NAVLE Question of the Day

Which nerve block would most specifically relieve lameness resulting from fracture of the navicular bone? A - Low four point B - Abaxial sesamoidean C - Palmar digital D - Median and ulnar E - Tibial and peroneal

C - Palmar digital -PD or heel block. desensitizes 70-80% of the foot in horses. This block is the most specific for the navicular bone.

An owner brings her 4-year old female Labrador Retriever to your clinic because she believes she might be pregnant. She does not remember when the dog's last heat cycle was. The dog's abdomen appears fairly distended and you take a lateral abdominal radiograph which is shown below. What would be the earliest time you would expect to be able to see fetal skeletons on abdominal radiographs in the dog? 43 days gestation 33 days gestation 23 days gestation 53 days gestation

43 days

At what age do a cow's permanent 4th incisors begin to erupt in the mandible? A - 3.5 to 4 years B - 2 to 2.5 C - 3 years D - 5-6 years E - 7-8 years

A - 3.5 to 4 years -the 4th incisors are actually canine teeth. Cattle age is not always given in a history and estimating age during PE helps narrow differentials. -1st permanent incisor: 1-1.5 years -2nd permanent incisor: 2-2.5 years -3rd permanent incisor: 3.5 years -4th permanent incisor: 3.4-4 years -full eruption of a new tooth can take another 6 months

A dozen young chickens at a broiler-raising facility are found dead on their backs and sides with no premonitory signs. Other birds appear cyanotic, with distended and reddened abdoments and congested blood vessels. Affected birds have an increased respiratory rate and reduced exercise tolerance. Necropsy of a dead chicken shows typical lesions below. What is the clinical diagnosis? A- Ascites syndrome B - Flip over disease C - Spontaneous cardiomyopathy D - Dissection aneurysm E - Infectious bursal disease

A - Ascites syndroms Suddenly dead/cyanotic, panting chickens with abdomens distended by ascites fluid suggests ascites syndrome (waterbelly). It is a form of right ventricular heart failure secondary to pulmonary hypertension or more rarely, hepatic failure. Because broilers affected with ascites syndrome frequently die on their backs, differential diagnosis includes flip-over disease.

A 12-week-old chicken from a young backyard flock is presented for evaluation because of weight loss, decreased appetite and diarrhea. The irises in the affected bird are lighter than normal with irregylar pupillary margins, and the hendoes not have a normal pupullary light reflex. Several other young birds appear to be growing poorly compared to the rest of the flock. Based on the presumptive diagnosis, how can this problem be prevented going forward? A - Buy only vaccinated chicks B - Use only mucoplasma-resistant bloodlines for new additions to flock C - Cull birds from the same genetic line D - Collect pharyngeal swaps from affected birds; Antibiotic Rx for entire flock based on culture and sensitivity. E - Isolate unaffected animals; breed from survivors of disease.

A - Buy only vaccinated chicks. This chicken is likely to have ocular manifestations of Marek disease. There is no treatment, but it is preventable when chicks are vaccinated at hatching or before two weeks of age.

A four-month old mixed breed puppy is presented with a one-month history of generalized wobbliness when walking and head bobbing when attempting to eat. Owners do not think there has been progression of the signs. Based on the MRI findings, which one of the following choices is most likely the diagnosis? A - Cerebellar hypoplasia B - Normal MRI C - Chiari malformation D - Lead toxicosis E - Distemper encephalitis

A - Cerebellar hypoplasia Likly cerebellar hypoplasia, although cerebellar abiotrophy is also possible. The MRI shows that the cerebellum is small with a resulting large collection of CSF in the vicinity.

A 1.5-year old Quarter Horse gelding is presented to you for symmetric ataxia, weakness, and spasticity of all limbs, but worse in the hind limbs. When walking, the horse frequently drags his toes and the hind limbs frequently interfere with one another. Based on the signalment, history and physical examination findings, which of the following is the most likely cause of these clinical signs? A - equine degenerative myeloencephalopathy (EDM) B - equine motor neuron disease (EMND) C - equine protozoal myeloencephalitis (EPM) D - cauda equina syndrome E - botulism

A - EDM The horse in this question has clinical signs most consistent with EDM; cervical vertebral malformation (wobblers) is also a possibility, but was not provided as an answer. The cause of EDM is unknown, but this disease typically affects young horses (< 2-3 years of age; but older horses can develop disease). Clinical signs are a result of diffuse neuronal fiber degeneration of various portions of the central nervous system. This disease has been associated with low serum vitamin E concentrations, suggesting that oxidative damage may play a role in the development of disease. EMND is typically associated with muscle tremors, shifting of weight while standing, muscle atrophy and recumbency. Botulism is associated with generalized muscle weakness. Cauda equina syndrome causes analgesia of the perineum. EPM can cause a range of clinical signs, but is typically with asymmetric neurologic deficits.

A hobbyist fish owner is concerned because many of the fish in his freshwater tank have cloudy eyes, inflammation and necrosis of the gills, and excess mucus covering them. They seem to be moving slowly.Based on this history what is the most important question to ask? A - Have you cleaned with chlorine recently? B - Were any new fish added to the aquarium in the last month? C - How often do you measure ammonia levels in the tank water?D - What are the levels of vitamin A in the feed? E - When were these fish last treated with ivermectin?

A - Have you cleaned with chlorine recently? Chlorine is commonly used to disinfect tanks and equipment but is highly toxic to fish. This is a common problem because both chlorine and chloramine are frequently found in municipal water sources. Chronic chlorine exposure results in signs as described here: cloudy eyes, inflammation and necrosis of the gills, excess mucus covering gills, and lethargy. Acute chlorine toxicosis can cause sudden death. Treat with dechlorination products and recheck both free and total chlorine levels.

Two eight-week old calves are presented down and extremely weak. They are depressed and lying in pools of foul-smelling brown diarrhea with a small amount of blood. Another calf died suddenly the previous night with no prior signs. The down calves are dehydrated, with rectal temperatures of 105.2A. What is the treatment plan? A - IV fluids; NSAIDS; frequent milk feedings B - Corticosteroids; amprolium in water; rumensin in feed C - Isolate sick calves; oral electrolytes D - Immunize calves and adult cattle with MLV vaccine; probiotics for sick calves E - Cull sick calves; prophylactic oxytetracycline in feed for well animals

A - IV fluids; NSAIDS, frequent milk feedings -the symptoms described are indicative of septicemia due to salmonellosis. -Isolate sick calves -Parenteral antibiotics if animal is septic -Prognosis is poor with neonatal salmonella and deaths can approach 100% in affected calves.

A 12-year-old female spayed Laborador Retriever dog is presented for dental cleaning. After she is induced under general anesthesia, her pulse oximetry drops below normal at 91%. Thoracic radiographs show the following changes (see image). What is the most clincally significant finding evident on thoracic radiographs? A - Left cranial lung lobe has alveolar infiltrates B - Hear is globoid in appearance C - There is a gastric foreign body D - Osteochondritis dissecans is evident in the left shoulder E - Spondylosis deformans is present

A - Left cranial lung lobe has alveolar infiltrates Dog has pneumonia of the left cranial lung lobe. There are diffuse alveolar infiltrates within the left cranial lung lobe with air bronchograms. The anesthetized procedure should be cancelled since the patient is oxygenating poorly. Recheck radiographs when she is awake to rule out atelectasis due to recumbency and sedation.

If a mass appears in the lungs on a right lateral radiograph but not on a left lateral radiograph, where is the mass located? A - Left lung B - Mediastinum C - Right lung D - Body wall

A - Left lung On a right lateral radiograph, the right side is down. In the situation, the right lung lobes are compressed and the left lung lobes inflated, accentuating a mass in the left lung. On a left lateral radiograph, the left lobes are compressed and a mass in the left lung can be concealed due to compression of the lung surrounding the mass.

A 6-year old male neutered Weimaraner presents for left forelimb lameness. Radiographs are shown below and show a mixed productive and destructive lesion affecting the left distal radius with accompany soft tissue swelling. The lesion does not cross the joint. What is the most common primary bone tumor in the dog? A - Osteosarcoma B - Fibrosarcoma C - Multiple myeloma D - Chondrosarcoma E - Hemangiosarcoma

A - Osteosarcoma Chondrosarcoma, fibrosarcoma, and hemangiosarcoma can all be primary bone tumors but are much less common in dogs than osteosarcoma.

