be minimised. 2. Write short notes on the use of ethylene oxide for the sterilisation of surgical instruments. 3. Write short notes on the mechanism of action and application of the following antimicrobial agents in the horse: a) Ceftiofur sodium. b) Enrofloxacin. c) Metronidazole. 4. Write short notes describing THREE different types of surgical drains and their applications in equine surgery. P.T.O. for Questions 5, 6, 7 and 8

41 5. Briefly state and justify how haemostasis can best be achieved during the following surgical procedures. a) Pedal bone sequestrum removal b) ethmoid haematoma removal c) uterine closure during caesarean section hysterotomy d) Partial penile amputation e) Persistent haemorrhage following open castration. 6. A sick diarrhoeic neonatal foal, which has been admitted to your hospital, dies. The mare is sent back to the stud from which she came. The following morning the laboratory confirms a profuse growth of Salmonella-like organism from the foal s faecal swab. List the actions you should take in a logical, sequential order. 7. Briefly, what are the advantages and disadvantages of the following suture materials? a) Polydioxanone b) Polyglactin 910 c) Silk d) Poliglecaprone a) Describe the mechanism of action of local anaesthetics. b) List the routes of administration, with an example of an appropriate agent for each route of administration.

42 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY (ORTHOPAEDICS) WEDNESDAY 30 JULY 2003 PAPER I SECTION B ORTHOPAEDICS (1 hour) Candidates are required to answer ALL of the following FOUR questions. Write short notes and use clear diagrams where applicable. Allow 15 minutes per question 9. Discuss the use of local anaesthetic agents in lameness diagnosis. 10. a) Describe the various surgical methods used to treat sepsis affecting the tarsocrural joint in an adult horse. b) How would you maximise the chance of a successful outcome? 11. a) Describe the aetiopathogenesis of dorsal metacarpal bone disease. b) Outline the diagnosis and treatment options for this condition. 12. LIST the TWO major types of fractures of the plantar proximal first phalanx. Comment on the clinical features, treatment and prognosis for each type.

43 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY (ORTHOPAEDICS) WEDNESDAY 30 JULY 2003 PAPER II - ORTHOPAEDICS (2 hours) This Paper is in two Sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each Section Illegible handwriting may result in examiners being unable to award marks for information which candidates intended to convey. SECTION A (l hour) Candidates are required to answer ALL of the following EIGHT questions. Write short notes and use clear diagrams where applicable. Allow 7½ minutes per question. 1. Briefly describe techniques used for imaging the palmar region of the equine foot, indicating advantages and limitations of each in the diagnosis of palmar foot pain. 2. A horse is presented with a wound over the lateral proximal sesamoid on one hind limb. Briefly describe how you would manage this case, indicating the structures, which may be involved and how you would deal with each lesion. 3. List the commonly recognised sites for stress fractures in young thoroughbred racehorses. Indicate which are most common, and which are rare. 4. You are presented with a set of good quality, plain, standing, lateral radiographs of the cervical vertebrae of a 3 year-old thoroughbred colt, suspected to be suffering from cervical vertebral malformation ( Wobbler Syndrome ). Briefly describe the radiographic features you would inspect with reference to this condition, listing the radiological changes which would support a diagnosis of CVM. P.T.O. for Questions 5, 6, 7 and 8

44 5. Write short notes on molecular markers of cartilage and bone metabolism. 6. State the precise origin and insertion of the peroneus tertius muscle. How would you diagnose and treat a rupture of this muscle, and what is the prognosis? 7. What techniques are in clinical use to stimulate articular resurfacing? Make brief notes on the benefits and limitations of each technique. 8. List the situations when you would select 5.5mm ASIF screws in equine orthopaedic surgery. What properties of 5.5mm screws influence your selection of that particular screw type? P.T.O. for Section B

45 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY (ORTHOPAEDICS) WEDNESDAY 30 JULY 2003 PAPER II - ORTHOPAEDICS (2 hours) SECTION B (l hour) Candidates are required to answer TWO of the following THREE essay questions. Allow 30 minutes per question. Illegible handwriting may result in examiners being unable to award marks for information which candidates intended to convey. 9. Describe your initial management, investigation and treatment of a horse that sustains an acute medial condylar fracture of a metatarsus at a racecourse. What is the prognosis? 10. Describe how you would investigate sudden onset ataxia in a 2 year-old Thoroughbred filly. 11. Discuss the diagnosis and treatment of suspensory ligament problems in the horse. THE ROYAL COLLEGE OF VETERINARY SURGEONS

46 CERTIFICATE IN EQUINE SURGERY (SOFT TISSUE SURGERY) WEDNESDAY 30 JULY 2003 PAPER I (2 hours) This Paper is in two Sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each Section Illegible handwriting may result in examiners being unable to award marks for information which candidates intended to convey. SECTION A GENERAL SURGERY (1 hour) Candidates are required to answer ALL of the following EIGHT questions. Write short notes and use clear diagrams where applicable. Allow 7½ minutes per question 1. List THREE potential complications, which may be associated with intravenous fluid therapy in the horse, and describe how the risks of such complications may be minimised. 2. Write short notes on the use of ethylene oxide for the sterilisation of surgical instruments. 3. Write short notes on the mechanism of action and application of the following antimicrobial agents in the horse: a) Ceftiofur sodium. b) Enrofloxacin. c) Metronidazole. 4. Write short notes describing THREE different types of surgical drains and their applications in equine surgery. P.T.O. for Questions 5, 6, 7 and 8

