Musculoskeletal
9.What is the primary source of energy for skeletal muscle during prolonged endurance aerobic exercise? A. Glucose b. Glycogen C. Fatty acids D. Ketones
Answer: C rationale: Basic physiological information connection to prework: Duke's page 272
8. Muscle contraction is not 100% efficient in accomplishing work. The non-work portion: Is dissipated as heat Leads to rigor Results in shivering Results in the formation of additional ATP
Answer: a rationale: Basic physiological knowledge connection to prework: Duke's page 272
1. This condition usually presents secondary to trauma in working dogs. Clinical signs include a characteristic adduction of the elbow, abduction of the foreleg, and external rotation of the carpus and paw. This condition is most likely: Tenosynovitis of the biceps brachii tendon Quadriceps contracture Infraspinatus contracture Achilles tendon rupture
Answer: c rationale: This is a clinical condition of working dogs connection to prework: In Merck reading
1. The underlying defect in horses with hyperkalemic periodic paralysis is: a. A point mutation in the gene encoding the alpha subunit of the skeletal muscle sodium channel b. Abnormal (quicker) activation of the sodium channel c. Muscle cell membrane depolarization with continuous deactivation of the potassium channel. d. Abnormally increased intracellular potassium within the cell.
a rationale: The underlying defect in HYPP is a point mutation in the gene encoding the α subunit of the skeletal muscle sodium channel. This defect causes abnormal (delayed) inactivation of sodium channel activity, resulting in membrane instability and continuous muscle fiber electrical activity, which is reflected in EMG findings connection to prework: Pathologic Basis of Veterinary Disease: Chapter 15 Skeletal Muscle
1. Which of the following structure(s) is/are correctly paired with the definition? A. Epimysium the connective tissue sheath that surrounds the entire muscle B. Endomysium connective tissue that surrounds the muscle bundles C. Perimysium connective tissue that surrounds each of the muscle fibers D. Sarcolemma the muscle fiber membrane E. All are correctly paired
answer: A and D rationale: Basic physiological knowledge. connection to prework: Duke's page 265
1. Immune mediated myositis has been described in almost all our veterinary patients. Which of the following are examples of immune mediated muscle disorders and the species they affect? a. Acquired myasthenia gravis - dogs, cats b. Masticatory myositis - dogs c. Polymyositis - dogs d. Purpura hemorrhagica - horses
answer: A, B, C, D rationale: All of the above have an immune mediated component connection to prework: Pathologic Basis of Veterinary Disease: Chapter 15 Skeletal Muscle
5. Select all the drugs that can be used in the treatment of immune-mediated polyarthritis in dogs: a. Azathioprine b. Cyclosporine c. Methotrexate d. Prednisone
answer: A, B, C, D rationale: All of these drugs can be used. Additional immunosuppressive drugs should be administered to dogs with persistent inflammation of synovial fluid despite prednisone therapy and to dogs that cannot be maintained on a low dose of prednisone without relapse. Azathioprine(Imuran) is often used for this purpose, and it may also be used as initial treatment in dogs that are known to not tolerate prednisone therapy. Azathioprine (2.2 mg/kg) is administered PO once daily for 4 to 6 weeks. The frequency of administration can be decreased to every other day and then discontinued if the animal is doing well clinically and synovial fluid inflammation has resolved; however, some dogs will require lifelong azathioprine therapy. In most dogs azathioprine is well tolerated, with myelosuppression the most common adverse effect. A CBC and platelet count should be performed initially every 2 weeks and then every 4 to 8 weeks during treatment Azathioprine, leflunomide, mycophenolate mofetil, cyclosporine, and cyclophosphamide have all be shown to be effective add-on treatments for idiopathic IMPA in dogs. Cats with idiopathic IMPA can be treated with cyclosporine, leflunomide, chlorambucil, or methotrexate if prednisolone alone is ineffective. connection to prework: Small Animal Internal Medicine: Part 10 - Joint Disorders
4. Postmortem findings with infarctive purpura hemorrhagica shows severe vasculitis in horses. Which of the following best explains the mechanism behind this type of vasculitis: a. Acute signs of myocardial decompensation, whereas the skeletal form results in stiffness, weakness, and difficulty in ambulation. b. Hypoglycin A is metabolized in the liver to methylene cyclopropyl acetic acid (MCPA), and MCPA CoA irreversibly binds to multiple acyl-CoA dehydrogenases, enzymes that are essential for metabolism of short- and medium-chain fatty acids c. Immunoglobulin A (IgA) immune complex deposition in vessel walls resulting in cell membrane destruction, cell death, and vascular occlusion. d. A point mutation that causes a phenylalanine/leucine substitution in a key part of the voltage-dependent skeletal muscle sodium channel alpha subunit
answer: C rationale: IPH resembles Henoch-Schönlein purpura in humans, which is characterized by infarctive vasculitis of the skin, kidneys, and gastrointestinal tract due to immunoglobulin A (IgA) immune complex deposition. Immune complexes are present in the sera of horses with purpura hemorrhagica that appear to be primarily composed of IgM or IgA and streptococcal M protein.99 Deposition of complement near immune complexes in vessel walls may result in cell membrane destruction, cell death, and vascular occlusion. The distinctive feature of IPH in horses is the extensive infarction of skeletal muscle and consequently marked elevation in serum CK and AST activity. connection to prework: Large Animal Internal Medicine (Sixth Edition): Chapter 42 - Diseases of Muscles
2. After an actional potential arrives at the axon terminal of a motor neuron innervating a skeletal muscle, which of the following occurs?: a. Calcium enters the axon terminal moving against its electrochemical gradient b. Chloride enters the axon terminal moving down its electrochemical gradient c. Ligand gated calcium channels open d. Voltage gated calcium channels open
answer: D rationale: Voltage gate Calcium channels are open when the action potential reaches the neuromuscular junction. connection to prework: Dukes Physiology of Domestic Animal Prereading
1. How are all skeletal muscle cells activated? a. An autonomic neuron that is part of the parasympathetic nervous system b. An autonomic neuron that is part of the sympathetic nervous system c. A somatic motor neuron that is completely in the peripheral nervous system d. A somatic motor neuron with its neuronal cell body in the central nervous system
answer: D rationale: skeletal muscles are innervated by somatic motor neurons that originate in the central nervous system connection to prework: Dukes Physiology of Domestic Animal Prereading
3. Which of the following conditions is often accompanied by the dog being often systemically ill with fever, lethargy, inappetence, or diarrhea? Hypertrophic osteodystrophy Panosteitis Osteochondrosis dissecans Swimmer syndrome
answer: a connection to prework: In prework
7. A twelve year old Golden Retriever with generalized lymphadenopathy (enlarged lymph nodes) has a serum calcium of 14.5 mg/dl and serum phosphorus of 5.6 mg/dl. Is this patient at risk for metastatic calcification of soft tissue? a. Yes, the calcium:phosphorus product is greater than 70 which increases the risk for tissue calcification. b. No, the calcium:phosphorus product must be greater than 100 to see an increased risk of tissue calcification. c. There is not enough information provided to determine increased risk for tissue calcification.
answer: a rationale: A calcium:phosphorus if greater than 70 increases the risk of soft tissue calcification due to precipitation of calcium phosphates in tissue when they exceed their solubility. connection to prework: Video and Powerpoint: Calcium and Phosphorus balance.
