Zuku: Nursing

Answer is A: Any animal that is having respiratory difficulty should have supplemental oxygen provided immediately. Further workup and procedures such as radiographs and ultrasound should be postponed until the patient is more stable. Any stress or restraint in a dyspneic animal may result in cardiac arrest. Oxygen can be provided with nasal prongs or cannulas, face mask, flow-by, or an oxygen cage.

A 10-year-old domestic short hair cat is presented in respiratory distress with a pronounced expiratory effort and wheezes heard on auscultation. What should be done first? (A) Provide supplemental oxygen (B) Obtain thoracic radiographs (C) Transtracheal wash (D) Perform ultrasound of the chest (E) Place intravenous catheter

Answer is D: Give two 500 mg pills, three times a day for this dog. Remember that 2.2 pounds = 1 kilogram, so to get the weight of the dog in kilograms, divide 110 lb by 2.2 kg=50 kg. The dose is 50 kg X 20 mg/kg = 1000 mg, which is two 500 mg pills.

A 110 lb Siberian husky with a severe urinary tract infection, has been prescribed Amoxicillin at a dose of 20 mg/kg PO t.i.d. In your clinic pharmacy, you have 500 mg pills. How many pills should the dog receive in each dose? (A) 1/2 pill (B) 1 pill (C) 3 pills (D) 2 pills

Answer is D: Milk fever (parturient paresis) in cows is not a fever at all. Parturient paresis usually occurs within 72 hr of parturition, caused by the loss of blood calcium to the milk in dairy cows soon after calving due. It is characterized by LOWER body temperatures, higher heart rate but weaker pulses, staggering, weakness and decreased urination and defecation. Treatment is IV and oral calcium.

All of the following are symptoms of milk fever in dairy cows except...? (A) Down, weak (B) Weak pulse (C) Decreased defecation (D) High fever (E) Tachycardia (rapid heart rate)

Answer is C: Wound lavage is the initial cleaning of a wound with fluids. Antibiotics are not recommended. Using large amounts of fluids with moderate pressure is the most important part of the treatment.

All of these statements about wound lavage are true except: (A) It removes debris and bacteria from the wound (B) Mechanical action of lavage is most important (C) Antibiotics should be used in the solution (D) Warm sterile electolyte solution is preferred

Answer is A: Nematode. Heartworms are a filarial type of nematode or roundworm.

Canine heartworms are which one of the following types of parasites? (A) Nematode (B) Strongyle (C) Ascarid (D) Protozoa

Answer is A: Cushing's disease, or hyperadrenocorticism, is caused by chronic excess cortisol.

Chronically elevated levels of the hormone cortisol is characteristic of which one of the following diseases? (A) Cushing's disease (B) Diabetes mellitus (C) Thyroid disease (D) Addison's disease

Answer is D: Icterus is yellowing of the skin and mucous membranes, caused by increased levels of bilirubin in the blood. It is not necessarily a sign of dehydration. Hyperbilirubinemia is seen most commonly with hemolysis and liver disease in most animals. Horses often have a yellow tinge when off feed as liver metabolism of bilirubin is slowed. It is normal in horses on pastures with high levels of beta carotene. Tachycardia, weak pulses, dry mucous membranes, skin tenting, and delayed capillary refill are signs of dehydration. Hypothermia is seen with fluid loss and with shock. Click to see a chart with the clinical signs of dehydration.

Clinical signs of dehydration include all of the following choices EXCEPT one. Which choice is not a sign of dehydration? (A) Skin tenting (B) Tachycardia (C) Hypothermia (D) Icterus (E) Slow capillary refill time

Answer is D: Goat's milk most closely approximates camelid milk. Care should be taken to use local animals as they should have immunity to regional diseases. Recently, commercial camelid colostrum and milk replacers have become available.

Colostrum and milk from which one of the following animals can be used to feed orphan crias? (A) Sheep (B) Horse (C) Dog (D) Goat (E) Only another camelid

Answer is E: Normal saline is the appropriate fluid choice. IV fluids are routinely given to patients with urethral obstruction. These patients are usually hyperkalemic, hyponatremic, and hypochloremic due to the composition of urine. Therefore, fluids that contain potassium (e.g., Lactated Ringer's solution, Normasol-R) should be avoided.

An adult male goat is presented with straining to urinate and moderate dehydration. Urethral obstruction is suspected. What type of IV fluids would be best to get ready for administration while awaiting further diagnostic results? (A) No IV fluids should be given since patient cannot urinate (B) Lactated Ringer's solution (C) Normasol-R (D) Mannitol (E) Normal saline

Answer is A: Compared to the circumference of the limb at the site of placement, a blood pressure cuff should be approximately 40% the width of the limb. Proper and consistent technique is essential for accuracy when performing indirect blood pressure measurements

Approximately what width should a blood pressure cuff be in a dog or cat as compared to the limb at the site of cuff placement? (A) 40% circumference of limb (B) 30% circumference of limb (C) 60% circumference of limb (D) 50% circumference of limb (E) 20% circumference of limb

Answer is A: The position of recumbent horses should be changed at least every 6 hours to help minimize the risk of pressure sores and to replace any soiled bedding and provide adequate padding. These cases are very difficult to manage. Ideally they should be maintained in sternal recumbency. Recumbent horses often have decreased gastrointestinal motility and therefore need to be fed soft feeds and possibly laxatives such as mineral oil. They typically also have decreased ability to urinate—especially males—so urinary catheterization is often necessary. A sling can be used if the horse is able to bear some weight.

As a general guideline, how often should a down horse's position be changed? (A) Every 6 hours (B) Every 8 hours (C) Every 12 hours (D) Every 2 hours (E) Every 24 hours

Answer is B: Splints can readily be incorporated between the elastic gauze layer and the outer protective layer. Modified Robert Jones bandages are used very commonly in veterinary medicine. They consist of a primary layer, which varies based on whether or not a wound is present, a secondary layer of padding, an elastic gauze (or Kling®) layer, and an outer protective layer.

How are splints incorporated into a modified Robert Jones bandage in small animal patients? (A) Between the secondary layer and the elastic gauze layer (B) Between elastic gauze layer and outer protective layer (C) They should not be incorporated into this type of bandage (D) Between the skin and the primary layer (E) Between the primary layer and the secondary layer

Answer is A: Benign tumors can cause impaired tissue function by taking up space (crowding) in the tissue. Tumors are generally initially classified as benign or malignant. Benign tumors do not invade and destroy local tissue like malignant tumors do. They also do not metastasize to secondary locations (e.g., lung, liver) via the circulation or lymphatics like malignant tumors do. For example, a space-occupying benign tumor in the brain or spinal cord could cause significant compression and therefore functional impairment of the surrounding tissues. However, a similar benign tumor in the skin on the back might not cause any significant functional impairment.

How can benign tumors cause significant problems? (A) Space-associated impairment of function (B) Metastasize to lung, liver, kidneys, spleen, brain (C) Invade and destroy normal local tissues (D) Enter circulation and travel to bone marrow (E) Benign tumors do not cause significant problems

Answer is A: Sheep have a 17-day estrous cycle (range 14-20 days) and estrus lasts about 1-2 days. Goats cycle roughly every 21 days (range 16-24 days) and estrus lasts about 2-3 days. Sheep and goats are also seasonally polyestrous, but cycle in the fall and early winter, so as to have babies 5 months later in the spring, when the weather is mild. Click the following link for a table of reproductive cycle features, most animals.

How do sheep and goats differ in their estrous cycles? (A) Longer estrous cycle in goats (B) No difference in estrous cycles (C) Behavioral estrus more obvious and prolonged in sheep (D) Higher incidence of double ovulation in goats (E) Sheep reach puberty sooner than goats

Answer is B: Emesis is another name for vomiting. Remember that xylazine can make cats vomit. Apomorphine crumbled into the conjunctival part of a dog's eye can cause vomiting too. If an owner is on the phone and needs to make their dog vomit right away using household ingredients, 5-10 ml of 3% hydrogen peroxide orally works. Follow this link to see a Merck table of common emetic drugs.

Emesis is another name for what problem? (A) Defecation (B) Vomiting (C) Urination (D) Anemia

Answer is C: Fetlock. Exuberant granulation tissue (proud flesh) is most likely to develop on equine wounds over high motion areas and/or distal to the carpus or hock. It is characterized by the excessive development of granulation tissue over the wound instead of the epithelialization and contraction process that occurs during normal healing. Click here to see a good summary on general wound management in horses, with images, courtesy of the American College of Veterinary Surgeons (ACVS).

Exuberant granulation tissue (proud flesh) would be most likely to complicate the healing of a wound on a horse in which one of the following locations? (A) Pectoral region (B) Head (C) Fetlock (D) Abdomen (E) Gluteal region

Answer is B: The fecal floatation technique relies on eggs being less dense than the float solution used. Most trematode eggs are too dense to float. Sedimentation procedures are used to identify trematode eggs. Trematodes are flukes, such as the lung flukes of small animals, Paragonimus westermani and P kellicotti.

Fecal floatation does not work for most trematode eggs because of which one of the following characteristics? (A) Flagella keep them suspended in solution (B) Eggs are too heavy to float (C) Entire life cycle is inside the animal (D) Cell membranes rupture in the float solution

Answer is E: Uterine torsion is defined as the pregnant uterus rotating in relation to the maternal pelvis. It is most common in cattle, camelids, and horses. It can cause dystocia, colic, or fetal damage. An anesthetized cow can be rolled with a plank in the flank to stabilize the uterus. An assistant (the heaviest one around) bounces up and down on the plank while the cow is rolled in the desired direction with the help of ropes on the legs. Sometimes multiple rolls are necessary to correct a torsion.

For what condition is the "plank-in-the-flank method" used in cattle? (A) Abomasal volvulus (B) Vagal indigestion (C) Prolapsed vagina (D) This method should not be used in cattle (E) Uterine torsion

Answer is D: Furosemide blocks the main sodium transport mechanism in the loop of Henle in the renal tubules. Thus, the kidneys excrete more sodium and water (and also potassium).

Furosemide is the most commonly used diuretic in veterinary medicine. Where is its target site of action? (A) Glomerulus (B) Cardiac muscle cells (C) Small intestine (D) Loop of Henle (E) Large colon

Answer is B: Interpersonal communication skills are key to help clients fully understand all options. Sometimes helping an owner is not about showing how much you know, it's more about showing how much you care. Simply taking time to listen matters too.

How do you help ensure that a client is able to make their best veterinary service options? (A) Verbal recommendation provided (B) Help client fully understand all options (C) Written recommendation provided (D) Recommendation must be repeated at least three times

Answer is E: A lubed, gloved finger is used to place the medication at least 5 cm into the rectum. Some medications can be given intrarectally because the large colon mucosa is highly absorptive. It is preferable if there is decreased fecal matter present when the medication is administered. Alternatively, a lubed short rubber tube (e.g., feeding tube or urinary catheter) can be used. Intrarectal administration is especially helpful in vomiting animals who cannot hold down food or liquids.

How far cranially into the rectum should intrarectal medications be deposited in dogs and cats? (A) 1 cm or more (B) Medications should not be given intrarectally (C) 2 cm or more (D) 10 cm or more (E) 5 cm or more

Answer is C: It is recommended that IV fluid lines be changed daily in these patients to prevent contamination. If a fluid line becomes accidently disconnected it should be replaced immediately as it may have been contaminated. Foals in the neonatal intensive care unit are particularly susceptible to complications during hospitalization and maintaining the fluid lines is an easy way to help decrease this risk.

How frequently should IV fluid lines used for a critically ill foal in the neonatal intensive care unit be changed to prevent possible contamination? (A) Twice a day (B) Every 5 days (C) Once daily (D) Every other day (E) Weekly

Answer is C: The bovine estrous cycle is 21 days long (range 18-24 days). Behavioral estrus itself ("heat") lasts about 18 hours and breeding should occur from mid-estrus to about 6 hours after the end of estrus (in the case of artificial insemination). Click the following link for a table of reproductive cycle features, most animals.

How long is the bovine estrous cycle? (A) Depends on day length (B) 17 days (C) 18 hours (D) 21 days (E) 24 days

Answer is A: Down foals should be maintained in sternal recumbency for at least 1 minute after an oral medication is given. This helps decrease the risk of aspiration.

How long should a down neonatal large animal patient (such as a foal) be kept in sternal recumbency after administering oral medications, and why? (A) More than 1 min; decrease risk of aspiration (B) It is unnecessary to keep patient in sternal recumbency (C) More than 10 min; facilitate swallowing (D) 5-10 min; prevent mare from ingesting any that isn't swallowed (E) More than 5 min; improve gastric absorption

Answer is C: Stage 2 labor begins with the rupture of the placenta (water breaking) and is explosive in horses, taking less than 30 minutes. Any delay in stage 2 labor is considered an emergency as the foal very quickly becomes hypoxemic and may die.

How long should stage 2 labor take in horses? (A) Less than 1 hour (B) 1-3 hours (C) Less than 30 minutes (D) Less than 6 hours (E) 2-4 hours

Answer is B: If the testicle(s) are not in the scrotum by 2-6 months, then the animal is cryptorchid. Normally testes descend by 6-8 wks in dogs, prenatally in cats). Cryptorchidism is COMMON (1-2% dogs, right side 75%; In horse more common on LEFT) Remember that cryptorchid dogs are 10X to 14X more likely to develop sertoli cell tumors and seminomas. Also see increased risk of testicular torsion. The treatment is CASTRATION. Discourage breeding.

How long should you wait before you can definitively say a dog is cryptorchid? (Has an undescended testicle) (A) Birth-2 months (B) 2-6 months (C) Cannot say (D) 7-12 months

Answer is E: Horses have 3 blind spots. They have a huge field of vision - almost 360 degrees, with 60-70 degrees of binocular vision. They cannot see directly behind them, directly in front of their nose, or between their eyes on their forehead. Horses turn their heads quickly to judge distance and determine whether something is a threat. It is important to understand blind spots when approaching a horse.

How many blind spots do horses have in their visual field? (A) None (B) 2 (C) 1 (D) 4 (E) 3

Answer is A: In most situations, 8-12 breaths should be administered per minute during CPCR. This does not depend on patient size. Hyperventilation of the patient causes cerebral blood vessel constriction and decreased perfusion of the brain. An Ambu bag or anesthetic machine can be used to provide ventilator support during CPCR. A target of 10-20 cm H2O should be provided for each breath if a pressure manometer is present.

How many breaths per minute should be administered to small animal patients during cardiopulmonary cerebral resuscitation (CPCR)? (A) 8-12 (B) As fast as possible (C) 4-6 (D) 6-9 (E) 14-16

Answer is B: It is recommended that 3 people restrain foals for arterial or venous access procedures. One should hold the foal's head and protect the eyes, a second on the front limbs, and a third on the hind limbs. It is best to restrain a foal using bones (such as holding onto joints) rather than soft-tissue structures such as the abdomen, which can become injured during restraint.

How many people are typically needed to restrain a critically ill foal in the neonatal intensive care unit for arterial or venous puncture? (A) 1 (B) 3 (C) 4 (D) 2 (E) 5

Answer is B: It is a poor practice to keep a client waiting more than 3 rings on the telephone. Picking up every call after only one ring would be great, but probably also impossible in the real world.

How many times are acceptable for a clinic telephone to ring before answering? (the most rings acceptable are....?) (A) 1 (B) 3 (C) Until the Cubs win the World Series (D) 5

Answer is D: Fluids with an osmolality of greater than 600 mOsm/L should not be administered via a peripheral venous catheter because they cause phlebitis. Examples include mannitol, diazepam, and pentobarbital.

Over what osmolality should fluids only be administered via a jugular venous catheter (as opposed to a peripheral venous catheter)? (A) 500 mOsm/L (B) 600 mOsm/L (C) 700 mOsm/L (D) 400 mOsm/L (E) 300 mOsm/L

Answer is A: It is recommended that calves receive 10% of their body weight in colostrum within 4-6 hours after birth. Otherwise, they are considered to have failure of passive transfer. Cows' placentas do not allow the passage of immunoglobulins in utero. Therefore, calves must ingest colostrum, which is high in immunoglobulins, soon after birth in order to prevent infectious disease. The specialized small intestinal epithelial cells that allow the absorption of these large proteins are no longer present by approximately 24 hours after birth.

How much colostrum should a calf receive after birth, and within what time interval from birth? (A) 10% body weight; within 4-6 hours (B) 20% body weight; within 6-8 hours (C) 2.5% body weight; within 12-24 hours (D) 15% body weight; within 12-24 hours (E) 5% body weight; within 6-12 hours

Answer is A: A healthy adult horse drinks approximately 4-6% of its body weight per day, or 20-30 L for a 500-kg horse. This is an important number to remember when monitoring water intake in hospitalized horses.

How much does an average adult healthy horse drink per day? (A) 20-30 L (B) 10-15 L (C) 15-20 L (D) 30-40 L (E) Less than 10 L

Answer is B: A healthy foal will drink approximately 20% of its body weight in milk each day. Usually critically ill foals are started at approximately 5% of their body weight per day and the amount is slowly increased as they can tolerate. Parenteral nutrition can be administered if a foal cannot tolerate any enteral nutrition. This is not uncommon in critically ill foals.

How much milk does a healthy foal consume each day as a percentage of its body weight? (A) 15% (B) 20% (C) 10% (D) 40% (E) 30%

Answer is A: Stranguria is painful and usually difficult urination; a frequent cause is urethral obstruction.

If the veterinarian says a client is bringing in a cat with stranguria. Which one of the following choices is the correct explanation of this clinical sign? (A) Painful urination (B) Difficult birth (C) Labored breathing (D) Racing heart rate

Answer is E: Frightened cats can have very high sympathetic drive and may lack a pupillary light response in the absence of a brain injury. Fixed and dilated pupils are usually a poor prognostic indicator, because they indicate an irreversible mid-brain lesion. It is important to evaluate the entire animal. If the cat is a bit dull but interacting in a normal manner, fixed and dilated pupils might be due to fear. If the cat has been hit by a car and is nonresponsive in lateral recumbency, fixed and dilated pupils likely indicate traumatic brain injury.

In which animal can sympathetic drive override the pupillary light response and make a frightened animal without an irreversible mid-brain lesion have fixed and dilated pupils (A) Cows (B) Dogs (C) Horses (D) Rabbits (E) Cats

Answer is A: Coughing is a common sign of congestive heart failure in dogs.

In which animal is coughing a common sign of congestive heart failure? (A) Dogs (B) Cats (C) Cattle (D) Pigs (E) Sheep

Answer is C: Urethral catheterization is a challenging procedure in cats and typically requires sedation or anesthesia. It is not common to pass a urethral catheter in male or female cats unless relieving a urethral obstruction.

In which animal is sedation or anesthesia almost always necessary for urethral catheterization in both sexes? (A) Dogs (B) Goats (C) Cats (D) Horses (E) Cows

Answer is A: Ketoacidosis is a life threatening complication of diabetes mellitus.

Ketoacidosis is associated with which disease? (A) Diabetes mellitus (B) Kennel cough (C) Lyme disease (D) Anthrax (E) Parvovirus infection

Answer is A: Grass tetany is caused by low of magnesium levels in the blood and cerebrospinal fluid (CSF) of cattle and sheep. (Hypomagnesemia means low blood magnesium). It is called grass tetany because many pasture grasses and cereal crops are somewhat low in magnesium, but much magnesium is lost in the milk too, so the problem is primarily seen in lactating animals.

What causes grass tetany in cows? (A) Low magnesium level in blood (B) Cows are not allowed to graze fresh grass (C) Toxic levels of potassium (D) Clostridial spores on stems and roots of pasture grasses (E) Cows are not allowed to eat silage

Answer is C: A balling gun is used to give large capsules and pills to cattle and small ruminants. There also similar-looking small plastic pilling devices for cats and dogs. The advantage is the animal chews/bites the instrument instead of your fingers!

What is a balling gun used for? (A) Euthanasia (B) Castrate cattle (C) Administer large pills (D) Marking cattle with paintballs

Answer is D: Pet birds commonly are diagnosed with C. psittaci infections. The clinical presentation can include "poor doing," vomiting, and diarrhea. It is especially common in birds that have come from a group situation such as a pet shop. Psittacosis in humans is a respiratory disease that can be fatal. Proper biosecurity measures should be used when handling suspect birds. These include face masks and gloves for people in contact with the bird, isolation of the bird, and proper disposal of feces and materials from the cage.

What is a common avian disease that is zoonotic to humans? (A) West Nile virus (B) Salmonellosis (C) Staphylococcus aureus (D) Chlamydophila psittaci (E) Pseudomonas aeruginosa

Answer is E: This horse has unilateral epistaxis (nose bleed, one sided). You will need to do further work up to clarify the causes. Here are some examples of diseases that can cause epistaxis in horses. Exercised-induced pulmonary hemorrhage occurs in many racehorses, but only a small percentage will have epistaxis. Nasal polyps are pedunculated masses that can obstruct airflow and cause a nasal discharge. Guttural pouch mycosis plaques are typically located on the caudodorsal aspect of the medial guttural pouch, over the internal carotid artery and may cause sudden and severe hemorrhage. An ethmoid hematoma can have unilateral, mild epistaxis as the only symptom.

What is a horse nose bleed called? (A) Atopy (B) Brachycephaly (C) Mydriasis (D) Apnea (E) Epistaxis

Answer is A: It is imperative to stay close and keep a hand on the horse. This will not prevent kicking, but decreases the likelihood of a kick being fatal.

What is a key way to avoid fatal injury by a horse? (A) Stay close and keep a hand on the horse (B) Loudly announce yourself each time you approach (C) Do not touch the horse caudal to the front legs (D) Maintain a 1-foot distance from the front leg (E) Maintain a 1-foot distance from the hind legs

Answer is E: Male ferrets are called "Hobs" and females are called "Jills" and a group of ferrets is called a "business". In 1971, a female ferret named "Felicia" did in fact help clean pipes at Fermi National physics labs by pulling a string attached to a cotton swab behind her.

What is a male ferret called? (A) Jake (B) Boar (C) Sprite (D) Felicia (E) Hob

Answer is E: Ketosis is a common name for acetonemia. Cows with ketosis are usually off-feed and depressed. Ketosis is a poorly understood metabolic/nutritional problem that occurs when high-producing dairy cows are using up more nutritional energy to make milk than they take in from eating. As their bodies try to adapt by burning fat, ketones build up in the bloodstream and make the cow sick. Common in cows who have just given birth, and in cows at peak lactation.

What is a more common name for acetonemia in cattle? (A) Orf (B) Bog spavin (C) Milk fever (D) Bloat (E) Ketosis

Answer is C: A prodromal period is the period of disease where only mild symptoms are present. For example, in meningitis, the prodromal stage may only be fever and limb stiffness

What is a prodromal period? (A) Period of acute symptoms (B) Period of peak infectiousness (C) Early mild symptoms (D) Period just before clinical disease ends (E) Subclinical period

Answer is C: A ranula is a mucocele of the sublingual salivary gland. Mucocoeles occur secondary to damage of the salivary duct or gland causing an accumulation of mucoid saliva, under the tongue. They are usually treated by drainage, marsupialization, or gland removal. Oral papillomas are benign, but contagious growths on the oral mucosa of young dogs or puppies.

What is a ranula? (A) Any foreign body under the tongue (B) Sublingual lymphadenopathy (C) Salivary mucocele (D) Sublingual tonsil (E) Oral papilloma

Answer is D: Blood pressure is routinely monitored noninvasively (via a cuff on the tail) in foals in the neonatal intensive care unit (NICU). A decreased blood pressure is often an early sign of failure to respond to treatment. Direct blood pressure via an intra-arterial catheter is not routinely performed in non-anesthestized patients.

What is a readily available measurement a veterinary technician can take that often is an early indication that a foal in the neonatal intensive care unit is not responding to treatment? (A) Central venous pressure (B) Heart rate (C) Serum fibrinogen concentration (D) Noninvasive blood pressure (E) Pulse oximetry

Answer is D: Water consumption can be encouraged by putting a little syrup or molasses on the tip of the sipper tube. Sipper bottles or other water delivery systems are preferred for rabbits over water dishes that can become contaminated or spill.

What is a recommended way to encourage water consumption in pet rabbits? (A) Salt lick (B) Add apple juice to the water (C) Loose mineral salt in feed (D) Syrup on tip of sipper tube (E) Large dish of fresh water changed daily

Answer is A: No safe level of occupational exposure to chemotherapeutic medications has been identified. Chemotherapeutics are teratogens, mutagens, and carcinogens. Accidental exposure must be avoided through extreme care when handling these medications. Owners should be informed in detail about how to handle these medications if they are being administered at home.

What is a safe occupational level of exposure to chemotherapeutic drugs? (A) None (B) Varies with each medication (C) Less than once daily (D) Less than once weekly Less than once monthly (E)

Answer is B: Owners can easily be taught to monitor the resting respiratory rate at home and make an appointment if it begins to increase. Most often, tachypnea at rest is the first sign that heart disease is progressing to heart failure.