47 6. Briefly state and justify how haemostasis can best be achieved during the following surgical procedures. a) Pedal bone sequestrum removal b) ethmoid haematoma removal c) uterine closure during caesarean section hysterotomy d) Partial penile amputation e) Persistent haemorrhage following open castration. 6. A sick diarrhoeic neonatal foal, which has been admitted to your hospital, dies. The mare is sent back to the stud from which she came. The following morning the laboratory confirms a profuse growth of Salmonella-like organism from the foal s faecal swab. List the actions you should take in a logical, sequential order. 7. Briefly, what are the advantages and disadvantages of the following suture materials? a) Polydioxanone b) Polyglactin 910 c) Silk d) Poliglecaprone a) Describe the mechanism of action of local anaesthetics. b) List the routes of administration, with an example of an appropriate agent for each route of administration. P.T.O. for Section B THE ROYAL COLLEGE OF VETERINARY SURGEONS

48 CERTIFICATE IN EQUINE SURGERY (SOFT TISSUE SURGERY) WEDNESDAY 30 JULY 2003 PAPER I SECTION B SOFT TISSUE SURGERY (1 hour) Candidates are required to answer ALL of the following FOUR questions. Write short notes and use clear diagrams where applicable. Allow 15 minutes per question 9. Describe the clinical manifestations of equine squamous cell carcinoma. Briefly describe the treatment options for SCC of the third eyelid in a horse. 10. Describe the hypotheses for the aetiology of dorsal displacement of the soft palate, including experimental data to support them. Outline the surgical treatments available for treatment of this condition. 11. Discuss the different types of intestinal disease involving the caecum, including possible causes and treatments. 12. List FOUR conditions of the horse potentially resulting in a fatal haemorrhage. Make brief notes about the surgical treatment of ONE naturally occurring condition and the prevention of ONE iatrogenic condition.

49 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY (SOFT TISSUE SURGERY) WEDNESDAY 30 JULY 2003 PAPER II - SOFT TISSUE SURGERY (2 hours) This Paper is in two Sections (A and B) and instructions relating to the number of questions to be answered are given at the head of each Section Illegible handwriting may result in examiners being unable to award marks for information which candidates intended to convey. SECTION A (l hour) Candidates are required to answer ALL of the following EIGHT questions. Write short notes and use clear diagrams where applicable. Allow 7½ minutes per question. 1. List the surgical approaches to the equine guttural pouches with relevant landmarks and an indication for each technique. 2. Outline the aetiopathogenesis recurrent laryngeal neuropathy (RLN, ILH). With the aid of a diagram, demonstrate which muscles are affected. Briefly describe ONE commonly used grading system for this disease. 3. Briefly outline (with diagrams) how you would diagnose and treat a late gestational mare presented with uterine torsion. 4. Outline the factors which affect the success of an equine skin graft. 5. List the conditions affecting the paranasal sinuses that can be managed in the standing horse. List the technique for each case. P.T.O. for Questions 6, 7 and 8

50 6. Describe briefly the steps which can be taken to try and prevent ventral midline incisional hernias after laparotomy. How can they be repaired? 7. With the use of diagrams, briefly outline the events leading to the formation of adhesions in the equine gastrointestinal tract. List THREE extrinsic treatments currently used to limit the development of postoperative adhesions following colic surgery. 8. Write short notes on 4 th branchial arch anomalies. P.T.O. for Section B

51 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY (SOFT TISSUE SURGERY) WEDNESDAY 30 JULY 2003 PAPER II - SOFT TISSUE SURGERY (2 hours) SECTION B (l hour) Candidates are required to answer TWO of the following THREE essay questions. Allow 30 minutes per question. Illegible handwriting may result in examiners being unable to award marks for information which candidates intended to convey. 9. Describe the surgical techniques available for removal of a second maxillary cheek tooth with an apical abscess in a 7 year-old horse. Discuss the factors which would influence your choice of technique and the predicted outcome. 10. Discuss the potential complications following surgical correction of a pedunculated lipoma in a 19 year-old Shetland pony. Describe how you would manage a thoroughbred cross gelding showing signs of colic 48 hours after undergoing a jejunocaecostomy. 11. List FOUR causes of uroperitoneum in the equine neonate, and discuss their diagnosis, treatment and management.

52 THE ROYAL COLLEGE OF VETERINARY SURGEONS CERTIFICATE IN EQUINE SURGERY (Soft Tissue) WEDNESDAY 19 JULY 2006 PAPER 1 (2 hours) SECTION A GENERAL SURGERY (1 hour) Candidates are required to answer ALL of the following EIGHT questions. Write short notes and use clear diagrams where applicable. Allow 7½ minutes per question 1. Your hospital has recently had an unacceptable level of intravenous catheter-related complications and a high incidence of jugular thrombophlebitis. What are the risk factors for a horse developing jugular thrombophlebitis? List the measures you would take to reduce the incidence of these complications. 2. Write short notes on the sequence of events between injury to a blood vessel and the formation of a clot. Use diagrams if required. 3. Magnetic resonance imaging is used increasingly as a diagnostic imaging modality in the horse. What are the differences between T1-weighted, T2 weighted and short inversion recovery (STIR) sequences? 4. Compare and contrast chlorhexidine and povidine-iodine as agents for surgical preparation and wound lavage. 5. What measures may be undertaken to reduce the incidence of problems during recovery from general anaesthesia in the horse? 6. List how you would classify equine surgical wounds and the characteristics of each classification.