4. Casting of a long bone, with the resultant decrease in use, results in: A reduced amount of bone because of increased resorption and decreased formation A reduced amount of bone because of increased mechanical use (weight of cast) An increased amount of bone because of mechanical use (weight of cast) An increased amount of bone because of decreased resorption and increased formation
answer: a rationale: Basic bone physiology. Review Page 965 in prework connection to prework: Zachary page 965
9. Which one of the following statements is true? a. Initially, resorption of the fracture ends results in widening of the fracture gap radiographically b. Callus formation is noted radiographically before mineralization c. The fracture line will never disappear and will always be visible radiographically.
answer: a rationale: Basic fracture healing physiology connection to prework: A Practitioner's Guide to Fracture Management, Part 2: Selection of Fixation Technique and External Coaptation
1. Fracture or dislocation of lumbar vertebrae with compression or severing of the spinal cord is common in pet rabbits due to: a. Struggling during restraint b. Living on wire floors c. Osteoporosis from bad rabbit chow d. Not enough carrots in the diet
answer: a rationale: This is a common musculoskeletal injury in rabbits. connection to prework: Merck pre-reading
2. Any severe insult, (whether it be ischemia caused by recumbency or another myodegenerative disorder) that causes myonecrosis within a muscle covered by a tight and nonexpansible fascia, can result in ischemic injury. The resulting compromise of blood circulation leads to ischemic myodegeneration. This condition is known as: Compartment syndrome Exertional rhabdomyolysis Monday morning disease White muscle disease
answer: a rationale: Basic muscle physiology. Review Page 924 in prework connection to prework: Zachary, page 924
9. What is the non-mineralized component of bone primarily composed of? Type I collagen Type II collagen Hydroxyapatite Proteoglycans
answer: a rationale: Basic physiology connection to prework: Page 598
3. Muscle cells change shape by a. Actin and myosin filaments sliding past one another b. Change in length of the actin and myosin filaments c. Movement of the myosin filaments d. Z - lines remaining stationary
answer: a rationale: Basic physiology knowledge connection to prework: Duke's page 270
10. In bone, which of the following is necessary for osteoblast collagen hydroxylation reactions? Ascorbic acid 1,25‐dihydroxyvitamin D Vitamin K Osteocalcin
answer: a rationale: Basic understanding of physiology connection to prework: Page 598
4. Why is the type of cartilage found within this structure is more flexible than hyaline cartilage? Elastin fibers embedded in the ground substance Increased amount of ground substance within the tissue Thicker collagen fiber bundles None of the above
answer: a rationale: Basic understanding of the structure of cartilage connection to prework: Page 594
4. Which of the following is true about a degenerative myopathy? a. They result in segmental or global myofiber necrosis in which inflammatory cells are not the cause of myofiber damage. b. They occur with the onset of increased circulation to a muscle c. Muscle enzymes on blood work are usually normal to low. d. Is always due to bacteria such as clostridial organisms
answer: a rationale: Degenerative myopathies are those resulting in segmental or global myofiber necrosis in which inflammatory cells are not the cause of the myofiber damage. Rather, muscle damage is due to the underlying condition such as physiological causes, nutritional/toxic, etc. connection to prework: - Pathologic Basis of Veterinary Disease: Chapter 15 Skeletal Muscle
5. You are investigating a case of sudden equine death of a 7 year old gelding on a ranch in northern Arizona. The rancher has had trouble putting weight on his cattle and you prescribed Monensin to help with feed efficiency last month. Yesterday, the rancher feed all his cattle and horses in the same pen Based on the sudden death, you suspect ionophore ingestion. What is the mechanism of ionophore toxicity? a. Calcium overload and death of skeletal and cardiac muscle b. Interruption of the Na-K ATPase pump c. Premature release of chloride during muscle excitation d. Skeletal muscle myotonia
answer: a rationale: Ionophore toxicity results in calcium overload and death of skeletal (also cardiac) myocytes connection to prework: Pathologic Basis of Veterinary Disease: Chapter 15 Skeletal Muscle
11. Definitive diagnosis of osteomyelitis is diagnosed based on Bacterial culture of affected bone History Physical examination Radiographic findings
answer: a rationale: Microbiology and etiology of osteomyelitis in dogs. Review page 816 in Canine and Feline Infectious Diseases connection to prework: Page 816 Canine and Feline Infectious Diseases
5. Which of the following correctly matches the cause for degenerative myopathies with a correct example? a. Nutritional deficiency: Vitamin E or selenium b. Exertional myopathy: Monensin c. Toxic Myopathy: capture myopathy d. Traumatic: sarcocystis
answer: a rationale: Myofibers are particularly sensitive to nutritional deficiencies that result in the loss of antioxidant defense mechanisms. Nutritional myopathies are most common in livestock, including cattle, horses, sheep, and goats. Although nutritional myopathy of livestock is often referred to as selenium/ vitamin E deficiency, in the vast majority of cases, it is deficiency of selenium that is the cause of myofiber degeneration. The trace mineral selenium is a vital component of the glutathione peroxidase system, which helps to protect cells from oxidative injury. The high oxygen requirement combined with contractile activity makes striated muscle, both skeletal and cardiac, particularly sensitive to oxidative injury. connection to prework: Pathologic Basis of Veterinary Disease: Chapter 15 Skeletal Muscle
4. Which of the following is NOT a characteristic finding on regional radiographs of canine osteosarcoma cases: a. Involvement of bones on both sides of the joint space b. Codman's triangle c. Cortical lysis d. Loss of trabecular pattern e. 'Sunburst' extension into soft tissues
answer: a rationale: Osteosarcoma does not cross the joint space connection to prework: musculoskeletal PP #9
5. Ovine hereditary chondrodysplasia is the most common inheritable skeletal disorder in sheep. The gene responsible for this disease is: a. A simple autosomal recessive mode of inheritance b. A polymorphic complete mode of inheritance
answer: a rationale: Pedigree analyses and breeding studies have established that the gene responsible for this disease has a simple autosomal recessive mode of inheritance.The breeding of carrier animals will produce 25% of offspring with the genetic disorder.The breeding of a spider ram in a population of carrier females produces 50% of offspring with spider lamb syndrome. connection to prework: connection to prework: Large Animal Internal Medicine (Sixth Edition): Chapter 38 - Diseases of the Bones, Joints, and Connective Tissues
4. What is phytase? a. A vitamin b. A mineral c. An enzyme d. An antibiotic
answer: a rationale: Phytase is an enzyme that breaks bonds (hydrolysis) to release phosphorous in free form for increased absorption into the body and decreasing the need for supplemental inorganic phosphorous. Remember that most enzymes end in "ase." connection to prework: Listed in History in Overview of Lameness in Pigs in the Merck Veterinary Manual and Dr. Darrin Madson presentation time 5:06 - 5:09 (http://www.swinecast.com/dr-darin-madson-pig-lameness-and-diagnostic-lab-views).