What is a very helpful way to help owners identify the progression from heart disease to heart failure in dogs and cats? (A) Teach them to palpate peripheral pulses (B) Teach them to count resting respiratory rate (C) Teach them to measure the heart rate (D) Teach them to auscult for cardiac murmurs (E) Teach them to evaluate the mucous membranes

Answer is A: Ewes often have a thick wax plug at the end of the teat. Sometimes this cannot be readily removed by the lamb and needs to be removed by an attendant. Cleft palate is a congenital problem that might affect nursing, but it is not easily fixable. Lambs (and kids) are very susceptible to hypoglycemia and hypothermia if they do not ingest enough colostrum within the first 12-24 hours after birth.

What is an easily fixable reason that a lamb might not be able to nurse successfully immediately after birth? (A) Teat plugged by waxy deposits (B) Clogged nostrils impede lamb's ability to suckle (C) Hypoglycemia (D) Hypothermia (E) Lamb cannot reach udder

Answer is C: An ectopic pregnancy is one where the egg is developing outside the uterus. This can be a life threatening complication for both fetus and mother.

What is an ectopic pregnancy? (A) False pregnancy (B) Pregnancy that lasts more than 20% of normal term (C) Pseudopregnancy (D) Pregnancy from artificial insemination

Answer is A: An iatrogenic problem is caused by the therapy itself. A common example of an iatrogenic disease occurs when chronic treatment with glucocorticoids (like prednisolone) for a common problem like flea allergy causes iatrogenic hyperadrenocorticism, (also known as Cushing's disease). Basically, by overdosing a dog with glucocorticoids to control itching, you cause a hormonal imbalance and subsequent Cushing's disease. Follow this link to see a dog with classic Cushing's disease.

What is an iatrogenic medical or surgical problem? (A) A bad outcome, inflicted by the therapy itself (B) A disease that gets better without treatment (C) A disease secondary to inbreeding (D) A genetic predisposition

Answer is D: Anastomosis is the removal of a section of the intestine and sewing together the two ends to reconnect the organ. It is a surgical connection of separate or severed tubluar organs

What is anastomosis? (A) Removal of the rectum and attachment of colon to a bag to receive solid waste (B) When a piece of intestine invaginates into an adjacent piece of intestine (C) When dissolved nutrients move across a cell membrane to equalize concentration on both sides (D) Cutting out a section of intestine and sewing the remaining ends together (E) Infusion of digested food from intestine via villi

Answer is D: The femoral triangle is a good place from which to take the femoral pulse inside the medial hindleg. The triangle is formed by the sartorius muscle cranially, pectineus muscle caudally and the body wall dorsally. Anterior cruciate injuries are stifle problems (often called the knee by laypeople). Surgical approaches to repair hip dysplasia (like a triple pelvic osteotomy) would not go through the femoral triangle. Follow this link to see a radiograph of severe hip dysplasia in a German Shepherd dog.

QWhat is the clinical significance of the femoral triangle in dogs and cats? (A) Pulse oximeters attach there (B) Surgical approach for hip dysplasia repair (C) Associated with brachial plexus avulsion (D) Good place to take pulse from femoral artery (E) Often damaged with anterior cruciate injuries

Answer is A: On a wall near the treatment area. A chart with drug dosages (and basic CPCR protocol) should be posted prominently on the wall where everyone can read it easily. The crash cart contains most of the basic supplies needed to work up and treat emergency patients, especially when cardiopulmonary cerebral resuscitation is needed. An oxygen source and supplies (Ambu Bag, hoses, flowmeter, etc), an electrocardiogram, and a defibrillator should be close by

QWhere should a chart of standard drug dosages and resuscitation steps be kept in a clinic? (A) On a wall near the treatment area (B) In the controlled substances cabinet (C) In the emergency crash cart (D) On exam room doors (E) In the surgical suite

Answer is X:

Question: (A) (B) (C) (D) (E)

Answer is C: Over 75% of cardiac cases in dogs are due to valvular disease. Over 80% of cardiac cases in cats are due to myocardial disease. Patients with heart disease might present with tachycardia, cardiac murmur or arrhythmia, and abnormal peripheral pulses.

Question: (A) Myocardial disease (B) Disease of the great vessels (C) Valvular disease (D) Ventricular disease (E) Atrial disease

Answer is A: About half, 45%, of canine mammary tumors are malignant. Note that this is DIFFERENT than cats. About 90% of feline mammary tumors are malignant!

Roughly what percentage of mammary tumors in dogs are malignant? (A) 45 (B) 10 (C) 90 (D) 30

Answer is A: If anthrax is suspected, the area federal veterinarian should be notified immediately. Anthrax is caused by Bacillus anthracis and causes sudden death in animals and HUMANS. The disease is zoonotic. Necropsies should NOT be performed because of the risk of human infection and contamination of the surrounding environment. Carcasses should be buried with lime or incinerated. The vaccine should be administered in high-risk areas but is not something that would be done before notifying the federal area veterinarian. Penicillin can be used in animals with the disease that are not yet dead; usually there is not time. There is no anthrax anti-serum.

Several cows were found dead on a farm with no warning. Anthrax is highly suspected. What is the first thing that should be done? (A) Notify the area federal veterinarian (B) Administer anthrax vaccine to remaining cows (C) Perform necropsies to submit necessary tissue samples (D) Treat remaining cows with penicillin (E) Administer anthrax antiserum to remaining cows

Answer is B: Anisocoria is having pupils of different sizes. Determining which one is the abnormal eye [mydriatic (abnormally dilated) or miotic (abnormally constricted)] is a challenge even for an experienced clinician. It can help to look at the animal in a lighted room then in a darkened room. In a lighted room, an abnormally dilated pupil is more obvious because the normal pupil constricts. . In a darkened room, an abnormally constricted pupil is more obvious because the normal pupil dilates.

What is anisocoria? (A) Inflammation of lungs (B) Pupils of unequal size (C) Lack of intestinal peristalsis (D) Vocal cord inflammation (E) Involuntary movement secondary to viral infection

Answer is C: Parturition (giving birth) in cats is called queening. Dogs whelp. Parturition in ferrets and rabbits is called kindling. Mammary gland hypertrophy is caused by hormonal imbalances in unsprayed female cats.

What is another name for parturition in cats? (A) Mammary gland hypertrophy (B) Pseudopregnancy (C) Queening (D) Kindling

Answer is D: Parturition (giving birth) in ferrets and rabbits is called kindling. Parturition in cats is called queening. Dogs whelp. False pregnancy is more of a dog problem.

What is another name for parturition in rabbits? (A) Shearling (B) False pregnancy (C) Queening (D) Kindling

Answer is C: Atopy is a form of generalized allergy, where an animal (10% of dogs!) is allergic to almost everything, including allergens in food, the environment, flea bites and in the air. Absence of breathing is apnea. You may see apnea when inducing anesthesia in an animal with thiopenthal or propofol. Dyspnea is the difficulty breathing.

What is atopy? (A) Heart murmur (B) Difficult breathing (C) Allergy (D) No breathing

Answer is E: The noises produced in the intestines by the digestion of food are called borborygmus.

What is borborygmus? (A) Heartbeat (B) Harry Potter's favorite house elf (C) Wheezing (D) Rales (E) Abdominal noise

Answer is B: Cystocentesis is the percutaneous aspiration of urine directly from the bladder with a needle and syringe. Cystocentesis is the preferred method of collection for urine culture because it avoids contamination of sample from lower urinary tract. Click here to see a Table on urine collection methods showing advantages and disadvantages of each.

What is cystocentesis? (A) Surgical removal of dentigerous cysts (B) Percutaneous aspiration of urine (C) Surgical closure of an umbilical hernia (D) Form of pregnancy testing

Answer is B: These are the waxing teats of a mare about to foal in 6 to 48 hours. "Waxing" happens in about 95% of mares before foaling. In the final two to three days of pregnancy, the teats of most mares distend with colostrum. Colostrum drips and dries on the nipples to make a waxy coating at each teat orifice.

What is demonstrated in the following image from a horse? (A) Normal teats (B) Waxing (C) Contagious agalactia (D) Mastitis (E) Normal sebaceous plugs

Answer is A: This is the normal location of hamster flank glands (also called "hip glands"), which are most prominent in the male hamster. Flank glands become wet and matted during sexual excitement.

What is demonstrated in this image of an adult male hamster? (A) Flank gland (B) Typical grooming site (C) Dominance-related bite wound (D) Moist dermatitis, usually secondary to Dermatophilus spp (E) Suggestive of high humidity or overheating

Answer is B: This is malocclusion of the incisors and they need to be carefully trimmed. Rabbit teeth grow throughout life, and malocclusion is probably the most common inherited disease in rabbits. Dental trimming is done under anesthesia with bone or wire cutters, or with a grinding tool or dental burr (safer).

What is demonstrated in this image? (A) Pica (B) Malocclusion (C) Severe ascarid infestation (D) Rabbits like to eat spaghetti (E) Foreign body

Answer is A: Hemoptysis is coughing up blood.

What is hemoptysis ? (A) Coughing up blood (B) Carrying oxygen from the lungs to the cells (C) An inflammation of the rectum (D) Clumping of red blood cells

Answer is B: It is critical to continually monitor tongue color and respiratory rate during restraint and muzzling of small animal patients. If any abnormal respiration or coloration of the tongue are noted, the procedure needs to be stopped immediately and the animal given a break.

What is important to continually monitor during muzzling and restraint of dogs and cats? (A) Eye position and heart rate (B) Tongue color and respiratory rate (C) Heart rate and pulse quality (D) Capillary refill time and eye position (E) Mucous membrane quality and breathing pattern

Answer is E: Intranasal catheters should be advanced to the level of the medial canthus of the eye. This should be measured and marked on the tube prior to placement. The tube can be sutured in place using a wrap around the muzzle and a tape butterfly on the catheter.

What is measured to determine how far into the nostril intranasal oxygen tubing will need to be inserted in large animals? (A) Not necessary, nasal prongs are used for intranasal oxygen (B) Entrance of nostril to caudal border of ramus of mandible (C) Entrance of nostril to halfway to infraorbital foramen (D) Entrance of nostril to base of ear (E) Entrance of nostril to medial canthus of eye

Answer is D Meconium is the thick and tarry accumulation of glandular secretions, swallowed amniotic fluid, and sloughed cells present at birth in the gastrointestinal tract. In horses, the most common cause of colic in the newborn foal is meconium impaction. Affected foals will swish their tail from side to side, roll, and strain to defecate. Most foals can be treated successfully with a warm, soapy water enema or an acetylcysteine retention enema

What is meconium?: (A) Umbilical/urachal discharge (B) Byproduct of hemoglobin degradation (C) Colostrum before birth (D) Feces of the newborn (E) Buttercup genus associated with toxicity

Answer is D: Mice often develop geriatric conditions such as neoplasia and live for approximately 2 years.

What is one of the most commonly seen diseases in pet mice? (A) Wet tail (diarrhea) (B) Dermatitis (C) Gastrointestinal parasitism (D) Neoplasia (E) Tail degloving injuries

Answer is D: Urticaria, also called hives is an edematous skin disorder that is immunologic (e.g. allergies) or non-immunologic (e.g. cold, heat, stress) in nature. Angioedema is similar but is rather characterized as a focally extensive swelling (e.g. facial swelling in a puppy after vaccination). These lesions are short living, tend to wax and wane, and often do respond to anti-inflammatory therapy or by avoiding exposure to the triggering factors.

The 12-year-old Quarter horse gelding shown below develops these cutaneous skin lesions every summer for the last 3 years. These lesions seem to wax and wane and currently have a multifocal distribution. What is the medical term used to describe this type of lesion? (A) Macules (B) Hyperemia (C) Angioedema (D) Urticaria (E) Granulomas

Answer is D: When using a syringe, allow the puppy to hold its own head in a natural position to prevent aspiration of the food. Use the syringe to place the food in the back of the throat to trigger the swallow reflex. Be careful not to give too much at one time and make sure the animal swallows each bolus.

The veterinarian at your clinic asks you to feed an orphaned puppy. Using a feeding syringe, what is the best position for the head? (A) Head elevated laterally 45 degress, body in lateral recumbency (B) Head held straight down (C) Head held straight up (D) A natural position

Answer is C: When using a syringe, allow the puppy to hold its own head in a natural position to prevent aspiration of the food. Use the syringe to place the food in the back of the throat to trigger the swallow reflex. Be careful not to give too much at one time and make sure the animal swallows each bolu

The veterinarian at your clinic asks you to feed an orphaned puppy. Using a feeding syringe, what is the best position for the head? (A) Head held straight down (B) Head elevated laterally 45 degrees, body in lateral recumbency (C) A natural position (D) Head held straight up

Answer is D: Dystocia is abnormal or difficult birth.

The veterinarian at your clinic tells you that a dog is coming in with dystocia. What is happening? (A) Unable to urinate (B) Unable to defecate (C) Trouble breathing (D) Trouble giving birth (E) Dog is temporarily blind

Answer is D: This colt has an umbilical hernia, in which there is a failure of normal closure of the umbilical ring. This results in the protrusion of abdominal contents into the subcutaneous tissues. If the hernia is reducible and less than 10 cm, it should be managed with frequent manual reduction and potentially a compressive belly bandage. If this does not result in resolution or there are signs of intestinal strangulation, surgical treatment is indicated.

This 4 month old colt is presented for evaluation. Which of the following choices best describes this colt's abnormality? (A) Diaphragmatic hernia (B) Paraphimosis (C) Inguinal hernia (D) Umbilical hernia (E) Sheath swelling

Answer is A: Pharyngeal trauma is common in ruminants, most commonly due to improper use of a balling gun, speculum, or stomach tube. Affected cows present with an extended head and neck position, with possible feed coming from the nose, anorexia, hypersalivation, mild bloat, and malodorous breath. In severe cases there may be obvious external pharyngeal swelling, fever, dysphagia, coughing, and aspiration pneumonia. Treatment includes antibiotics, anti-inflammatories, and supportive care.

What is the most common cause of pharyngeal abscessation in cattle? (A) Balling gun trauma (B) Feed penetration (C) Actinomycosis (D) Actinobacillosis (E) Improper head gate use

Answer is B: The normal equine stomach can contain up to 2L of light green to yellow, possibly foamy fluid that should not be malodorous. Greater than 2L of fluid, or fluid that is reddish or brown, dark green, or malodorous is abnormal. Horses can have excessive nasogastric reflux due to either a mechanical obstruction or ileus of the small intestine. Occasionally it can be due to a stomach abnormality (e.g., motility disorder or mass at the pylorus).

What is typically considered the maximum amount of nasogastric reflux that can be obtained from a normal horse's stomach? (A) 4L (B) 2L (C) 6L (D) 1L (E) No amount is normal

Answer B: Debridement is the removal of damaged tissues from a wound. Severe wounds, such as fourth degree burns, may require repeated treatments.

What is wound debridement? (A) Removal of fluids from lungs (B) Removal of damaged and necrotic tissues (C) Initial wound cleansing with fluids (D) Loss of skin in an injury (F) Wrapping a wound loosely until dead tissue sloughs off

Answer is D: Wound lavage is the initial cleaning of a wound with fluids like sterile electolyte solution to remove debris and bacteria. Antibiotics are not recommended. Using large amounts of fluids with moderate pressure is the most important part of the treatment.

What is wound lavage? (A) Closing of an open wound with sutures (B) Covering the wound with bandages (C) Removal of damaged and necrotic tissues (D) Initial wound cleansing with fluids

Answer is B: The large pectoral muscle mass is the best site for IM injections in birds.

What it the best location for intramuscular administration of medication in a bird? (A) Neck musculature (B) Pectoral muscle (C) Epaxial musculature (D) IM injections are not given to birds (E) Semimembranosus muscle

Answer is B: Think of acidifying diets with feline urolithiasis (FUS, bladder stones). Acidifying the diet prevents struvite-related urinary tract disease (by dissolving the crytals). Struvite crystal formation is not possible at a urine pH below 6.5. An acidifying diet is NOT recommended for kittens and older cats.

What kind of diet could help in preventing struvite urolith formation in cats? (A) Alkaline diet (B) Acidifying diet (C) Low fat diet (D) Dry food

Answer is A: The most common way to induce anesthesia in a bird is to administer 5% isoflurane with 2L oxygen/minute via mask or induction chamber. Birds are typically ready for intubation within 1 minute.

What is the most common way to induce anesthesia in a bird? (A) 5% isoflurane with 2L oxygen/minute via mask (B) Ketamine 2.5 mg/kg and diazepam 2.2 mg/kg IV (C) 60% nitrous oxide with 2L oxygen/minute via flow-by (D) 1% propofol at 6 mg/kg IV (E) 2% sevoflurane with 2L oxygen/minute via induction chamber

Answer is A: Retained placenta has been associated with nutritional deficiencies in selenium and vitamins A and E during the dry period. Proper nutrition during the dry period is critical for a healthy post-partum cow. Unbalanced prepartum diets have been associated with an increased incidence of metritis in cattle. Well-balanced diets low in calcium during the dry period have been shown to help prevent milk fever.

What management factor can be responsible for retained placenta, metritis, and milk fever in cattle? (A) Dry cow nutrition (B) Improper vaccination schedule (C) Substandard sanitation (D) Over-use of hormone therapy (E) Unattended calving

Answer is C: The lateral saphenous vein is the preferred site for blood collection and IV catheter placement in rabbits. It has a more proximal position on the leg in rabbits than in dogs. The marginal ear vein can be used for blood collection but tissue necrosis can occur if the blood supply is disrupted by the procedure. Therefore this site is not recommended unless other sites are not usable. The cephalic vein and cranial vena cava (the latter with strict professional supervision) can also be used.

What is the preferred site for blood collection and IV catheter placement in rabbits? (A) Cephalic vein (B) Marginal ear vein (C) Lateral saphenous vein (D) Jugular vein (E) Femoral vein

Answer is D: Formaldehyde is commonly used as tissue preservative. Formaldehyde and glutaraldehyde are aldehydes; they are toxic and irritating to living tissue. Glutaraldehyde is used as the disinfecting solution in cold sterilization baths for instruments and endoscopy equipment. Chlorhexidine is also used for instrument baths.

What is the primary use of formaldehyde in veterinary practice? (A) Hard surface disinfectant (B) Surgical scrub solution (C) Antiseptic agent (D) Tissue specimen preservative

Answer is D: Ankylosis means stiffness in a joint, either from injury or disease. For example, if a pregnant cow grazes on a plant called Lupine, the calf may be born with arthrogryposis which includes crooked and ankylosed joints. Click here to see a calf with ankylosed, crooked joints.

What is the problem if a calf has ankylosis? (A) Molars are mis-aligned (B) Delayed long bone growth (C) Dietary deficiency of copper (D) Stiff, rigid joints (E) Enlarged ankles (carpus and tarsus)

Answer is C: The rumen is permanently fistulated in the left paralumbar fossa to allow cows to be donors for transfaunation of rumen contents to other cows. Ruminal fluid can also be collected via siphon from a stomach tube or from animals at the slaughter house. Fresh ruminal fluid contains microbes (bacteria and protozoa), volatile fatty acids (VFAs), microbial proteins, vitamins, minerals, and other buffers. Transfaunation is used to treat OTHER cows with conditions like ruminal acidosis, vagal indigestion, and peritonitis. Ruminal fistulas are also used to study ruminant physiology. Click here to see a video of a fistulated steer from Oregon State University Extension Service.

What is the purpose of placing a permanent rumen fistula in some cattle? (A) Manage vagal indigestion in the fistulated animal (B) Treat traumatic reticuloperitonitis in the fistulated animal (C) Create transfaunation donors (D) Allow for direct administration of medications into rumen long-term (E) This procedure is not done on a permanent basis in cows

Answer is B: The right jugular vein is the recommended blood collection site for almost all avians. It is highly mobile and can be tricky to stabilize for puncture. However, with practice, venipuncture in this location becomes a routine procedure. The bird should be properly restrained and then the vein located in the featherless tract to the right of the trachea. The medial metatarsal and basilic veins are also used in some cases, and are good for IV catheter placement in larger birds. The basilic vein is good for IV injections, but a large hematoma almost always forms when the needle is removed. The owner should be warned about this in advance. The medial metatarsal vein may not yield a very large blood sample in psitticine birds. The toenail can be clipped to obtain a small blood sample, mostly for DNA-based gender determination. It is painful and these patients are often lame for a few days afterwards. Furthermore, the results for other blood tests are often invalid.

What is the recommended blood collection site for almost all the avians? (A) Cranial vena cava (B) Right jugular vein (C) Medial metatarsal vein (D) Toenail clipping (E) Basilic vein

Answer is A: The cranial vena cava is usually the preferred location for blood draw in ferrets. Ferrets have thick skin and significant subcutaneous fat, so jugular venipuncture can be difficult. Ferrets are often anesthetized with gas anesthesia for this procedure in order to allow adequate restraint of the animal

What is the typical preferred location for blood sampling in ferrets? (A) Cranial vena cava (B) Tail vein (C) Jugular vein (D) Femoral vein (E) Lateral saphenous vein

Answer is C: Paresis means weak, but still able to move. Paralysis means weak, but not able to move. Paresis and paralysis are often further described as flaccid (limp) or tetanic (stiff). An example of a flaccid paresis is milk fever (parturient paresis) in dairy cows. Another example of a flaccid paralysis is botulism in animals affected by the neurotoxin of Clostridium botulinum. Click here to see limp duck, paralyzed with botulism. Examples of tetanic (stiff) paresis or paralysis include tetanus in animals affected by the neurotoxin of Clostridium tetani and eclampsia in a dog or person who just gave birth.

What is paresis? (A) Inability to urinate (B) High fever (C) Weakness (D) Stiffness (E) Rapid heart rate

Answer is C: Pyrexia means fever.

What is pyrexia? (A) Blue bag (B) Brittleness to bones (C) Fever (D) When a female is in heat (E) Lameness

Answer is A: The "shock dose" of IV fluids for foals is 20 mL/kg/hour. This dosage is commonly given for the first 1-2 hours after a critical foal is admitted to the neonatal intensive care unit.

What is the "shock dose" of IV fluids in a critically ill foal? (A) 20 ml/kg/hr (B) 40 ml/kg/hr (C) 30 ml/kg/hr (D) 10 ml/kg/hr

Answer is B: Food administered should be several degrees lower than the bird's body temperature. For example, if the bird's temperature is 102ºF (38.9 ºC), the food administered should be approximately 98ºF (36.7 ºC). Tube-feeding is often employed in birds to administer nutritional supplementation or medications. It is readily performed by passing the tube over the trachea at the base of the tongue and into the esophagus. The tube should be easily palpated in the crop through the skin and crop wall. It is important to make sure no food or water is coming up around the tube at the back of the bird's mouth, or else the bird might aspirate. The bird should be left quietly after tube-feeding unless it is having respiratory difficulty.

What is the appropriate temperature for food administered via a feeding tube into the crop of a bird? (A) The same as the bird's body temperature (B) Several degrees lower than the bird's body temperature (C) Slightly higher than the bird's body temperature (D) The same as the bird's desired body temperature (if it is abnormal) (E) At room temperature

Answer is B: Hydroflotation is the best option for prolonged support. It involves maintaining a cow in a specialized float tank. Cows can be recumbent or "downers" due to hypocalcemia (milk fever) or hypokalemia, orthopedic problems, neurologic disease, or septic shock. Recumbency leads to skin, tissue, and muscle damage. Further, cows' digestion is impaired when down for long periods. Slings and hip-lifters can help the cow get up, but are not appropriate for prolonged support.

What is the best option to support a down cow to stand for prolonged periods? (A) Hip lifter (B) Hydroflotation (C) There is no good option (D) Prop up using straw bales (E) Sling

Answer is A: The best treatment is rumen transfaunation. Indigestion is very common in ruminants, and just means abnormal reticulorumen function. It can be caused by rapid feed change, especially with overheated or moldy feeds. Clinical signs include anorexia, malodorous diarrhea, and decreased rumen motility. Indigestion is typically self-limiting.

What is the best way to help a cow return to normal rumen function after an episode of indigestion? (A) Rumen transfaunation (B) Probiotic paste therapy (C) Oral fluids and electrolytes (D) Parenteral thiamine (E) Dioctyl sodium sulfosuccinate

Answer is D: The site is identified by lifting the tail up and down and simultaneously palpating the coccygeal vertebrae. Usually the site is near where the tail hairs begin. A caudal epidural is administered between the fifth sacral and first coccygeal or first and second coccygeal vertebrae. A cranial epidural is administered between the sixth lumbar and first sacral vertebrae (i.e., the lumbosacral junction).

What is the best way to locate the site for a caudal epidural injection in a horse or cow? (A) Feel for the ischial prominences (B) Palpate the lumbar vertebrae (C) Locate the wings of the atlas (D) Lift the tail up and down (E) Palpate the sacral tuberosities

Answer is A: Sinus arrhythmia is related to breathing. It is normal in dogs and horses and abnormal in cats. Heart and pulse rates increase slightly with inspiration and decrease slightly with expiration with sinus arrhythmia

What is true regarding a sinus arrhythmia? (A) Normal in dogs and horse, abnormal in cats (B) Normal in cats and horse, abnormal in dogs (C) Normal in cats, dogs, and horses (D) Abnormal in dogs, cats, horses

Answer is E: Down foals should be maintained in sternal recumbency when possible to allow for complete lung ventilation and expansion. There are special wedge-shaped pads designed for this or a pillow can be placed at the shoulder to prop up the foal. Foals that will not remain in sternal recumbency should have their recumbency changed (turn them over) every 2 hours.