This nine-month-old German shepherd is presented for limping on the right forelimb. Radiographs show an un-united aconeal process on the right. What other problem is visible? A - Panosteitis B - Septic arthritis C - Hypertrophic osteopathy D - Osteoporosis E - Hypertrophic osteodystrophy

A - Panosteitis this is visible in the right proximal ulna (increased mineral opacity in the proximal ulna, caudal to the head of the R radius)

A 6-month old cat presents for having ptyalism and for being underweight. On physical examination, you note a bright copper color to that cat's iris bilaterally. What is this suggestive of? A - Portal systemic shunt B - Toxoplasmosis C - Hemolytic anemia D - Polycystic kidney disease

A - Portal systemic shunt Ptyalism is a sign commonly seen with PSS in cats but not dogs, and the copper-colored iris is a striking and almost pathognomonic finding in conjunction with other clinical findings. Hemolytic anemia could cause icterus, not change in iris color Polycystic kidney disease would not have a copper-colored iris. Toxoplasma can cause ocular signs like uvetis, but not this

Which of these are used in the minor cross match for blood products when looking for a compatible blood donor for a dog? A - Recipient RBCs, donor plasma B - Donor RBCs, recipient plasma C - Recipient RBCs, recipient plasma D - Donor RBCs, donor plasma

A - Recipient RBCs, donor plasma

A 6-year old West Highland White Terrier comes in to see you for the mucopurulent ocular discharge as seen in the photo below. A Schirmer tear test shows no tear production. What is the treatment of choice for chronic canine keratoconjunctivitis sicca? A - Topical cyclosporine and topical steroid B - systemic cyclosporine and antibiotics C - topicl cyclysporine and systemic corticosteroids

A - Topical cyclosporine and a topical steroid The correct answer is topical cyclosporine and a topical steroid. The treatment of KCS is aimed at reducing immune destruction of the lacrimal glands. Topical cyclosporine (Optimmune) and a topical steroid (frequently in a triple antibiotic/steroid ointment) are the treatment of choice. You should be cautious using steroids in acute cases due to the risk of corneal ulceration

Which of these nerve block is used to examine the eyes of a horse? A - Auriculopalpebral nerve block B - Oculomotor nerve block C - Trigeminal nerve block D - Corneal nerve block

A - auriculopalpebral nerve block Blocking this branch of cranial nerve VII (Facial) disrupts the motor innervation to the orbicularis oculi, which is the muscle that closes the eye. Use lidocaine; caudal aspect of zygomatic arch.

A 6-year old female spayed English Pointer presents for lethargy and weight gain. The owner notes that the dog is eating and drinking a normal amount, but the dog is still gaining weight. A physical exam reveals weak pelvic limbs, facial nerve paralysis, a symmetrically patchy haircoat, and seborrhea. Lab work reveals a normocytic, normochromic anemia with a PCV of 29%, lipermic serum, and cholesterol of 1090. What is the most likely diagnosis? A- Hypothyroidism B - Pituitary dependent hyperadrenocorticism C - Hyperthyroidism D - Adrenal dependent hyperadrenocorticism

A - hypothyroidism -all abnormalities are consistent with this. Other common abnormalities include pyoderma, neuromuscular signs, elevated triglycerides. Hyper is commonly seen in cats.

A 21-year old scarlet macaw is presented with polydipsia, watery droppings, and inappetence. On examination, the bird was fluffed and depressed with minimal pectoral muscle atrophy. The crop was fluctuant. Which of the following choices is most likely the diagnosis? A - retained egg B - vitamin D toxicosis C - Normal rads D - Thymoma E - Air sacculitis

A - retained egg The lateral radiograpjh shows a 4.5 cm, well circumscribed, soft tissue opacity in the central abdomen.

A ten-year-old female spayed Persian cat is presented for evaluation of a bleeding lump. There is a two-cm diameter, firm, solitary, hairless, dome-shaped, ulcerated mass on her left neck just behind the jaw that is bleeding. Cytology obtained by fine needle aspirate reveals cohesive clusters of large cells with round to oval nuclei that are tightly adherent to each other. Based on these findings, which choice is the most appropriate treatment option? A - Surgical removal B - Wide excision of mass, remove regional lymph node, prednisolone, radiotherapy. C - Debulk, intralesional implant chemotherapy, minimize sun and cigarette smoke exposure D - Cryosyrgery, debridement, repeat in 3-5 weeks E - immunotherapy, wide margin excision, chemotherapy

A - surgical removal This is a basal cell tumor. This tumor is benign, but surgical removal is the treatment of choice due to ulceration and secondary inflammation. This is common in older cats (15-26% of all feline skin tumors). Most are slow growing. Persians, Himalayans, and DLHs are predisposed.

In September in the southeastern US, a 2 year old angus heifer died the previous night. She had a 3 week history of poor appetite, unthriftiness, and diarrhea. Several other younger cows in this herd have the same symptoms the cattle are vaccinated yearly and dewormed twice a year. Necropsy reveal that the abomasum is edematous and covered with small umbilicated nodules, 1-2 mm in diameter (cobblestone appearance) What action should you take next? A-treat affected cows with 2 classes of dewormer B-medicate for liver flukes C-provide free choice monesin and thiamine supplemented feed. D-vaccinated against clostridium C and D E-provide loose trace mineral salt

A - treat affected cows with 2 classes of dewormer

A nine-year old Irish setter is presented for vomiting. The owner states that the dog does not really retch, but just spits up food soon after eating. The dog is normal otherwise. Based on the lateral radiograph below, which choice is most likely the diagnosis? A) megaesophagus B) persistent right aortic arch C) gastric foreign body D) pulmonary bullae F) mediastinal mass

A) megaesophagus

A dog hit by a car in the last three hours is presented recumbent and traumatized. Plain radiographs of the awake dog are shown below. Positioning is not perfect because the dog is in pain, but if there is a problem evident in the radiographm in which quadrant does it lie? A-upper right B-upper left C-looks normal D-lower left E-lower right

B-upper left -this is a left ilial fracture -when doing pelvic rads after trauma look for pelvic fractures, femoral fractures, hip dislocation/luxation

You are asked to perform a necropsy on a 17-year old Standardbred mare on a large horse ranch. Although not related to the cause of death, you notice the parasite shown in the image within the stomach. You tell the owner that this parasite is also responsible for the eggs that he sees seasonally on the hair of the front legs of his horses. The owner asks what should be done about this. You discuss the importance of promptly cleaning up feces and transporting feces away. In addition, which of the following is the most appropriate recommendation for ongoing control of this parasite?

Administer ivermectin twice annually, once in the early summer and again in the fall This case describes the appearance of the horse bot fly, Gasterophilus spp. Gasterophilus is frequently asymptomatic but treatment is recommended because bots can cause gastritis and frequently are a source of annoyance and stress to horses. In addition, the larval instars can cause stomatitis, and colic.

You are called to examine and treat a valuble 3-year old show cow that appeared normal yesterday but has collapsed and is too weak to get up. You examine her and find T=102F, HR=130, and RR=42. Her heart is pounding very loudly. The mucous membranes of her eyes, mouth and vulva are all very pale. You diagnose an acutely abomasal ulcer. What is the most important treatment? A - 40 liters balanced electrolytes orally B - 4-8 liters of fresh whole blood IV C - 4 liters of commercial plasma IV, plus vitamin K D - 20 liters of 1.3% sodium bicarbonate IV E - 40 liters of saline IV

B - 4-8 liters of fresh whole blood IV In the case of an acute blood loss like this, the most importnat treatment is whole blood. Other sodium containing fluids may be beneficial while the blood is being collected if this will not result in losing time in getting the whole blood into this cow. Most cases of single blood transfusion results in recovery.

A five-year old boxer is presented for routine vaccinations. The owner points out a small, smooth mass on the right ear. Fine needle aspiration cytology is shown below. Which one of the following choices is likely the diagnosis? A - Lymphoma B - Bacterial infection C - Histiocytoma D - Degranulating mast cell tumor E - Aural hematoma

B - Bacterial infection -Intra and extracellular bacteria are present in this cytology. The abcess should be drained and the animal placed on appropriate antibiotics.

A three-year old female goat presents in poor body conditions, slightly depressed, and febrile. The goat is mildly pruritic. The skin shows mild to moderate erythema and alopecia and marked hyperkeratosis and crusting on all four extremities, as shown in the image below. Skin scrapings are negative for mites. A cytology taken from the understide of a crust shows parallel stacks or rows of cocci ("railroid tracks") between keratinocytes, also shown below. Which one of the following choices is the most likely diagnosis. A - Malassezia dermatitis B - Dermatophilosis C - Streptococcus infection D - Pyoderma E - Dermatophytosis

B - Dermatophilosis This is a crusting dermatitis caused by the filamentous bacteria Dermatophilus congolensis that is seen in all ruminants and horses. Infection is seen most often in younger or systemically ill animals. Many are housed in areas with poor hygiene or without shelter. Excessive moisture, rainy conditions, skin damage, and concurrent illness that results in immunosuppression are predisposing factors.