4. Unfortunately the young foal from question 3 becomes too weak to stand and is euthanized. Which of the following would BEST describe the necropsy findings? a. Muscle necrosis with macrophage infiltration; pale, chalk white streaks in the muscle b. Most severely affected muscles are the smooth muscles around the gastrointestinal tract c. Massive regeneration of muscles with hypertrophy d. Normal cardiac muscle
answer: a rationale: Selenium deficiency leads to muscle necrosis and has the characteristically pale streaks. connection to prework: Pathologic Basis of Veterinary Disease: Chapter 15 Skeletal Muscle
7. What was the most common primary diagnosis for lameness in pigs submitted to the Iowa State University Diagnostic Laboratory? a. Inconclusive b. Mycoplasma spp c. Metabolic bone disease d. Osteochondrosis
answer: a rationale: Unfortunately 22% of the close to 400 submissions to the Iowa State University Veterinary Diagnostic Laboratory resulted in an inconclusive primary diagnosis. Although this can be frustrating, connection to prework: See Table 1 of the National Hog Farmer article "4 top lameness diagnoses point to management strategies." (https://www.nationalhogfarmer.com/animal-health/4-top-lameness-diagnoses-point-management-strategies)
4.The most common bone disease seen in reptile practice is: a. Secondary nutritional hyperparathyroidism b. Secondary renal hyperparathyroidism c. Hypertrophic osteopathy d. Panosteitis
answer: a rationale: Very common metabolic bone disease in reptiles connection to prework: In Merck reading
5. Polysulfated glycosoaminoglycans (PSGAGs) like the drug Adequan ® are considered: a. component building blocks necessary for cartilage function and regeneration b. boundary lubricants c. nutraceutical supplements d. non-FDA approved drugs
answer: a rationale: drug fact connection to prework: Provided in pressbook prework
10. Compared to dogs, cats are less able to activate the prodrug, prednisone to its active form, prednisolone. a. TRUE b. FALSE
answer: a rationale: drug fact connection to prework: in pressbook prework
7. Which statement about NSAIDs is NOT true? a. Coadministration of NSAIDs and glucocorticoids is preferred, since it allows each to be used at a reduce dose b. NSAIDs act at more than one point in the pain pathway c. NSAIDs can impair platelet function d. Gastric ulcers resulting from NSAID use usually appear within the first 4 weeks of therapy
answer: a rationale: drug fact connection to prework: in pressbook prework
8. The mechanism of action of Galliprant is: a. Antagonist at a prostaglandin receptor b. Inhibition of primarily cyclooxygenase 2 production of prostaglandins c. Agonist at an arachodonate receptor d. Inhibition of phospholipase-2 production of arachidonic acid
answer: a rationale: drug fact connection to prework: in pressbook prework
9. The duration of effect of dexamethasone is substantially _______ its pharmacokinetic half-life. a. greater than b. less than c. equal to d. none of the responses is correct
answer: a rationale: drug fact connection to prework: in pressbook prework
3. Polysulfated glycosoaminoglycans (PSGAGs) like the drug Adequan ® have a recognized potential for increasing bleeding time in patients. a. TRUE b. FALSE
answer: a rationale: drug fact, PSGAGs are heparinoid molecules connection to prework: in pressbook prework
9. The most clinically relevant opioid receptors are mu and kappa. An agonist at which receptor would generate the best analgesic response in a patient in severe pain from an orthopedic surgery? a. mu b. kappa c. either receptor would be equally effective d. neither receptor can provide relief in severe pain
answer: a rationale: kappa agonists provide moderate analgesia at best, mu agonists provide maximal analgesia connection to prework: Provided in pressbook prework
4. A callus often contains hyaline cartilage, the amount of which reflects: a. the adequacy of the blood supply b. the lack of osteoblasts c. the disruption of the periosteum d. The proximity to a joint
answer: a or b rationale: the adequacy of the blood supply, as less than optimal oxygen supply promotes mesenchymal stem cells to differentiate into chondroblasts rather than osteoblasts. connection to prework: Zachary page 996
5. Which of the following best describes the fracture in the figure? a. right closed mid-diaphyseal comminuted femoral fracture b. left closed proximal-diaphyseal comminuted femoral fracture c. right closed metaphyseal incomplete femoral fracture d. left closed mid-diaphyseal comminuted femoral fracture
answer: a or d rationale: Classification of fractures is important for proper analysis of treatment plan connection to prework: A Practitioner's Guide to Fracture Management, Part 1: Diagnosing Fractures and Choosing a Fixation Technique
3. The ability of bone to change its shape and size (modeling) to accommodate altered mechanical use, as can occur in hip dysplasia as an example, is called Wolff's law. Which of the following are correctly paired? (Select All That Apply) Bone formation is favored at sites of compression Bone resorption is favored at sites of tension Bone formation is favored at sites of tension Bone resorption is favored at sites of compression
answer: a, b rationale: Basic bone physiology. Review Page 963 in prework connection to prework: Zachary page 963
3. You are evaluating a 1 week old foal in the state of Washington in the early spring. The foal has generalized weakness that became apparent soon after birth. The foal appears bright and alert but has difficulty standing and suckling when feeding. The foal was born to a mare that was stabled and fed only hay. The mare also some generalized muscle atrophy and dysphagia. She appears weak and has a stiff short strided gait. Both the foal and the mare have elevated CK and AST values. You also find the selenium and vitamin E in the blood is deficient. How could you prevent or treat this nutritional disease? a. Give injectable Vitamin E and selenium to the foal b. Supplement the ration of the mare c. Add zinc phosphate to the diet to bind glutathione perosidases d. Give IV calcium gluconate.
answer: a, b rationale: This disorder in foals can be prevented by supplementing the ration of mares with selenium during gestation. Foals born in selenium-deficient areas can also be given injectable vitamin E and selenium soon after birth. Young adult horses should be given sufficient dietary vitamin E and selenium. Treatment with selenium and vitamin E after the onset of clinical signs is far less effective than prevention. connection to prework: : Pathologic Basis of Veterinary Disease: Chapter 15 Skeletal Muscle
4. Deficiency in which of the following nutrients is associated with myopathy? a. Vit E b. Selenium c. Vit D
answer: a, b rationale: Vitamin E and Selenium are nutrients that support the activity of several biological antioxidants necessary for maintenance of cell integrity. Deficiency in these nutrients places significant antioxidant stress on highly active cells, like myocytes during normal cellular metabolism. connection to prework: Large Animal Internal Medicine, chapter 42, pg 1438.
9. The horse has hypsodont teeth also known as a. Low crowned b. High crowned c. Mesial d. Lingual
answer: b. rationale: Need to know connection to prework: In Guide to the skeleton of the equine and ruminant
1. NUTRITIONAL/TOXIC causes of muscle dysfunction include: a. Deficiency of selenium and/or vitamin E b. Toxic plants or plant products c. Feed additives such as ionophores d. Peripheral nerve tumors
answer: a, b, c rationale: NUTRITIONAL/TOXIC causes of muscle dysfunction include: Deficiency of selenium and/or vitamin E Toxic plants or plant products Feed additives (ionophores) Other toxins (e.g., some snake venoms) connection to prework: Pathologic Basis of Veterinary Disease: Chapter 15 Skeletal Muscle
4. Although physitis is a term used to describe a developmental orthopedic condition in which there is a disturbance in endochondral ossification as the physis or growth plate, there is evidence that there is a genetic component to this condition. Which of the following factors have been implicated as causes of physitis in horses? a. A genetic component for faster-growing horses and for specific conformation b. Overweight foals c. Intake of high levels of carbohydrates causing hormonal changes affecting the physis d. Improper mineral balance - such as copper or zinc deficiencies, excessive or deficient calcium intake
answer: a, b, c, d rationale: All of these have been implicated in physitis connection to prework: Large Animal Internal Medicine (Sixth Edition): Chapter 38 - Diseases of the Bones, Joints, and Connective Tissues
1. Which of the following are the most common causes of lameness in commercial swine? a. Genetics b. Trauma c. Infectious diseases d. Metabolic diseases
answer: a, b, c, d rationale: Most lameness in production animals is caused by pain associated with infections, trauma-related injuries, or underlying metabolic diseases. connection to prework: See Introduction in Overview of Lameness in Pigs in the Merck Veterinary Manual
10. Which of the following are true regarding Intramedullary (IM) pins and cerclage wires? a. IM pins resist bending loads well, but are poor at resisting rotational forces b. Cerclage wires provide interfragmentary compression c. Cerclage wires do not damage the blood supply to the bone. d. IM pins with cerclage wires are limited to long oblique fractures and spiral fractures of certain bones.