What is the best way to promote complete ventilation of the lungs in a down foal in the neonatal intensive care unit? (A) Administer clenbuterol per os (B) Change sides every 4 hours (C) Intranasal oxygen therapy (D) Nebulization and coupage (E) Maintain in sternal recumbency

Answer is C: A Dremel motor tool should be used to trim the nails of larger avian species. It cauterizes as it cuts. An electrocautery unit or human nail clippers can also be used. It is important to have silver nitrate sticks on hand.

What is the best way to trim nails in larger avian species? (A) Electrocautery unit (B) Canine nail clippers (C) Dremel motor tool (D) Scissors (E) Human nail clippers

Answer is C: Most animals that are aggressive at the veterinary clinic have fear and/or find the situation threatening. In the majority of situations in which a pet displays fear and aggression, the situation can be improved by backing up to decrease the threat.

What is the cause of most of the aggressive behaviors that dogs and cats display at the veterinary clinic? (A) Excitement (B) Poor training (C) Fear (D) Dominance (E) Pain

Answer is A: Obesity is the leading cause of shortened life span and health problems in potbellied pigs. It can lead to cardiovascular disease, arthritis, and kidney disease. Potbellied pigs often are not given enough exercise and are fed too much. The veterinary technician can be instrumental in advising owners how best to care for their animals. Adequate water intake can be a problem in all pigs; they are very sensitive to water temperature.

What is the leading cause of shortened life span and health problems in potbellied pigs? (A) Obesity (B) Decreased water intake (C) Hypothyroidism (D) Diabetes mellitus (E) Porcine stress syndrome

Answer is B: Nasogastric tubes are a good short-term feeding solution for small animals- According to Fossum, they can be left in place for "several weeks". Acccording to Merck, leave them in 1-7 days. If feeding is necessary for a longer term (weeks to months), gastric tubes are the better option.

What is the longest period of time a nasogastric tube can be safely left in place in small animals? (A) 72 hours (B) 1 to 3 weeks (C) 24 hours (D) 48 hours (E) 1 to 4 months

Answer is C: Lesions and problem with feet. Almost 90% of all lameness in cattle involves lesions and problems with the feet. Laminitis is a common problem.

What is the most common cause of lameness in cattle? (A) Upper leg problems (B) Leg fractures (C) Lesions in feet (D) Arthritis

Answer is A: Premature foals are those born before 320 days of gestation with low birth weight, silky hair coat, floppy ears, domed forehead, weakness, flexor tendon laxity, and angular limb deformities. Radiographs will show incomplete ossification of the cuboidal bones of the carpus and tarsus. Dysmature foals typically have prolonged gestational lengths and have a long, coarse haircoat, visible incisor teeth, angular limb deformities, and weakness.

What would be the term to describe a foal with low birth weight, silky hair coat, floppy ears, domed forehead, weakness, flexor tendon laxity, and angular limb deformities? (A) Premature (B) Failure of passive transfer patient (C) Perinatal asphyxia syndrome (D) Dysproportional (E) Septic

Answer is E: The cranial drawer sign is palpable in the stifle (often called the knee by laypeople) when there has been a rupture of the cranial cruciate ligament. Commonly after trauma (hit by car) and seen in active dogs (especially ball and Frisbee-catching dogs who often jump while running, then land badly and rupture the cranial cruciate). Instability in stifle joint after cranial cruciate ligament damage can cause injury to the medial meniscus.

When a clinician tests for a positive drawer sign in a dog, what part of the dog is he or she handling, anatomically? (A) Temporomandibular joint (B) Hock (C) Carpus (D) Hip joint (E) Stifle

Answer is B: It is recommended to wait between 3 and 5 minutes between different ophthalmic medications. This gives enough time for each medication to be properly absorbed. If administering both a solution and an ointment, the solution should be administered before the ointment. Otherwise, the ointment can "shield" the cornea from the solution.

When administering ophthalmic medications, how long should you wait between different medications? (A) 30-60 seconds (B) 3-5 minutes (C) 8-10 minutes (D) 1-2 minutes (E) 2-3 minutes

Answer is D: Every mare is unique, but they typically prefer to foal overnight when there is no audience or possible disturbance. Mares can halt stage 1 labor if they feel threatened. There are several ways to monitor for foaling that do not involve standing stall-side. These include video monitoring and the "FoalAlert" system sutured to the vulva that sends a signal when the vulvar lips open during stage 2 labor.

When are mares most likely to foal? (A) Any time (B) Afternoon (C) Morning (D) Overnight (E) Within 1 hour before or after sunset

Answer is B: Pigs and cattle both have 21-day estrus cycles and are polyestrous all year long. Horses are seasonally polyestrous, cycling regularly through the spring and summer in North America. Sheep and goats are also seasonally polyestrous, but cycle in the fall and early winter, so as to have babies 5 months later in the spring, when the weather is mild. Hamsters are seasonally polyestrous. Mustelids are either mono or seasonally polyestrous depending upon species and induced ovulators. Click the following link for a table of reproductive cycle features, most animals.

Which animals are polyestrous year round? (A) Cats, Rabbits (B) Pigs, Cattle (C) Goats, Dogs (D) Horses, Sheep (E) Hamsters, mustelids

Answer is B: Pigs and cattle are polyestrous all year long. Sheep and goats are seasonally polyestrous, cycling in the fall and early winter (including December). Horses and cats are typically anestrus in December in North America. Click the following link for a table of reproductive cycle features, most animals.

Which animals might be in estrus during the month of December on a farm in North America? (A) Llamas, Horses, Pigs (B) Sheep, Pigs, Cattle (C) Cattle, Cats, Horses (D) Goats, Dogs, Cats (E) Horses, Dogs, Goats

Answer is A: Apnea is the absence of breathing. You may see apnea when inducing anesthesia in an animal with thiopenthal or propofol. Dyspnea is the difficulty breathing. Atopy is a form of generalized allergy, where an animal (10% of dogs!) is allergic to almost everything, including allergens in food, the environment, flea bites and allergens in the air.

Which choice correctly describes apnea? (A) No breathing (B) Straining to defecate (C) Atopic allergy (D) Heart murmur

Answer is A: Newborn piglets routinely require supplemental heat for the first few weeks of life because they have very little fat stores.

Which neonatal large animal routinely requires supplemental heat for the first few weeks of life? (A) Piglets (B) Foals (C) Calves (D) Lambs (E) Crias

Answer is A: The blood vessel supplying a developing feather is large and damage can result in dangerous hemorrhage, especially if the feather is a large primary feather. Typically, once hemostasis is achieved, broken blood feathers are of little consequence unless damage to the follicle has occurred.

Which of one of the following choices is the most important clinical issue associated with a broken blood feather in a bird? (A) Hemorrhage (B) Infection (C) Cyst formation (D) Flight impairment (E) Permanent feather deformation

Answer is D: Disseminated intravascular coagulation (DIC) is characterized by concurrent thrombosis and bleeding. It is a serious—often fatal—complication of septic shock. Multiple organ dysfunction syndrome (MODS) is characterized by organ damage secondary to microvascular clotting and DIC. Systemic inflammatory response syndrome (SIRS) is a complicated phenomenon of widespread inflammation secondary to sepsis.

What syndrome is characterized by concurrent thrombosis and bleeding? (A) Systemic inflammatory response syndrome (B) Multiple organ dysfunction syndrome (C) Cardiogenic shock (D) Disseminated intravascular coagulation (E) Sepsis

Answer is B: Dermatophytosis (ringworm) most likely occurs in cattle that have been stabled for the winter. Trichophyton verrucosum is the most common cause of ringworm in cattle. The lesions are typically scaling areas of alopecia with gray crust formation and often ring-shaped. Treatment is not usually required as cattle often spontaneously recover.

What time of year is dermatophytosis in cattle most likely to occur? (A) Summer (B) Winter (C) Autumn (D) Non-seasonal (E) Spring

Answer is E: The Frick speculum is used to help pass an orogastric tube in adult cattle. In small ruminants, a piece of PVC piping or a roll of tape may be used to hold the mouth open.

What tool is used to help pass an orogastric tube in adult cattle? (A) This is unnecessary (B) Roll of white tape (C) Assistant's hand (D) Do not use orogastric tubes in adult cattle (E) Frick speculum

Answer is D: A gram scale with 1-gram increments is essential for weighing avian and exotic animals. Hospitalized patients might be weighed twice daily to monitor for weight changes. One-gram changes are critical to note in smaller patients.

What type of scale must be used to weigh avian and exotic animals? (A) Gram scale with 10-gram increments (B) Pound scale with 5-ounce increments (C) Gram scale with 5-gram increments (D) Gram scale with 1-gram increments (E) Pound scale with 1-ounce increments

Answer is C: A volume of saline up to 1% of the patient's body weight can be used. Colonic washes can be easily obtained in reptiles by passing a lubricated tube through the cloaca into the colon. These samples are examined for gastrointestinal parasites when fresh fecal samples are not readily available.

What volume of saline should be used for a colonic wash in a reptile? (A) Up to 2% body weight (B) Up to 10% body weight (C) Up to 1% body weight (D) Up to 5% body weight (E) These are not performed in reptiles

Answer is D: 8-12 months is the amount of time that gastrostomy tubes made of silicone can last. Latex tubes do not last more than about 12 weeks as the latex eventually breaks down from exposure to stomach acids. A gastrostomy tube is a feeding tube that passes through the abdominal wall into the stomach. These allow placement of food directly into the stomach and are used when the patient is unable or unwilling to eat normally because of damage to the esophagus, head, or neck. Often called "PEG" (percutaneous endoscopic gastrostomy) tubes because they are placed using an endoscope.

Which of the following choices is the correct period of time that a silicon gastrostomy tube can be used? (A) 3 to 7 months (B) 2 to 4 weeks (C) 5 to 8 weeks (D) 8 to 12 months

Answer is A: In horses, a site just to the right of the ventral midline, approximately 2-4 inches caudal to the xiphoid, is typically chosen to avoid splenic puncture during abdominocentesis. With increasing frequency, ultrasound is used to identify the best site. Abdominocentesis is routinely performed in large animal patients to obtain peritoneal fluid for analysis.

Why is abdominocentesis routinely performed 1-2 inches to the right of the ventral midline in standing adult horses? (A) To avoid the spleen (B) It is performed to the left of midline (C) It is performed to the left of midlineTo avoid the liver (D) To avoid the large colon (E) To avoid the stomach

Answer is D: 5% is the minimum fluid deficit detectable on clinical examination. Loss of fluid from the vascular space is reflected by cardiovascular changes such as tachycardia, poor pulse strength, delayed capillary refill, abnormal mucous membrane color, and in severe cases, hypothermia. Loss of ICF and interstitial fluid is indicated by loss of skin elasticity, dry mucous membranes, and sunken eyes. Most dehydrated patients have loss from both areas, so signs are combined to evaluate the fluid deficit. Click to see a chart with the clinical signs of dehydration.

Which of the following is the minimum amount of dehydration that can be detected on physical exam of a dog or cat? (A) 8% (B) 3% (C) 2% (D) 5%

Answer is A: Dystocia, difficult parturition (birth), is the most common reproductive emergency in ruminants. Prompt diagnosis and treatment is vital to save the life of dam and fetus and to preserve reproductive function in the dam. Abnormal presentation of the fetus is the most common cause for dystocia. Occasionally, uterine torsion is present. Most dystocias are corrected manually and vaginal delivery is performed. Caesarian section or fetotomy are sometimes necessary. Technical assistance is often vital to a successful outcome with dystocia.

Which of the following is the most common reproductive emergency in ruminants? (A) Dystocia (B) Mastitis (C) Endometritis (D) Pyometra

Answer is A: Changes in behavior are the most common and reliable signs of pain in animals. Painful animals will usually resist interaction with humans, hide in the back of their cage (cats especially), seem quieter than normal, vocalize, may bite or become aggressive, resent handling, and may not eat or drink normally. Physiologic abnormalities such as increases in heart rate or respiration can be caused by pain but they are also caused by the anxiety and fear associated with hospitalization. Alterations of homeostasis such as dehydration, hypovolemia, electrolytes, etc, and the effects of numerous drugs may also affect heart rate, blood pressure, and even temperature. The stress response is an endocrine response to pain that also causes physiologic abnormalities from the release of cortisol, catecholamines, etc.

Which of the following is the most common sign of pain in animals? (A) Behavior change (B) Hypertension (C) Swelling and erythema of the incision (D) Anorexia post-operatively (E) Tachycardia and/or tachypnea

Answer is A: Equine herpesvirus is highly contagious via aerosolization, respiratory secretions, fomites, and aborted fetuses. It can cause abortions in the seventh to eleventh month of gestation. Equine herpesvirus can also cause upper respiratory tract disease that looks very similar to other upper respiratory tract infections with fever, anorexia, lethargy, and serous nasal discharge. Lastly, it can less commonly cause neurologic disease, with several large outbreaks reported in the US in the last few years.

Which of the following diseases can cause abortion storms, neurologic disease, and upper respiratory tract disease in horses? (A) Equine herpesvirus (B) Equine influenza virus (C) Equine viral arteritis (D) Streptococcus equi subspecies equi (E) Equine infectious anemia

Answer is A: Hypoproteinemia is best treated with a colloid. A natural colloid source such as albumin, plasma, or blood is best. However, synthetic colloids are also useful to help maintain osmotic pressure and prevent fluid loss from the circulation. Synthetic colloids are solutions with high osmotic pressure due to the presence of high molecular weight compounds, usually starches or dextrans. Examples of synthetic colloids are Hetastarch, Hextend, Vet Starch, etc.

Which of the following problems is best treated with the intravenous infusion of a colloid? (A) Hypoproteinemia (B) Hemorrhagic hypotension (C) Hyperglobulinemia (D) Cardiogenic shock

Answer is D: In cattle, a prolapse almost always means a uterine prolapse, where the uterus has pushed itself inside out and is hanging outside the cow.(note: there is such a thing as vaginal prolapse, but it is much less common). When the penis cannot retract into the prepuce, the problem is called paraphimosis. A proptosis means "popping out or protruding". The most common emergency proptosis you will see in practice is a ocular proptosis (sometimes called an eye prolapse, too). Follow these links to see a proptosed eye in a dog and a severely proptosed eye in another dog.

You and the vet are called to a dairy farm at 4 a.m. for a "prolapse". What kind of problem is this likely to be? (A) Eyeball popped out of socket (B) Mismating (C) Penis cannot retract into prepuce (D) Uterus is hanging out

Answer is D: Pain, excitement, post exercise test Normal heart rate for a horse is between 28-50 beats per minute (BPM) (Pasquini). Hospitalized animals should be continually monitored for any changes, including signs of pain. Pain is now considered the 4th vital sign and is evaluated by the use of pain scales in humans, small animals, and horses.

Which one of the following choices best explains the underlying cause(s) of a heart rate of 60 beats per minute in a hospitalized horse? (A) Bradycardia, vagal response, anorexia (B) This pulse rate is within normal parameters (C) Chronic atrial fibrillation (D) Pain, excitement, post exercise test

Answer is B: Strangles is a highly contagious respiratory disease of horses caused by Streptococcus equi equi that usually causes abscessation of lymph nodes in the throat and the submandibular space. Bastard strangles occurs when abscesses develop in other areas- the thorax, abdomen, and sometimes the central nervous system. This version can be difficult to treat. A mild case of strangles does not require antibiotics as the abscesses usually rupture and drain. Bastard strangles is usually treated with long term antibiotics, especially when drainage of abscesses is not possible.

Which one of the following choices correctly explains the difference between strangles and bastard strangles? (A) Bastard strangles occurs 1-3 weeks after strangles (B) Bastard strangles cases have abscesses in the thorax, abdomen, and central nervous system (C) Strangles is caused by Streptococcus equi, bastard strangles by Streptococcus zooepidemicus (D) Bastard strangles causes urogenital disease in males (E) No difference, two different names for the same presentation

Answer is C: Besides having no fur, newborn piglets have very little subcutaneous body fat and need additional heat for the first weeks of life. Excessive shivering in cold piglets also predisposes them to hypoglycemia as they use up glucose rapidly trying to stay warm.

Which one of the following choices correctly explains why piglets are very susceptible to hypothermia? (A) Piglets must avoid being crushed by sow (B) Higher metabolism than other mammalian neonates (C) Low subcutaneous body fat (D) Colostrum intake is slower in piglets (E) Sows frequently reject their piglets

Answer is C: Pseudorabies and mad itch. Aujeszky's disease is also known as Pseudorabies and "mad itch" because of the neurologic signs it can cause. It is caused by a herpesvirus, can affect all ages of pigs, and can devastate a herd. Clinical signs vary, usually with the age of the pigs, and include neurologic, respiratory, and gastrointestinal signs. High mortality can be seen in nursing pigs, less in finishing groups, and mostly reproductive problems in adults. The other choices are correctly paired names for other diseases.

Which one of the following choices correctly states alternate names for Aujeszky's disease? (A) Glanders or farcy (B) Tetanus or Lockjaw (C) Pseudorabies or mad itch (D) Distemper or hardpad disease

Answer is C: A retained placenta commonly leads to metritis in the bitch. Clinical signs associated with metritis are those of systemic illness/toxemia. Retained placenta may be identified based on client's observation of the whelping process, ultrasound, and/or persistence of a greenish-black vaginal discharge, especially if it is foul-smelling. Normal lochia is reddish brown with no odor.

Which one of the following choices is a common sequela of a retained placenta in a bitch? (A) Polyphagia (B) Uterine subinvolution (C) Metritis (D) Post-partum hemorrhage (E) Agalactia

Answer is D: Campylobacter is a curved gram negative rod that causes diarrhea in many animals. Two subspecies of C. fetus cause abortion and infertility in cattle.

Which one of the following choices is a gram negative organism with a curved shape? (A) Borrelia (B) Rhodococcus (C) Leptospira (D) Campylobacter

Answer is B: This is an esophageal stricture secondary to doxycycline that remained in the esophagus too long. Administration of doxycycline to cats should be in a slurry or followed by a bolus of food or water. Plain radiographs were unremarkable. Fluoroscopy was performed using liquid barium. There was a persistent narrowing in the cranial cervical esophagus which never dilated as the peristaltic bolus passed through it. There was also slowing of the bolus passage at this site. Spirocerca lupi is the esophageal worm of the dog. It can cause the formation of a radiodense mass in the esophagus.

Which one of the following choices is a likely cause for this condition in a cat? (A) Spirocerca lupi larvae (B) Doxycycline (C) Gastrointestinal reflux (D) Poinsettia

Answer is B: Left laryngeal hemiplegia is paralysis of the left arytenoid cartilage and vocal fold usually caused by dysfunction of the left recurrent laryngeal nerve in horses. Abduction of the cartilage is impaired or lost. This leads to obstruction of airflow during inspiration and a "roaring" sound during exercise. Horses with this problem are often called "roarers"

Which one of the following choices is left laryngeal hemiplegia? (A) Chondritis of the larynx (B) Paralysis of the left arytenoid cartilage (C) Entrapment of the epiglottis (D) Blood in the trachea

Answer is A: Two good sites for obtaining an arterial blood sample for blood gas analysis in the dog are the femoral artery and the dorsal metatarsal artery.

Which one of the following choices is the best arterial sampling site for blood gas analysis in the dog? (A) Femoral artery (B) Brachial artery (C) Carotid artery (D) Sublingual artery (E) Ulnar artery

Answer is A: Introduce dietary changes slowly. Grain overload results when ruminants ingest too much feed with readily digestible carbohydrates at one time. Excessive carbohydrate causes a shift to gram-positive organisms in the rumen, especially Streptococcus bovis, which proliferate excessively. These organisms produce large amounts of acid which damage the rumen and are absorbed, causing acidosis, dehydration, ileus, and eventually cardiovascular collapse and death. Transfaunation of the rumen fluid is helpful after grain overload is resolved to help restore the normal flora of the rumen.

Which one of the following choices is the best way to prevent grain overload? (A) Introduce dietary changes slowly (B) Ensure adequate water supply (C) Give penicillin when concentrates are increased (D) Transfaunate the rumen

Answer is B: 0.9% saline is isotonic to plasma. Its osmolality is very similar to plasma and so will not change the tonicity of the intravascular space. Sodium and chloride are present at a slightly higher concentrations than plasma. It has an acidifying effect because of the chloride levels. Saline is used most often for specific patients rather than as a replacement or reususcitation fluid. It is used for patients with metabolic alkalosis or hypochloremia (vomiting) and in some hypernatremic patients. Refs: McCurnin's Clin Textbk for Vet Techs, 8th ed. pp. 883-5 and the Merck Veterinary Manual online edition.

Which one of the following choices is the concentration of isotonic saline? (A) 23% (B) 0.9% (C) 7% (D) 3% (E) 0.45%

Answer is D: An allergen is any substance that provokes an allergic reaction. This is another word for "antigen" used specifically when referring to allergy and hypersensitivity reactions.

Which one of the following choices is the correct description of an allergen? (A) Produced in response to an irritant (B) An antibody specific to an allergic reaction (C) Antigen found only in nasal secretions (D) Substance that provokes allergy

Answer is B: Guttural pouch mycosis is a fungal infection of the guttural pouch, often caused by Aspergillus spp. Epistaxis is the most common clinical sign. Guttural pouch empyema is a bacterial infection of the guttural pouch. It is frequently associated with strangles caused by Streptococcus spp. Guttural pouch tympany is swelling of the pouch(es) caused by trapped air, usually found in young horses. Refs: McCurnin and Bassert's Clin Textbook for Vet Technicians, 7th ed. pp.714-5, and the Merck Veterinary Manual online edition.

Which one of the following choices is the correct description of guttural pouch mycosis? (A) Bacterial infection of the guttural pouch (B) Fungal infection of the guttural pouch (C) Air trapped in the guttural pouch (D) Viral infection of the guttural pouch

Answer is D: Guttural pouch tympany is extra air in the guttural pouch found in young horses. A non-painful fluctuant swelling is present on one or both sides of the throat. Guttural pouch empyema is a bacterial infection of the guttural pouch. It is most often seen with or following strangles infection. Guttural pouch mycosis is a fungal infection of the guttural pouch. Epistaxis is the most common clinical sign.

Which one of the following choices is the correct description of guttural pouch tympany? (A) Fungal infection of the guttural pouch (B) Viral infection of the guttural pouch (C) Bacterial infection of the guttural pouch (D) Air trapped in the guttural pouch

Answer is D: Seroconversion is the production of antibody in response to an antigen, most often seen in response to an infectious organism or immunization. Increased levels of antibody are measurable in the serum and described as changing from a seronegative state to a seropositive state. Antibody levels measured on one sample usually only provide proof of exposure to a specific antigen. To provide evidence of infection, a 4-fold rise in serum titer seen between 2 consecutive serum tests is expected.

Which one of the following choices is the correct explanation of seroconversion? (A) A decrease in antibody levels in consecutive serum tests (B) A very low antibody level in multiple serum tests (C) No change in antibody levels in consecutive serum tests (D) Increase in antibody levels in consecutive serum tests

Answer is B: Immunological tolerance is the lack of response to an allergen (or antigen) by the immune system. This occurs naturally or can be induced. Tolerance to "self" is important so that the immune system does not respond to antigens on normal cells. Without self-tolerance, autoimmune or immune-mediated disease develops. Autoimmune hemolytic anemia and/or thrombocytopenia is an example of failure of self-tolerance. Self-tolerance is also important in the maintenance of pregnancy and in the prevention of rejection of organ transplants. Induced tolerance develops when small doses of antigen are introduced repeatedly over time as in desensitization protocols for allergies.

Which one of the following choices is the correct explanation of tolerance as used in reference to activity of the immune system? (A) Number of antigen binding sites per antibody (B) Lack of response by the immune system to an antigen (C) A measure of antibodies produced at initial contact with allergen (D) The reaction of the immune system to foreign antigens

Answer is A: An antibody titer refers to the amount or concentration of antibody measured in serum. It is proof of exposure to a specific antigen, such as those found on a virus, a bacteria, or a vaccine. It is determined quantitatively by titration using increasing dilutions of the sample and reported as a ratio of the highest dilution where antibody was measurable, such as 1:10, 1:20, etc. Or, it can be measured qualitatively for presence or absence of antibody, and reported as positive or negative.

Which one of the following choices is the correct explanation of what an antibody titer measures? (A) The level of antibody in a serum (B) The presence of a chronic viral infection (C) The amount of antigen in blood (D) The change in antibody levels in serum

Answer is B: Obstipation is chronic constipation so severe that the patient is unable to defecate on its own. It is more common in elderly and infirm animals. It results from chronic intra- or extraluminal obstruction caused by foreign bodies, trauma, or neoplasia, and secondary to motility dysfunction (megacolon). Moderate cases may be resolved with enemas, but severe cases may require manual extraction with the patient under anesthesia.