A ten-year-old male neutered domestic shorthair cat is presented with a history of being hit by a car one month ago. There is recent onset of weight loss. Lung sounds are muffled on the right side. What is most likely the diagnosis based on interpretation of these radiographs? A - Aspiration pneumonia B - Diaphragmatic hernia C - Vascular ring anomaly D - Pleural effusion E - Megaesophagus

B - Diaphragmatic hernia There is soft tissue opacity of the right hemithorax. There are irregular gas opacities within the soft tissues of the right hemithorax. The trachea and carina appears displaced to the left. The cardiac silhouette is difficult to evaluate. In the viewable cranial abdomen, the stomach and liver are not identified.

The night affter Valentine's day, a male neutered Schnauzer is presented with a combination of hyperactivity, urinary accidents, and diarrhea. On physical exam there is muscle rigidity and chocolate wrappers in the diarrhea. The dog has a seizure on the exam table. An ECG is shown below. Which of the following is the best treatment plan? A - Activated charcoal, sodium sulfate, methocarbamol IV B - Diazepam, lidocaine drip C - Phenobarbital, glycopyrrolate D - Apomorphine, gastric lavage, Na-bicarbonate IV E - Ipecac, theophylline, digoxin

B - Diazepam, lidocaine drip You need to treat the ventricular tachycardia with a lidocaine drip and address seizures with diazepam or methocarbamol. If the response to diazepam is inadequate, consider barbiturates like phenobarbital (slowly given). This is a classic presentation of severe chocolate toxicity, due to mathyxanthine alkaloids like theobromine and caffiene. This is common around holidays, see excitement, seizures, and arrythmias. Induced apomorphine is appropriate up to 8 hours after exposure in asymptomatic dogs. When the animal is sedated because of seizures, consider gastric lavage. Give activated charcoal only if a lethal dose of chocolate was ingested. Chocolate will increase the risk of hypernatremia from activated charcoal, so the benefit must outweigh the risk. 49 grams of baking chocolate (2 oz bar) can kill a 4-kg dog. I t would take 420 grams of milk chocolate (8 2 oz bars) to kill a 7-kg dog.

Which of these is an adrenergic vasopressor in dogs? A - Atropine B - Dopamine C - Glycopyrrolate D - Hydralazine

B - Dopamine Frequently used to treat hypotension during anesthesia. Other drugs in this category include dobutamine, ephedrine, phenylephrine, and norepinephrine Atopine and glycopyrrolate are anticholinergic drugs hydralazine is a vasodilator used to treat hypertension

Roughly 10% of the dry sows in a herd of pigs have poor appetite, fever, and are coughing. There have been several late-term abortions and an increase in returns post-service. Some of the farrowing sows have poor appetite and thirst. Several have mastitis and/or agalactia and are farrowing 2-3 days early. Some piglets born alive have diarrhea, and some in the litter were born dead and mummified. There's been more respiratory disease in the piglets recently and the farmer has heard a funny thumping noise when the most severely affected piglets breath. The farmer noticed that several of the sows have transiently had blue ears. Based on the presumptive diagnosis, if this disease becomes endemic in the herd, which of the following is a likely sequela? A - Necrotic ear syndrome in piglets B - Enzootic pneumonia in grower/finisher units C - Chronic diarrhea in breeding sows D - Diamond shaped erythematous skin lesions in most pigs E - Neurologic syndromes in breeding boars

B - Enzootic pneumonia in grower/finisher units This is a likely sequela of PRRS. It is common to have increased enzootic pneumonia once the infection has spread to all parts of the herd. PRRS is caused by a highly contagious artevirus that is spread by fomites, aerosolization, insects, and silent shedders. There are 2 clinical phases; reproductive failure and postweaning resp diseases. Initial outbreak lasts 1-4 months, but can become chronic and endemic. PRRS is one of the most economically significant diseases in US swine production. Diagnostics include virus detection/serology of oral fluids.

What behavior is the mare displaying in the image below? A - Aggression B - Flehmen C - Lignophagia D - Cribbing E - Windsucking

B - Flehmen This behavior is seen as a normal stallion response to pheromones, a normal response of all horses to new smells, a sign of colic, or associated with granulosa cell tumors in mares. Other animals, like cats, show this response.

A 20-year-old Burmese python is presented for unusual lethargy after its meal of a rat. Which one of the following choices is the most likely diagnosis? A - egg peritonitis B - foreign body C - normal radiographs D - dysecdysis E - Pneumonia

B - Foreign body Linear amorphous heterogenous opacity consistent with fiber is visible throughout the proximal GI tract. A complete small animal skeleton, most likely the rat the snake also ingested, is visible immediately caudal to the fiber material.

A four-year old Rat Terrier is presented with a three day history of progressive stumbling and falling. Physical exam reveals a right head tilt, left sided hypermetria, generalized ataxia and vertical nystagmus. Which one of the following choices is at the top of the differential list? A - Ascending and descending myelomalacia B - Granulomatous meningoencephalitis C - Central pontine myelinolysis D - Fibrocartilagenous embolism E - Amyotrophic lateralizing sclerosis

B - Granulomatous -lesion that localizes to the left cerebellum, causing the left hypermetria and a right paradoxical head tilt. Another top differential would be cerebellar neoplasm. Ascending/descending myelomalacia: complication of thoracolombar intervertebral disk herniation. CS - sensory motor loss in pelvic limbs, tail. Central pontine myelinolysis: myelinosis of white matter tracts in pons. CS - rigid quadriparesis Fibrocartilagenous embolism: occurs following mild trauma or during vigorous exercise. It is the sudden onset of spinal cord injury due to blockage of blood supply to an area of the spinal cord. CS - crying out in pain, weakness, paralysis. Amyotrophic lateralizing sclerosis: loss of muscle control due to nerve cell damage in brain/spinal cord. This is Lou Gehrig's disease. CS - loss of coordination and weakness of hind legs. Sometimes mistaken for arthritis or intervertebral disc disease. Progresses to total hind-end paralysis, loss of urinary/bowel control, paralysis of front legs, and then death.

An obese eight-year-old Labrador Retriever is presented for annual vaccinations. The owners claim that they have restricted his diet and try to exercise him, but he still keeps the weight on. There is alopecia on the dorsum of his tail, and he has an unusual worried faicial expression. Which of the following choices is the most likely diagnosis? A - Hypoadrenocorticism B - Hypothyroidism C - Sarcoptic Mange D - Hyperadrenocorticism E - Male pattern alopecia

B - Hypothyroidism Tail alopecia and tragic facial expression are classic signs of hypothyroidism in dogs.

A farmer recently purchased a ram from a feedlot. The ram soon became ill, with progressive depression, lethargy, and inappetance. He had respiratory problems, breathing hard with abdominal effort, and died after three days with a frothy nasal discharge just prior to death. At necropsy, the lungs had the appearance shown below. What was the most likely cause of death? A - Ovine progressive pneumonia B - Mannheimia haemolytica C - Corynebacterium pseudotuberculosis D - Dictyocaulus filaria E - Perilla frutescens

B - Mannheimia haemolytica This is a type of pneumonia that has cranioventral distribution, demonstrated by the hepatized lung (dark red, liver like). Pneumonia with these pathogens is most common after recent stress or somingling with new animals. Prevention involves decreasing stress and exposure.

Which group is most at risk of developing the lesion evident in this image? (image of endocardiosis) A - Sheep or goats pastured above 2000 meters; Saanens B - Old, small breed dogs; Cavalier King Charles Spaniel C - Obese cats, any breed; Burmese cats D - Cattle without reticular magnets; Charolais E - Young horses ingesting Perilla mint; Standardbreds

B - Old, small breed dogs; Cavalier King Charles Spaniel -endocardiosis; degenerative valve disease. Thickening of mitral valve margins. -do not confuse with infective endocarditis (infection of cardiac vessels)

These larvae have been removed from the topline of beef cattle in the early winter (see below). Which one of the following treatments is the most appropriate in both dairy and beef cattle? A - Rapid hand expulsion/squeezing B - Pour-on moxidectin C - Organophosphate spray D - Chloramphenicol E - None. These are self-limiting

B - Pour-on moxidectin These are the larvae of Hypoderma bovis or H. lineatum (northern cattle grub). Pour-on moxidectin or eprinomectin are approved for use in both lactating dairy and beef cattle. Withdrawal times must be followed. While grubs can be manually expulsed/squeezed out, care must be taken to prevent grub rupture. This can lead to a systemic anaphylactic reaction.

