Pharmacy and Pharmacology
13%of exam
Drug calculationsDosage and CRIControlled substancesDrug classes and reversalAdministration routes
Surgical Nursing
13%of exam
Asepsis and sterilizationSurgical prepInstrument IDSterile fieldPerioperative monitoring
Dentistry
7%of exam
Triadan chartingPeriodontal probingProphy sequenceDental radiographsFORL recognition
Laboratory Procedures
9%of exam
Tube anticoagulantsHematology methodsUrinalysisParasitologyQuality control
Animal Care and Nursing
20%of exam
Diagnostic Imaging
6%of exam
ALARA safetyPositioningTechnique kVp mAsContrast agentsRadiation protection
Anesthesia
13%of exam
Machine checksMonitoring parametersBreathing systemsRecovery and extubationAnesthetic drugs
Emergency and Critical Care
7%of exam
Pain Management and Analgesia
7%of exam
Pain scoringMultimodal plansNSAID safetyLocal blocksPre-emptive analgesia
Communication and Client Relations
5%of exam
Informed consentTeach-back dischargeMedical records SOAPProfessionalismDocumentation
Quick Facts
- Exam
- VTNE
- Questions
- 170 MCQ
- Pass Score
- 425 scaled
- Pass Rate
- About 65%
- Time
- 3 hours
- Administrator
- AAVSB and PSI
- Cost
- $375 application fee
Drug Calculation Chain
Dose mg/kg x BW then divide
Dose: mg/kg x kgVolume: dose / concCRI: x60 / conc
NSAID vs Corticosteroid
NSAIDs
- COX inhibitor
- GI renal risk
- Never combine
Steroids
- Immunosuppress
- Anti-inflammatory
- Never combine
Both ulcer risk
Dosage Calculation Picker
- Need drug dose→mg/kg x BW(Dose in mg)
- Need drug volume→dose / concentration(Result mL)
- Need CRI mL/hr→dose x BW x 60(/ concentration)
- Need fluid deficit→BW x % x 1000(mL deficit)
- Need maintenance→60 mL/kg/day(Dog baseline)
- Need RER→70 x BW^0.75(kcal/day)
Pharmacy Calculations
- CRI
- Constant rate infusion
- mg/kg
- Dose per weight
- mL/hr
- Pump rate
- q12h
- Every 12 hours
- PO
- By mouth
- mEq
- Milliequivalent unit
- mcg/kg/min
- CRI dose rate
Atipamezole vs Naloxone
Atipamezole
- Alpha-2 reversal
- Dexmedetomidine
- Sedative reversal
Naloxone
- Opioid reversal
- Hydromorphone
- Pure mu antagonist
Sedative vs opioid
Pharmacology Drug Classes
- Naloxone
- Opioid reversal
- Atipamezole
- Alpha-2 reversal
- Maropitant
- NK-1 antiemetic
- Furosemide
- Loop diuretic
- Carprofen
- COX inhibitor NSAID
- Acepromazine
- Phenothiazine sedative
- Flumazenil
- Benzodiazepine reversal
Surgical Asepsis
- Mayo-Hegar
- Needle holder
- Metzenbaum
- Delicate tissue scissors
- Backhaus
- Towel clamp
- Spore test
- Sterilization proof
- Damp pack
- Treat contaminated
- Clean-contaminated
- Hollow viscus entry
- Clipping
- Preferred over shaving
Perioperative Flow
- Skin prep
- Incision outward circles
- Sterile zone
- Front gown and gloves
- Instrument count
- Reconcile before closure
- Circulator
- Non-sterile supply role
- Hands up
- Water drips to elbows
- Hypothermia
- Slows recovery and clotting
- Active warming
- Prevent heat loss
Triadan Quadrants
1R 2L upper 3L 4R lower
1xx right maxillary3xx left mandibularClockwise right to left
Dental Charting Triadan
- Triadan 1xx
- Right maxillary
- Triadan 2xx
- Left maxillary
- Triadan 3xx
- Left mandibular
- Triadan 4xx
- Right mandibular
- Tooth 104
- Right maxillary canine
- Adult dog
- 42 permanent teeth
- Adult cat
- 30 permanent teeth
Dental Prophylaxis
- Dog pocket
- 1-3 mm normal
- Cat sulcus
- Under 1 mm
- Prophy sequence
- Scale polish irrigate
- M3 mobility
- Severe extraction cue
- FORL
- Feline tooth resorption
- Cuffed ET
- Airway protection
- Low speed polish
- Avoid pulp heat damage
Lab Tubes and Anticoagulants
- EDTA purple
- CBC anticoagulant
- Sodium fluoride
- Gray top glucose
- Serum red
- Chemistry clots
- Lithium heparin
- Blood gas syringe
- Order of draw
- Prevent additive carryover
- Hemolysis
- Falsely raises potassium
- Gray top
- Inhibits glycolysis
Lab Diagnostic Methods
- Refractometer
- Urine specific gravity
- PCV
- Spun hematocrit tube
- Buffy coat
- WBC and platelets
- Fecal flotation
- Eggs float dense solution
- Diff-Quik
- Romanowsky cytology stain
- Neutrophil
- Most numerous WBC
- Reticulocyte
- Regenerative anemia marker
Five Rights of Meds
Patient drug dose route time
Right patientRight drug doseRight route time
Contact vs Airborne Precautions
Contact
- Gown gloves
- Dedicated equipment
- Treat last
Airborne
- Negative pressure
- N95 respirator
- Aerosol route
Surface vs aerosol
Vital Signs
- Rectal temp
- 100.5-102.5 F
- Dog HR
- 70-120 bpm
- Cat HR
- 140-220 bpm
- Resting RR
- 16-30 breaths per min
- CRT
- Under 2 seconds
- Maintenance fluid
- 60 mL/kg/day
- Gestation