Which one of the following choices is the correct explanation of what is present in a dog with obstipation? (A) Rectal polyps (B) Intractable constipation (C) Anal sac tumor (D) Inflammation of anal sacs

Answer is C: Keds are exceptional among dipterans because they have no wings. An important external parasite of sheep and goats, they spend their entire life cycle on the animal, cause pruritus and sometimes anemia. Melophagus ovinus is the scientific name for the sheep ked; Diptera is the genus

Which one of the following choices is the correct explanation of why keds are unusual dipterans? (A) Keds have a bayonet-like proboscis (B) They are the only dipteran that causes myiasis (C) They have no wings (D) Keds live on saliva and mucosa

Answer is C: 7% saline is a hypertonic solution that is used in fluid resuscitation of patients in shock. HSS as it is called, contains only sodium and chloride, 1283 mEq of each, compared to 154 found in normal saline (0.9%). The osmolality of HSS is 2567 milliosmoles/L, compared to 300 in plasma. It is effective at small doses, 1-4 ml/kg, given over 15-20 minutes. This is 1-20 mls for a 10 lb cat, 23-92 mls for a 50 lb dog. 1-2 liters are given to a 1100 lb horse.

Which one of the following electrolyte solutions is hypertonic? (A) Lactated Ringers solution (B) Normosol®R (C) 7% saline (D) 0.45% saline in 2.5% dextrose (E) 5% Dextrose

Answer is B: Feline immunodeficiency virus (FIV) is a retrovirus spread between cats primarily by bites, therefore it is most common in free-roaming male cats likely to be involved in cat fights. Frequently cats have no clinical signs, especially early in the course of disease; when clinical signs do occur, they include stomatitis, signs related to lymphoma, neurologic disorders, and refractory opportunistic infections. Diagnosis is made by identification of FIV-specific antibodies in blood, except in cases where the cat has been vaccinated or in cats less than 6 months of age that may still have maternal antibodies from an infected or vaccinated queen. If clinical signs are present, the use of zidovudine (AZT) has been shown to improve quality of life by mitigating clinical signs.

Which one of the following groups is most likely to be infected with feline immunodeficiency virus? (A) Young kittens in crowded catteries (B) Adult, free-roaming males (C) Cats living indoors in households with pet birds (D) Multiparous queens in catteries

Answer is D: Oxytocin causes secretion and release of milk after birth. It is a hormone produced by the posterior pituitary gland in the brain and secreted in response to nursing by neonates. Oxytocin is also available commercially and can be given to start or increase milk production. Another important effect of oxytocin is stimulation of uterine contractions, so it is also used to to encourage passage of a retained placenta, and sometimes to induce parturition.

Which one of the following hormones assists in the secretion and release of milk after parturition? (A) Estrogen (B) Relaxin (C) Luteninizing hormone (D) Oxytocin

Answer is B: Lactated Ringers solution (LRS) is an isotonic, balanced electrolyte crystalloid solution. The osmolality and the concentrations of sodium, chloride, and potassium are similar to that of plasma. Normal or 0.9% saline is also used but it has an acidifying effect and has only sodium and chloride as electrolytes. It is useful for vomiting patients as they often have low chloride and metabolic alkalosis. LRS is useful for patients with metabolic acidosis as it has an alkalinizing effect.

Which one of the following intravenous fluids is the best isotonic fluid to use for replacement of fluid losses in most patients? (A) 0.45% saline (B) Lactated Ringers solution (C) Hetastarch (D) Plasma (E) 5% Dextrose

Answer is B: A salivary mucocele is a disorder where saliva accumulates in surrounding tissues after trauma to the duct or gland. Gallbladder mucoceles (accumulation of bile-rich mucus within the gall bladder) can also occur.

Which one of the following is a correct description of a mucocele? (A) A fluid filled cyst in the lungs (B) An accumulation of saliva (C) An inflammation of the stomach lining (D) A swelling in the uterus

Answer is C: Angular limb deformity is a condition that affects the appendicular skeleton and causes deviation of the limb in a medial or lateral direction. Flexural limb deformity is hyperflexion of joints caused by unequal development of the soft tissues and bones. Excessive synovial fluid is caused by synovitis or inflammation of synovial tissues. Bog spavin of the hock is one example.

Which one of the following statements is the correct description of angular limb deformity in foals? (A) Hyperflexion of the carpus, fetlock, and/or pastern joints (B) Excessive synovial fluid in the joints of the forelimb (C) Deviation of bones of the appendicular skeleton (D) Rupture of the common extensor tendons

Answer is A: A 19-gauge needle with a 35-mL syringe is appropriate. Wound lavage with isotonic crystalloids is critical to remove any loose necrotic debris or foreign material from a wound. The recommended lavage pressure is 8-12 psi, as it effectively removes debris without damaging tissue. The ideal way to create this appropriate amount of pressure is use of a 19-gauge needle with 35-mL syringe. This can be attached via a fluid line and sterile fluid bag with a 3-way stop-cock to maintain a sterile, closed lavage system.

Which of the following generates the appropriate amount of pressure for most effective wound lavage? (A) 19-gauge needle with 35-mL syringe (B) 18-gauge needle with roller pump (C) No needle with 60-mL syringe (D) 25-gauge needle with 60-mL syringe (E) 14-gauge needle with 20-mL syringe

Answer is B: Treatment of cerebral edema with mannitol or hypertonic saline is important in a patient with head trauma. They pull fluid out of the brain by causing an osmotic gradient between the blood and brain tissue. Analgesics and diazepam are also used in head trauma. Sodium bicarbonate should not be given.

Which one of the following therapies would be most useful to treat a dog with suspected head trauma and cerebral edema? (A) Isoproterenol to maintain blood pressure (B) Mannitol or hypertonic saline IV (C) Sodium bicarbonate for acidosis, then CSF tap (D) Phenobarbital to prevent seizures

Answer is B: Coxiella Burnetti is the cause of Q fever. Because C. Burnetti is zoonotic and a class B bioterrorism agent, animals infected with Q fever are reportable.

Which organism causes Q fever? (A) Pasteurella hemolytica (B) Coxiella Burnetti (C) Arcanobacterium pyogenes (D) Arcanobacterium pyogenesEscherichia coli

Answer is A: Cats, rabbits, ferrets, and camelids are induced ovulators. Basic questions on estrus cycle and gestation come up over and over, so commit them to memory for the major animals at LEAST (Cow, Horse, Dog, Cat, Sheep/Goat, Pig). Merck has two excellent tables: Click Here for an estrus cycles table, most animals. Click Here for a gestation table, most animals.

Which pair of animals is induced ovulators? (A) Cat, ferret (B) Rabbit, pig (C) Dog, horse (D) Sheep, cat (E) Cow, pig

Answer is B: Fresh or frozen plasma is stored at -4 F to -22 F (-20 C to -30 C) for up to 1 year. Frozen plasma should be thawed to 98.6 F (37 C) in a warm water bath to 30-60 minutes before administration. Typically, plasma is given for volume expansion to animals in shock, or who had suffered heavy burns. Whole blood with acid citrate can last up to 14 to 21 days when refrigerated. Heparinized blood must be used within 48 h. Typically we give blood transfusions to animals who have suffered severe blood loss from injury or anemia. Follow this link for more on blood transfusion in animals.

Which statement about the proper storage of fresh or frozen plasma is most correct (A) can be stored at 39.2 F - 50 F (4 C - 10 C) for up to 3 weeks (B) can be frozen for up to 1 year (C) should be stored above 98.6 F (37 C) (D) must be used within 48 h

Answer is D: Cryptorchid animals have an undescended testicle. Follow this link to see a dog with an undescended testicle in his inguinal area. Orchitis is inflammation of one or both testicles characterized by pain, and sensitivity to touch. Phlebitis is inflammation of the veins and may be associated with formation of blood clots. Phimosis is a condition where the penis cannot be extruded because of a small constricted preputial orifice.

Which term describes an animal with an undescended testicle? (A) Orchitis (B) Phlebitis (C) Phimosis (D) Cryptorchid

Answer is D: Otitis means inflammation or infection of the ear. Follow this link to see a dog's ear with otitis. Gingivitis is inflammation of the gums. Look for reddening at the gumline. Follow these links to see gingivitis in a dog. Phlebitis is inflammation of the veins and may be associated with formation of blood clots. Orchitis is inflammation of one or both testicles characterized by pain, and sensitivity to touch.

Which term describes inflammation of the ear? (A) Phlebitis (B) Orchitis (C) Gingivitis (D) Otitis

Answer is D: Gingivitis is inflammation of the gums. Look for reddening at the gumline. Follow these links to see gingivitis in a dog. Phlebitis is inflammation of the veins and may be associated with formation of blood clots. Orchitis is inflammation of one or both testicles characterized by pain, and sensitivity to touch. Otitis means inflammation or infection of the ear. Follow this link to see a dog's ear with otitis.

Which term describes inflammation of the gums? (A) Orchitis (B) Phlebitis (C) Otitis (D) Gingivitis

Answer is B: Orchitis is inflammation of one or both testicles characterized by pain, and sensitivity to touch. Phlebitis is inflammation of the veins and may be associated with formation of blood clots. cryptorchid animals have an undescended testicle. Follow this link to see a dog with an undescended testicle in his inguinal area. Phimosis is a condition where the penis cannot be extruded because of a small constricted preputial orifice.

Which term describes inflammation of the testicle? (A) Phlebitis (B) Orchitis (C) Phimosis (D) Cryptorchid

Answer is A: Phlebitis is inflammation of the veins and may be associated with formation of blood clots. Cryptorchid animals have an undescended testicle. Follow this link to see a dog with an undescended testicle in his inguinal area. Orchitis is inflammation of one or both testicles characterized by pain, and sensitivity to touch. Gingivitis is inflammation of the gums. Look for reddening at the gumline. Follow these links to see gingivitis in a dog.

Which term describes inflammation of the veins? (A) Phlebitis (B) Varicose (C) Cryptorchid (D) Gingivitis

Answer is A: Water soluble vitamins include vitamin C and the B complex vitamins. This matters because water-soluble vitamins are POORLY absorbed, and extra is lost in the urine, so animals need them regularly in their diet. Remember that GUINEA PIGS get SCURVY (low vitamin C- think of a guinea pig in a pirate costume to help you remember). In contrast, fat-soluble vitamins (K,A,D,E) ARE stored in the body fat, so you don't need as much in your daily diet

Which vitamin is water soluble? (A) vitamin C (B) vitamin E (C) vitamin D (D) vitamin A

Answer is D: Injections are typically given in the cranial half of the body in reptiles to avoid clearance by the renal portal system. The caudal third of the body drains through a capillary network in the kidneys prior to entering general circulation. Nephrotoxic drugs in particular should never be administered in the caudal third of a reptile.

Why are most injections administered to reptiles in the cranial half of their bodies (i.e., the epaxial and forelimb muscles)? (A) Easiest access location (B) Largest muscle mass (C) Least painful location (D) Avoid renal clearance (E) Minimize hepatic uptake

Answer is E: Black-brown coffee ground debris in the ear canal of a cat with these clinical signs is classic for an ear mite infection (Otodectes cynotis). Over 50% of otitis externa cases in cats are caused by O. cynotis. Dx - otoscopic or microscopic visualization of mites and/or eggs. Click here to see a microscopic image of a mite. Rx - cleanse the ear canals with a cerumitic then apply an acaricidal. O. cynotis is highly contagious but has low zoonotic risk. Psoroptes cuniculi is the ear mite in rabbits. Otobius megnini is the ear tick of cattle that infects dogs and cats. Sarcoptes scabiei causes sarcoptic mange in dogs and cats.

A 1-year-old male neutered indoor-outdoor domestic shorthair cat is presented with a several-week history of scratching at both his ears and shaking his head. The cat is sedated and brown-black exudate with a "coffee ground" appearance is seen in bilateral ear canals. What is the most likely cause?: (A) Otobius megnini (B) Poor hygiene (C) Sarcoptes scabiei (D) Psoroptes cuniculi (E) Ear mites

Answer is E: This presentation is classic for a cat with hepatic lipidosis and subsequent hepatic encephalopathy. Cats who are anorexic for more than 7 days, especially obese cats with environmental stress or other illness, are at highest risk for this condition. Lipids are mobilized from the fat tissue to provide energy when cats are not eating, and they overwhelm the liver's ability to utilize them. The lipids build up in the hepatocytes and cause damage and subsequent signs of liver disease, including hepatic encephalopathy. Rx involves aggressive fluid therapy, nutritional support, antioxidants, vitamin supplementation, and supportive care.

A 10-year-old obese female spayed domestic long-haired cat is presented for strange behavior, hypersalivation, head-pressing, and some circling that the owners noted upon arrival home after being out of town for 2 weeks. The cat-sitter said the cat had been really upset while they were gone and she wasn't sure how much she'd been eating (there's another cat in the house). Which of the following conditions is likely occurring in this cat that the vet will want to treat aggressively? (A) Urethral obstruction (B) Hypothyroidism (C) Chronic pancreatitis (D) Hepatic lipidosis (E) Diabetes mellitus

Answer is D: This is a cataract in the LENS, a common problem of older dogs. A cataract is a lens opacity and can be inherited; traumatic; age-related; or secondary to diabetes mellitus, uveitis, glaucoma, retinal disease, or lens luxation. Cataracts are common and are classified by age of onset (congenital, juvenile, or senile), location (capsule, cortex, or nucleus), and severity (incipient, immature, mature, or hypermature). Progressive retinal atrophy (PRA) is an example of a condition that affects the fundus (retina) and leads to a progressive loss of photoreceptor cells, resulting in blindness. It would be difficult to diagnose based on this photograph. Ophthalmoscopic lesions include an increase in the reflectivity of the tapetal fundus bilaterally with decreased pigmentation of the nontapetal fundus, a decrease in the number of retinal vessels, and atrophy of the optic papilla. Glaucoma is an example of a condition that is caused by decreased aqueous outflow through the iridocorneal drainage angle or uveoscleral network. Abnormalities visible with the naked eye might include buphthalmos (big eye), corneal edema, fixed/dilated pupil, and conjunctival venous congestion. Keratoconjunctivitis sicca (KCS) and corneal ulcerations are examples of conditions of the cornea . KCS, or "dry eye syndrome," results from insufficient tear production. Clinical signs of KCS include significant ocular mucus production, conjunctival hyperemia, corneal edema, and corneal ulcers. Uveitis is an example of a condition affecting the anterior uvea. It can be caused by trauma, cataracts, infectious disease, or be idiopathic. Visible clinical signs include corneal edema, conjunctival hyperemia, epiphora, and blepharospasm.

A 10-year-old small mixed breed spayed female dog is presented with a history of progressively bumping into things around the house. Ophthalmic exam reveals the following problem in both eyes: Where, anatomically, is the problem identifiable in this image? (A) Cornea (B) Fundus (C) Iridocorneal angle (D) Lens (E) Anterior chamber

Answer is B: Blood pressure will likely be evaluated next. Enlarged retinal vessels and retinal hemorrhages are early indicators of retinal detachment secondary to hypertension. Hypertension is defined as systolic blood pressure greater than 180 mmHg. It can be primary or secondary. Secondary hypertension is very common in small animals secondary to renal disease, hyperadrenocorticism, hyperthyroidism, and diabetes mellitus. The most frequent presentation of an animal with undiagnosed hypertension is blindness due to retinal detachment. Blood pressure can be lowered with antihypertensive medications and the underlying predisposing factors should be addressed

A 10-year-old terrier mix is presented for re-evaluation of poorly managed chronic renal disease and hyperadrenocorticism. A fundic exam reveals enlarged retinal vessels and some retinal hemorrhages bilaterally. What would the vet likely want to evaluate next to help determine the cause of these ophthalmic abnormalities? (A) Urinalysis (B) Blood pressure (C) Bilateral fluorescein stains (D) Retrobulbar ultrasound (E) Serum biochemistry

Answer is C: Dermatophytosis (Ringworm) results from the infection of keratinized tissue (skin, hair, and claws) with fungi, usually Microsporum canis in cats and dogs. The incidence of disease is higher in cats than dogs, and typically young animals are affected. Classical lesions of dermatophytosis are focal or multifocal, sometimes circular, regions of alopecia, scaling, and crusting with variable amounts of inflammation and pruritus. Fungal culture of hair stubble and skin scale can confirm infection. Treatment, which can be local or systemic, is generally recommended to minimize spread and shorten the clinical course of disease. Itraconazole is the drug of choice for cats but is cost-prohibitive in dogs; ketoconazole, while a good choice for dogs, is avoided in cats due to hepatotoxicity and anorexia issues. Dermatophytosis is a zoonosis.

A 102 pound [46 kg] dog is presented with clinical signs of focal alopecia, scaling, and crusting around the ears and face and is diagnosed with dermatophytosis. If systemic treatment is elected, which one of the following would be the most effective and inexpensive choices? (A) Enrofloxacin (B) Praziquantel (C) Ketoconazole (D) Itraconazole (E) Amoxicillin/clavulanic acid

Answer is B: Diabetic ketoacidosis (DKA) can develop subsequent to poorly controlled diabetes mellitus. The body cannot utilize all the excess glucose, so ketones build up as a result of alternative carbohydrate metabolism. Ketones can be identified in the urine and make the breath smell fruity. DKA is a critical condition that requires aggressive and complicated therapy, including insulin and fluid therapy to correct electrolyte and acid-base imbalances.

A 13-year-old male neutered Dachshund with chronic diabetes mellitus is presented with anorexia, lethargy, weight loss, and for having accidents in the house. During the initial exam you note a fruity odor to his breath. With what condition is the veterinarian likely to diagnose the dog? (A) Hyperadrenocorticism (B) Diabetic ketoacidosis (C) Acute renal disease (D) Hypoadrenocorticism (E) Hypothyroidism

Answer is A: Temporohyoid osteoarthropathy (THO) is arthritis at the junction between the stylohyoid bone (part of the apparatus that suspends the larynx) and the temporal bone of the skull. THO may have no clinical signs early on, or horses may show pain on palpation of the parotid region, head-shaking behavior, or difficulty eating. Over time, the bones fuse together and any sudden head movement (e.g., dental work, passing a nasogastric tube) can lead to fracture of the petrous temporal bone and the onset of acute neurological signs. Diagnosis involves endoscopy, radiography, or computed tomography to show enlargement and/or fracture of the affected stylohyoid bone.

A 15-year-old Thoroughbred gelding is presented with an acute onset of unilateral facial nerve paralysis with a head-tilt and ataxia. He had a dental performed just prior to the development of clinical signs. The veterinarian will want to scope the guttural pouch to look for which most likely cause? (A) Temporohyoid osteoarthropathy (B) Guttural pouch tympany (C) Guttural pouch empyema (D) Equine protozoal myeloencephalitis (E) Equine leukoencephalomalacia

Answer is A: s.i.d. means once a day. Remember "S" for Single" (s.i.d.), "B for Bi" (twice a day, b.i.d.), "T for Tri" (3 times a day, t.i.d.) and "Q for Quad" (4 times a day, q.i.d.). Many clinics use capital letters (SID, BID, TID, etc., to mean the same things). prn or PRN means "as needed". q.o.d. means "every OTHER day". Some clinics use e. o.d. to mean every other day. Follow this link to see Table of medical abbreviations.

A cockatoo has been prescribed 10 mg of Supercillin, s.i.d. for 10 days. How often does the bird get medicine each day (A) Once a day (B) Twice a day (C) As needed (D) Three times a day

Answer is D: Give one capsule, twice a day for this dog. Remember that 2.2 pounds = 1 kilogram, so to get the weight of the dog in kilograms, divide 27 lb by 2.2 kg= 12.3 kg. The dose is 12.3 kg X 20 mg/kg = 245 mg, which is about one capsule.

A 27 lb dog has been prescribed Ampicillin at a dose of 20 mg/kg PO b.i.d. The medication is available in 250 mg capsules. How many capsules should the dog receive in a single dose? (A) 3 capsules (B) 2 capsules (C) 1/2 capsule (D) 1 capsule

Answer is C: Intravenous fluids with sodium bicarbonate must be given immediately for this calf to survive. She likely has a bacterial enteritis and may also be septic. Calf diarrhea is often a hypersecretory diarrhea that results in loss of huge volumes of fluid and bicarbonate. Dehydration and metabolic acidosis are life-threatening in severe cases. Isotonic bicarbonate at 100 ml/kg is recommended as the initial fluid volume, given over 4-6 hours. Dextrose is added as many calves are hypoglycemic. Once the calf is stronger and able to suckle, oral fluids alternated with milk are given in addition to maintenance fluids given intravenously.

A 3 day old, 110 pound (50 kg), Holstein heifer calf with a history of watery diarrhea for 36 hours is presented in lateral recumbency. Her temperature is..95F (35C) [N=100.4-102.8F (38.0-39.3C)], heart rate is............190 beats minute [N=100-140 bpm], respiratory rate is...64 breaths per minute [N=26-50 brpm]. She quite thin and barely responds to examination. The mucous membranes are pale and dry, bluish in color, and capillary refill time is 4 seconds. Her eyes are sunken, and a skin tent remains in place. Which of the following is the best therapy for this calf? (A) 5% dextrose and calcium (B) Subcutaneous lactated ringers (C) Intravenous fluids and sodium bicarbonate (D) Intragastric fluids with hypertonic saline

Answer is B: 5 liters is the initial fluid volume required. This is calculated from the % dehydration estimated from the physical examination. Fluid deficit is calculated from - % dehydration X body weight in kg = the # of liters required. 100 pounds / 2.2 = 50 kg. 50 kg X 0.1 = 5 liters

A 3 day old, 110 pound, Holstein heifer calf with a history of watery diarrhea for 36 hours is presented in lateral recumbency. Her temperature is 95F (35C) [N =100.4-102.8F (38.0-39.3C)], heart rate is 190 beats minute [N 100-140], respiratory rate is 64 breaths per minute [N 26-50]. She quite thin and barely responds to examination. The mucous membranes are pale and dry, bluish in color, and the capillary refill time is 4 seconds. Her eyes are sunken, and a skin tent remains in place. If the estimated dehydration is at least 10%, which of the following is the correct volume of fluid required for initial resuscitation of this calf? (A) 1 liter (B) 5 liters (C) 10 liters (D) 50 liters

Answer is D: Permethrin toxicity in cats is relatively common occurrence after being treated with a concentrated permethrin-containing flea product labeled for dogs. Rx with METHOCARBAMOL (Robaxin ®) a centrally-acting muscle relaxant and if needed, with seizure control (ie: diazepam, pentobarbitol, or inhalant anesthesia). UNLIKE OPP/carbamate toxicities, DO NOT Rx permethrin toxicity with Atropine. Big DDXs are Organophosphate (OPP) toxicity, and Carbamate toxicity which look similar. With OPP and Carbamates, may see MIOSIS, UNlike permethrin/pyrethroid toxicity. D-Limonene is a citrus-based anti-flea med that can cause vomiting in dogs.

A 3 year-old domestic longhair female spayed cat is presented at your clinic with hypersalivation, vomiting, diarrhea, tremors, stumbling and a temperature of 105.2 F (40.7 C). Her pupils are normal size and responsive to light. While the vet examines the animal, she has a seizure. The owner relates that he had treated her the night before with a flea dip he had originally bought for his dog. What toxic ingredient do you suspect most highly? (A) D-Limonene (B) Carbamate (C) Organophosphate (D) Permethrin

Answer is D: Thoracocentesis would be the first procedure to stabilize the patient prior to performing further diagnostics such as thoracic radiographs, ultrasound, or transtracheal wash. This cat sounds like he has a pleural filling defect (e.g., pneumothorax or pleural effusion). Oxygen is typically administered during stabilization

A 3-year-old indoor-outdoor male neutered cat is presented in respiratory distress with open-mouthed breathing, diminished lung sounds, and cyanotic mucous membranes. For what procedure do you think it is appropriate to set up first? (A) Transtracheal wash (B) Pericardial sac aspiration (C) Chest radiographs (D) Thoracocentesis (E) Urinary catheterization

Answer is A: Estrogen toxicity occurs in intact female ferrets, causing prolonged estrus because the adrenal glands produce too much estrogen. Ferrets are induced ovulators. If Jills (females) in heat are not bred, they can get stuck in estrus. Estrogen is toxic to the bone marrow and these animals can become severely anemic and thrombocytopenic. Clinical signs include lethargy, vomiting, diarrhea, petechial hemorrhages, and dyspnea.