answer: a, b, c, d rationale: Used a lot in practice so need to know connection to prework: A Practitioner's Guide to Fracture Management, Part 3: Selection of Internal Fixation Technique
8. In horses with an open joint wound, prognosis is greatly improved if: The wound is contaminated but not infected The wound is infected but not contaminated You are a cow, not a horse A and C All of the above
answer: a, c rationale: Microbiology and susceptibility to disease. Please review Smith 1213-1214 connection to prework: Smith 1213-1214
13. Treatment of discospondylitis involves which of the following (more than one may be correct): Prolonged antimicrobial drug treatment Strict restriction of movement Exercise Short course of antibiotics once the causative agent is identified
answer: a,b rationale: Microbiology and etiology of osteomyelitis in dogs. Review page 824 in Canine and Feline Infectious Diseases connection to prework: Page 824 Canine and Feline Infectious Diseases
9. Which the following are commonly associated with metabolic bone disease in pigs? (Select All That Apply) a. Vitamin D b. Calcium c. Phosphorous d. Parathyroid hormone
answer: a,b,c rationale: Metabolic bone disease in pigs is traditionally associated with nutritional disturbances associated with vitamin D, calcium, and phosphorous imbalance. connection to prework: Dr. Darrin Madson presentation time 2:55 - 3:25 (http://www.swinecast.com/dr-darin-madson-pig-lameness-and-diagnostic-lab-views)
1. Common medications used in degenerative joint disease include chondroprotectives. Which of the following are true regarding articular cartilage that makes chondroprotectives such a good option for patients with degenerative disease? (Select All That Apply) a. Articular cartilage is made of aggrecan, which is composed of an immensely long, nonpolysulfated glycosaminoglycan known as hyaluronan b. Articular cartilage is also made up of smaller polysulfated glycosaminoglycan known as chondroitin sulfate and keratan sulfate c. Collagen fibers are arranged in arcades so that the strongest sides are parallel to the articular surface to resist shearing forces d. Osteocytes constantly turn over synovial fluid
answer: a,b,c rationale: Synovial fluid is made by the synovial membrane lining a joint capsule called B-cells. Normal synovial fluid contains hyaluronic acid, lubricin (a water-soluble glycoprotein), proteinases, and collagenase and is clear, colorless to pale yellow, and viscous. In addition to lubricating the joint surfaces, it supplies oxygen and nutrients to and removes carbon dioxide and metabolic wastes from the chondrocytes in articular cartilage. connection to prework: Pathologic Basis of Veterinary Disease: Chapter 16 Bones, Joints, Tendons and Ligaments
3. Type II intervertebral disk protrusion is a degenerative disease in older animals. Which of the following are common in a multi modal medical treatment plan if surgical decompression of the spinal cord is not warranted? (Select All That Apply) a. Restricted exercise b. Antiinflammatory drugs c. Muscle relaxants d. Antibiotics
answer: a,b,c rationale: antibiotics should be reserved for cases where a bacterial infectious condition is present. connection to prework: Small Animal Internal Medicine: Part 9 - Nervous System and Neuromuscular Disorders
2. You are evaluating a 12 year old FS yellow lab for hip dysplasia. Select the characteristics of a joint with advanced hip dysplasia: (Select All That Apply) a. Notable erosion and ulceration of articular cartilage of both the femoral head and acetabulum b. Articular capsule is distended and thickened, sometimes containing areas of osseous and chondroid metaplasia c. The dorsal rim of the acetabulum flattens and become shallow and wide d. Eburnation of underlying bone and formation of periarticular osteophytes on both the proximal femur and acetabulum
answer: a,b,c,d rationale: All of the above occur with hip dysplasia in dogs connection to prework: Pathologic Basis of Veterinary Disease: Chapter 16 Bones, Joints, Tendons and Ligaments
10. Which of the following clinical signs can be associated with hypocalcemia in pigs? (Select All That Apply) a. Sudden Death b. Lameness c. CNS signs associated with tremors/seizures and weakness d. Bone fractures
answer: a,b,c,d rationale: Hypocalcemia can be the result of low calcium or vitamin D deficiency. This can result in sudden death, muscle weakness, tremors/seizures, muscle fasciculations/tetany, reluctance to move (pain), lameness, and broken bones. connection to prework: Dr. Darrin Madson presentation time 7:30 - 8:20 (http://www.swinecast.com/dr-darin-madson-pig-lameness-and-diagnostic-lab-views)
9. Which of the following is true regarding clostridial myositis? (Select All That Apply) Can be rapidly progressing to death There is no vaccine against clostridial organisms Clostridial organisms are ubiquitous in the environment Local necrotizing myositis and systemic toxemia are caused by released toxins.
answer: a,c,d rationale: Basic clostridial microbiology. Please review 1432-1433 Smith connection to prework: Pages: 1432-1433 Smith
7. Which of the following, when substituted for a few OH- ions in hydroxyapatite Ca10(PO4)6(OH)2 crystals, increases the strength of bone? Fluoride Lead Phosphorus Selenium
answer: a. Fluoride rationale: Basic bone physiology connection to prework: Page 597
6. Which compound(s) impart the compressive strength of cartilage by providing the amorphous matrix? Proteoglycans Glycosaminoglycans Fibril bundles Elastic fibers
answer: a. and b. rationale: Understanding of basic cartilage physiology connection to prework: Page 595
2. Which of the following will present as a 'dropped hock?' More than one may apply. a. Achilles (calcanean) tendon rupture b. Tibial nerve paralysis c. Fibular nerve paralysis d. Sciatic nerve paralysis
answer: a. b. d. rationale: Important clinical presentation connection to prework: In Merck reading
2. In most horses, the underlying inherited cause of equine polysaccharide storage myopathy (EPSEM) is? a. Abnormal levels of serum glycogen b. A point mutation in the skeletal muscle glycogen synthase 1 (GYS1) gene c. PAS-positive, amalyse sensitive DNA d. Glycogen brancher enzymes deficiency
answer: b rationale: A point mutation in the skeletal muscle glycogen synthase 1 (GYS1) gene has been associated with some, but not all, cases of EPSSM. A DNA test for this mutation is available, and horses with GYS1 mutations are sometimes classified as EPSSM type 1. Abnormal accumulation of intracytoplasmic glycogen (confirmed by being PAS-positive, amylase-sensitive) within type 2 fibers is the histologic finding. In severe cases, aggregates of abnormal glycogen are eventually ubiquitinated, resulting in amylase-resistant inclusions composed of glycogen and filamentous protein. connection to prework: Pathologic Basis of Veterinary Disease: Chapter 15 Skeletal Muscle
8. You are evaluating a 4 year old mare presenting for acute muscle weakness, sweating, fasciculations, stiffness, tachycardia, and tachypnea. The only change in environment is that the mare was recently moved to a paddock next to a line of trees. This is done yearly in the fall as the tree line protects the horse from harsh winter winds. No additional feed is provided yet. While examining the mare, you notice that she urinates and the color is a reddish brown indicating myoglobinuria. You immediately start supportive care, but despite your efforts, the mare collapses and dies while in respiratory distress. Based on the history and physical exam findings alone, which is the most likely explanation? a. Blister beetles in hay cause hypocalcemia preventing normal muscle function b. Box elder seeds that contain the toxin hypoglycin A, which causes seasonal pasture myopathy c. High nonstructural carbohydrate (NSC) content and low forage content leading to sporadic exertional rhabdomyolysis
answer: b rationale: B or C are correct. A highly fatal acquired lipid storage myopathy of pastured horses occurs in the fall and less often in the spring in Europe and central and northeastern parts of North America. Affected horses are usually young or new to affected pastures and kept on wooded pastures for more than 12 hours a day without additional feed provided. Windy weather often precedes outbreaks connection to prework: Large Animal Internal Medicine (Sixth Edition): Chapter 42 - Diseases of Muscles
4. Hypocalcemia (milk fever) is not uncommon in post-partum dairy cattle. How would low levels of calcium affect the proteins responsible for muscle contraction? a. Tropomyosin production will be limited, inhibiting the binding of myosin to actin b. Myosin will be unable to bind to actin because troponin holds tropomyosin into place on actin c. Myosin will be unable to slide along actin because there is not enough ATP d. Troponin production will be limited, inhibiting the binding of myosin to actin
answer: b rationale: Basic physiological knowledge connection to prework: Duke's page 270
5. In rigor mortis, muscles become 'fixed' in position because of: a. Depletion of ADP b. Depletion of ATP c. Increase of Ca++ d. Autolysis and dissociation of myosin and actin
answer: b rationale: Basic physiological knowledge connection to prework: page 272
3. What is the primary source of calcium for the body? A. The bones B. The diet C. Vitamin D3 D. Spinach
answer: b rationale: Basic physiology connection to prework: page 601
5. You are monitoring a 5 year old Quarter Horse Mare that originally presented for a stiff stilted gait with excessive sweating and a high respiratory rate following light exercise after being rested for 2 days. Based on the history, clinical exam findings and laboratory data, you make a diagnosis of rhabdomyolysis. What can you say about the timeline of this horses disease process. Analyte Day of presentation Creatine Kinase* 10,569 Aspartate Aminotransferase* 6,854 *Reference interval for CK in the adult horse: 119-287 U/L **Reference interval for AST in the adult horse: 168-494 U/L Which of the following is likely true concerning the timeline of a. The horse experienced an episode of acute rhabdomyolysis within the last 24 hours b. The horse has ongoing recent rhabdomyolysis c. The horse had an episode of rhabdomyolysis in the past but it is not ongoing d. The horse has irreversible muscle damage.