- 63 days dog cat
Nursing Care and Husbandry
- RER formula
- 70 x BW^0.75
- Fluid deficit
- Weight times percent times 1000
- Decubital ulcer
- Reposition and pad
- Isolation rule
- Treat patient last
- Leptospirosis
- Zoonotic via urine
- Cage card
- ID allergies alerts
- Refeeding
- Start below RER
ALARA Principle
ALARA: time distance shielding
Short exposure timeStep back distanceLead apron shield
Barium vs Iodinated Contrast
Barium
- Upper GI study
- No perforation
- Cheaper
Iodinated
- Perforation safe
- Water-soluble
- Faster clearance
Perforation decides
Contrast Agent Picker
- No perforation→Barium(Upper GI)
- Perforation suspected→Iodinated(Water-soluble)
- Image too dark→Reduce mAs(Fix technique)
- Motion artifact→Sedate(Avoid retakes)
- High scatter→Collimate(Restrict beam)
Imaging Safety and Contrast
- ALARA
- Time distance shielding
- Collimation
- Restrict beam reduce scatter
- kVp
- Beam energy penetration
- mAs
- X-ray quantity density
- Lead PPE
- Out of primary beam
- Sedation
- For motion artifact
- Right lateral
- Right side down
- Barium
- Upper GI no perforation
- Iodinated
- Safe if perforation
SpO2 vs EtCO2
SpO2
- Oxygenation
- 95-100 percent
- Hemoglobin saturation
EtCO2
- Ventilation
- 35-45 mmHg
- CO2 elimination
O2 vs CO2
Anesthesia Troubleshooting
- EtCO2 rising→Assist ventilation(Hypoventilation)
- SpO2 below 90→Check airway O2(Hypoxemia)
- Hypotension→Reduce depth(Per clinician)
- Bradycardia→Atropine(Anticholinergic)
- Hypothermia→Active warming(Monitor temp)
- Shallow breathing→Ventilate(Check depth)
Anesthesia Monitoring
- EtCO2
- 35-45 mmHg ventilation
- SpO2
- 95-100 percent saturation
- Hypotension
- Reduce anesthetic depth
- Bradycardia
- Atropine anticholinergic
- Depth signs
- Eye position jaw tone
- Preoxygenation
- Oxygen reserve before induction
- Hypothermia
- Slows recovery metabolism
Anesthesia Equipment
- Cuffed ET
- Secure airway prevent aspiration
- Non-rebreathing
- Under 5-7 kg
- Soda lime
- CO2 absorbent change when colored
- Scavenging
- Remove waste anesthetic gas
- Pop-off valve
- Keep open avoid barotrauma
- Leak test
- Before every anesthetic case
- Brachycephalic
- Extubate fully awake
RECOVER CPR
RECOVER: CAB then drugs
C compressions 100-120A airway intubateB breathe 10/min
Triage Priority Order
- Airway blocked→Intubate first(A first)
- Breathing cyanotic→O2 first(B priority)
- Shock signs→Crystalloid bolus(10-20 mL/kg)
- GDV tympany→Stabilize then surgery(Emergency)
- Heatstroke→Cool actively(Stop 103 F)
Emergency and CPR
- RECOVER rate
- 100-120 compressions per min
- Compression depth
- One-third to half chest
- Ventilation
- 10 breaths per min
- Triage ABC
- Airway breathing first
- Shock bolus
- 10-20 mL per kg
- Heatstroke
- Stop cooling at 103 F
- GDV
- Tympany unproductive retching
- Emesis
- Noncaustic toxin only
Pre-emptive vs Rescue Analgesia
Pre-emptive
- Before stimulus
- Prevents wind-up
- Lower total drug
Rescue
- After pain onset
- Harder to control
- More drug needed
Before vs after
Pain and Analgesia
- Multimodal
- Different pain pathways
- Pre-emptive
- Before painful stimulus
- Opioids
- Acute pain cornerstone
- NSAIDs
- COX inhibitor renal caution
- Bupivacaine
- No IV regional
- Lidocaine
- Nerve conduction block
- Glasgow scale
- Standardize pain assessment
- Cat pain
- Hiding reduced grooming
Client Communication
- Teach-back
- Confirm client understanding
- Informed consent
- Risks options signature
- Discharge
- Written home instructions
- SOAP
- Subjective objective assessment plan
- Treatment sheet
- Schedule and document
- Professionalism
- Empathy and clear language
Common Traps
Sterile field break
Glove outer is sterile ≠ Glove cuff not sterile
KCl route danger
Never IV push bolus ≠ Dilute and infuse slowly
NSAID steroid combo
Both cause GI ulcers ≠ Never give together
Bupivacaine IV risk
Cardiotoxic if IV ≠ Regional block only
Damp autoclave pack
Moisture wicks microbes ≠ Reprocess as contaminated
Barium perforation
Barium causes granuloma ≠ Use iodinated instead
SpO2 EtCO2 confusion
SpO2 is oxygenation ≠ EtCO2 is ventilation
Last Minute
- 1.RER = 70 x BW^0.75
- 2.Maintenance 60 mL/kg/day
- 3.Pass score 425 scaled
- 4.170 questions 3 hours
- 5.RECOVER 100-120 compressions per min
- 6.EtCO2 target 35-45 mmHg
- 7.SpO2 target 95-100%
- 8.Bupivacaine no IV regional
- 9.KCl never IV bolus
- 10.Barium no perforation
- 11.Extubate brachycephalic awake
- 12.Triadan 1R upper 3L lower
- 13.Animal care 20% top weight
- 14.NSAIDs inhibit COX enzyme
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