A 7-year old Lhasa Apso presents to you for lethargy and inappetence. On your exam, you detect mandibular lymphadenopathy and perform a fine needle apirate. You see the aspirate depicted here. Which of these treatments would be given to this patient as part of a first line therapy? A-Doxycycline B-Prednisone C-Carboplatin D-Milbemycin E-Itraconazole

B - Prednisone This is a case of lymphoma. The cytology depicts the classic finding of a population of lymphoid cells that are predominantly lymphoblasts based on their size and characteristics.

A horse presents to you with a corneal ulcer. You are concerned because it appears to be infected, as shown in this image. You perform cytology and find gram negative rods. What is the most likely organism infecting the corneal ulcer in this horse? A - E. coli B - Pseudomonas C - Pasteurella multiocida D - Staphylococcus spp

B - Pseudomonas Most common agent causing bacterial keratitis in the horse. Staph: gram positive others: agents are not associated with keratitis in the horse

Under what conditions is a very sensitive test used? A - Zoonoses; untreatable disease B - Rare disease; early diagnosis improves prognosis C - Lethal disease; highly prevalent disease D - Treatment does not affect prognosis; non-infectious diseases E - Common disease; infectious diseases

B - Rare disease; early diagnosis improves prognosis You need a very sensitive test if: 1) the disease is rare 2) early diagnosis improves prognosis 3) the disease is highly lethal or consequences of missing a case are severe (rabies) Remembrer that a highly sensitive test will have very few false negative; if a highly sensitiive test is negative, you can trust it.

A lion is presented with a fracture of an upper left premolar, exposing the pulp. Dental radiographs are normal and no periodontal disease is present. Which of the following choices is the best treatment? A - Wait until the exposure fills in then re-radiograph B - Root canal therapy C - Extraction D - Restore the tooth with light cured resin E - Nothing

B - Root canal therapy Extraction is not necessary if the radiographs and periodontal tissue are normal.

A five-year-old lactating Holstein dairy cow is being evaluated for a two-month history of watery diarrhea, weight loss, and decline in milk production. On examination, the cow is bright, alert, and responsive with a good appetite, but is unthrifty and very thin, with a soft intermandibular swelling. What is the most appropriate management of this herd? A - Quarantine the premises, review biosecurity protocols B - Test herd, cull positives, remove calves from dam at birth C - Treat clinical animals, spread lime on pasture D - Increase protein in the ration, ensure 4 L colostrum intake E - Add coccidostat to ration, perform liver biopsies

B - Test herd, cull positives, remove calves from dam at birth This is likely to be Mycobacterium avium subspecies paratuberculosis (Johne's disease) There is no treatment. Test-and-cull programs offer the best chance of attaining a Johne's disease free herd. Calves should be birthed in manure-free areas. Dairy calves should be removed from the dam immediately after birth and bottle-fed pasteurized colostrum. They should be segregated as much as possible from adult cows. This is a reportable disease in some states.

A seven-year-old Thoroughbred event gelding is presented after coming up lame on the left forelimb following completion of a course. The horse is 4/5 lame on the left forelimb. There is moderate swelling over the palmar aspect of the left metacarpus as seen in the image below. The horse is sensitive to palpation of the swollen area. Which diagnostic would be most appropriate to recommend? A - Diagnostic perineurial anesthesia (aka nerve blocks) B - Ultrasound the metacarpus C - Nuclear scintigraphy (aka bone scan) D - No further diagnostics needed - diagnosis is clear E - Digital radiographs of the distal limb

B - Ultrasound of the metacarpus This appearance of a "bowed tendon" is a typical of an acute superficial digital flexor tendinitis. Ultrasound is necessary to confirm and to evaluate the extent and severity of the lesion.

A 10-year old male castrated cat that you have previously diagnosed with hyperthyroid ism presents to you for acute onset of blindness. You perform an opthalmic exam and note retinal hemmorrhage. What diagnostic test should you perform first? A - Total T4 levels B - Blood pressure C - Serum BUN and creatinine D - Coagulation times E - Free T4 levels by equilibrium dialysis

B - blood pressure Cats with hyperthyroidism are likely to develop hypertension. They can be at risk for acute retinal detachment or hemmorrhage resulting in blindness. Prompt resolution of the hypertension is critical to prevent further damage to the eye and other organs.

A 6-year old Friesian cow presents to you with a mass on the left mandible. The farmer reports that the mass has developed over th last several weeks and the cown has recently had some difficulty eating and lost weight. On examination, the mass is firm, immobile, and painful on manipulation. You note a thick discharge with small granular particles. Based on the most likely diagnosis, what should you tell the farmer? A - intravenous penicillins are likely to be effective B - treatment is unlikely to be successful and the cow should be culled C - Treatment with sodium iodide intravenously is likely curative, but the cow's milk and meat will not be suitable for human consumption for 120 dyas D - the most effective treatment is oral sodium iodide

B - cull -this is a case of Actinomyces bovis or 'lumpy jaw'

Half of the flock from a local broiler poultry farm has died in the last 10 days. Examination shows chickens that are gasping and coughing, extending their necks to inhale. Some have blood-stained beaks. There are no obvious neurologic signs. Necropsy finds hemorrhage in the airways, as shown below. What is the most likely presumptive diagnosis? A - Infectious coryza B - Infectious laryngotracheitis C - Fowl pox, diphtheritic form D - Viscerotropic Velogenic Newcastle disease E - Marek's disease

B - infectious laryngotracheitis Blood in the trachea and this Hx suggests ILT. It is highly contagious, and it is a herpesvirus infection. It is characterized by respiratiry signs. This is reportable in most states. Infectious coryza: milder resp disease, swelling around eyes and head, sneezing, nasal discharge Newcastle disease: resp signs only; GI hemorrhage is most severe form, REPORTABLE

Which of these drugs has the greatest potential for causing acute renal failure in the horse? A - Xylazine B - Oxytetracycline C - Neomycin D - Diphenhydramine E - Dexamethasone

C - Neomycin The correct answer is neomycin. Aminoglycosides are one of the most common causes of renal tubular nephrosis and acute renal failure. Of the aminoglycosides, neomycin is probably the most nephrotoxic, followed by gentamicin, amikacin, and streptomycin. The other big class of nephrotoxic drugs is non-steroidal anti-inflammatory drugs.

You are visiting a small "back-yard" flock of chickens and examining the animals. You find several small gray-red mites (approx. 0.7 mm) on several of the chickens, which you recognize as Dermanyssus gallinae and Ornithonyssus sylviarum. How are these mites best controlled? A - Ornithonyssus sylviarum is controlled primarily by thorough insecticidial treatment of the environment and Dermanyssus gallinae must be controlled by application of approved pesticides to affected birds. B - control of both Ornithonyssus sylvarium and Dermanyssus gallinae relies on applicatio of approved pesticides to affected birds. C - Dermanyssus gallinae is controlled primarily through insecticidal treatment of the environment and Ornithonyssus sylvarium must be controlled by application of approved pesticides to affected birds.

C

You have a 6-kg cat that you wish to raise his PCV from 15 to 25%. You plan to administer packed red blood cells. How many milliliters of packed red blood cells will this cat need? A - 15 ml B - 120 ml C - 60 ml D - 30 ml

C - 60 mL % would be 1mL/kg of packed red blood cells. It takes 6 mLs to raise the PCV by 1%. If we are going to increase it by 10% we will need 60 mL of packed red blood cells.

A nine-year-old male neutered cat is presented with a two to three week history of anorexia, halitosis, and ptyalism. A smooth black mass, see image below, is evident on the upper gingiva and hard palate that seems to have invaded and replaced the upper right incisors. Click the labwork icon to review hematology, blood chemistry, and urinalysis test results. Based on these findings, what is the best step to take next? A - Debulk, immunosuppressive-dose prednisone B - Thoracic radiographs, radiation therapy C - Biopsy mass, submit for histopathology D - Abdominal ultrasound E - Initiate masitnib mesylate trial, monitor for response

C - Biopsy mass, submit for histopathology. The description of the mass is consistent with malignant melanoma, but you cannot conclusively say this without histopathology.

Several ornamental freshwater fish (Betta splendens) have recently developed a velvety, rust-colored appearance, especially around the eyes and gills. What is the appropriate treatment in pet fish for the presumptive diagnosis? A - MS222 B - None; this condition is self limiting C - Chloroquine D - Potassium permanganate E - Hydrogen peroxide

C - Chloroquine -This is velvet disease, a parasitic dinoflagellate infection. Treatment is chloroquine or copper sulfate given as a bath in a quarantine tank.