answer: b rationale: Concurrent elevations in CK and AST indicate ongoing or persistent myolysis. In acute rhabdomyolysis the CK is elevated but the AST is not increased or only minimally increased. When there is past injury to a muscle that is resolved then CK is usually normal and AST is increased. You cannot determine reversibility of injury to tissue based on the degree of enzyme elevation. connection to prework: Video and Powerpoint: Clinical pathology of Muscle.
3. Which of the following describes a bone fractured into several pieces where one has broken through the skin? Choose one. a. Simple compound fracture b. Open comminuted fracture c. Avulsion fracture d. Simple comminuted fracture
answer: b rationale: Descriptions of fractures are critical for medical records connection to prework: Zachary page 996
3. Which of the following factors can contribute to significant changes in the feeding values of micronutrients such as vitamin D and phytase. (Select All That Apply) a. Storing for a short period of time b. Storing for a long period of time c. Inadequate mixing of feed d. Water quality
answer: b, c, d rationale: Vitamin D and phytase, as well as other micronutrients (especially other vitamins) deteriorate over time. It is important to keep feed ingredients as fresh as possible to maximize their nutritional value. connection to prework: See History in Overview of Lameness in Pigs in the Merck Veterinary Manual
8. A 7 month old Labrador Retriever presents to your clinic with progressive facial swelling. The owner has been feeding a proprietary homemade food since the puppy was adopted. Analysis of the diet reveals high phosphorus and low calcium. The clinical chemistry profile reveals hypocalcemia (normal albumin) and hyperphosphatemia. Which of the following is true concerning the disease process in this puppy? a. The low calcium diet leads to increased PTH release and increased bone deposition. b. The low calcium diet leads to increased PTH release and increased bone resorption. c. The low calcium diet leads to decreased PTH release and decreased bone resorption. d. The low calcium diet leads to decreased PTH release and decreased bone deposition.
answer: b rationale: Low calcium will stimulate release of PTH. The PTH will act on bone to cause increased resorption of bone mineral to attempt to increase the serum calcium back to normal. Over time, the constant removal of bone mineral results in proliferation of fibrous connective tissue and subsequent swelling of the facial bones. connection to prework: Video and Powerpoint: Calcium and Phosphorus balance.
14. Discospondylitis is considered a potential public health concern because the potential causative agent could be: Bartonella Brucella canis E. Coli Staph ssp
answer: b rationale: Microbiology and etiology of osteomyelitis in dogs. Review page 825 in Canine and Feline Infectious Diseases connection to prework: Page 825 Canine and Feline Infectious Diseases
9. A 6 year old spayed female Scottish Terrier presents with chronic renal disease and is hypocalcemic. What is the first thing to evaluate on chemistry profile before you do additional diagnostics to determine the cause of the hypocalcemia? a. Check serum potassium concentration b. Check serum albumin concentration c. Check plasma protein concentration d. Check phosphorus concentration
answer: b rationale: The first step in evaluating the hypocalcemia is to determine if there is hypoalbuminemia that may be causing a hypocalcemia due to decreased albumin bound calcium. If the albumin is within reference range the total calcium is likely due to a decrease in ionized calcium. If the albumin is decreased, a direct measurement of ionized calcium is the best determination of the significance of the hypocalcemia. A corrected albumin could be calculated in this dog, but direct measurement of ionized is the best way to confirm a true hypocalcemia. connection to prework: Video and Powerpoint: Calcium and Phosphorus balance.
3. The median survival time for canine osteosarcoma patients with no treatment is? a. 8-10 weeks b. 18-20 weeks c. 24-36 weeks d. 48-52 weeks
answer: b rationale: The median survival time is 19 weeks connection to prework:
2. It is recommended that if a female guinea pig is to be used for breeding, she be bred before 6 months of age. Why? a. Older guinea pigs are less likely to get pregnant b. The pelvic symphysis fused and will lead to dystocia c. Older females will get too thin during pregnancy d. Older guinea pigs are more prone to pregnancy toxemia
answer: b rationale: The pelvic symphysis will not separate enough and will lead to a need for a C-section. connection to prework: In Merck reading
10. Which of the following sets of findings on a PTH or Calcium profile is indicative of Vitamin D toxicity? a. Increased Calcium, increased PTH, decreased Phosphorus b. Increased Calcium, decreased PTH, increased Phosphorus c. Decreased Calcium, increased PTH, increased Phosphorus d. Decreased Calcium, decreased PTH, decreased Phosphorus
answer: b rationale: Vitamin D toxicity results in increased intestinal absorption of calcium and phosphorus and increased calcium and phosphorus resorption in bone. Because the increased calcium will inhibit PTH secretion by the parathyroid gland, the kidney will not be able to effectively excrete phosphorus and serum phosphorus will be increased (or occasionally normal). connection to prework: Video and Powerpoint: Calcium and Phosphorus balance.
