1. What are the various grades of open fractures and how are each of these defined?
2. What is the first line antibiotic used for open fractures? When should they be started after wounding? How long should they be administered?
3. What is the reason to cover the open wound initially?
4. Describe care of the wound associated with an open fracture.
5. When is the proper time to culture the wound?
6. Describe management of grade IIIa & b fractures. 
7. List all of the Salter classification of fractures. 
8. How are fractures described? What are 2 reasons to describe a fracture?
9. List 4 configurations of fractures. 
10. What is the difference between a short oblique versus a transverse fracture. 
11. What are descriptors of fracture location?
12. How is displacement described?
13. Why is the type of a ballistic important? How is the energy of a ballistic calculated?
14. What are the four “A’s” for assessing a fracture after repair?
15. List rules for use of cerclage wire. Why shouldn’t only 1 cerclage wire be used? List 2 types of cerclage wire. 
16. Describe tension band repair.  How many pins should be used? How far away from the fracture line should the the hole be drilled in the bone? What is cold working? What is the effect if notching the wire?
17. List 6 mistakes of tension band application.
18. What size of IM pin size in the area  of the fracture? Is normograde or retrograde placement used when possible? How far should the pin be seated? If the pin is used with plates, how large should the pin be? Does stack pinning neutralize torsional forces?
19. What orientation should a lag screws be placed relative to the fracture line. 
20. How is the size of a screw determined so that the bone is not weakened? How many cortices on each fragment proximally and distally?
21. What measurement of the screw determines its size? What is screw pitch? Core diameter? How does the core diameter affect the moment of inertia? How many cutting flutes should a self tapping screw have? What is the proper shape of a screw thread 
22. Memorize the screw chart. 
23. How does a DCP plate work?
24. What is pre-stressing a plate and why is this done?
25. What are the differences of locking versus nonlocking DCP’s?
26. Describe the mechanics of a locking plate.
27. What is bone slicing in reference to screws?
28. List rules of external fixators. 

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1. What are the 4 phases of wound healing?
2. What the 3 primary cells are important during wound healing?
3. What signaling molecules are involved in wound healing?
4. Define autocrine, paracrine, juxtacrine and encocrine. 
5. List the various extracellular components involved in wound healing. 
6. What are 5 functions of the ECM?
7. What happened in the inflammatory phase?
8. What interleukin is released when wounding occurs?
9. What is released from the platelets during degranulation?
10. How does the platelet shape change during activation?
11. Which healing phase is most vulnerable to develop infection?
12. What two cells are very important during the inflammatory phase?
13. What happens during the early inflammatory phase of wound healing?
14. What happens during the late inflammatory phase of wound healing?
15. What is the function of the metalloproteases? What cell releases this enzyme?
16. What events happen during the proliferative phase?
17. What cells are the players during the proliferative phase?
18. Describe the process of collagen synthesis in the fibroblasts. 
19. What is graduation tissue?
20. Why does granulation tissue get pale as it matures?
21. Describe what happens during epithelialization. 
22. What is contact inhibition?
23. What happens during the maturation phase? How long does this phase last?
24. What is the strength of the wound after final healing?
25. What is contracture?

• Medical records
  1. Add a place holder for rDVM letter, surgery report, diagnosis, discharge and test results
  2. Add a template to a place holder
  3. Complete a report such as rDVM letter, surgery report, diagnosis and discharge
  4. review medical records in the DMS
  5. Add a PDF to the DMS
  6. Fax/email a report to primary care veterinarian
• Search for a patient
  1. By patient name
  2. By client name
  3. By phone number
• Labs on SpecVet
  1. Look up lab results
  2. Be able to edit a lab result
     1. click edit button
     2. go into lab and add edit
  3. Find missing lab results in the orphan labs
  4. Relink a missing orphan lab into the patient record
     1. find the order number of the missing lab
     2. go to orphan lab
     3. find the missing lab test
     4. put the order number in the appropriate to return lab to patient file
  5. Checking invoices
     1. Ensure accuracy of invoices, avoid double charges, avoid missed charges
     2. Patients staying longer than 24 hours ned to have at minimum the following on the invoices
        1. daytime hospitalization
        2. night time hospitalization
        3. analgesia per day
        4. fluid therapy per day (based on body weight)
        5. Any additional treatment such as injections (usually add automatically by smart flow), diagnostics such as blood work (usually added automatically by specvet unless technician forgets to hit the performed button), diagnostics like imaging
     3. Keep clients informed regarding balance of invoice if it is going over the top end of the estimate.

Smartflow

1. Be able to log into Smartflow from computer, laptop, phone
2. Approval doctor initial of a treatment sheet
3. Add or delete a treatment on a treatment flow sheet
4. Add a new flowsheet for the next day

Checking charges

Labs and radiologist’s reports: all reports obtained from a lab or radiologist must be discussed with the owner, preferably on the day of receipt from the third party, and a time period of no longer than 2 days should lapse between receiving results and a phone call or text message with the client. For simple results, text messages to report results is fine. For more complex diagnoses (also those that are unexpected bad news diagnoses) a phone call to the owner should be made.

Expectations of specialist

Vacations: Any specialist must inform Dr. Lisa Degner at least 6 weeks prior to a vacation so that we can find a fill in locum doctor. Having multiple doctors on vacation at the same time is not ideal. Please notify Dr. Lisa of when you are planning to go on vacation and see if other doctors are also on vacation at the same time. Vacations are unpaid time off, as we base paychecks on gross production.

Shared Cases between internal medicine and surgery:

1. The doctor receiving the financial compensation for the laboratory tests (cultures, histopathology and blood tests) is responsible to contact the client to inform them of the lab results and discuss the further treatment plan. The report also must be faxed to the primary care veterinarian with recommendations on further treatments.
2. Cases shared by two services (typically internal med and surgery)
   1. Any patient that has had surgery or of significant diagnostic/therapeutic procedure by internal medicine or surgery services must receive a phone call or text message to obtain a progress report on the patient. If the patient is shared between internal medicine and surgery, the service dealing with the patient lastly to the time of discharge is responsible for the following:
   2. Making sure the that charges are complete and accurate, however, surgery service or IM service is responsible for items that they have completed on the patient. If errors are noticed or charges are not up to date, regardless each service should help the other so that the invoices are accurate.
   3. Flowsheets in Smartflow are to be reviewed by the doctor at after they are made and to be reviewed at least once daily to check on the patient’s progress.