A 1-year old female spayed Doberman Pinscher has presented after being hit by a car. Initial chest radiographs show mild contusions, and the patient appears to be otherwise stable. A right mid-shaft long oblique femoral fracture has been identified. Routine pre-operative blood work is unremarkable. A buccal mucosal bleeding teset (BMBT) is elecated at 6 minutes. What will you administer prior to surgery? A - 1,23 dihydrocholecalciferol B - Whole blood transfusion C - Desmopressin acetate D - Vitamin K

C - Desmopressin acetate DDAVP releases von Willebrand factor, which will help this patient with clotting. Doberman's are predisposed to von Willebrand's disease.

A nine-year-old German shepherd is presented with unchecked bleeding from a gut on the gums above the right canine tooth. The owner relates that the dog has lost weight and had an episode of collapse 3 days ago, but he recovered. On PE, the gums are pale with petechiae and ecchymotic hemorrhages. There is tachycardia and a palpable cranial abdominal mass. A coagulation proflie shows the following: Thrombocytes = 82,533 per microliter (N=200,000-900,000) Buccal mucosal bleeding time (BMBT), increased Activated partial thromboplastin time (aPTT), increased Prothrombin time (PT), increased Thrombin time (TT), increased Fibrin degeneration products(FDPs), increased What disorder of coagulation best fits this pattern? A - idiopathic thrombocytopenia B - Antigoagulant rodenticide toxicity C - Disseminated intravascular coagulation D - Hepatic insufficiency E - Von Willebrand's disease

C - Disseminated intravascular coagulation -low platelets, increased bleeding time indicates DIC. Secondary to other dieases. H diseases associated with DIC: -heartworm -heart failure -hemolytic anemia -hemangiosarcoma -hemorrhagic gastroenteritis -hepatic disease (hepatic lipidosis) -GDV and mammary gland carcinoma and pancreatitis can also lead to DIC

On fecal examination of a seven-year-old dog, this organism is evident. Which one of the following drugs is the best treatment? A - Diethyl carbamizine B - Piperazine C - Fenbendazole D - Metronidazole E - Ivermectin

C - Fenbendazole This is a whipworm egg (looks like an american football). Rx with antihelmintics like fenbendazole or febantel.

A 7-year old male intact Chesapeake Bay Retriever presents to your clinic with the presenting complaint of an intermittent cough. On exam, the dog is bright and alert with a temperature of 100.5F (38.1 C), heart rate of 110 beats per minute and respiratory rate of 30 breaths per minute. You perform chest radiographs which are shown below. A CBC shows a hematocrit of 39% (35-57%), neutrophil count of 8,659/ul (2,900-12,000/ul), monocyte count of 984/ul (100-1,400/ul) and eosinophil count of 1,980/ul (0-1,300/ul). What is the treatment of choice for the most likely diagnosis? A - Terbutaline B - Enrofloxacin C - Immiticide D - Pericardiocentesis

C - Immiticide The radiograph is the classic finding for heartworm diseases, including right sided ventricular enlargement with very prominent pulmonary arteries.

A 12-year-old female spayed Labrador Retriever dog is presented for dental cleaning. After she is induced under general anesthesia, her pulse oximetry drops below normal at 91%. Thoracic radiographs show the following changes. What is the most clinically significant finding evident on thoracic radiographs from this dog? A - Spondylosis deformans is present B - Heart is globoid in appearance C - Left cranial lung lobe has alveolar infiltates D - Osteochondritis dissecans is evident in the left shoulder E - There is a gastric foreign body

C - Left cranial lung lobe has alveolar infiltrates Anesthetized procedure should be cancelled because the patient is oxygenating poorly. Recheck once patient is awake to rule out atelectasis due to recumbency and sedation.

What is the most likely etiology of the distorted pupil in the chicken eye on the right (with the smaller pupil)? Other affected chickens from this flock showed depression, transient paralysis, atherosclerosis, and persistent neurologic disease. A - Newcastle disease B - Infectious laryngotracheitis C - Marek's disease D - Tuberculosis E - Campylobacteriosis

C - Marek's disease This is caused by an alphaherpesvirus. You can tell it is Marek's by the gray iris and constricted pupil

A three-year ols Appaloosa mare presents with a four-week history of exercise intolerance and recent epistaxis after exercise. An irregular heart rhythm is auscultated during physical examination. No cardiac murmurs are auscultated ad her lungs auscult clear. An electrocardiogram (ECG) from this patient is shown in the following image. Which one of the following choices is the correct treatment? A - Calcium gluconate A ml 10% soln/kg IV SLOW B - Glycopyrrolate IM C- Quinidine sulfate PO D - Digoxin IV then PO E - Nutroprusside IV, theophylline PO

C - Quinidine sulfate PO -most commonly used treatment for atrial fibrillation in horses.

Which infectious agent causes the clinical presentation of pigs most similar to that of Haemophilus parasuis (Glasser's disease)? A - Erysipelothrix rhusiopathiae B - Mycoplasma hyosynoviae C - Streptococcus suis D - Fusobacterium necrophorum

C - Streptococcus suis

Some farmed salmon appear lethargic with darkened skin and exophtalmia. Necropsy of one that died reveals vent hemorrhages and grayish granulomatous nodules on the kidneys. Gram stain from the kidney lesion reveals the intracellular bacteria shown below. How could this condition have been prevented? A - Increase water temp in tank/pond to 52-63 degrees F; supplement diet with vitamin C B - Vaccinate all new arrivals C - Treat females with erythromycin before spawning D - Oxytetracycline in water; Cull fish older than 2 years E - Test incoming fish with ELISA and use formalin for any positives.

C - Treat females with erythromycine before spawning Renibacterium salmoninarum (bacterial kidney disease) is prevented by treating females with erythromycin before spawning to prevent vertical transmission. It is one of the few gram positive organisms that causes disease in fish and it is economically important. FIsh appear lethargic with darkened skin and sometimes exopthalmia. There may be grayish granulomatous nodules on the kidneys. It is transmitted both horizontally and vertically and disease is more common in younger fish. Bacterial kidney disease is most common in both farmed and wild salmonids, but also occurs in other fish species. Purchase disease-free stock to avoid introducing this into the system. Erythromycin is not FDA-approved for treatment.

A one-month old foal develops fever, icterus, and diarrhea acutely. Bloodwork shows hyperfibrinogenemia, hypoglycemia, and elevated liver enzymes. Which of these conditions is most likely? A. Clostridium novyi type B B. Theiler's disease C. Tyzzer's disease D. Herpesviral hepatitis

C - Tyzzer's disease -most likely due to age of foal and acute nature of disease. Caused by clostridium piliformis, which causes an acute necrotizing hepatitis. It affects foals from 1-6 weeks of age/ Theiler's: adult horses only Clostridium novyi: rare in horses. Seen in sheep and cattle. Herpes: can cause hepatitis, see at or very soon after birth.

You are called one hot summer day to see a group of horses in New Mexico which are slobbering and not eating their hay. Three out of 20 horses seem to be visibly affected. On PE of the first one, your find fever of 104 and obvious oral ulcers shown in the image, mainly on the tongue. What is your tenative diagnosis? A - African Horse Sickness B - Glanders C - Vesicular stomatitis D - Bovine papular stomatitus

C - Vesicular stomatitis VS affects horses, cattle and pigs with similar cilincal signs. It is a viral disease of high morbitiy and low mortality that appears about every 7-10 years in SW US. Yearly outbreaks occur in mexico and northern South America. Black flies and midges appear to be the vectors. Affected premises should be quarantined. Feed soft feeds to reduce mouth discomfort. Anti-inflammatory medications can be used as supportive care to minimize pain and swelling. IV fluids are used for horses that become dehydrated. Risk of secondary bacterial infection of the ulcers are an area of concern. Use antibiotics if there is fever, swelling, inflammation, or pus around the sores. Flushing the mouth with dilute antiseptic solutions may reduce secondary bacterial contamination.