A 3-year old unspayed female ferret is presented in the clinic. She is almost completely bald on her hind end, with hair loss beginning on the tail and rump and progressing up the flank and head. She has a pale swollen vulva and enlarged mammary glands. What relatively common problem in ferrets is she likely to have? (A) Estrogen toxicity (B) Mammary gland carcinoma (C) Uterine carcinoma (D) Adrenal hypoplasia (E) Pyelonephritis

Answer is B: Gastric dilation and volvulus (GDV) is most likely to result in obstructive shock. The distended stomach impairs return of venous blood to the heart. This type of shock can also be caused by pericardial effusion. Cardiogenic shock is due to underlying heart disease causing impaired cardiac output. This can occur in animals with cardiac arrhythmias, valvular disease, or cardiomyopathy. Septic shock occurs secondary to severe infection, such as GI perforation, infected bite wounds, pneumonia, or parvovirus infection. Distributive shock occurs when blood flow is improperly distributed into peripheral capillary beds. This can happen with anaphylaxis, envenomation, or heat stroke. Hypovolemic shock is the most common type of shock in cats and dogs. It occurs because of decreased blood volume secondary to hemorrhage, trauma, or severe vomiting and diarrhea.

A 3-year-old female spayed Weimaraner is presented with a history of hypersalivation, retching, and restlessness. The owner has noted progressive abdominal distention. Examination reveals tachycardia, weak peripheral pulses, dyspnea, and pale mucous membranes with a prolonged capillary refill time. Gastric dilation and volvulus is suspected. What type of shock is most likely primarily affecting this dog? (A) Hypovolemic shock (B) Obstructive shock (C) Cardiogenic shock (D) Distributive shock (E) Septic shock

Answer is D: The answer is 454.5 mg. To make this calculation, you must first convert pounds(lbs) to kilograms(kg). There are 2.2 lbs in a kg. To convert lbs to kg divide lbs by 2.2. So 100 lbs ÷ 2.2 = 45.45 kg. Since the dose is 10 mg per kg, multiply the 45.45 kg from the first step by 10. (lbs÷2.2lbs/kg) × mg/kg= one dose (100 lbs ÷ 2.2lb/kg) × 10mg/kg 45.45 kg × 10 mg/kg = 454.5 mg Infectious keratoconjunctivitis (pinkeye) in cattle is usually caused by Moraxella bovis.

A calf with pinkeye is being treated with an injection of long acting oxytetracycline. The calf weighs 100 lbs and the dose is 10mg/kg. How many milligrams will be needed for one dose? (A) 22 milligrams (B) 4.5 milligrams (C) 75 milligrams (D) 454.5 milligrams (E) 2200 milligrams

Answer is B: This dog has ventricular tachycardia (VTach), which is common in dogs with GDV. VTach = high heart rate, no P waves are associated with QRSTs, the QRSTs are wide and bizarre. The decrease in venous return caused by gastric distension and the effects of inflammatory mediators cause heart damage that results in arrhythmia. Lidocaine is used to treat VTach. Most dogs with GDV are kept on a lidocaine infusion to help prevent or minimize the occurrence of this dysrrhythmia. Click this link for excellent website - Interpretation of ECGs from UPenn.

A 4 year old male great dane recovering from emergency surgery to correct a gastric dilatation-volvulus (GDV) is still quite weak and depressed after 24 hours. Auscultation of the heart reveals a cardiac arrhythmia, seen on this electrocardiogram. Which of the following correctly identifies this rhythm? (A) Atrial fibrillation (B) Ventricular tachycardia (C) Ventricular fibrillation (D) Premature ventricular complexes

Answer is B: Lidocaine is used most often to treat ventricular tachycardia (VTach) in dogs with GDV. In fact, most are put on a lidocaine infusion to help prevent or minimize the occurrence of this dysrrhythmia. VTach is characterized by ventricular complexes that occur in runs of > 30 seconds. Heart rate is high, >170 beats/min. Hydration, electrolytes, blood pressure, oxygenation, and pain management should also be evaluated and treated accordingly as these abnormalities can also affect cardiac function. Follow this link to an excellent website - Interpretation of ECGs from UPenn.

A 4 year old male great dane recovering from emergency surgery to correct a gastric dilatation-volvulus is still quite weak and depressed after 24 hours. Auscultation of the heart reveals a cardiac arrhythmia, seen on this electrocardiogram. Which of the following is the best treatment for this arrhythmia? (A) Apply pressure to both globes to slow the heart rate and allow sinus rhythm to restart (B) A bolus of lidocaine followed by a continuous infusion (C) Perform cardiac compressions and shock the heart with 1 joule/kg (D) Give a test dose of atropine to see if the dysrhythmia goes away

Answer is C: The hamster is not dead. At temperatures under 41°F (5°C), hamsters will enter pseudohibernation. Though not a true hibernation, they are called "permissive hibernators". They may look "dead" to the owner, but they are alive. Cold temperatures may also stimulate hamsters to gather up food.

A client calls in the middle of winter to say her furnace went out the night before and the whole house became very cold. This morning one pet hamster appears to be dead and several others are lethargic. What message should be communicated to the owner? (A) Need to examine the lethargic animals and increase calorie intake (B) Put tetracycline in the water and maintain the ambient temperature (C) The hamster is not dead (D) The other animals are likely to die (E) Males are more likely to die from cold stress

Answer is B: A foul smelling discharge combined with depression after whelping is probably metritis or inflammation of the uterus. Dystocia is difficult birth. Hypocalcemia is lack of calcium due to milk production. Mastitis is an inflammation of the mammary glands. Cystitis is inflammation, infection of the urinary bladde

A client calls into the clinic and says that her female beagle whelped a litter of pups two weeks ago but now seems depressed and has a foul smelling discharge from her vulva. You ask her to bring the dog in immediately. What do you suspect is the problem? (A) Dystocia (B) Metritis (C) Mastitis (D) Hypocalcemia (E) Cystitis

Answer is C: 10% calcium gluconate will likely be given. This is a classic presentation for a bitch with eclampsia (hypocalcemia). Eclampsia is more common in bitches with large litters than in queens, and usually occurs 2-3 weeks post-partum. It can rarely occur pre-partum. Diagnosis involves hypocalcemia in a dog with classic clinical signs and signalment. Treatment of progressive or severe cases is 10% calcium gluconate to effect. Owners can administer oral calcium lactate or calcium gluconate with vitamin D. Puppies are usually hand-fed and prevented from nursing.

A 5-year-old Golden Retriever bitch is presented 2 weeks post-partum with a litter of 10 puppies that are strong and growing. The owner noted that the bitch has been weak and trembling since that morning. As you are examining her, she begins to have tonic convulsions (involuntary contractions of voluntary muscles). What treatment should you get ready for the vet to administer as quickly as possible? (A) Diazepam (B) 8.4% sodium bicarbonate (C) 10% calcium gluconate (D) Injectable corticosteroids (E) 50% magnesium sulfate

Answer is D: 8 L should be collected. Blood transfusion volume (in mL) = (weight (in kg) x blood volume (in mL/kg) x [desired PCV - actual PCV])/donor PCV. So, blood transfusion volume (in mL) = (500kg x 80mL/kg x [25-18])/35 blood transfusion volume (in mL) = 8 L

A 500-kg mare that foaled the night before is presented in hemorrhagic shock due to rupture of the uterine artery into the uterus (so she is hemorrhaging into the uterus). Her PCV is 18%, her lactate is 4.2 mmol/L, and she is tachycardic and tachypneic. What volume of blood will need to be collected from the blood donor (whose PCV is 35%) in order to transfuse her to achieve a PCV of 25%? Assume that blood volume is 80 ml/kg. (A) 6L (B) 8L (C) 12L (D) 10L (E) 4L

Answer is A: These are signs of colic (abdominal pain). Colic has many causes, but always presents with abdominal pain. Colic calls are typically emergencies and need to be examined by the veterinarian the same day. Note the founder is the same thing as laminitis, a lameness of the front feet where there is inflammation of the sensitive laminae that connect the hoof wall to the bones of the foot.

A client calls the clinic and reports her horse is pawing with his front feet, attempting to roll and looking at his belly. What problem is this horse most likely to be suffering from? (A) Colic (B) Laminitis (C) Founder (D) Strangles (E) Anthrax

Answer is D: These are signs of colic (abdominal pain). Colic calls are typically emergencies and need to be examined by the veterinarian the same day.

A client calls the clinic and reports her horse is pawing with his front feet, attempting to roll and looking at his belly. What should be done? (A) Advise owner to give plenty of water and a laxative (B) Advise owner to call back if condition gets worse (C) Schedule veterinary visit for next day (D) Schedule veterinary visit right now (E) Advise owner to feed only dry hay

Answer is C: Calcium gluconate IV is the most appropriate therapy. This cat likely has a urethral obstruction. Patients with urethral obstruction are at risk for hyperkalemia due to the high concentration of potassium in urine that is absorbed into the systemic circulation. Hyperkalemia causes the following cardiac abnormalities as it worsens: bradycardia; tall, tented t-waves; loss of the p-wave; wide and bizarre QRS complexes; and eventually asystole. Calcium gluconate stabilizes cell membranes to help mitigate the effects of the hyperkalemia. Following calcium gluconate administration, additional IV fluid therapy often including dextrose and insulin therapy is initiated.

A 7-year-old male neutered domestic short hair cat is presented in a stuporous state with a history of straining to urinate. Initial bloodwork reveals hyperkalemia and he is bradycardic. What treatment should be immediately prepared for administration? (A) Insulin therapy (B) Intranasal oxygen (C) Calcium gluconate IV (D) Dextrose administration (E) Crystalloids

Answer is C: prn or PRN means "as needed". Remember "S" for Single" (s.i.d.), "B for Bi" (twice a day, b.i.d.), "T for Tri" (3 times a day, t.i.d.), and "Q for Quad" (4 times a day, q.i.d.). Many clinics use capital letters (SID, BID,TID etc, to mean the same things). q.o.d. means "every OTHER day". Some clinics use e. o.d. to mean every other day. Follow this link to see Table of medical abbreviations.

A basset hound with galloping halitosis has been prescribed with medicated mint dog treats prn for bad breath. How often does the dog get treated? (A) Four times a day (B) Once a day (C) As needed (D) Every other day

Answer is B: o.u. means BOTH eyes. q.i.d. means 4 times a day. Remember o.d. means the RIGHT eye and o.s. is the LEFT eye. Remember "S" for Single" (s.i.d.), "B for Bi" (twice a day, b.i.d.), "T for Tri" (3 times a day, t.i.d.), and "Q for Quad" (4 times a day, q.i.d.). Many clinics use capital letters (SID, BID, TID, etc., to mean the same things). prn or PRN means "as needed". q.o.d. means "every OTHER day". Some clinics use e. o.d. to mean every other day. Follow this link to see Table of medical abbreviations.

A box turtle is prescribed eye drops o.u., q.i.d. How should this medicine be given (A) Left eye, as needed (B) Both eyes, 4 times a day (C) Both eyes, every other day (D) Right eye, 4 times a day

Answer is C: An immunosuppressed animal should be handled and have its cage cleaned first, to prevent infection from other organisms. A parvo puppy should be in isolation, and is probably best to handle last. Examples of immunosuppressive diseases include:

A clinic has several patients in different wards. Which one should have its cage cleaned first in the morning? (A) A cat recovering from a routine ovariohysterectomy (B) A puppy with parvovirus diarrhea (C) A dog getting immunosuppressive chemotherapy (D) A pair of rabbits who are boarding

Answer is B: o.d. means the RIGHT eye, prn means "as needed". Remember o.s. is the LEFT eye and o.u. means BOTH eyes. Remember "S" for Single" (s.i.d.), "B for Bi" (twice a day, b.i.d.), "T for Tri" (3 times a day, t.i.d.), and "Q for Quad" (4 times a day, q.i.d.). Many clinics use capital letters (SID, BID, TID, etc., to mean the same things). prn or PRN means "as needed". q.o.d. means "every OTHER day". Some clinics use e. o.d. to mean every other day. Follow this link to see Table of medical abbreviations.

A Brazilian flying hamster has flown into a window and injured himself. The hamster is prescribed ophthalmic ointment o.d., prn. How should this medicine be given? (A) Left eye, as needed (B) Right eye, as needed (C) Right eye, as neededBoth eyes, 3 times a day (D) Both eyes, once a day

Answer is A: There is not a specific cut-off, but generally animals with a PCV less than 12-15% require blood transfusion. Physical examination findings, such as tachycardia, tachypnea, lethargy, and pale mucous membranes, can help indicate when blood transfusion is necessary. Blood lactate levels also help indicate the animal's oxygen perfusion status.

A PCV below what value generally indicates that blood transfusion is necessary in animals with chronic anemia? (A) Less than 12-15% (B) Less than 18-22% (C) Less than 20-25% (D) Less than 15-18% (E) Impossible to generalize

Answer is D: Atrial fibrillation (Afib) is present in this horse. It is an irregularly irregular rhythm, with no P waves but normal QRS waveforms. Remember that with a base-apex recording of the ECG in a horse, the QRS should be negative in Lead I. It will be positive with Lead III. The fibrillation waves are large and easy to see in horses, they completely obscure the baseline. In dogs, sometimes they are almost inapparent at usual settings. Afib can be a cause of poor performance, especially in disciplines that require speed or extreme intensity, such as racing or eventing. Afib is not commonly caused by heart disease in horses as it is in dogs. Since it is associated with vagal tone and large heart size, it is sometimes seen in giant breed dogs (wolfhound) without heart disease

A cardiac arrhythmia is ausculted during the preoperative examination of a 10 year old quarterhorse gelding used for barrel racing. The horse performed poorly this season and a laryngoplasty is planned to correct 'roaring' that has been heard occasionally while racing. The resting heart rate is 36 beats/minute [N=28-48] and the rhythm is irregularly irregular. All other vital signs are normal and the horse is in good condition. (A) 3rd degree AV block (B) Sinus tachycardia (C) Respiratory sinus arrhythmia (D) Atrial fibrillation

Answer is B: q.i.d. means 4 times a day. Remember "S" for Single" (s.i.d.), "B for Bi" (twice a day, b.i.d.), "T for Tri" (3 times a day, t.i.d.), and "Q for Quad" (4 times a day, q.i.d.). Many clinics use capital letters (SID, BID, TID, etc., to mean the same things). prn or PRN means "as needed". q.o.d. means "every OTHER day". Some clinics use e. o.d. to mean every other day. Follow this link to see Table of medical abbreviations.

A cat has been prescribed 100 mg of Supercycline, q.i.d. for 10 days. How often does the cat get medicine each day? (A) Twice a day (B) Four times a day (C) Once a day (D) As needed

Answer is C: o.s. is the LEFT eye, treated 3 times a day (t.i.d.). Remember o.d. means the RIGHT eye and o.u. means BOTH eyes. Remember "S" for Single" (s.i.d.), "B for Bi" (twice a day, b.i.d.), "T for Tri" (3 times a day, t.i.d.), and "Q for Quad" (4 times a day, q.i.d.). Many clinics use capital letters (SID, BID, TID, etc., to mean the same things). prn or PRN means "as needed". q.o.d. means "every OTHER day". Some clinics use e. o.d. to mean every other day. Follow this link to see Table of medical abbreviations.

A cat is prescribed ophthalmic ointment o.s., t.i.d. How should this medicine be given? (A) Both eyes, once a day (B) Right eye, as needed (C) Left eye, 3 times a day (D) Left eye, as needed

Answer is A: Animals suffering from ethylene glycol toxicity [antifreeze] have urine that has a specific gravity and osmality similar to glomerular filtrate and plasma. Their kidneys are not functioning well enough to concentrate urine.

A cat is presented after drinking antifreeze (ethylene glycol). Urinalysis shows that the urine has become isosthenuric. What does isosthenuria indicate about the urine specific gravity (USpG)? (A) USpG similar to glomerular filtrate and plasma (B) USpG Greater than glomerular filtrate but less than plasma (C) USpG greater than glomerular filtrate and plasma (D) USpG Less than glomerular filtrate and plasma

Answer E: pruritus means itching. Sometimes hair loss occurs secondary to itching (pruritus) as the dog or cat chews on itself due to flea allergy, for example. Refs: The Merck Veterinary Manual online edition.

A cat is presented for pruritus. What is the problem? (A) Inflamed gums (B) Seizure (C) Severe sunburn (D) Inner ear imbalance (E) Itching

Answer is C: 0.2 mg*11 lb = 2.2 mg, which is closest to one tablet. The best choice in this question is a one tablet dose for this cat. In reality, many medicines will have a dose range. For example, in a cat with a soft tissue infection, amipicillin is recommended at a dose range of 20-40 mg/kg PO (per os, which means by mouth). Click here to see a Table of basic antibiotic dosages recommended for staph infections.

A cat that weighs 11 lb (5 kg) is prescribed antibiotics at a dosage of 0.2 mg/lb (0.44 mg/kg). The medication is available only in 2 mg tablets. How many tablets should the cat receive in a single dose? (A) ~1/4 tablet (B) ~1/2 tablet (C) ~1 tablet (D) ~1 1/2 tablets

Answer is D: Think uncontrolled bleeding and collapse with RAT POISON; It interferes with vitamin K and leads to uncontrolled bleeding in animals that eat rat poison or rats that died from eating rat poison. Follow this link to see blood in the chest of an animal that died from rat poisoning. Refs: Bassert and Thomas, McCurnin's Clinical Textbook for Veterinary Technicians, 8th ed. pp. 932-3, Comp Review for Vet Techs, Tighe & Brown, 3rd ed. pp. 218-21 and table 15-2 , and the Merck Veterinary Manual online edition.

A client brings in her dog who ate a box of rat poison in the last 2 days. What symptoms would be expected? (A) Seizures, vomiting (B) Severe pain, depression (C) Unconscious, rapid heartrate (D) Bleeding, weakness

Answer is B: Alopecia means hair loss. Sometimes hair loss occurs because of a hormonal imbalance, like hyperadrenocorticism. Click here to see a dog with alopecia due to hyperadrenocorticism. Sometimes hair loss occurs secondary to itching (pruritus) as the dog or cat chews on itself due to flea allergy, for example.

A dog is presented with alopecia on the dorsal back and hind quarters. What is the problem? (A) Hemorrhages (B) Hair loss (C) Bruising (D) Sunburn (E) Itching

Answer is D: Epiphora means a runny eye, often associated with a blocked tear duct.

A dog is presented with epiphora. What is the problem? (A) Itching (B) Hair loss (C) Ear infection (D) Runny eye (E) Hemorrhages on sclera

Answer is A: 1-2 cm diameter skin or mucous membrane hemorrhages are called ecchymoses. Click here to see a dog with ecchymosis on the gums. Click here to see a dog with ecchymosis on the abdomen. Small pinpoint hemorrhages on the skin or mucus membranes are called petechiae. Click here to see a dog with petechia.

A dog is presented with numerous small 1-2 centimeter wide hemorrhages on the abdomen. What are these hemorrhages called? (A) Ecchymoses (B) Wheals (C) Petechiae (D) Epiphora (E) Alopecia

Answer is A: Small pinpoint hemorrhages on the skin or mucus membranes are called petechiae. It is found in diseases that cause problems with coagulation. Larger hemorrhages (1-2 cm diameter) are called ecchymoses. Click here to see a dog with petechia. Click here to see a dog with ecchymosis on the gums. Click here to see a dog with ecchymosis on the abdomen

A dog is presented with numerous small pinpoint hemorrhages on the mucous membranes of the mouth. What are these hemorrhages called? (A) Petechiae (B) Hematomas (C) Ecchymoses (D) Suppuration (E) Epiphora

Answer is B: Priapism is a prolonged erection in the absence of sexual stimulation. Paraphimosis is the inability to retract a swollen penis into the prepuce. Balanoposthitis is inflammation of the glans penis and preputial mucosa. Posthitis is inflammation of the preputial mucosa.

A dog is presented with priapism. What is the problem? (A) Inability to retract swollen penis (B) Prolonged penile erection (C) Undescended testicle (D) Uncontrolled salivation (E) Inflammation of the preputial mucosa

Answer is C: When the penis cannot retract into the prepuce, the problem is called paraphimosis. A proptosis means "popping out or protruding". The most common emergency proptosis you will see in practice is a ocular proptosis (sometimes called an eye prolapse, too). Follow these links to see a proptosed eye in a dog and a severely proptosed eye in another dog.

A dog with a paraphimosis comes in on emergency. What kind of problem is this? (A) Mismating (B) Eyeball popped out of socket (C) Penis cannot retract into prepuce (D) Uterine proplase

Answer is A: If a cow that has been treated for milk fever is still down after 3 hours, she needs to be seen again the same day by the vet. Downer cows are in danger of suffering nerve and muscle damage and being permanently paralyzed. Also, other life-threatening conditions may be going on, like septic mastitis.

A down cow who recently calved was treated for milk fever with calcium gluconate IV by the vet. The farmer calls to say that three hours have gone by and the cow is still down. What should be done? (A) Schedule vet to return immediately (B) Tell farmer to retreat the cow with IV calcium gluconate (C) Tell farmer to retreat the cow with oral calcium gel (D) Return to farm yourself and retreat cow (E) Schedule vet to return to farm first thing tomorrow

Answer is B: This is rectal prolapse in a sheep, a common problem of young straining animals of many animals. Rectal prolapse is differentiated from mass lesions, colonic prolapse or intussuseption by the inability to pass anything between the anus and the rectal wall. In females must differentiate from uterine prolapse.

A gentle gloved finger cannot pass between the anus and the rectal wall in the 6-month old ewe presented in the image below. What anatomical structure is affected? (A) Uterus (B) Rectum (C) Cervix (D) Vagina (E) Cecum

Answer is E: This proglottid could be Taenia taeniaformis or Dipylidium caninum. Cats acquire T. taeniaformis from eating wild rodents (common). D. caninum is the most common cestode infection in both cats and dogs. Fleas carry the parasite, and dogs and cats are infected when they bite at fleas and ingest them. Adult cestodes in the intestine of cats do not usually cause clinical signs. Diagnosis is straightforward-Identify proglottids or eggs in feces. Rx: You can treat with epsiprantel or praziquantel. Fenbendazole works on T. taeniaformis.

A healthy adult indoor-outdoor male intact cat is presented for vaccination. The following is structure is noted protruding from the anus during the exam (see below). What is this? (A) Foreign body (B) Salmon poisoning fluke (C) Grain of rice (D) Adult whipworm (E) Cestode proglottid

Answer is B: Recurrent airway obstruction (RAO) in horses is often called "heaves" and was formerly called chronic obstructive pulmonary disease (COPD). You are likely to still hear the term heaves in practice. RAO is primarily an ALLERGIC disease. It is common in mature horses housed indoors. Think of COUGHING, WHEEZY, SNOT-NOSED HORSES, with tachypnea at rest and without fever. RAO is part of the equine asthma complex. The ACVIM consensus statement on inflammatory airway disease nicely covers the equine asthma complex.

A horse is presented for recurrent airway obstruction (RAO). What is another name for this problem? (A) Roaring (B) Heaves (C) Dorsal displacement of the soft palate (D) Bleeder (E) Guttural pouch tympany

Answer is D: Temporary tracheotomies should be performed immediately in horses in severe respiratory distress due to upper airway obstruction. The physical examination and further supportive care can be delayed until after an airway is obtained.

A horse is presented in severe respiratory distress after a suspected snake bite with nasal swelling, flared nostrils, significant abdominal movement with each breath, stridor, and significant tachypnea. What procedure should you prepare for the vet to do immediately? (A) Pass nasopharyngeal tube (B) IV catheter placement (C) Intranasal oxygen administration (D) Temporary tracheotomy (E) Arterial blood gas analysis

Answer is C: A persistent hymen is usually a thin membranous fold of tissue located at the junction of the vagina and the vestibule in females. It occurs when the paramesonephric ducts do not fuse normally with the vaginal ectoderm. Click here to see persistent hymen in a different mare. Most of the time, a persistent hymen is not problematic because it is normally broken down by breeding via natural cover or artificial insemination. But occasionally a buildup of fluid or secretions can be seen that encourage infection. This can be a medical cause of infertility as well as mechanical as a physical barrier to the introduction of sperm. Occasionally a persistent hymen is difficult to break down easily. It must be incised using a scalpel or scissors, taking great care NOT to damage the urethra or the urethral orifice. Ringwomb is a heritable condition seen in sheep and sometimes goats where the cervix cannot dilate normally for parturition to proceed.

A horse owner reports that she sometimes sees something pale pink intermittently protruding from her yearling filly's vulva when she runs around the pasture. On physical examination, the mare looks like the image below. Which of the following is the correct diagnosis? (A) Vaginal hypoplasia (B) Vaginal septum (C) Persistent hymen (D) Adhesions of vaginal vault (E) Ringwomb

Answer is E: The prognosis depends most heavily on the length of time between the injury and the treatment. Luxated joints are not uncommon traumatic injuries in cows. A delay between injury and assessment/treatment allows for muscle contracture around the joint and for debris to build up in the joint. In these cases, surgery is often necessary.

A mature dairy cow is presented with a luxated hip joint that the owner thinks occurred the night before during a thunderstorm that scared the cattle. What is the main factor affecting the prognosis in this cow (A) Weight of the cow (B) Which joint is affected (C) Cow's willingness to be handled and maintained in a cast (D) Whether or not surgery is necessary (E) Length of time between injury and treatment

Answer is B: This type of ulcerated sore on the underside of the hocks is most often due to poor husbandry or other environmental factors.