3. Amantadine is particularly effective when used as a single drug to treat chronic pain. a. TRUE b. FALSE
answer: b rationale: amantadine is far more effective in combination with another analgesic connection to prework: Provided in pressbook prework
5. Select the drug that has antiviral properties, as well as being an NMDA receptor antagonist a. gabapentin b. amantadine c. fluoxetine d. codeine
answer: b rationale: drug fact connection to prework: in pressbook prework
6. The longer a patient takes NSAIDS, the greater is their risk of an NSAID-associated GI lesion (e.g. gastric ulcers). a. TRUE b. FALSE
answer: b rationale: drug fact connection to prework: in pressbook prework
1. NSAIDs block the activity of which enzyme? a. Phospholipase A2 b. Cycloxygenase c. Cyclic ATP Phospatase d. Hexoseaminidase
answer: b rationale: drug fact, MOA of NSAIDs connection to prework: Provided in pressbook prework
6. Dantrolene exerts its effect by acting on: a. nerve tissue b. muscle tissue c. cartilage d. bone
answer: b rationale: drug fact, dantrolene is a direct muscle relaxant connection to prework: Provided in pressbook prework
2. For immediate local anesthesia, bupivicaine is superior to lidocaine. a. TRUE b. FALSE
answer: b rationale: drug fact, onset of anesthesia is faster with lidocaine connection to prework: Provided in pressbook prework
7. You have a patient you suspect to have septic arthritis. Which of the following are true (Select All That Apply): You can be patient, these often heal themselves This is an emergency and treatment must be initiated immediately Determining the causative agent is a priority Lavage of the joint is an important component of treatment
answer: b, c, d rationale: Clinical physiology of the joint. Review Smith page 1213 connection to prework: 1213 Smith
15. Which of the following are true about septic arthritis? (Select All That Apply) Septic monoarthritis is usually secondary to hematogenous spread Septic monoarthritis can be a consequence of surgery on that joint Septic polyarthritis can be a consequence of tick-borne infections Septic polyarthritis means more than one joint is involved
answer: b, c, d rationale: Etiology of septic arthritis in dogs. Review page 825 in Canine and Feline Infectious Diseases connection to prework: Page 825 Canine and Feline Infectious Diseases
1. Why does bone have a more rapid ability to heal than cartilage? Bone has more proteoglycans Bone is highly vascular while nutrients must diffuse across the cartilage matrix Increased vascularization of the cartilage matrix leading to calcification rather than healing Type II collagen heals more slowly than Type I
answer: b. rationale: Bone is highly vascular while nutrients must diffuse across the cartilage matrix connection to prework: Page 593
1. Gonadectomy prior to physeal closure will result in an animal: of the same stature regardless of timing of the surgery significantly shorter than it would have otherwise been significantly taller than it would otherwise have been with skeletal changes only significant in male dogs.
answer: c connection to prework: In prework
2. Which of the following are typical for panosteitis in young dogs? Associated with toy breeds Progressive and permanently debilitating Shifting leg lameness Surgical intervention results in more favorable outcome
answer: c connection to prework: In prework
1. Which of the following substances is the most specific marker for skeletal muscle lysis because it is only found in myocytes? a. Aspartate aminotransferase (AST) b. Creatine Kinase (CK) c. Myoglobin d. Potassium
answer: c rationale: All of these analytes are found in the cytoplasm of skeletal muscle. However, CK, AST, and Potassium can be found in other tissues. Myoglobin is only found in the cytoplasm of the myocyte. CK is a more specific marker for muscle lysis than AST because it is in the highest concentration in skeletal muscle and will only increase significantly with skeletal muscle injury. Of the analytes found on a chemistry profile, CK is the most muscle specific. Remember, myoglobin does not increase in serum because it is rapidly cleared by the kidney into the urine resulting in visible pigmenturia or myoglobinuria. AST will increase in serum with both skeletal muscle injury and liver cell (hepatocyte) injury. Potassium is the predominant cation in the cytosol of all cells. connection to prework: Video and Powerpoint: Clinical pathology of Muscle.
8. Which of the following radioactive elements that, when consumed on contaminated feed, can be incorporated into bone and slowly leached into milk? Cesium - 137 Lead Strontium - 90 Uranium - 235
answer: c rationale: Basic bone physiology connection to prework: page 598 Dukes
6. Compared to fast twitch muscles cells, slow twitch muscle cells are characterized by a. Larger fiber diameter b. Less vascularization c. More mitochondria d. Oxidative metabolism is of secondary importance
answer: c rationale: Basic physiological knowledge connection to prework: 265
2. Muscle contraction involves multiple specialized proteins and energy expenditure. Which of the following statements best summarizes a muscle contraction? a. Troponin slides along myosin by utilizing energy from ATP b. Calcium ions bind to receptors on actin, causing muscle contraction to occur c. Myosin slides along actin by utilizing energy from ATP d. Tropomyosin attaches to myosin and utilizes energy from calcium ions
answer: c rationale: Basic physiological knowledge connection to prework: Duke's page 270
7. The force generating unit in a muscle is the: a. Myofiber b. Myofibril c. Myofilament d. Sarcomere
answer: c rationale: Basic physiological knowledge connection to prework: page 269
2.Which of the following is true concerning pigmenturia (hemoglobinuria and myoglobinuria). a. The color of the urine (red versus red-brown) is a reliable way of differentiating hemoglobinuria from myoglobinuria. b. The heme reaction on the urine chemistry reagent strip will be positive with hemoglobinuria but negative with myoglobinuria c. The color of the plasma is most helpful in differentiating hemoglobinuria from myoglobinuria. d. Myoglobin has a carrier that prevents the majority of myoglobin from being filtered by the kidney.
answer: c rationale: Both myoglobin and hemoglobin are small molecules that are freely filtered by the kidney into the urine. However, Hemoglobin can bind to a carrier protein (haptoglobin) that prevents some of the hemoglobin from being filtered resulting in visible hemoglobin in plasma (red plasma). The remaining unbound hemoglobin will be filtered into the urine resulting in hemoglobinuria (red urine). Myoglobin has no carrier, so all myoglobin released from the myocytes is quickly cleared from the plasma keeping it normal in color (clear or yellow plasma). The filtered myoglobin is results in myoglobinuria (red urine) connection to prework: Video and Powerpoint: Clinical pathology of Muscle.
7. According to the reading, fracture ends should have at least how much contact to expect fracture healing? a. 25% b. 33% c. 50% d. 75%
answer: c rationale: Important for determining what type of fixation is required. connection to prework: A Practitioner's Guide to Fracture Management, Part 2: Selection of Fixation Technique and External Coaptation
6. The surface of the tooth that faces the opposite dental arch is known as the. a. Mesial surface b. Lingual surface c. Occlusal surface d. Vestibular surface
answer: c rationale: Important information connection to prework: In Dissection of the dog
2. Which part of the bone is most commonly affected in canine osteosarcoma? a. Diaphysis b. Physis c. Metaphysis
answer: c rationale: Metaphysis is the most common site connection to prework: musculoskeletal pp #4
6. What is the overall effect of increased PTH activity on serum calcium and phosphorus? a. Increased serum calcium and serum phosphorus b. Decreased serum calcium and serum phosphorus c. Increased serum calcium and decreased serum phosphorus d. Decreased serum calcium and increased serum phosphorus
answer: c rationale: PTH acts on the bone and intestine (through Vitamin D) to increased serum calcium and phosphorus. However, in the kidney, PTH promotes reabsorption of calcium and excretion of phosphorus. The amount of phosphorus excreted exceeds the amount of phosphorus that comes from the bone and intestine causing a net decrease in serum phosphorus. connection to prework: Video and Powerpoint: Clinical pathology of calcium and phosphorus balance.