A 22-year-old Thoroughbred mare is presented for bilateral green nasal discharge, retching, coughing, and inappetence noted after feeding this evening. The owner recently switched the mare to a pelleted diet because of the mare's poor dentition. Physical exam reveals bilateral green nasal discharge. The mucous membranes are pink and moist with a capillary refill time of 1.5 seconds. A slight swelling is notable in the proximal-left jegular groove just caudal to the vertical ramus of the mandible. Based on the most likely diagnosis, what initial therapy would be recommended? A - Adminiter antimicrobials, refer horse immediately for endoscopy and lavage under general anesthesia B - Pass nasogastric tube; give atropine; lavage the esophagus until the onstruction clears C - Withhold food and water; give sedatives and oxytocin; recheck in 2 hours D - Ultrasound thorax, perform transtracheal wash for cytology and culture, begin broad-spectrum antimicrobials E - Cautious guttural pouch endoscopy with lavage for Streptococcus equi spp. equi PCR, quarantine horse until results are available

C - Withhold food and water; give sedative and oxytocin; recheck in two hours. This is the appropriate treatment for a systemically stable horse with acute esophageal obstruction (or choke). The sedative and oxytocin relaxes the esophagus, and this is often successful in uncomplicated cases. If the obstruction has not resolved within 2-5 hours, sedate to lower the head, pass a nasogastric tube to the level of the obstruction, and gently lavage the esophagus with water. This is typically successful. In cases that do not resolve, refer for ultrasound, esophageal endoscopy, or general anesthesia with esophageal lavage at a referral center.

A pig farm has several sick and dying adult pigs. Affected animals are febrile and depressed. Some seem constipated and others have diarrhea. A few are ataxic. A necropsy on one of the dead pigs shows widespread petechial and ecchymotic hemorrhages in the kidneys ("turkey egg kidneys"), bladder, spleen, and larynx. Which one of the following choices is the most likely diagnosis? A - Haemophilus parasuis B - Hemagglutinating encephalomyelitis C - Classical swine fever D - Postweaning multisystemic wasting syndrome E - Anthrax

C - classical swine fever Hemorrhages on the kidneys and other organs are characteristic of both classical swine fever and african swine fever. Confirmation is based on either PCR or ELISA antigen testing. Both are reportable diseases. CSF was last reported in north america in the 70s.

A 12-year old West Highland Terrier disappeared from its home for six hours and returned lame on his left pelvic limb. Based on the pelvic radiograph taken on presentation to the clinic the same day, which one of the following choices is the best initial treatment? A - Femoral head osteotomy and acetaminophen B - Tibial tubercle transposition and Robert-Jones bandage C - Closed reduction and Ehmer sling D - Decompression and Kirschner-Lemur apparatus E - NSAIDs and rest

C - closed reduction and Ehmer sling The radiograph shows a traumatic coxofemoral luxation. This comprises of 90% of all luxations in small animals. Closed reduction can be attempted when the luxation duration is less than 48 hours and there are no other hip injuries. If closed reduction fails, then an open reduction technique using sutures or toggle pins is indicated. Femoral head osteotomy, hip replacement are surgical interventions if reduction is not successful.

A three-month-old French bulldog is presented with respiratory distress and vomiting. Based on the radiographs shown below, which of the following choices is the most likely diagnosis? A - Normal Radiographs B - Cranio-ventral aspiration pneumonia C - Laryngeal foreign body D - Hiatal hernia with gastric displacement E - Vascular ring anomaly

C - laryngeal foreign body There is a laryngeal foreign body of small, round, mineral opacity. In larynx ventral to C2.

A 10 year male castrated German Shepherd dog presents for an acute onset of ptosis, drooping of the lip, and drooping of the cheek all on the left side. What nerve has been damaged? A - CN VII B - CN VI C - CN V D - CN III

CN VII -this is the facial nerve, which is responsible for motor of the facial muscles as well as sensation in the ear and lacrimation. CN V - sensation CN III - oculomotor; eye movement CN VI - abducens; movement of eye as well

An aquatic turtle is presented (see below). What is you treatment plan for the presumptive problem A - Amikacin, Ceftazidime, Decrease dietary protein B - Antibiotic opthalmic ointment, Cod liver oil C - Vitamin D, calcium supplementation, metronidazole D - Vitamin A 200 IU/kg, q two weeks E - Increase UV exposure, Increase ambient temperature

D - Vitamin A 200 IU/kg, q two weeks -swollen eyes in a turtle is a classic presentation of vitamin A deficiency, a common disease in turtles (alligators and other reptiles too). There can also be froth from the nose/mouth and ear infections.

A herd of 25 Holstein heifers present with fever (104 to 106 °F, 40 to 41.1°C, N=100-102.5 F, N=37.8-39.7 C) lethargy, and purulent nasal discharge. They also have loud harsh coughs. Physical exam reveals crackles over the trachea, but not the lungs. Fibrinonecrotic plaques are randomly dispersed over the nasal and ocular mucosa, but no oral ulcers are present. Urine and feces appear normal. Several affected heifers have an arched back and are straining because of a fibrinonecrotic vaginitis. Which choice is the most impotant step to take next to evaluate and prevent this problem in the future? A - Check for elevated mycotoxin levels in feed, particularly zearalonone due to Fusarium spp B - Evaluate breeding program. Consider 100% artificial insemination or use of Tritrichomonas foetus-negative bulls C - Test water for Leptospira serovars; Check feed for fecal contamination by dogs with Neospora caninum D - Review infectious bovine rhinotracheitis vaccination protocols E - Perform vaginal cultures for genital Campylobacter fetus venerealis

D Evaluation of the herd vaccination program is a top priority to prevent IBR. It is common in cattle; infected animals develop fibrinonecrotic plaques at the site of inoculation and the virus ascends to the regional ganglia and becomes latent.

An immunochromatographic test kit for detection of fecal canine parvoviruses (CPV) antigen is being tested in a local cat shelter where as many as 10% of the cats there may have panleukopenia secondary to infection with the canine parvovirus. Here are simulated test results, compared to a gold standard test for CPV. CPV pos CPV neg Total Test kit positive 128 734 862 Test kit negative 63 1575 1638 Total 191 2309 2500 What is the sensitivity of this test kit? A - 734/862 B - 128/734 C - 1575/2309 D - 128/191 E - 1575/1638

D - 128/191 -this is a 2x2 epidemiology table

What kind of organism causes equine granulocytic anaplasmosis? A - Chlamydia B - Ehrlichia C - Protozoa D - Anaplasma E - Spirochete

D - Anaplasma

The night after Valentine's day, a male neutered Schnauzer is presented with a combination of hyperactivity, urinary accidents, and diarrhea. On PE, there is muscular rigidity and chocolate wrappers visible in the diarrhea. The dog has a seizure on the exam table. The ECG is shown below. Which one of the following choices is the best treatment plan? A - Ipecac, theophylline, digoxin B - Activated charcoal, sodium sulfate, methocarbamol IV C - Apomorphine, gastric lavage, Na-bicarb IV D - Diazepam, lidocaine drip E - Phenobarb, glycopyrrolate

D - Diazepam, lidocaine drop Treat ventricular tachycardia with lidocaine drop and address hyperactivity/seizures with diazepam (Valium) or methocarbamol. If diazepam is inadequate, give phenobarb VERY SLOWLY. This is a classic presentation of severe chocolate toxicity (theobromine, theophylline, caffiene)

The goose shown in the image below was found weak on the shore of a local pond where oil had been dumped. The goose was covered in oil, dehydrated and weak, but responsive. Which of the following is an important acute clinical effect of oil on affected birds? A - Nephrotoxicity B - Contact Dermatitis C - Lead Tocicity D - Disruption of function of plumage E - Hepatotoxicity

D - Disruption of function of the plumage Feathers serve a critical waterproofing, insulatory function which is disrupted by oil and can rapidly result in hypothermia. Other concerns include GI irritation from ingestion of oil, hemolytic anemia, and pneumonia due to oil inhalation. Treatments include heat, supportive care, and activated charcoal. Once stabilized, frequent high pressure, warm, mild detergent baths and clean warm water rinses until water beads freely off of the feathers is important. Birds should be placed in warm air flow until dry and they should be maintained on self-skimming ponds for several days after washing to ensure full waterproofing.

A four-year-old Quarter horse is presented with a three-week history of diffuse patchy alopecia on the ventral midline and face, including a "bulls-eye" lesion in the center of the forehead. There is a mild conjuntivitis and uveitis OU (both eyes). A punch skin biopsy looks like the image below. What is the most appropriate treatment? A - Nothing B - Corticosteroids, benzimidazole-piperazine every 12 weeks C - Topical DMSO, oxybendazole every 8 weeks D - Ivermectin now, repeat in 4 months E - Trichlorfon drench, antibiotic opthalmic ointment TID

D - Ivermectin now, repeat in 4 months. The treatment of choice for Onchocerca spp. microfilaria is an avermectin-family drug, with retreatment at 4 month intervals. Adult filaria like to migrate to the ventral midline, face, and chest.