A mature pet rabbit is presented with ulcerated skin lesions on the underside of both hocks. What is the most likely cause that will be discussed with this owner? (A) Pasteurella multocida dermatitis (B) Poor husbandry (C) Psoroptes cuniculi infection (D) Excess calcium in the feed (E) Vitamin A deficiency

Answer is E: This is an example of diversionary restraint. There are three types of restraint used to control animals for examination or treatment. Physical restraint involves halters and lead ropes. Diversionary restraint includes mechanical restraint (twitch) or manual restraint (tapping the horse) to try to distract the horse. Chemical restraint involves the use of sedatives and anesthetic agents to manage the horse.

A nose twitch is an example of which type of restraint in horses? (A) Chemical (B) Electrical (C) Physical (D) Nose twitches are not appropriate in horses (E) Diversionary

Answer is A: Cystoisospora felis and C.rivolta are the most common causes of coccidiosis in cats. Coccidiosis occurs most frequently in young cats after stressful events such as weaning. While the disease is typically self-limiting, treatment with sulfadimethoxine can shorten the length of illness and decrease shedding of oocysts. Cystoisospora spp. of dogs and cats are not zoonoti

A recently weaned kitten presents with clinical signs of foul-smelling, pasty diarrhea. Oocysts of Cystoisospora spp. are identified on microscopic examination of feces. Which one of the following would be the best treatment? (A) Sulfadimethoxine (B) Fenbendazole (C) Amikacin (D) Amoxicillin/clavulanic acid (E) Enrofloxacin

Answer is C: Coccidiosis. Cystoisospora felis and C. rivolta are the most common causes of coccidiosis in cats. Coccidiosis occurs most frequently in young cats after stressful events such as weaning. While the disease is typically self-limiting, treatment with sulfadimethoxine can shorten the duration of illness and decrease shedding of oocysts. Cystoisospora spp. of dogs and cats are not zoonotic.

A recently weaned kitten presents with clinical signs of foul-smelling, pasty diarrhea. Oocysts of the Cystoisospora genus are identified on microscopic examination of feces. Which one of the following is the common name of this infection? (A) Cryptococcosis (B) Cryptosporidiosis (C) Coccidiosis (D) Corynebacteriosis (E) Coccidioidomycosis

Answer is B: q.o.d. means "every OTHER day". Some clinics use e. o.d. to mean every other day. Because of potential for confusion, the the American Medical Association (AMA) discourages use of this abbreviation, and recommends spelling out "every other day" for clarity. However, because many textbooks and some clinics may still use the term QOD, at least be aware what it means. Remember "S" for Single" (s.i.d.), "B for Bi" (twice a day, b.i.d.), "T for Tri" (3 times a day, t.i.d.) and "Q for Quad" (4 times a day, q.i.d.). Many clinics use capital letters (SID, BID, TID, etc., to mean the same things). prn or PRN means "as needed". Follow these links to see Merck Table of medical abbreviations and the AMA list of medical abbreviations.

A rare Albanian hairy iguana has been prescribed "Iggy-cote" medicated shampoo q.o.d. for dandruff. How often does the iguana get treated? (A) As needed (B) Every other day (C) Four times a day (D) Once a day

Answer is C: Coccidia have schizonts, multi-nucleated structures that are part of the asexual reproductive cycle. An infective oocyst ingested from the environment releases sporozoites. These invade a cell in the large intestine, enlarge and become multi-nucleated. This enlarged multi-nucleated cell is the schizont. Each nucleus becomes the next stage, called a merozoite. Merozoites are released into the intestinal lumen, invade another intestinal cell, and then reproduce sexually to produce more oocysts. Thousands of oocysts are produced via this two part life cycle and released into the environment in the feces. Click for an excellent tutorial of the coccidia life cycle from Merial.

A schizont is part of the life cycle of which one of the following organisms? (A) Trypanosomes (B) Dipterans (C) Coccidia (D) Trematodes (E) Cestodes

Answer is A: Vitamin A deficiency is the most common nutritional deficiency in captive turtles. Clinical signs include those seen in this patient, respiratory infection, and urogenital tract obstruction. Diets high in beta-carotene (found in earthworms, small fish, and leafy green vegetables) prevent hypovitaminosis A. Metabolic bone disease is caused by diets deficient in calcium or Vitamin D3 or excessive in phosphorous. Reptiles need natural or artificial exposure to UV light.

A turtle is presented with an overgrown beak, conjunctivitis, and palpebral edema. What is the most likely dietary deficiency the veterinarian will discuss with the owner? (A) Vitamin A (B) Thiamine (C) Selenium (D) Phosphorous (E) Calcium

Answer is B: 42 tablets of gabapentin are required to treat this dog for 1 week. 10 mg/kg (30 kg) = 300 mg/dose x 2 doses/day = 600 mg/day 600 mg/day x 7 days = 4200 mg/100 mg/tablet = 42 tablets

A veterinarian selects gabapentin as a medication for a boxer dog in chronic pain. The dose is 10 mg/kg PO twice daily. The dog weighs 30 kg. Available gabapentin tablets are 100 mg/tablet. How many tablets are required to treat this dog for 1 week? (A) 14 tablets (B) 42 tablets (C) 96 tablets (D) 21 tablets (E) 28 tablets

Answer is D: Flea control. Fleas are the intermediate hosts for tapeworms (Dipylidium caninum) and are the cause of recurring infections.

An adult Siamese indoor only cat has had several episodes of tapeworm infestation. After treating the latest occurrence, which one of the following recommendations is necessary to prevent future outbreaks? (A) Clean litter box twice a day (B) Use heartworm preventative (C) Treat all pets in the household (D) Consistent flea control

Answer is B: Proglottids are segments of the body of a tapeworm. They're frequently found in an animal's feces when adult tapeworms are present in the intestine. They contain thousands of packets of tapeworm eggs to be released into the environment.

An owner brings in a sample of his dog's feces in for examination. The veterinarian says it contains proglottids. Which one of the following choices is the correct explanation of what the vet means? (A) The patient has a liver fluke infestation. (B) This is evidence of tapeworm infection. (C) This is a normal finding in feces. (D) The animal is passing undigested rice granules.

Answer is B: Hydrogen peroxide can be administered at a dose of 1 tsp./10 pounds to induce vomiting in small animals. It should only be given if the possible toxin consumed is noncorrosive. Corrosive substances (e.g., ammonia, quaternary ammonium cleaners, and drain cleaner) could cause esophageal damage if vomited up. It should NOT be given to sleepy or comatose pets that cannot swallow. It should not be given to cats. Only a single dose should be given.

An owner calls because her 10-pound Shih Tzu just ate a bar of fancy dark chocolate. The dog seems fine right now. What can the owner administer to induce vomiting? (A) 1 tablet Benadry (B) 1 tsp. hydrogen peroxide (C) Nothing, she should bring dog to clinic ASAP (D) 2 tablets Benadryl (E) 2 tbsp. hydrogen peroxide

Answer is B: Puppies and kittens can stand and should have good postural reflexes by 3 weeks of age. They should be able to lift their heads by 3 days of age and they start crawling by 2 weeks of age.

At what age can both puppies and kittens stand and have good postural reflexes? (A) 4 weeks (B) 3 weeks (C) 1 week (D) 2 weeks (E) 5 weeks

Answer is D: Left side of the neck. The esophagus runs down the left side of the horse's neck. The nasogastric (NG) tube can be seen and palpated here as it passes down the neck. It is NOT possible to see or safely palpate it in the larynx or oropharynx. It is critical to confirm proper placement prior to administration of fluids or medications through the NG tube. Other methods to confirm that the NG tube is in the stomach: 1) Blow into the end and have an assistant auscult the stomach with a stethoscope. 2) Most patients cough if the tube is placed into the trachea; however, this is NOT fool-proof. Sedated or very sick patients, or those in which a very small diameter tube is used, may not cough. 3) Negative pressure upon aspiration is a sign of being in the stomach. However, can also get negative pressure if the tube is up against soft tissue (in the lung or esophagus) so is not definitive. Do NOT attempt to suck fluid out of the stomach - personnel can become very sick from the possible contents.

At what location can palpation and visualization confirm proper nasogastric tube placement in the horse? (A) Right jugular groove (B) It is not possible to confirm this way (C) Larynx (D) Left side of the neck (E) Oropharynx

Answer is A: B. burgorferi is vector-borne and requires a biological vector (i.e., ticks) for transmission. There are several categories used to classify the way that infectious diseases are transmitted. Contagious diseases (e.g., Bordatella bronchiseptica) are transmissible directly or indirectly (i.e., via fomites) between animals. Zoonotic diseases are transmitted from animals to humans (e.g., rabies). Reverse-zoonotic diseases are transmissible from humans to animals (e.g., dermatophytosis). Diseases can fall into more than one category. For example, Salmonella spp. are contagious, zoonotic, and reverse-zoonotic. Nosocomial diseases do not fall into this type of categorization. Nosocomial diseases are those diseases that are acquired during hospitalization or treatment.

Borrelia burgdorferi infection (e.g., Lyme disease) is transmitted in what way? (A) Vector-borne (B) Contagious (C) Zoonotic (D) Nosocomial (E) Reverse-zoonotic

Answer is a: The normal range for a cat's respiration is about 16 to 40 breaths per minute. Different sources use slightly different ranges of numbers, but 20-30 breaths per minute is in the middle of the normal range for cats. A stressed out cat will breath faster in the clinic. Click here for a chart of resting respiration rates of common domestic animals

During initial evaluation, a Siamese is breathing at 20-30 breaths per minute. This respiration rate is: (A) Normal (B) Suggestive of stress in the office (C) Hypoventilation (D) 10 breaths per minute above normal

Answer is B: The normal range for a dog's respiration is about 15 to 30 breaths per minute. Different sources use slightly different ranges of numbers, but 25 breaths per minute is in the middle of the normal range for a dog. Smaller dogs will have faster respiration rates than larger ones. Click here for a chart of resting respiration rates of common domestic animals

During initial evaluation, an adult German Shepherd dog is breathing at 25 breaths per minute. This respiration rate is: (A) Hyperventilation (B) Normal (C) Suggestive of lung disease (D) 10 breaths per minute below normal

Answer is D: Succussion is a physical exam technique used to elicit sounds of splashing in the gut. It involves pushing your fist gently but firmly into an the animal's side several times while listening with a stethoscope. Ballottement is a similar technique, but you use it to feel for the rebound "bump" an organ or of a baby animal's head or hips in the uterus of a late-pregnant cow, sheep or goat. Ref: The Merck Veterinary Manual online edition.

During physical exam on a cow that is off-feed, the vet gently but firmly pushes her fist rapidly into the cow's left side several times while listening with a stethoscope. What is she doing? (A) Palpation (B) Pinging (C) Ballottement (D) Succussion

Answer is E: Ballottement is a physical exam technique most often used in ruminants to see if an animal is in the late stages of pregnancy (right side) or to get a feel for the rumen contents (left side). It involves pushing your fist gently but firmly in and out of an the animal's side several times and feeling for the rebound of organs or rumen contents. Usually done on the right side of a late-pregnant cow, sheep or goat to feel for the rebound "bump" of a baby animal's head or hips in the uterus. Succussion is a similar technique, but you listen to the animal with a stethoscope while you do it for sounds of splashing in the gut. Ref: The Merck Veterinary Manual online edition.

During physical exam on a cow that was bred 8 months ago, the vet gently but firmly pushes a fist rapidly in and out of the cow's right lower side, above and in front of the udder. He does this movement several times then pauses to feel what happens next. What is he doing? (A) Pinging (B) Auscultation (C) Succussion (D) Palpation (E) Ballottement

Answer is A: A Second degree AV block was likely present. This is a normal rhythm in horses. It is caused by the high vagal (parasympathetic) tone in horses. It disappears when sympathetic tone increases, as with excitement, fear, pain, anxiety, etc. Atrial fibrillation is an irregularly irregular rhythm. Although it can sometimes occur intermittently in racehorses, when present older horses, it is rarely intermittent. It does not disappear with exercise. Premature ventricular contractions do not disappear, rather they increase with sympathetic stimulation caused by excitement, anxiety, exercise, etc. Follow this link to an excellent website - Interpretation of ECGs from UPenn.

During the preoperative examination of a 15 year old horse scheduled for arthroscopy, a regularly irregular cardiac rhythm is identified by a vet student and the anesthesia technician. However, no abnormality is ausculted by the surgeon when she examines the horse outside in the lameness testing arena 30 minutes later. Which of the following is the best explanation of this scenario? (A) 2nd degree AV block is normal in horses, it disappears when heart rate increases (B) Premature ventricular contractions often stop when the patient gets excited or nervous (C) The doctor didn't auscult the heart long enough and missed the arrhythmia (D) Supraventricular bradycardia is common in horses, especially in large breeds

Answer is D: During the inflammatory phase the wound is at its weakest and the wound is most likely to dehisce. The three phases of wound healing include the inflammatory (or lag) phase, the proliferative phase, and the maturation phase. Strength begins to develop during the proliferative phase and finalizes with the remodeling and aligning of collagen fibers during the maturation phase. The inflammatory phrase lasts for the first 3-5 days after the wound occurs, the proliferative phase lasts for the following approximately 3 weeks, and the maturation phase can last weeks to months, depending on many factors related to the wound.

During which phase of wound healing is the wound weakest? (A) Proliferative (B) Epithelialization (C) Granulation (D) Inflammatory (E) Maturation

Answer is E: The neonatal period for puppies and kitten lasts 2-4 weeks. Neonatal animals are very vulnerable and rely fully on their mothers for warmth, nutrition, and safety.

For how long are puppies and kitten considered "neonates"? (A) 6-8 weeks (B) 0-7 days (C) 1-3 weeks (D) 5-6 weeks (E) 2-4 weeks

Answer is a: Pregnancy toxemia is common in late-term pregnant ewes and does of any body condition. It usually occurs in dams carrying more than one fetus, after a period of negative energy balance. Clinical signs include anorexia, incoordination, weakness or recumbency, impaired vision, and death in untreated cases. The ketones are increased in the blood and urine and the animals are typically hypoglycemic. Treatment involves IV dextrose, B-vitamins, calcium, and propylene glycol; corticosteroids, and supportive care. Pregnant ewes and dams should have their body condition scores assessed by palpation of the lumbar epaxial musculature at 4-6 weeks prior to the expected date of parturition. The scores should be at 3-3.5 at time of parturition. Other preventive measures include proper deworming of pregnant animals, slowly increasing grain in the last weeks of parturition, and minimizing stress.

For prevention of what disease is it important to assess the body condition score in pregnant ewes as part of an exam 4-6 weeks prior to the expected date of parturition? (A) Pregnancy toxemia (B) Ovine progressive pneumonia (C) Caseous lymphadenitis (D) Copper toxicity (E) Parasitism

Answer is A: Small ruminants should be vaccinated at 4-6 weeks of age, at weaning, and then every 6 months thereafter to prevent enterotoxemia. C. perfringens type D is the main causative agent of enterotoxemia, a disease that affects young sheep and goats. It is more common in dairy goats and lambs in feedlots, both under intensive management conditions. Sudden changes in feed allow the commensal C. perfringens organisms in the intestine to rapidly proliferate. Clinical signs in lambs include lethargy, neurologic signs, and death. Clinical signs in kids include diarrhea, colic, and death.

How frequently should mature small ruminants be vaccinated against Clostridium perfringens types C and D, and why? (A) Every 6 months; to prevent enterotoxemia (B) Every 12 months; to prevent blackleg (C) Every 4 months; to prevent tetanus (D) Every 24 months; to prevent botulism (E) There is no available vaccine against this organism

Answer is D: Passive range-of-motion exercises should be performed four times a day. These help promote venous drainage and stimulate lymph flow, thereby decreasing peripheral edema. They also prevent muscle contracture and wasting.

How frequently should passive range-of-motion exercises be performed on recumbent hospitalized small animal patients? (A) Every 2 hours (B) Once daily (C) This should not be done (D) Four times a day (E) Twice daily

Answer is D: The length of the tube should be measured from the tip of the nose to the 13th rib, which is a good approximation of the location of the stomach. Orogastric intubation is used in small animals to administer medications, food, and fluids, or to release gas or perform gastric lavage. The 8th rib is an approximation of the location of the distal esophagus.

How is the necessary length of tube for orogastric administration measured in a dog or cat? (A) Nose to 8th rib (B) Pharynx to 13th rib (C) Pharynx to 8th rib (D) Nose to 13th rib (E) It's not; done during passing

Answer is C: Immediately. According to the 2016 Compendium for Rabies Control, a peak rabies virus antibody titer is reached 28 days after initial vaccination and immediately after booster vaccination. Here are some thoughts on rabies: When in doubt, it is never wrong to check with your local health department. Basically all potential rabies exposures boil down to 2 questions: 1. Who is involved? Animal-Animal exposure (less alarm bells) Animal bites/exposes human (more alarm bells) 2. Was dog/cat/ferret vaccinated? --Documented up to date on rabies vaccination (booster + 45 days owner observation) --Documented vaccinated, but overdue (booster + 45 days owner observation) --UN-documented vaccinated, and overdue (Handle on case-by-case basis). --Ferrets that are OVERDUE for booster (Handle on case-by-case basis). --UN-vaccinated pet (euthanize or vaccinate + 4-6 month strict isolation) --Wild animal, esp. bats, raccoon, skunk (euthanize, send head to state lab) When dealing with rabies questions, ask yourself if this seems like a HIGH-risk exposure (ie: wild raccoon bites a child) or a LOWER risk exposure (ie: Up-to-date vaccinated dog messes with woodchuck but no bite wounds on dog). For high risk lean towards euthanasia/testing or immediate vaccination + long, strict isolation (4 months, dogs/cats, 6 months, ferrets). For low risk lean towards immediate vaccination + shorter, easier observation period (45 days). In general, both Canadian and U.S. guidance on rabies post exposure management conforms with Compendium guidelines.

How long after a booster rabies vaccination is a dog, cat or ferret considered to be currently vaccinated and protected against rabies? (A) After 7 days (B) After 24 hours (C) Immediately (D) After 14 days (E) After 48 hours

Answer is B: Gut closure typically occurs with 18-24 hours after birth. During this time, a newborn can absorb maternal immunoglobulins (IgM, IgG) in colostrum from the gut directly into the bloodstream. Specialized enterocytes absorb the immunoglobulins by pinocytosis and move them to the blood. These cells are shed and replaced with mature enterocytes within 24 hours Failure of Passive Transfer (FPT) leads to greatly increased risk of bacterial and viral infection and death before weaning. Think GI disease, pneumonias, septic foals and septic umbilicus /joints (Joint Ill, Naval Ill). Recommendations vary, but calves should get a MINIMUM colostrum of 2 liters and foals 1 liter within hours after birth. Can divide this amount and give in smaller volumes, multiple feedings. According to Merck online, healthy foals should have serum IgG concentrations >800 mg/dL and ruminants >1,600 mg/dL.

How long after birth does gut closure typically occur in calves and foals? (when protective maternal antibodies can no longer be absorbed from the gut to the bloodstream) (A) 15-18 hours (B) 18-24 hours (C) 3-6 hours (D) 1-3 hours (E) 9-12 hours

Answer is B: According to the 2016 Compendium for Rabies Control, a peak rabies virus antibody titer is reached 28 days after initial vaccination and IMMEDIATELY after booster vaccination. In general, both Canadian and U.S. guidance on rabies post exposure management conforms with Compendium guidelines.

How long after the FIRST rabies vaccination is a dog, cat or ferret considered to be immunized and protected against rabies? (A) After 14 days (B) After 28 days (C) After 7 days (D) Same day

Answer is A: Hamsters typically live 18-24 months. They have an average gestation length of 16 days and have litters of approximately 5 offspring.

How long do hamsters typically live? (A) 18-24 months (B) 3-4 years (C) 4-5 years (D) 12-18 months (E) 2-3 years

Answer is B: A good rule of thumb is that approximately 5 mLs of milk replacer can be fed to a 160-gram puppy or kitten. Milk replacer is used when the mother's milk is not available or tube feeding is necessary. Tube feeding carries less risk than bottle or syringe feeding and is safe and readily performed. Tube feeding is used for supplementing neonates that are not gaining proper weight for a variety of reasons. The distance from the tip of the nose to the end of the chest is measured and a mark is made on the tube (usually a 5-French) at 75% of this distance. The neonate is held upright and the tube is easily inserted through the mouth into the esophagus. Neonates usually swallow the tube readily. Negative pressure with gentle aspiration via a syringe indicates that the tube is properly placed in the distal esophagus.

How much milk replacer can typically be given to a 160-gram puppy or kitten via a feeding tube? (A) 15 mL (B) 5 mL (C) 2 mL (D) 10 mL (E) 8 mL

Answer is C: Normal neonatal puppies and kittens sleep approximately 80% of the day and nurse every 2-4 hours.

How much of the day do normal neonatal puppies and kittens sleep and how frequently should they nurse? (A) 40%; every 5-6 hours (B) 70%; every 1-2 hours (C) 80%; every 2-4 hours (D) 50%; every 1-3 hours (E) 30%; every 3-5 hours

Answer is D: A normovolemic, normotensive dog or cat without renal deficits should produce approximately 1-2 mL/kg/hour urine. This is a useful number to keep in mind when monitoring urinary output via an indwelling urinary catheter.

How much urine should a normovolemic, normotensive dog or cat without renal deficits produce per hour? (A) 4-5 mL/kg/hour (B) 3-4 mL/kg/hour (C) 0-1 mL/kg/hour (D) 1-2 mL/kg/hour (E) 2-3 mL/kg/hour

Answer is D: Heparin locks should be changed every 12 hours. Heparin locks are used in small animals when an IV catheter is not being frequently used. The dead space of the catheter is filled with 100 U/mL of heparin to help prevent the catheter from becoming blocked. The heparin is not flushed into the patient; it is removed and then replaced with fresh heparin. It is important to clearly label these catheters to prevent accidental heparin overdosing.

How often should a heparin lock be replaced on an IV catheter? (A) Every 16 hours (B) Every 8 hours (C) Every 6 hours (D) Every 12 hours (E) Every 24 hours

Answer is B: Pet birds should ideally be transported to the clinic in their regular cages, uncleaned. This enables the veterinarian to evaluate the bird's regular environment and stool. If the cage is very large, a routine carrier is appropriate. The cage or carrier should be covered with a towel (or blanket). Birds should never come unsecured (on the arm or on a tether) as this poses a risk to their safety.

How should owners be advised to transport their pet birds to the veterinary hospital? (A) In a cardboard box to minimize stress (B) In regular, uncleaned cage, covered (C) In cage, freshly cleaned, open to fresh air (D) On the owner's arm (E) On a tether

Answer is A: The cardiac pump method should be used in cats and small dogs at a rate of 120-130 compressions/minute. The animal is placed in lateral recumbency and a hand encircles the ventral chest. Compressions are performed over the heart using the entire hand. Blood flow occurs due to direct compression of the heart. The cardiac pump method does not work in larger animals. For them, the chest should be compressed at the widest part—with the animal in lateral recumbency—at a rate of 100 compressions/minute. Blood flow occurs passively because of changes in intrathoracic pressure with each compression and recoil

How should routine chest compressions be performed in a cat or small dog (weighing under 15 pounds) and at what rate? (A) Cardiac pump method; 120-130 compressions/minute (B) Compress the widest part of the chest; 120-130 compressions/minute (C) Compress the widest part of the chest; 80-100 compressions/minute (D) Open-chest compressions; 100-110 compressions/minute (E) Cardiac pump method; 80-100 compressions/minute

Answer is B: A dog with flaccid paresis is weak and limp, but can still move some. Paresis means weak, but still able to move. Paralysis means weak, but not able to move. Paresis and paralysis are often further described as flaccid (limp) or tetanic (stiff). An example of a flaccid paresis is milk fever (parturient paresis) in dairy cows. Another example of a flaccid paralysis is botulism in animals affected by the neurotoxin of Clostridium botulinum. Click here to see limp duck, paralyzed with botulism. Examples of tetanic (stiff) paresis or paralysis include tetanus in animals affected by the neurotoxin of Clostridium tetani and eclampsia in a dog or person who just gave birth.

If a dog has flaccid paresis, what is the problem? (A) Inability to mate (B) Weak and limp (C) Weak and stiff (D) Stiff and paralyzed (E) Limp and paralyzed

Answer is C: Syncope is a general term for fainting or collapse. It can be caused by different things (cardiac arrhythmia, hypoxia, others) One example of a disease characterized by syncope is arrhythmogenic right ventricular cardiomyopathy (ARVC, old name-boxer cardiomyopathy).

If a dog is presented with a history of syncope, what is the problem (A) Slow heart rate (B) Loss of balance (C) Fainting (D) Disorientation (E) Snoring

Answer is E: Tetany means stiff. Paresis (weakness) and paralysis are often described as flaccid (limp) or tetanic (stiff). Examples of tetanic (stiff) paresis or paralysis include tetanus in animals affected by the neurotoxin of Clostridium tetani and eclampsia in a dog or person who just gave birth.