2. Which of the following components of the animal's/herd's signalment is most valuable in helping identify the most relevant differential list when evaluating causes for pig lameness? a. Sex b. Breed c. Age d. Housing
answer: c rationale: The causes of lameness vary depending on the age of the pigs. The susceptibility and exposure to different pathogens changes with age as the pig's immunity level will also vary. Nutritional and metabolic contributors to lameness become more common as pigs get older. connection to prework: See Signalment in Overview of Lameness in Pigs in the Merck Veterinary Manual
3. The most common dental disease of guinea pigs is a. Overgrown incisors b. Cavities c. Coronal elongation of the cheek teeth d. Plaque build-up
answer: c rationale: This is the most common dental issue in Guinea Pigs connection to prework: In Merck reading
5. Which of the following tumors does NOT have a very high (>75%) metastatic rate? a. Osteosarcoma b. Hemangiosarcoma c. Chondrosarcoma d. Histiocytic sarcoma
answer: c rationale: chondrosarcomas metastatic rate is reported to be lower in all species connection to prework: musculoskeletal PP #38
1. Manufacturer data reported that studies in dogs administered relatively high doses of _________ for nine months tolerated the treatment with mild GI adverse effects noted. a. naproxen b. carprofen c. galliprant d. acetaminophen
answer: c rationale: drug fact connection to prework: Provided in pressbook prework
10. Gabapentin's most common adverse effects are: a. vomiting/diarrhea b. hyperactivity/aggression c. sedation/ataxia d. vocalization/anxiety
answer: c rationale: drug fact connection to prework: Provided in pressbook prework
8. Which of the following modifications of a base glucocorticoid drug is a non-cleavable modification that has the potential to change the potency of the base drug? a. phosphate b. succinate c. acetonide d. acetate
answer: c rationale: drug fact connection to prework: Provided in pressbook prework
2. Siri, a 10 Y-O FS DSH cat presents with anemia. Along with a CBC, the veterinarian performed a blood smear, and a serum biochemistry panel, which collectively revealed Heinz body hemolysis. When interviewed about any medications the cat might have been exposed to, the owner said, "Interesting you should ask, her arthritis flared up yesterday and I have her a dose of _________." Select the drug that most logically fits this case vignette. a. meloxicam b. robenacoxib c. acetaminophen d. carprofen
answer: c rationale: drug fact connection to prework: acetaminophen causes Heinz body hemolysis in cats
4. Dantrolene can be used to treat: a. immune mediated polyarthropathy b. cholecystitis c. exertional rhabdomyolysis d. all of the above
answer: c rationale: drug fact, PSGAGs are heparinoid molecules connection to prework: in pressbook prework
8. External coaptation (Splint/cast) as a primary fixation method is a. Unsuitable for fractures distal to the humerus or stifle b. Best suited for incomplete diaphyseal fractures of the tibia c. Can result in cast sores d. Is the best choice for radial/ulnar fractures in small breed dogs
answer: c, b rationale: Important to understand the choices for treatment. connection to prework: A Practitioner's Guide to Fracture Management, Part 2: Selection of Fixation Technique and External Coaptation
6. Which of the following pigs is most likely to carrier of the PSS gene? a. A commercial gilt (female) used for breeding purposes b. A commercial boar (male) selected for its red skin color c. A show pig boar (male) selected for its heavy muscling d. A show pig gilt (female) selected for its white skin color
answer: c, d rationale: PSS or porcine stress syndrome is associated with heavy muscled pigs. Heavy muscling can be associated with both males and females. The pig show industry promotes heavy muscling especially in males. The push to have heavy muscled male pigs increases the probability for the selection of PSS positive animals unless they are tested to be double negative for the stress gene. connection to prework: See website on Porcine Stress Syndrome (https://vetmed.iastate.edu/vdpam/FSVD/swine/index-diseases/PSS#:~:text=Porcine%20stress%20syndrome%2C%20sometimes%20called,and%20by%20depolarizing%20muscle%20relaxants.)
8. What is likely the primary reason for inconclusive diagnostic results in lameness submissions to the Iowa State Veterinary Diagnostic Laboratory? a. Lack of diagnostic assay availability b. Improper sample handling c. Lack of sample submissions d. Improper diagnostic sample submission
answer: c, d rationale: The National hog farmer article identified a large number of samples submissions resulting in inconclusive diagnostic results. In the Swine Cast presentation, with Dr. Darrin Madsen comments that unfortunately lack of attention to details results in the improper submission of diagnostic samples which will result in an inclusive result. connection to prework: National Hog Farmer article "4 top lameness diagnoses point to management strategies." (https://www.nationalhogfarmer.com/animal-health/4-top-lameness-diagnoses-point-management-strategies) and Dr. Darrin Madson presentation time 1:15 - 1:30 (http://www.swinecast.com/dr-darin-madson-pig-lameness-and-diagnostic-lab-views)
5. Hematogenous osteomyelitis can begin in any capillary bed in bone in which viable bacteria localize. In practice, it occurs most commonly in young animals and is localized typically at the zone of vascular invasion on the metaphyseal side of the growth plate OR immediately subjacent to the articular-epiphyseal cartilage complex because (choose one): The cartilage is thinner in young animals The vascular supply to the growth plate is shutting down when the growth plate closes. This is where capillaries in both sites make sharp bends to join medullary veins. Young animals have many vascular anastomoses in this area.
answer: crationale: Basic bone physiology. Review Page 971 in prework connection to prework: Zachary page 971
10. A detached osteochondritis dissecans flap is known as a A. Cartilage plug B. Cruciate rupture C. Joint crepitus D. Joint mouse
answer: d connection to prework: In prework
4. Which of the following is true regarding the treatment of panosteitis in a young dog? Exercise should be encouraged High protein diets are encouraged Steroids are critical for more rapid resolution Treatment does not affect outcome
answer: d connection to prework: In prework
5. The mulefoot hog is a rare breed of pig which lacks cloven hooves and instead has a single hoof, as in a horse. This fusion of the digits is called: Ectrodactyly Hemimelia Polydactyly Syndactyly
answer: d connection to prework: In prework
3. The prognosis for patients with x-linked (dystrophin-deficient) muscular dystrophy is: a. Excellent b. Good c. Fair d. Poor
answer: d rationale: Affected dogs have a severe and progressive myopathic phenotype, including gradual loss of muscle mass and development of contractures. Tongue hypertrophy and pharyngeal and esophageal dysfunction result in drooling, dysphagia, and regurgitation. The serum CK activity is persistently and dramatically elevated, which can be detected at a few weeks of age. No specific therapies are currently available. Early death can occur from cardiomyopathy, complications of dysphagia and esophageal dysfunction, or respiratory impairment from a greatly thickened diaphragm. connection to prework: Pathologic Basis of Veterinary Disease: Chapter 15 Skeletal Muscle
5. The difference between osteocytic osteolysis and osteoclastic osteolysis is that osteocytic osteolysis A. Is a result of long-term parathyroid hormone secretion B. Results in release of Calcium from the cortex of the diaphysis C. More rapidly releases Calcium ions in response to metabolic alkalosis D. Is the initial response of the body to hypocalcemia.
answer: d rationale: Basic bone physiology connection to prework: Page 596
6. The most common cause of septic arthritis in adult horses is a. Hematogenous b. Iatrogenic (from joint injections) c. Idiopathic d. Trauma
answer: d rationale: Basic joint physiology. Review Page 1207 in prework connection to prework: Page 1207 Smith's
1. Myofiber necrosis caused by recumbency can occur because of: Decreased blood flow because of compression of major arteries, Reperfusion injury when the compression is relieved Increased intramuscular pressure causing compartment syndrome Any combination of these factors.