A four-month-old calf from a small beef herd in Louisiana presents with a fracture of the right metatarsus. He was normal last night. The owner found the calf this morning after rounding up the herd for deworming. This is the fifth calf this season with fractured bones. one had a vertebral fracture, two calves had humeral fractures, and one had a cannon bone fracture. Which of the following choices is most likely the problem in this herd? A - Hypovitaminosis D B - High dietary phosphorous C - Low dietary protein D - Low dietary copper E - High dietary calcium

D - Low dietary copper Low dietary copper levels causes bone of growing animals to be brittle because they do not develop the normal trabecular structure. Pathologic fractures are more common during periods of exertion, like morning round up. Treatment includes copper glycinate injections, fedding of mineral mixes with Cu.

Where is the location of the main lesion in this cat? A - Lung parenchyma B - Trachea and mainstem bronchi C - Rib and body wall D - Mediastinum E - Pulmonary vessels

D - Mediastinum -there is a mediastinal mass with a small volume pleural effusion causing widened fissue lines and retraction of the lung lobes. (see VD view of soft tissue opacity) -also causing elevated, narrow trachea -most common causes of cranial mediastinal mass in cats are thymoma and thymic lymphoma

On a cold winter day in the Northeastern U.S., a lactating dairy is examined for pruritus and crusts around the perineum. A skin scrape shows some kind of mite with long legs and short unsegmented pedicles. What should be done next? A - Slaughter B - Amitraz SQ C - Topical Furazolidone D - Pour-on eprinomectin E - Quarantine animal

D - Pour-on eprinomectin This is chorioptic mange (leg mange). Pour-on dorametin and ivermectin also work for treatment.

A seven-year-old female chinchilla is presented with a history of anorexia and lethargy. Which one of the following organs has the most prominent pathology in these radiographs? A - Urinary bladder B- Nomral rads C - Stomach D - Uterus E - Colon

D - Uterus This chinchilla as pyometra. The abdomen is markedly distended with poor detail caused by organomegaly. There are two soft tissue tubular masses in the caudal abdomen along the lateral margins. The small bowel loops are displaced cranially and medially.

A high-producing dairy cow that freshened 3 weeks ago is off-feed. On PE, her heart and resp rates are within normal limits. Rumen motility is decreased and a urine test for ketone bodies is positive. There is no evidence of mastitis, and the uterus is clear of infection. On the left side, a high-pitched musical "ping" is audible via stethoscope during percussion over the ribs on a line between the elbow and tuber coxae. What acid-base abnormality is most likely in this cow? A - depends on severity of displacement B - respiratory alkalosis C - respiratory acidosis D - metabolic alkalosis E - metabolic acidosis

D - metabolic alkalosis -hypochloremic metabolic alkalosis due to HCL sequestration in the abomasum of a cow with a displaced aboasum.

It is late summer and a six-year old Quarter horse gelding is presented with a mass-like lesion, which started about one month ago. Systemic antibiotics for two weeks did not show any improvement, and the mass continued to grow. The horse is pastured with free access to a shallow pond with standing water. At presentation, the parge, well-circumscribed mass with abnormal tissue resembling excessive granulation tissue show below is revealed. Within the lesion, draining tracts with abundant discharge and white, coral like structures (kunkers) are found. This area seems to be pruitic. Based on history and clinical presentation, what is the most effective therapy? A - IV sodium iodide B - topical 5-floururacil cream C - cryotherapy D - none E - platelet rich plasma

D - none This case is pythiosis, and there is currently no available therapy for it. Treatment options often tried are complete surgical excision, local/topical steroids, and systemic antifungals. Without complete surgical excision, the outcome is poor. Pythium is an aquatic organism that sporulates in warm weather and infects the skin through small skin lesions.

Which of the following choices is the most appropriate next step after a 3-year old stray cat tests positive for FIV on a routine FIV ELISA screening test? a) Treat with glucocorticoids b) recheck serum by FIV complement fixation test c) euthanize d) perform a western blot FIV test e) do a rivalta test to rule out feline coronavirus-related interference

D) perform a western blot FIV test (confirmatory Ab test. very imporatant to do in areas of low FIV prevalence. remember that cat vaccinated for FIV will test positive for FIV antibodies by ELISA and western blot.)

An eight-year-old female spayed Boston terrier is presented with a solitary well-circumscribed mass ~2 cm in diameter on the left hip area. The owner reports that the mass occasionally appears inflammed, and that the dog has a history of allergies. A fine needle aspirate of the mass is performed and the specimen stained using Diff-Quik Based on the clinical presentation, cytological findings and presumptive diagnosis in this patient, the owner opts for surgical resection. What pre-operative treatment if any, is indicated before surgery? A-Bacteriocidal beta-lactam antibiotics; Calcium channel blocker (vasodilator) B-Adrenergic agonist (epinephrine); bronchodilator (aminophylline, theophylline) C-No pre-operative treatment is indicated D-H1 histamine blocker (diphenhydramine); Corticosteroids E-Nonsteroidal anti-inflammatory analgesics; H2 histamine blocker

D-H1 hsitamine blocker (diphenhydramine); Corticosteroids The clinical presentation and uniform population round cells with basophillic granules in the aspirate is consistent with a well-differentiated mast cell tumor (MCT) Pre-operative treatments to shrink the tumor and minimize degranulation is key with diphenhydramine and prednisone. Omeprazole (protein pump inhibitor) and/or H2 histamine blockers can also be used to prevent/treat histamine associated gastric ulceration. Other pre-surgical workup is important. CBC/chem, urinalysis, regional lymph node aspiration. Boston terriers are predisposed to developing mast cell tumors, as well as pugs, shar-peis, staffordshire bull terriers, golden/laborador retrievers.

A practice is using an FeLV test with a sensitivity of 90% and a specificity of 95%. Assuming the prevalence of feline leukemia in the area is 5%, what is the predictive value positive (PVP) of the test? A. 45% B. 48% C. 55% D. 88% E. 99%

E - 99% -Pick an imaginary number of animals that you test, like 1000, and fill out the 2x2 table. If prev is 5%, 50/1000 cats with FeLV and 950 are disease free. .95x950=902 PVN=d/(c+d)=902/(902+5) =99%

An emaciated cow is presented. She appears weak and anorexic, with enlarged superficial cervical lymph nodes. The cow dies the next day. On necropsy, the following lesions in the lungs are evident. What is the diagnosis? A - Actinobacillosis B - Bovine lymphoma C - Contagious bovine pleuropneumonia D - Johne's disease E - Bovine tuberculosis

E - Bovine tuberculosis These are the classic granulomas and abcesses of bovine TB. This is a reportable disease. Johne's: cows with chronic debilitation, emaciation, but w/o the telltale watery diarrhea Transmitted via aerosol route. Actinobacillosis: wooden tongue in cows

A one-year-old spayed female mixed terrier is presented with a one-week history of coughing, lethargy, fever, and inappetance. Based on the history and images, which one of the following choices is the most likely diagnosis? A- Heartworm disease B - Diaphragmatic hernia of ventral liver lobe C - Spirocerca lupi D - Hiatal hernia E - Left caudal lung lobe abscess

E - Left caudal lung lobe abscess -soft tissue opacity mass in left caudal lung lobe -increased opacity in pleural spae, indicating a small pleural effusion -in this case, lobectomy was performed and an abscess was confirmed

A couple of days ago a client brough an 18-month old filly home from a kill pen (was headed for Mexico for slaughter). She just sent you photos of the horse showing thick bilateral mucopurulent nasal discharge and a swollen throat latch. She says that the horse's breathing is sterotorous and loud. You are on your way to see the horse, thinking you will need to do an emergency tracheotomy first thing. What are additional perliminary recommendations based on the top differential? A - Start antimicrobials; limit iodine intake and measure thyroid levels for goiter B - Will need to biopsy the mass if owner wants to proceed with chemotherapy C - Refer for laser ablation treatment for guttural pouch tymapny D - Pass a nasogastric tube to treat esophageal obstruction E - Quarantine the horse; take temps on all other horses

E - Quarantine the horse; take temps on all other horses -presentation is consistent with strangles, a highly contagious resp disease. This can be confirmed with PCR/culture of nasal swab or swab of drainage from an abcessed lymph node. -the mass described is an enlarged lymph nodes enlarge and eventually rupture/drain purulent exudate -this is treated with supportive care (judicious use of NSAIDs, facilitating abscess maturation, flishing abscess, +/- antibiotics)

What do the blue arrows indicate in the lower incisors of this horse? A - Cavities B - Cups C - Galvayne's groove D - EOTRH E - Stars

E - Stars Composed of secondary dentin. Equine lower incisor teeth develop wear (can be used to estimate age)/ The shape position, and central white spot of the dentral star changes with age as the tooth wears. Note that horses rarely get cavities, and even more rarely in the incisors.