If a foal is tetanic, what is the problem? (A) Foal thinks it is Leonardo DiCaprio (B) Umbilical infection (C) High fever (D) Inability to defecate (E) Stiffness

Answer is B: 50 drops/min. Drip rate =(Volume of solution in ml X drops/ml)/time in minutes. 300 ml X 60 drops/ml=18,000 drops. 6 hours X 60 min/hour= 360 minutes Drip rate= 18,000 drops/360 min=50 drops/min

If an IV set dispenses 60 drops/ml, what is the IV drip rate (drops per minute) needed to give a cat 300 ml of Lactated Ringer's solution (LRS) over 6 hours? (A) 10 (B) 50 (C) 60 (D) 100

Answer is C: 100 drops/min. Drip rate =(Volume of solution in ml X drops/ml)/time in minutes. 500 ml X 60 drops/ml=30,000 drops. 5 hours X 60 min/hour= 300 minutes Drip rate= 30,000 drops/300 min=100 drops/min

If an IV set dispenses 60 drops/ml, what is the IV drip rate (drops per minute) needed to give a dog 500 ml of saline solution over 5 hours?: (A) 50 (B) 60 (C) 100 (D) 10

Answer is A: Nyctalopia is nightblindness. A history of worsening nightblindness in a young dog with bilateral retinal abnormalities suggests early-onset progressive retinal atrophy (PRA).

If an dog is presented with nyctalopia, what is the problem? (A) Nightblindness (B) Congenital anomaly of third eyelid (C) Iris atrophy (D) Unequal pupil size

Answer is D: This parasite is occasionally found in cats and dogs. The usual hosts are rabbits, squirrels, chipmunks and mice. Such cases are usually seen during late summer and fall. Very characteristic is the fistula, which serves as a breathing hole. Eggs are laid near the nests, burrows, and traffic pathways of the host animals where they attach to the body of the animal. Most often, they enter the body via the mouth or nares during grooming, but may also enter through a wound. They penetrate the tissues and travel to specific subcutaneous areas where they mature. A fistula forms in the lesion as a breathing hole for the larva. The larva should be extracted carefully in one piece to avoid a severe local inflammatory reaction that can result. The area should not be squeezed to avoid damage to the larvae. Anaphylaxis has also been reported anecdotally. An abscess or foreign body are the most likely differential ruleouts for this lesion.

In September a 2-year-old female spayed DSH cat is presented with a painful swelling below the left ear. Following heavy sedation, the hair around the affected area is clipped and the skin is cleansed with disinfectant. An area with subcutaneous swelling ~1.5 cm in diameter is noted, with erythematous skin surrounding a fistulous tract that is oozing purulent discharge. On closer inspection a cream-brown colored structure is seen moving within the lesion. After removal with a hemostat, it appears to be a large, fat parasite larva, about 0.7 cm in length and 0.4 cm in width, with tiny black spines covering the body. Which one of the following choices is the mostly likely diagnosis? (A) Dracunculiasis (B) Pelodera dermatitis (C) Hypodermiasis (D) Cuterebra (E) Hookworm dermatitis

Answer is A: Hematochezia (frank blood in the feces) is seen with large bowel diarrhea vs. melena (digested blood in the feces) is seen with small bowel diarrhea. It is important to distinguish between large and small bowel diarrhea. A thorough questioning and history from the owner can help make this distinction so the veterinarian can direct the diagnostic workup. Mucus is often seen in the feces of large bowel diarrhea, not small. The frequency of bowel movements is usually increased with large bowel diarrhea, not small. The volume of feces if frequently increased with small bowel diarrhea, not large. Tenesmus (straining during a bowel movement) is common with large bowel diarrhea, not small. Weight loss is common with small bowel diarrhea, not large

In geriatric dogs and cats, which of the following would be the best site to prepare for a bone marrow aspirate? (A) Hematochezia occurs with large bowel diarrhea (B) Tenesmus is common with small bowel diarrhea (C) Melena is seen with large bowel diarrhea (D) Weight loss is common with large bowel diarrhea (E) Mucus in feces is common with small bowel diarrhea

Answer is B: The wing of the ilium would be the best choice of those listed. In geriatric patients, bone marrow is more active in flat bones than in long bones. The ribs and sternebrae are not frequently used in small animal patients. Bone marrow aspirates are performed using aspectic technique under heavy sedation or anesthesia with good analgesia and local anesthetic.

In geriatric dogs and cats, which of the following would be the best site to prepare for a bone marrow aspirate?: (A) Trochanteric fossa of the femur (B) Wing of the ilium (C) Greater tubercle of proximal humerus (D) Caudal sternebrae (E) Eighth rib

Answer is A: The primary way synovial involvement is determined is to aseptically distend the joint of interest with sterile fluid at a site distant from the wound. If fluid is seen leaking out of the wound, the joint is definitively involved/communicates with the wound. In some cases (i.e., especially chronic cases or with puncture wounds that might have sealed over quickly), fluid may not leak out of the joint, in which case cytology of aspirated joint fluid can be useful in determining joint involvement. Ultrasonography and contrast radiography can be helpful in challenging cases. Synovial involvement necessitates a different level of care and a more aggressive approach to wound management.

In horses, what is the most common way to determine whether or not a synovial structure is involved with a wound? (A) Leakage of fluid from wound when joint is aseptically distended (B) Ultrasonography (C) Visualization of interior aspect of joint through wound margins (D) Contrast radiography (E) Visualization of bacteria in synovial fluid aspirated from the joint of interest

Answer is A: Sheep cycle in cold weather (winter) and horses cycle in warm weather (Spring-summer). Horses have an 11 MONTH gestation, so if they get bred in June this year, they foal in May NEXT year. Sheep have a 5 MONTH gestation, so if they get bred in November this year, they lamb in March NEXT year. Basic questions on estrus cycle and gestation come up over and over, so commit them to memory for the major animal types at LEAST (Cow, Horse, Dog, Cat, Sheep/Goat, Pig). Merck has two excellent tables: Click Here for an estrus cycles table, most animals. Click Here for a gestation table, most animals.

In temperate North America, one animal is seasonally polyestrous (multiple estrus cycles) in the winter when the weather is COLD and the other animal is seasonally polyestrous in the spring and summer when weather is WARM. Both give birth in the Spring. Which animals are these? (A) Sheep, Horse (B) Sheep, Cat (C) Cow, Pig (D) Dog, Horse (E) Cow, Goat

Answer is B: This is the basic equation to calculate rehydration volume in a dehydrated animal. In calculating fluid therapy for a dehydrated animal, you must determine what fluids the animal needs to return to a normal fluid balance. Multiplying the body weight by dehydration % and then by 1000 will give you replacement fluid needed in ml. This figure combined with the normal losses of fluids through urine, feces, and respiration will give the total fluids needed. Percentage of dehydration can be roughly determined by assessing physical parameters such as skin turgor, capillary response time and dryness of mucus membranes.

In the equation body weight [kg] X % ? X 1000= ? ml What fills in the blank and what is being measured? (A) % of medication per hour, intravenous drip rate (B) % dehydration, fluids needed to rehydrate (C) % volume of fluid output, sensible losses (D) % calories in, vitamin dosage

Answer is C: The most common sites for venous access in cats include the medial saphenous vein, the femoral vein, and the cephalic vein. The most common sites for venous access in dogs include the cephalic and lateral saphenous veins. The jugular vein also can be used to collect blood or to place an IV catheter. The most common site for venous access in horses and cattle is the jugular vein. The cephalic and lateral thoracic veins may be also be used in horses. The coccygeal (tail) and auricular veins may also be used in cattle. It is strongly advised not to use the subcutaneous abdominal (milk) vein in cattle, as thrombosis could be career- and life-threatening in cattle. In pigs, the marginal ear veins and anterior vena cava/caudal jugular vein can be used.

In which animal is the medial saphenous vein often used for venipuncture? (A) Pigs (B) Cattle (C) Cats (D) Dogs (E) Horses

Answer is B: A minimally acceptable blood pressure is recommended in patients with ongoing hemorrhage. Aggressive fluid therapy and increased blood pressure in these patients may dislodge a blood clot, exacerbate hemorrhage, or worsen the situation. Blood pressure should typically be maintained within a specific range in order to perfuse tissues adequately. This is a range of 80-100 mmHg mean or 110-140 mmHg for systolic pressure. Ref: Bassert and Thomas, McCurnin's Clinical Textbook for Veterinary Technicians, 8th edition, p. 893.

In which clinical situation is the minimally acceptable blood pressure lower than normal (i.e., 60-70 mmHg mean rather than 80-100 mmHg mean)? (A) Acute renal failure (B) Ongoing hemorrhage (C) Septic shock (D) Gastric dilation and volvulus (E) Dystocia

Answer is B: Jugular venipuncture is often performed in the lower third of the neck in camelids. Jugular venipuncture can only be performed in the upper or lower third of the neck. Inadvertent carotid puncture is less likely in the upper site, but the skin is thicker. The lower site is located by identifying the transverse process of the sixth cervical vertebrae. The upper site is located by drawing two imaginary lines - one along the ventral border of the mandible and one dropping down from the caudal aspect of the ear. The site for venipuncture is where these two lines intersect. Fluid ballottement within the jugular vein can help in either site. Jugular venipuncture is difficult in camelids. It is not possible to see the jugular vein in adults, the overlying skin is very thick (up to 1 cm), they often have long fiber that owners do not want clipped, and the cervical vertebrae have transverse processes that overlie the jugular furrow.

In which large animal is jugular venipuncture routinely performed in the lower third of the neck? (A) Cows (B) Camelids (C) Horses (D) Goats (E) Sheep

Answer is C: The transverse facial vein is easily located in horses and venipuncture at this site is typically well tolerated. The site can be identified by placing the thumb at the medial canthus of the eye and the index finger at the lateral canthus. The site for puncture is at the point of a V drawn between these two lines where they intersect just dorsal to the facial crest. This site is particularly useful in hospitalized horses who are having blood drawn frequently. Caution is necessary to minimize the risk of puncturing the eye when using needles in this location.

In which large animal is the transverse facial vein used for aspiration of relatively small amounts of blood? (A) Goats (B) Cattle (C) Horse (D) Camelids (E) Cattle

Answer is C: Pulling blood from a lethargic, diabetic cat. Winged catheters (also known as butterfly catheters) are most appropriate for pulling blood or administering nonirritating substances to quiet patients. Seizing animals are moving too much to make this catheter use practical. They are not appropriate for long-term IV fluid administration. Phenylbutazone is very irritating perivascularly. Alpacas have very thick skin and neck musculature, and IV access often necessitates a cutdown. A winged catheter would be an inappropriate choice for this species.

In which of the following scenarios would the use of a winged (butterfly) catheter be appropriate? (A) Administering isotonic crystalloids as a constant rate infusion (B) Pulling blood from an alpaca (C) Pulling blood from a lethargic, diabetic cat (D) Administering diazepam to a seizing dog (E) Administering phenylbutazone to a 14-day-old foal

Answer is C: Patients with underlying respiratory disorders might have impaired ventilation because the additional intra-abdominal fluid during the procedure can put pressure on the diaphragm.

In which small animals patients might ventilation be especially impaired when performing diagnostic peritoneal lavage? (A) Patients with cardiovascular disease (B) Patients with hepatic disease (C) Patients with respiratory disorders (D) Young patients (E) Elderly patients

Answer is D: A facilitative incision is particularly helpful in patients that are severely dehydrated or have very thick skin. It is a small cut into the skin to decrease skin tension and friction against the catheter as it is placed. This is similar to a cutdown performed with a #15 blade or a large-bore needle in cattle and camelids due to their thick skin.

In which type of patients is a facilitative incision particularly helpful before placing an IV catheter? (A) Very small patients (less than 10 pounds) (B) Patients having long-term catheters placed (C) Fractious patients (D) Dehydrated patients (E) Young patients

Answer is B: Glaucoma is characterized by intraocular pressure.

Increased intraocular pressure is associated with which one of the following conditions? (A) Corneal ulcer (B) Glaucoma (C) Entropion (D) Cherry eye

Answer is C: Punishment-based negative reinforcement may INCREASE fear and anxiety in cats and make aggression among cats WORSE. Treatment can include all of the other choices. Examples of anxiolytic medication include- Tricyclic antidepressants (TCAs) such as amitriptyline or clomipramine Selective serotonin reuptake inhibitors (SSRIs) such as fluoxetine or paroxetine (for the aggressor) or Benzodiazepines such as diazepam, which can help some timid cats that are victims of aggression. Some medications may take up to 1-2 months to reach therapeutic levels. Treatment for up to a year or more is often necessary.

Inter-cat aggression in a multiple cat household can be treated with all of the following approaches EXCEPT? (A) Put a bell on the most aggressive of the cats (B) Anxiolytic medication (C) Punishment-based negative reinforcement (D) Desensitization (E) Providing more 3-dimensional space

Answer is B: Different kittens in the same litter can have different fathers. Cats are induced ovulators. Copulation stimulates the vagina and cervix, triggering an LH surge and ovulation. In cats, estrus can last 6-7 days, during which they may mate with DIFFERENT males, yielding offspring that look very different from one another Basic questions on estrus cycle and gestation come up over and over, so commit them to memory for the major animals at LEAST (Cow, Horse, Dog, Cat, Sheep/Goat, Pig). Merck has two excellent tables: Click Here for an estrus cycles table, most animals. Click Here for a gestation table, most animals.

It's been a long Saturday at your clinic in Fremitus, Wisconsin, when little Jimmy Placentome brings you a litter of kittens. Jimmy is an earnest 10-year old boy who likes to take in stray animals because someday he wants to be a veterinary technician like you. In the box you see a tortoiseshell queen nursing a diverse menagerie of kittens: there are two brindle shorthairs, a long-haired Siamese-ish one, a midnight black longhair and a gray domestic shorthair kitten with his mother's eyes. Jimmy looks up at you with hero worship in his eyes, and says, "The daddy cat at our house has short hair and he's all gray. How come these kittens are all different colors and some of them have long hair?" While his mother, who knows a bit about the birds and the bees, is giving you a steely glare, you answer "......." (A) Some of the different colors are recessive (B) Kittens in the same litter can have different daddies (C) Some of those kittens are adopted (D) Those kittens look like their grandparents

Answer is D: Lice. This clinical presentation is consistent with a blood-sucking louse infestation (Linognathus vituli, the long-nosed cattle louse). There are chewing lice (e.g., Damalinia bovis) and blood-sucking lice. Different lice have different site predilections on the host and tend to affect different age groups of cattle. For all types, stressors (e.g., health problems, high stocking density, poor feed quality, gestational status) contribute to susceptibility and degree of infestation. In addition to the clinical signs discussed in this case, pediculosis can cause damage to the hide and hair. L. vituli can act as a mechanical vector for Anaplasma marginale, the cause of bovine anaplasmosis. Rx: Pour-on (for biting and blood-sucking lice) or injectable (for blood-sucking lice) formulations of pyrethroids, macrocyclic lactones, or organophosphates. It is also important to effectively disinfect the premises.

Many cows in a dairy herd have lost weight and show poor milk production. Examination of the withers, shoulders, and dewlap of affected cattle reveal the following findings (see below). What is the presumptive diagnosis? (A) Argasid ticks (B) Chorioptic mange mites (C) Trombiculid mites (chiggers) (D) Lice (E) Culicoides spp. (biting midges)

Answer is A: C. pseudotuberculosis commonly causes lymph node abscessation of this type in small ruminants and the disorder is called caseous lymphadenitis (CL). CL is highly contagious and the organism can live in the soil for up to 8 months. Affected animals should be culled. Treatment, when employed, involves abscess management (lancing, draining, flushing) and long-term antimicrobial therapy.

Many dairy goats in a herd have abscessed lymph nodes that, when incised by the veterinarian, have thick capsules and dry, green-white material at the core. What is the most likely infection that the veterinarian will address in this herd? (A) Corynebacterium pseudotuberculosis (B) Bovine leucosis virus (C) Bacillus anthracis (D) Caprine arthritis encephalitis virus (E) Scrapie

Answer is A: There is no cure for equine infectious anemia (EIA). Horses with EIA must be euthanized or isolated for life. Euthanasia rules depend on State, provincial or federal regulations.

Most horses with equine infectious anemia (EIA) are euthanized. What should be done with an EIA-infected horse if the owner does not want to euthanize? (A) Isolate for life (B) Isolate till the end of treatment (C) Treat with anti-inflamatories (D) Treat with antibiotics

Answer is C: The physiologic process that results in the perception of pain is nociception. Nociception includes: 1) the initial reception and transduction of a painful stimulus by specialized afferent nerve endings called nociceptors 2) transmission via sensory nerves to the spinal cord 3) processing or modulation of the signal in the spinal cord 4) projection to the thalamus and cortex of the brain, where the signal(s) are integrated, resulting in 5) perception. The response to nociception is both physiologic and behavorial, and can be involuntary or voluntary. For example, tachycardia, reflex withdrawal of a limb, vocalization, moving away or hiding are all responses to painful stimuli. Note: some sources omit "projection", or call it "central transmission" of pain signals.

Nociception is correctly defined by which of the following choices? (A) Transduction of pain stimuli by nociceptors (B) Transmission of information from pain receptors to the brain (C) The physiologic process that results in the perception of pain (D) Perception of painful sensations processed by peripheral nerve endings

Answer is C: The Baermann sedimentation technique is the best method to identify the presence of lungworms in a fecal sample. Larval stages of Dictyocaulus spp, or lungworms are coughed up and swallowed, so they will be present in feces. Large samples of feces are wrapped in gauze, suspended in water and left undisturbed for a few hours. Use of a funnel enables simultaneous collection of the sample to be examined. Lungworm larvae will swim out into the fluid and settle to the bottom, where they can be examined.

Of the following diagnostic techniques listed, which one is the best method to diagnose Dictyocaulus infection in cattle and sheep? (A) Zinc centrifugation (B) Buffy coat evaluation (C) Baermann sedimentation (D) Microscopic examination of a fecal smear (E) Fecal culture of larvae

Answer is A: Omentopexy is fixation of the omentum.

Omentopexy is (A) Fixation of the omentum (B) Transplanting an omentum from one animal to another (C) Removal of the omentum (D) Suturing of a ruptured omentum

Answer is B: The maximum blood collection volume calculated for blood donors of any animals should be based on the lean body weight. The recommended maximum volume for horses and dogs is 20% blood volume. The recommended maximum volume for cats is 11-15 ml/kg. If 20% the blood volume is collected, volume replacement should be performed with 20-40 ml/kg of isotonic crystalloid fluids IV. Donors should have their mucous membrane color, heart rate, respiratory rate, and demeanor monitored during blood donation.

On what basis is the maximum blood collection volume calculated for blood donors of any animal? (A) Age of the patient (B) Lean body weight (C) Body condition score (D) Scale reading (E) PCV

Answer is C: Aspiration pneumonia can develop when the feeding tube is improperly placed into the trachea or when excessive volume is given at a one time.

Orphaned neonatal puppies and kittens sometimes must be tube fed. Which one of the following problems is the greatest risk when feeding neonates with a nasogastric tube? (A) Constipation (B) Malnutrition (C) Pneumonia (D) Hyperthermia

Answer is D: Pediculosis is infestation by lice

Pediculosis is correctly described by which one of the following choices? (A) Invasion of fly larvae (B) Infection of a dog's paw (C) Colonization with protozoa (D) Infestation with lice

Answer is B: Evaluation of both the motility and morphology of sperm cells is an important part of the fertility exam of the male and is virtually the same in all animals. By convention, 37°C (98.6°F), the normal temperature of humans, is used. Sperm are quite sensitive to cold and pH and do not move normally when these change. All equipment and samples must be kept warm to keep the cells viable and to be sure their motility can be correctly evaluated. To examine motility, a drop of undiluted semen is examined directly with microscopy at 40X power. The percent of cells that move progressively across the slide is estimated. If too many cells are present to evaluate motility accurately, a drop of sample can be diluted with a drop of fresh, warm saline. Morphology is examined with a dark stain added to a drop of semen using a higher power, the 100X objective. 100 sperm cells are evaluated and the number with normal morphology is reported. Click for links to a complete discussion of breeding soundness/fertility in dogs and stallions.

Please select one of the following choices that correctly fills in the blanks of the following sentence: During evaluation of male fertility, semen samples should be kept ______ to prevent ________. (A) At 0°C, heat shock (B) At 37°C, cold shock (C) In 5% saline, loss of motility (D) In distilled water, loss of motility

Answer is C: Sinus arrhythmia is related to breathing. It is normal in dogs and horses and abnormal in cats. Heart and pulse rates increase slightly with inspiration and decrease slightly with expiration with sinus arrhythmia.

Sinus arrhythmia is (A) Abnormal in dogs, cats, horses (B) Normal in cats, dogs, and horses (C) Normal in dogs and horse, abnormal in cats (D) Normal in cats and horse, abnormal in dogs

Answer is B: Sinus arrhythmia is related to breathing. It is normal in dogs and horses and abnormal in cats. Heart and pulse rates increase slightly with inspiration and decrease slightly with expiration with sinus arrhythmia.

Sinus arrhythmia is characterized by.. (A) Irregular heart rate seen with sinus congestion (B) Heart rate increases with inhalation, slows with exhalation (C) Nystagmus rates decrease with inspiration (D) Arrhythmic heartbeat depresses respiratory rate and pulse rates

Answer is A: Sinus arrhythmia is related to breathing. It is normal in dogs and horses and abnormal in cats. Heart and pulse rates increase slightly with inspiration and decrease slightly with expiration with sinus arrhythmia.

Sinus arrhythmia is characterized by... (A) Heart rate increases with inspiration, decreases with expiration (B) Heart rates are the same as pulse rates, except during sinus congestion (C) Arrhythmic heartbeat depresses respiratory rate and pulse rate (D) Nystagmus rates decrease with inspiration

Answer is C: Flea bite hypersensitivity or flea allergy dermatitis. With the hint that the other dogs in the household don't seem to have any skin problems, an uncomplicated flea infestation is less likely. Based on the location, the lesions are most likely due to flea bite hypersensitivity. Fleas may not be found as easily because a small number of fleas can cause the clinical signs.

The 5-year-old Labrador Mix shown below is suffering from intermittent severe pruritus during the warmer seasons of the year. The other 2 dogs in the house don't seem to show any clinical signs. The affected skin is alopecic, erythematous, and edematous, with some excoriations. The lesions are found on both hind legs, the tail base and the caudo-dorsal area. Which one of the following choices is this dog most likely suffering from? (A) Food allergy (B) Mosquito bite allergy (C) Flea bite hypersensitivity (D) Ctenocephalides canis infestation (E) Atopic dermatitis

Answer is C: Kimzey Leg Saver splints (Kimzey, Inc., Woodland, CA) are designed for distal limb (i.e., distal to the distal metacarpus or metatarsus) fractures, fetlock luxation, and suspensory apparatus breakdown injuries. The goal is to align the boney column of the distal limb. The splint is applied over a modified Robert-Jones bandage.

The Kimzey Leg Saver® splint is most appropriate for which type of fractures in horses? (A) Elbow (B) Radial (C) Distal limb (D) Femoral or humeral (E) Pelvic

Answer is B: The metabolic requirements of severely burned animals can increase substantially, so multiply BER by 2. Extraparental nutritional support, like feeding tubes and IV feeding may be needed to provide adequate nutrition when an animal may be unwilling or unable to take in as many calories as they need. Nutrition requirements also vary with different life stages for companion animals.

The basic energy requirement (BER) for an animal is the amount of calories it needs daily to live. This amount can change with changes in the animal's health status. When treating an animal with 3rd degree burns, what changes are needed in the BER to ensure proper nutrition? (A) Divide BER by 0.3 (B) Multiply BER by 2 (C) Add 50% to BER (D) Add 25% to BER

Answer is B: The most convenient location for taking the pulse of a horse is to place two or three fingers over the facial artery, in the notch of the mandible (lower jaw) just in front of the masseter (cheek) muscle. Click here to see a to see a video of a vet taking a horse's pulse. Click here to see a Table of normal heart-rates of different animals Table of normal respiration-rates of different animals.

The best place to take a horse's pulse is to place your fingers over which one of the following structures? (A) Carpus (B) Facial artery (C) Heart (D) Jugular vein (E) Vena Cava

Answer is B: This is ventricular tachycardia. Generally treated with a lidocaine drip and diazepam (Valium ®) or methocarbamol to address hyperactivity/seizures. This is a classic presentation of severe chocolate toxicity, due to toxic methylxanthine alkaloids (ie: theobromine, theophylline, caffeine). Common after Halloween, Christmas and Valentine's Day holidays, see EXCITEMENT, SEIZURES, ARRHYTHMIAS. The seizure and ECG which shows ventricular tachycardia (V-tach) are the key pieces of information here. Most chocolate toxicities are milder- hyperactivity, vomiting, urinating, diarrhea. If seen in first hour BEFORE signs occur, (and dog not seizing), induce vomiting with Apomorphine (0.03 mg/kg IV), Ipecac (1-2 ml/kg PO) or hydrogen peroxide (1-5ml/kg PO). If animal is sedated because of seizures, consider gastric lavage. If vomiting is controlled, give activated charcoal to decrease absorption of toxic alkaloids and an osmotic cathartic like Na-sulfate (1g/kg PO) to promote elimination. Chocolate toxicity from most toxic to least toxic: Cacao beans and baking chocolate are worse than semisweet chocolate which is worse than milk chocolate. 49 grams of baking chocolate (one 2 oz bar) can kill a 7 kg dog. It would take 420 grams of milk chocolate (about 8, 2 oz bars) bars to kill a 7 kg dog.