answer: d rationale: Basic muscle physiology. Review Page 924 in prework connection to prework: Zachary, page 924
11. Elevated levels of hydroxyproline in the urine can be an indication of which of the following? Decreased resorption of the collagen matrix Increased osteoblast activity Lack of proline hydroxylation due to vitamin C deficiency in scurvy Digestion of bone collagen fibrils
answer: d rationale: Basic physiology connection to prework: page 698
6. A 3 year old Holstein dairy cow presents for weakness and being unable to support the weight of her head. She calved about 4 weeks ago and produced a maximum amount of milk yesterday on her lactation curve. Today, she is off her feed and her serum ketone bodies are (acetone, acetoacetate, and beta-hydroxybutyrate) are elevated. A diagnosis of ketosis is made. She is treated with IV glucose only. The following day, her weakness becomes profound and she is recumbent. Serum concentration of potassium is below normal. What is the link between potassium and muscle function (hypokalemic myopathy)? a. Low potassium is due to glucagon release from the liver b. Potassium is released from the joints and bones to stimulate muscle contraction. c. Serum potassium is always equal to muscle potassium d. Type 2 muscle fibers are very sensitive to decreases in potassium and this interferes with normal muscle cell function
answer: d rationale: Decreased potassium interferes with normal muscle cell function and can lead to muscle weakness and myofiber necrosis. connection to prework: Pathologic Basis of Veterinary Disease: Chapter 15 Skeletal Muscle
6. Which of the following fixation methods provides the most fracture stability? a. Cast b. Splint c. IM pin d. Bone plate and screws
answer: d rationale: Determining the level of fixation required is part of the treatment plan. connection to prework: A Practitioner's Guide to Fracture Management, Part 1: Diagnosing Fractures and Choosing a Fixation Technique
3. Which of the following genetic myopathies in the horse is NOT usually associated with significant rhabdomyolysis characterized by significant increases in Creatin Kinase (CK) and Aspartate Aminotransferase (AST)? a. Malignant Hyperthermia b. Polysaccharide storage myopathy type 1 c. Polysaccharide storage myopathy type 2 d. Hyperkalemic periodic paralysis
answer: d rationale: Hyperkalemic periodic paralysis is an autosomal dominant mutation in a skeletal muscle sodium channel that results in persistent depolarization and muscle weakness. The usual changes in the chemistry profile in affected horses include "impressive" hyperkalemia, hemoconcentration, mild hyponatremia with no or minimal increases muscle enzymes (CK, AST). Rabdomyolysis is not a common manifestation of hyperkalemic periodic paralysis. The remaining genetic diseases are commonly associated with rhabdomyolysis with significant changes in CK, AST, K, Phos, and variable degrees of myoglobinuria. connection to prework: Video and Powerpoint: Clinical pathology of Muscle, Large Animal Internal Medicine, chapter 42, pg 1427-1429, 1444-1450
10. Of the domestic animals, which species has the full complement of both deciduous and permanent teeth? a. Horse b. Dog c. Cat d. Pig
answer: d rationale: Important veterinary knowledge connection to prework: In Guide to the Skeleton of the Equine and Ruminant
11. According to the reading, an intramedullary (IM) pin should not be used to fix which bone? a. Femur b. Tibia c. Humerus d. Radius
answer: d rationale: Important when treating treatment options connection to prework: A Practitioner's Guide to Fracture Management, Part 3: Selection of Internal Fixation Technique
12. Discospondylitis most often follows hematogenous spread of bacteria or fungi to the Disc shaped menisci within the stifle Hips Metal implants associated with internal fixation of a fracture Vertebral endplates with extension to the intervertebral discs
answer: d rationale: Microbiology and etiology of discospondylitis in dogs. Review page 820 in Canine and Feline Infectious Diseases connection to prework: Page 820 Canine and Feline Infectious Diseases
1. Osteosarcoma accounts for what percentage of canine primary bone tumors? a. <25% b. 26-50% c. 51-75% d. 75-90%
answer: d rationale: OSA accounts for about 85% of cases connection to prework: musculoskeletal pp #3
7. Because the Holstein dairy cow in question 6 is such a remarkable milk producer, efforts are made to correct the hypokalemic myopathy. Which of the following treatments would you select? a. Exogenous parathyroid hormone b. Isoflupredone acetate) c. IV insulin (1-2 units per liter IV solution) d. IV potassium (20-40mEq potassium per liter IV solution)
answer: d rationale: Reserve IV potassium (20 to 40 mEq potassium per liter IV solution, up to 80 mEq/L) for recumbent ruminants with severe hypokalemia and rumen atony. Do not to exceed a maximum infusion rate of 0.5 mEq/kg/h. Early treatment should also be directed at resolving the primary cause of ketosis and anorexia, as well as providing supportive care. connection to prework: Large Animal Internal Medicine (Sixth Edition): Chapter 42 - Diseases of Muscles
5. Which of the following joints is most difficult to evaluate in pigs? a. Carpal b. Fetlock c. Tarsal d. Shoulder
answer: d rationale: The pig's shoulder is protected by muscle mass making it difficult to visualize and/or manipulate. connection to prework: See Clinical Evaluation in Overview of Lameness in Pigs in the Merck Veterinary Manual
2. Myofibers are particularly sensitive to nutritional deficiencies that result in the loss of antioxidant defense mechanisms such as the glutathione peroxidase system. Which type of deficiency can lead to severe myofiber degeneration? a. Acer b. Cassia c. Eupatorium d. Selenium
answer: d rationale: The trace mineral selenium is a vital component of the glutathione peroxidase system, which helps to protect cells from oxidative injury. The high oxygen requirement combined with contractile activity makes striated muscle, both skeletal and cardiac, particularly sensitive to oxidative injury. Neonatal animals, which rely on stores of selenium accumulated during gestation, are most frequently affected. Affected muscle is pale as a result of necrosis, thus the common name white muscle disease connection to prework: : Pathologic Basis of Veterinary Disease: Chapter 15 Skeletal Muscle
7. Which anti-inflammatory drug is the best choice for post-operative pain from ovarohisterectomy in an 8 month-old cat? a. Ibuprofen b. Naproxen c. Acetaminophen d. Meloxicam
answer: d rationale: a and b are not recommended for cats or dogs. c is absolutely contraindicated in cats. connection to prework: Provided in pressbook prework
4. Which of the following statements is most accurate? a. Cox 1 is generally considered the "Bad Cox", because it is induced in injured tissues and generates inflammation and pain b. Cox 2 is generally considered to be the "Good Cox" because of its broad distribution in the body and its main function in supporting homeostatic functions c. Cox 1 stimulates sympathetic nervous system output to the heart d. Cox 2 modulates renal vascular tone
answer: d rationale: cox 2, while considered to be the drug target for pathological inflammation, does have homeostatic effects including modulating renal vascular tone to preserve GFR in hypovolemia connection to prework: Provided in pressbook prework
8. A horse has all of their adult teeth by how many years of age? a. 2 years b. 3 years c. 4 years d. 5 years
answer: d rationale: need to know connection to prework: In Guide to the skeleton of the horse and ruminant
5. Which of the following type of teeth has no deciduous predecessor? a. Incisors b. Canines c. Premolars d. Molars
answer: d. rationale: Important to know types of teeth connection to prework: in dissection guide
7.How many teeth does the adult dog normally have? a. 28 b. 36 c. 40 d. 42
answer: d. rationale: Need to know connection to prework: In dissection guide
10. The most common cause of osteomyelitis and infectious monoarthritis in dogs is Bartonella E. coli Mycobacterium Nocardia Staphylococcus spp.
answer: e rationale: Microbiology and etiology of osteomyelitis in dogs. Review page 814 in Canine and Feline Infectious Diseases connection to prework: Page 814 Canine and Feline Infectious Diseases