Where anatomically is the predominat abnormality located in these radiographs from an 11-year-old English sheepdog? A - Spleen B - Pancreas C - Liver D - Right Kidney E - Stomach

E - Stomach Markedly enlarged, filled with fluid and gas. Mineral opacity material with a sharp edge in the body and pyloris. There are small mineral opacities (gravel sign) in the dependent portion of the stomach. The enlarged stomach is causing a mass effect and displacing the other organs caudally. Peritoneal detail is good. Radiographs show evidence of pyloric outflow obstruction such as a mass, stricture, polyp, or granuloma.

Where, anatomically, is the predominant abnormality located in these radiographs from an 11-year-old English sheepdog? A - Spleen B - Pancreas C - Right Kidney D - Liver E - Stomach

E - Stomach The stomach is markedly enlarged and filled with fluid and gas. There is a mineral opacity material with a sharp edge in the body and pylorus. There are small mineral opacities (Gravel sign) in the dependent portion of the stomach. The enlarged stomach is causing mass effect and displacing the other organs caudally, however peritoneal detail is good. These radiograhs show evidence of pyloric outflow obstruction such as a mass, stricture, polyp, or granuloma.

The parents of a ten-year-old boy present his pet box turtle with a three-week history of lethargy and anorexia. On physical exam, there is bilateral blepharedema (swollen eyes), as well as ocular and nasal discharge. Which one of the following choices is the most likely diagnosis? A - Septicemic cutaneous ulcerative disease (SCUD) B - West Nile virus (WNV) C - Herpesvirus D - Inclusion body disease E - Vitamin A deficiency

E - Vitamin A deficiency -this is seen in turtles, alligators, and other reptiles. Ear infections are also a system of this. Vit A deficiency can predispose to bacterial pneumonia. SCUD: a shell disease; look for pitted shells.

A five-year-old boxer is presented for routine vaccinations. The owner points out a small, smooth mass on the right ear. Fine needle aspiration cytology is shown below. Which one of the following choices is most likely the diagnosis? A - Histiocytoma B - Lymphoma C - Degranulating mast cell tumor D - Aural hematoma E - Bacterial infection

E - bacterial infectin Both intra/extracellular bacteria present on cytology. Abcess should be drained and patient should be put on appropriate antibiotics.

An 11-year old female Pomeranian presents to you for coughing and exercise intolerance. On exam: Wt: 9.25 lbs, T: 101.2F, HR: 132 bpm. RR: panting, mucous membranes: pink. She has mild tracheal sensitivity and a grade 3-4/6 left apical holosystolic murmur and grade 2/6 right apical holosystolic murmur. Femoral pulses are strong and synchronous with a regular rhythm. She has harse lung sounds bilaterally. On abdomnial palpation, you note hepatomegaly. You find bilateral luxating patellas. You take chest radiographs and decide to treat the dog based on these findings. Which medication plan is most appropriate? A - Atropine and a temporary pacemaker B - Immiticide C - Oxygen and atenolol D - Clavamox and enrofloxacin E - Furosemide and enalapril

E - furosemide and enalapril The radiograph shows a servere symmetrical alveolar pattern in the perihilar region extending to the right and left caudal lung lobes. The heart is tall on lateral view, causing dorsal elevation of the trachea. In conjunction with physical findings, this is compatible with congestive heart failure (CHF) secondary to mitral valve regurgitation. The dog also has hepatic congestion. Treatment for CHF includes diuretics (furosemide/Lasix, hydrocholothiazide, spironlactone), arterial vasodilators (enalapril, benazepril, amlodipine, hydralazine), positive ionotropes (pimobendan), and venodilators (nitroglycerine) Clavamox and enrofloxacin: antibiotics that could be used to treat pneumonia; not this dog's problem Immiticide: heartworm treatment Atenolol: beta blocker; not part of management of mitral regurgitation or CHF. Atropine/pacemaker: would be indicated for conduction problems

A group of six-month-old Holstein heifers is experiencing and outbreak of respiratory disease and lameness. Examination of a few calves shows swollen hot joints, and one calf has suppurative drainage from one ear and a head tilt. Aspirated joint fluid from an affected calf is purulent. Auscultation suggests consolidation of ventral lung fields. Rectal temperatures range from 103.5-105 F. What is the most appropriate action to take next? A - treat chronic cases with parenteral antimicrobials; add organic iodine to feed B - quarantine entire herd; call state veterinarian C - culture silage samples for listeriosis; vaccinate healthy animals with autogenous bacterin D - divide suck animals into treatment groups; perform on-farm antibiotic efficacy trial E - necropsy affected calves; submit lung for Mycoplasma bovis testing

E - necropsy affected calves; submit lung for Mycoplasma bovis testing -this is a classic outbreak scenario for Mycoplasma bovis infection (resp signs, swollen joints, head tilt)

Which of the following is the correct location for placement of a proximal paravertebral block used to perform a standing laparotomy on a cow? A) in the spaces between L1, L2, L3, and L4 B) at the ends of the transverse processes of L1, L2 or L4 C) midway between spine and the ends of the transverse processes of L1, L2, L3 D) above and below the transverse processes of L1, L2 and L4 E) caudal to the transverse processes of T13, L1, and L2

E) caudal to the transverse processes of T13, L1, and L2

A client brings the one-half inch grub shown in the image to you one spring day, telling you it emerged from a hole in the back of one of his prize show cattle. He wants to know what to treat his cattle with and when.

Ivermectin in early fall This is a cattle warble called Hypoderma. The 2 species are H. bovis and H. lineatum. They undergo a long migration in tissues and only emerge from the back of the animal in spring. The crucial treatment time is early fall when larvae are just beginning to migrate in tissues. Organophosphates or one of the macrocyclic lactones (ivermectin, doramectin, eprinomectin or moxidectin) are effective.

What is the most common neoplasia seen in the equine stomach?

Squamous cell carcinoma

A four-year-old outdoor female spayed cat is presented with a history of anorexia and thin body condition. Which one of the following areas is most affected in these radiographs? A - Colon B - Uterus C - Peritoneal space D - Kidneys E - Mesenteric lymph nodes

The kidneys are bilaterally enlarged. On the images of the abdoment, there is poor peritoneal detail due to a mid abdominal mass effect. The cat is in thin body condition, which also contributes to poor detail. There are two oval soft tissue masses in the region of the kidneys. The kidneys are enlarged and irregular shaped. The other organs are displaced peripherally. The spleen is also enlarged. This cat was diagnosed with renal lymphoma.

A middle aged MN stray cat is left on the doorstep of your clinic. The cat has a large dry crusted area of alopecia over his nose. A skin scraping of the area is negative. The lesion fluoresces under Wood's lamp examination (see image). Which of the following would be the best treatment? A - Lufenuron B - Povidone-iodine scrub C - Doxycycline D - Full body lyme sulfur dip, itraconazole E - Athlete's foot cream (clotrimazole)

This cat has a ringworm infection caused by Microsporum canis. This fungi fluoresces blue under a Wood's lamp in 50% of cases. The best treatment for ringworm infection would include a combination topical and oral therapy. Lyme sulfur dip or an antifungal shampoo containing miconazole would be acceptable. Oral antifungals such as itraconazole or fluconazole are most effective with the least side effects. Povidone-iodine scrub has not been shown to be effective against ringworm. Lufenuron is classified as an insect development inhibitor because of its ability to inhibit chitin synthesis, thus in the past has been said to have some effect against fungal infections. This has been debated and not widely supported as a treatment for ringworm. Doxycycline is an antibiotic and would not be effective in treatment of fungal disease. Athlete's foot cream (clotrimazole) may have some effect at treating the lesion. Most over-the-counter creams such as this also include a steroid like betamethasone which would not be desired. Although this lesion appears to be localized to the nasal area, ringworm may also be subclinical and this cat may have infection elsewhere in the skin that is not grossly visible. Therefore, the best therapy is a combination of topical and oral.

While conducting a routine physical on a four-year old male intact bulldog, an irregular heart rhythm with a slow rate that is markedly slower on expiration is audible during auscultation. What should be done next? a) echocardiogram b) chest radiograph, CBC/Chem c) nothing d) refer for cardiology consult e) blood pressure assessment

c) nothing this is sinus arrythmia; regular irregularity.