The day after Halloween, an obese Schnauzer is presented with a combination of vomiting, urinary accidents and diarrhea. On physical exam, muscle rigidity and telltale chocolate bar wrappers coming out in the diarrhea are noted. The dog has a seizure on the exam table. An ECG looks like the one below. What is the predominant pattern on this ECG? (A) Atrial fibrillation (B) Ventricular tachycardia (C) Third degree heart block (D) Asystole (E) Sick sinus syndrome

Answer is B: NAVEL equals Naloxone, Atropine, Vasopressin, Epinephrine, and Lidocaine. These are emergency drugs that can be given IT. A higher dosage is used IT compared to the usual intravenous dose. The drug should be diluted into a volume of sterile water when it is given via an endotracheal tube. Vasopressin and epinephrine are potent vasoconstrictors that promote redistribution of blood back to the heart. Naloxone is used to reverse opioid medication. Atropine is for bradycardia, and lidocaine is for ventricular tachycardia. Download a free issue of the Journal of Vet Emergency and Critical Care with CPCR guidelines for animals.

The intratracheal (IT) route of administration of medication is sometimes used in emergencies and during cardiopulmonary cerebral resuscitation in small patients and when an intravenous catheter is not available. However, not all drugs are safe to give via the trachea. "NAVEL" is an acronym that corresponds to five emergency drugs that may be given IT. Which of the following is the correct meaning of NAVEL in this regard? (A) Nifedipine, amphotericin B, vancomycin, enrofloxacin (B) Naloxone, atropine, vasopressin, epinephrine, lidocaine (C) Neomycin, amoxicillin, vincristine, etomidate, (D) Neostigmine, atipamezole, verapamil, enalapril, lisinopril

Answer is A: Adult parasites live and reproduce within the definitive host, while the immature, asexual stages of a parasite's life cycle live in the intermediate host. For example, the life cycle of the heartworm, Dirofilaria immitis, involves the adult stage and 3 larval stages. The adult parasite lives and reproduces in the heart and pulmonary vessels of dogs (the definitive host). Here they produce the first larval stage, called microfilaria (= eggs in other parasites). During feeding on an infected dog, microfilaria are picked up by mosquitoes (intermediate host), where they must live to continue development of the larvae (immature parasites). The infective third stage larvae move to the mouthparts of the mosquito where they can be transmitted to another dog

The life cycle of many parasites involves multiple hosts and various immature stages. Please fill in the blanks using one the of the following choices that correctly describes the basic relationship between hosts and the different stages within the parasite life cycle. A(n) _______ host has ________ parasites, while a(n) ______ host has ______ parasites. (A) definitive, adult, intermediate, immature (B) definitive, immature, intermediate, adult (C) immature, intermediate, adult, definitive (D) adult, definitive, immature, intermediate

Answer is C: Conjunctivitis is inflammation of the tissues around the eyes. Look for reddening and swelling. Conjunctivitis can be caused by irritants or infections. Follow this link to see conjunctivitis in a cat.

The veterinarian assigns you a dog with a case of conjunctivitis. What is the health problem? (A) Inner ear infection (B) Sinus infection (C) Inflamed eyes (D) Epiglottal inflammation

Answer is A: Advanced Life Support (ALS) involves the administration of medical therapies to patients in cardiac arrest. Epinephrine and/or vasopressin are given to produce peripheral vasoconstriction that will promote blood flow back to the heart, lungs, and brain. Reversal agents such as naloxone or atipamezole should be administered to those with opioids or alpha2 agonists on board. Medical issues such as hypoglycemia or hypokalemia are identified and treated. Cardiac compressions and ventilation that were started during the initial phase of CPCR, called basic life support, should be continued throughout the resuscitation attempt. Click here to download a free issue of the Journal of Vet Emergency and Critical Care with CPCR guidelines for animals.

The protocol for cardiopulmonary cerebral resuscitation (CPCR) is divided into 2 major components - Basic Life Support (BLS) that is initiated immediately, and Advanced Life Support (ALS) that follows. Which of the following correctly describes the major elements of Advanced Life Support? (A) Administration of vasopressors and other medical therapy (B) Needling of the GV acupuncture point to stimulate respiration (C) Endotracheal intubation and ventilation with 100% oxygen (D) Cardiac compressions at 120 times/minute

Answer is C: A complete physical exam, thorough history, and minimum database are the main components of a secondary survey in a critical patient. Any required emergency therapy is performed during or after the primary survey but before the secondary and more detailed examination. The secondary phase is where more thorough diagnostics and therapy are instituted. The primary survey is also called triage - it helps determine how critical emergent patients are and identifies the need for resuscitation

The protocol for initial evaluation of critical care patients includes a primary survey (triage), needed emergency therapy, and then a secondary survey. Which of the following most correctly describes the components of an appropriate secondary survey in an emergent patient? (A) Neurologic exam, lactate and arterial blood gas analysis, thoracic and abdominal radiographs (B) Vital signs, blood pressure, hematocrit, and total solids (C) Complete physical exam, thorough history, minimum clin path database (D) Emergency therapy, cardiopulmonary evaluation, assessment of consciousness/pain

Answer is A: A cria is a neonatal or very young camelid. Camelids of the Americas include the llama, alpaca, guanaco, and vicuna.

The term, "cria", is correctly described by which one of the following choices? (A) A neonatal or very young camelid (B) A young or juvenile buffalo (C) An early elephant fetus (D) A stage in the development of an embryo

Answer is A: Some people can smell acetone (like juicy fruit gum) on the breath of a cow with ketosis. Cows with ketosis are usually off-feed and depressed. Ketosis is a poorly understood metabolic/nutritional problem that occurs when high-producing dairy cows are using up more nutritional energy to make milk than they take in from eating. As their bodies try to adapt by burning fat, ketones build up in the bloodstream and make the cow sick. Common in cows who have just given birth, and in cows at peak lactation.

The vet is called to examine a high-producing dairy cow who is off-feed and depressed. As she examines the cow, she smells the cow's breath. What is the vet checking for? (A) Acetone/fruity odor (B) Infection/necrotic odor (C) Metallic/blood smell (D) Bad breath/halitosis (E) Bad breath/halitosisGrassy smell

Answer is D: A proptosis means "popping out or protruding". The most common emergency proptosis you will see in practice is a ocular proptosis (sometimes called an eye prolapse, too). Follow these links to see a proptosed eye in a dog and a severely proptosed eye in another dog. When the penis cannot retract into the prepuce, the problem is called paraphimosis.

The vet says you have a dog with a traumatic proptosis coming in on emergency. What kind of problem is this likely to be? (A) Penis cannot retract into prepuce (B) Acute glaucoma (C) Punctured eye (D) Eyeball popped out of socket

Answer is D: 94ºF; 96ºF (34.4ºC, 35.6ºC). Hypothermia is a serious condition in neonatal puppies and kittens because they have very little subcutaneous body fat to keep them warm. They also lose more heat due to an increased ratio of body surface area-to-body mass and they cannot yet shiver. Hypothermia leads to decreased gastrointestinal motility, which can lead to regurgitation, aspiration pneumonia, bloat, cardiovascular collapse, and death. Neonatal puppies and kittens are considered hypothermic if the temperature is less than 94ºF (34.4ºC) at birth, less than 96ºF (35.6ºC) at 3 days of age, and less than 99ºF (37.2ºC) at 1 week of age. Treatment involves slow warming (approximately 2ºF (4.2ºC)/hour) with careful and attentive use of heating pads, incubators, and other warming devices. Oxygen should be supplied if possible. Food should not be given until the patient has audible gastrointestinal borborygmi and is partially rewarmed.

Under what body temperatures are newborn and 3-day-old puppies considered hypothermic? (A) 96ºF; 99ºF (36.7ºC, 37.2ºC) (B) 92ºF; 97ºF (33.3ºC, 36.1ºC) (C) 99ºF; 100ºF (37.2ºC, 37.8ºC) (D) 94ºF; 96ºF (34.4ºC, 35.6ºC) (E) 93ºF; 98ºF (33.9ºC, 36.7ºC)

Answer is A: Candida albicans is a normal member of the flora of the digestive system of many animals. Disease develops from Candida albicans usually only when the normal flora is disrupted by the presence of another pathogen or from prolonged antibiotic therapy, and when immunosuppression occurs.

Under which one of the following circumstances does Candida albicans cause disease? (A) Another pathogen is present (B) Overcrowding of animals occurs (C) Feed is contaminated with Candida (D) Owner takes fomites containing Candida home

Answer is B: Insensible losses are the fluids the animal loses that are hard to measure, like through vomiting, diarrhea and breathing. In humans and animals that sweat (like horses) sweating is part of insensible losses. Sensible losses are losses you can easily measure, like the fluids the animal loses by urination. Different sources categorize fluid losses due to other reasons (like vomiting, wounds, diarrhea) by different names. The important thing to remember is that these are also ways an animal can become dehydrated, and should be accounted for. In dealing with a dehydrated animal, both types of losses must be accounted for when calculating fluids needed to rehydrate.

What are insensible losses in fluid therapy? (A) Fluids given minus 10% body weight (B) Diarrhea and vomit (C) Urine (D) 25% of body weight

Answer is B: Ongoing losses are typically vomiting, diarrhea or other losses into a third compartment (pleura, abdomen etc). These are sometimes called "contemporary" losses. A classic example of a disease with significant ongoing losses is a puppy with parvovirus who has both diarrhea and vomiting. Sensible losses are easily measured, like the fluids the animal loses by urination. Insensible losses are the fluids an animal loses that are hard to measure, through breathing and via the skin. In humans and animals that sweat (like horses) sweating is part of insensible losses. Remember that all three types of loss must be accounted for (or at least estimated) when calculating fluids needed to rehydrate a dehydrated animal.

What are ongoing losses in fluid therapy? (A) Urine output (B) Vomit and diarrhea (C) The tears I shed when I can't make sense of fluid calculations (D) Fluids given minus extracellular volume estimate (E) Percent dehydration multiplied by body weight

Answer is C: TPN is Total Parenteral Nutrition, which is giving all the nutrition an animal needs through a route other than the mouth. (ie: through a nasogastric tube, or a gastrostomy tube). Animals suffering from severe anorexia may be fed this way.

What does the acronym TPN mean stand for in veterinary medicine? (A) Temporary Patient Number (B) Temporal Parietal Nodule (C) Total Parenteral Nutrition (D) Triple Phosphate Neomycin (E) Titrated Pediatric Nephrosis

Answer is D: Sensible losses are losses you can easy to measure (ie: "they make sense"), like the fluids the animal loses by urination. Insensible losses are the fluids the animal loses that are hard to measure, like through vomiting, diarrhea and breathing. In humans and animals that sweat (like horses) sweating is part of insensible losses. Different sources categorize fluid losses due to other reasons (like vomiting, wounds, diarrhea) by different names. The important thing to remember is that these are also ways an animal can become dehydrated, and should be accounted for. In dealing with a dehyrated animal, both types of losses must be accounted for when calculating fluids needed to rehydrate.

What are sensible losses in fluid therapy? (A) Volume of any diarrhea and vomit (B) Fluids given minus urine output (C) 25% of body weight (D) Roughly equal to urine output

Answer is B: Generally, most captive species should be maintained at 75-90ºF (24-32ºC) and 50-70% humidity. Reptiles are poikilotherms and therefore depend on the external environment to regulate their body temperatures. Ideally a temperature gradient should exist in the habitat, with warmer and cooler ends. Each species is unique, depending on where it originated (i.e., desert vs. jungle). Hospitalized reptiles should typically be maintained at the upper end of their regular temperature gradient to help with recovery.

What are the recommended temperature and humidity ranges for captive reptiles? (A) 85-100ºF (29-38ºC); 55-75% (B) 75-90ºF (24-32ºC); 50-70% (C) 70-95ºF (21-35ºC); 30-50% (D) 80-100ºF (27-38ºC); 60-80% (E) 65-85ºF (18-29ºC); 75-95%

Answer is C: The concurrent administration of calcium-containing fluids and blood can lead to activation of the coagulation cascade.

What can happen if blood is administered at the same time as calcium-containing IV fluids such as lactated Ringer's solution (LRS)? (A) Nothing; this is the recommended fluid to concurrently administer (B) Cardiac arrhythmias (C) Activation of coagulation cascade (D) Urticaria (E) Hemolysis

Answer is D: The fetus induces parturition in cattle. Hormones produced by the fetal pituitary start the process of birthing.

What induces parturition in cows? (A) Length of pregnancy (B) Calf size (C) Mother (D) Fetus (E) The stork, of course

Answer is E: Heat stress is very common in camelids because they are not accustomed to the weather often encountered in the United States and they typically have long fiber that traps heat. Clinical signs of heat stress include increased respiratory rate with nasal flare or open-mouthed breathing, drooling, depression, anorexia, scrotal swelling, weakness, and trembling with high temperatures and heart rates. Heat stress can be prevented by making sure there is access to shade, water, small pools, shearing before the hot season when possible, and minimizing stressful interactions during heat. Treatment includes cooling the animal with water, alcohol, and a fan. Supportive care including some combination of IV fluids and electrolytes, water flotation tanks, and good nursing care is essential.

What common condition in camelids leads to scrotal swelling in intact males? (A) Parelaphostrongylus tenuis infection (B) Peritonitis (C) Scrotal hematocele (D) Scrotal hematoceleHyperlipemia (E) Heat stress

Answer is E: This dog has ascites, or fluid distention of the abdomen. Ascites can occur due to: right congestive heart failure, liver disease, kidney disease, and hypoproteinemia.

What condition is visible in this image? (A) Anemia (B) Ecchymoses (C) Peripheral edema (D) Mammary cyst (E) Ascites

Answer is A: Acute diarrhea may turn into chronic diarrhea if not treated effectively, which can result in chronic renal failure. Diarrhea is common in neonatal camelids. It can be nutritional, infectious, or multifactorial in nature.

What condition may ultimately develop if diarrhea is not properly treated in neonatal camelids? (A) Chronic renal failure (B) Hepatic lipidosis (C) Peritonitis with adhesions (D) Pericarditis (E) Laminitis

Answer is E: Urolithiasis is common in male small ruminants. It can be prevented by feeding NO grain to these animals. Access to salt or mineral blocks is often recommended to increase water intake. Fresh water should always be available.

What dietary recommendation should be made to owners of male goats to help decrease the risk of urolithiasis? (A) Small ruminant feed at ¼ pound/10 pounds body weight (B) Alfalfa hay is best (C) No salt or mineral blocks (D) No salt or mineral blocksLimit water intake (E) No grain

Answer is A: One thing in avian nutrition that is agreed upon is that all caged birds should have a source of soluble grit (as a cuttle bone or mineral block in smaller or larger birds, respectively). Nutritional problems are very common in avian medicine. Unfortunately little is known about the specific nutritional requirements of each avian species. The current recommendation is to feed a commercially available pelleted diet as a base and supplement with a high-quality seed mixture, vegetables, and fruits. Infant birds especially require the amino acids glycine and proline. Sunflower seeds are often over-fed to pet birds, which can be detrimental because they are high in fat and low in calcium and vitamin A.

What dietary supplement is recommended for all pet birds? (A) Cuttle bone or mineral block (B) Glycine and proline (C) Sunflower seeds (D) Vitamin A (E) Well-balanced seed mixture

Answer is A: Kussmaul breathing typically indicates respiratory compensation for metabolic acidosis. Cheyne-Stokes breathing (i.e., alternating tachypnea and bradypnea) occurs most often as a result of abnormal CO2 regulation associated with increased intracranial pressure. Bradypnea (i.e., decreased respiratory rate) can also be due to increased intracranial pressure. Restrictive breathing (e.g, fast, shallow breaths) typically indicates pleural space disease (e.g, pleural effusion) or rib fractures. Hypoxemia and shock both usually result in tachypnea in the absence of other factors that affect the breathing pattern.

What does a Kussmaul breathing pattern (i.e., slow, deep respiratory pattern) most often indicate? (A) Metabolic acidosis (B) Increased intracranial pressure (C) Pleural effusion (D) Hypoxemia (E) Shock

Answer is E: An emetic causes vomiting (and an anti-emetic stops vomiting). Examples of emetis include apomorhine, xylazine and 3% hydrogen peroxide. Follow this link to see a common emetic drugs and their doses. For example, hydrogen peroxide will make a patient vomit if they drink it and is sometimes used when an animal is suspected of having eaten something toxic in the last 60 minutes.

What does an emetic do? (A) Stops coughing (B) Stops estrus cycle (C) Causes pupils to dilate (D) Causes constipation (E) Causes vomiting

Answer is C: If sweat is seen around the shoulders, it indicates that the mare will enter stage 2 labor and should be Foaling within 30 minutes. This is a very useful timeframe during which the technician can call the vet and prepare for foaling. During stage 1 labor, mares exhibit certain behaviors that indicate that parturition is impending. However, stage 1 labor can last for hours and mares can halt it if they feel threatened. The various behaviors of stage 1 can look like colic - getting up and down, kicking and looking at belly, lifting the tail head, nickering.

What does it indicate if a mare in labor has sweat around her shoulders? (A) This is not indicative of anything (B) Neonatal distress (C) Foaling within 30 minutes (D) Dystocia (E) Colic

Answer is D: A zoonotic disease can be transmitted from animals to people. Because of this danger, many zoonotic diseases are reportable, meaning that if you see a case, you must report it to the state veterinarian. Examples of zoonotic diseases include: Rabies(Wild animals, dogs, cats, people) West Nile Virus (Horses, birds, people) Avian Influenza (Birds, pigs, people) and Bovine spongiform encephalopathy (Mad Cow disease) (Cattle, people) Some zoonotic diseases are also bioterrorism agents, like Anthrax Plague Tularemia and Q fever. Finally, there are some diseases that are not zoonotic, but are still reportable because they can cause huge economic damage like Foot and Mouth disease (FMD) in cattle, Hog Cholera in pigs, or Contagious Equine Metritis (CEM) in horses.

What does it mean if a disease is zoonotic? (A) Insect or tick transmits disease to animals (B) Occurs primarily in zoos (C) Occurs only in zoo animals (D) Animals can transmit disease to people (E) Disease can infect only animals

Answer is A: A convenient way to take the pulse of a horse is to place two or three fingers over the facial artery, in the notch of the mandible just in front of the masseter (cheek) muscle. Click here to see a to see a video of a vet taking a horse's pulse. There are 4 other places on a horse you can take a horse's pulse, but only one is also on the head: -Transverse facial artery (caudal to lateral canthus of the eye) -Median artery (proximal, medial forearm) -Great metatarsal artery (hindlimb, between McIII and McIV) -Digital artery (caudal pastern area, above hoof). Palpate the digital artery to feel the "bounding pulses" of equine laminitis.

What is the clinical importance of the anatomic area indicated by the red arrow in this image? (A) Good place to take a pulse (B) Site of glossopharyngeal nerve block (C) Upper limit of Viborg's triangle (D) Most common site of tooth root abscess (E) Best surgical approach to mandibular sinus

Answer is C: Hypomagnesemia (low blood magnesium) is another name for grass tetany in cattle and sheep. Usually associated with low blood calcium at the same time. Cows or sheep with grass tetany may bellow, gallop in a blind frenzy, fall, walk stifly and exhibit severe paddling convulsions or die suddenly.

What is the common name for hypomagnesemia in lactating cows and sheep? (A) Bone spavin (B) Bloat (C) Grass tetany (D) Milk fever

Answer is B: Pregnancy can be determined at around 2 weeks (14 days) by gentle palpation or ultrasound. The gestation period of the ferret is 41-2 days. Like cats, ferrets are seasonally polyestrous and induced ovulators. If a female ferret in estrus is not bred, she may stay in estrus indefinitely until she is bred, the photoperiod changes to shorter days, or she dies from hyperestrogenism.

What is the earliest time that pregnancy can be reliably determined by palpation in the pregnant ferret? (A) 14 days (B) 21 days (C) 7 days (D) 28 days (E) 10 days

Answer is A: An easy place to reliably find a pulse is the femoral artery, palpated in the middle of the inner thigh. Click here for a chart of pulse rate of common domestic animals

What is the easiest place to take the pulse of a dog or cat? (A) Femoral artery, inner thigh (B) Carotid artery, foreleg (C) Jugular vein, angle of jaw (D) Brachial plexus, armpit

Answer is B: What is the first and easiest way to try to obtain a urine sample from a turtle?

What is the first and easiest way to try to obtain a urine sample from a turtle? (A) Cystocentesis (B) Handle the animal (C) It is not possible (D) Urethral catheterization (E) Cloacal catheterization

Answer is A: The carotid and aortic bodies are chemoreceptor organs that measure changes in the carbon dioxide, oxygen content and pH of the blood. They are sensitive barometers that help to regulate respiration and circulation. Sometimes they develop into tumors. chemoreceptor tumors are called "chemodectomas". It has been suggested that a genetic predisposition aggravated by chronic hypoxia may account for the higher risk of development of carotid and aortic body tumors in certain brachycephalic (pushed in face) breeds.

What is the function of the carotid and aortic bodies? (A) Measure carbon dioxide and oxygen levels (B) Control the amount of adrenaline secreted (C) Transfer oxygen into capillaries (D) Anatomic support for aorta and carotid arteries (E) Unknown

Answer is A: Final concentrations of dextrose should be less than 5% to avoid phlebitis due to hypertonicity. Intravenous or intraosseous dextrose is administered to neonatal puppies and kittens for treatment of hypoglycemia. Routine dosages are 0.5 to 1.0 g/kg as a 5-10% dextrose in normal saline. Dextrose cannot be given subcutaneously because it will damage the tissues. Dextrose can be applied topically to the oral mucous membranes if the patient is not hypothermic or dehydrated.

What is the highest concentration of dextrose that should be administered intravenously or intraosseously to a neonatal puppy or kitten? (A) 5% (B) 5%20% (C) 10% (D) 2.5% (E) 7%

Answer is A: Crystalloids are basically electrolytes in water. Colloids are crystalloids with high molecular weight (MW) polymers added. Because of the high MW, colloids remain in the circulation for several to many hours. Crystalloids are used for resuscitation, replacement, and maintenance fluid therapy. Examples include saline, ringers, lactated ringers, Plasmalyte, etc. Dextrose is often present in addition to electrolytes. Colloids are used for resuscitation in addition to crystalloids and when protein levels are low to improve colloid osmotic pressure and prevent fluid loss out of the circulation and edema. Crystalloids can be hypo-, iso-, or hypertonic in comparison to blood/plasma. Colloids are always isotonic. Dextrose solutions are NOT crystalloids, they are basically just water after the dextrose is metabolized.

What is the main difference between crystalloid and colloid types of intravenous fluids? (A) Crystalloids are electrolytes in water, colloids are crystalloids with high molecular weight polymers added (B) The addition of proteins to a crystalloid makes it a colloid (C) Colloids are albumin and globulins, crystalloids are 5% dextrose and normal saline (D) Crystalloids prevent fluid loss out of the circulation, colloids are used for maintenance fluid therapy

Answer is C: With a circulating blood volume (CBV) of ~15-20 ml, no more than 2.0 ml of blood should be taken from a neonatal puppy weighing 220 grams. No more than 10% of the patient's circulating blood volume should be drawn over the course of a week. Circulating blood volume is about 7%-9% of body weight in most domestic animals, except cats (6.5% CBV). Blood draw volumes should be recorded appropriately in the patient's chart and every effort should be made to draw the minimal amount of blood needed for each procedure or test. It is helpful to note that 1 drop of blood is equal to approximately 0.1 ml and 1 ml weighs ~ 1 gram. The jugular vein is an easily accessible site for venipuncture in these patients.

What is the maximum amount of blood that can safely be drawn from a 220-gram neonatal puppy over the course of one week if the puppy has a circulating blood volume of 15-20 mls? (A) 10.0 mL (B) 20.0 mL (C) 2.0 mL (D) 4.0 mL (E) 1.0 mL

Answer is B: The cannula should only be inserted partially into the teat (up to 4 mm) to minimize the risk of contaminating the udder. Strict sterile technique should also be used. Intramammary infusion is a common way to treat cows with mastitis. Usually the teat end is occluded after infusion and the udder is massaged to facilitate distribution of the medication.

What is the maximum distance the teat cannula should be inserted into an adult dairy cow's udder during intramammary infusion of medication? (A) Less than 2 mm (B) Less than 4 mm (C) Less than 10 mm (D) Less than 8 mm (E) Less than 6 mm

Answer is C: Potassium should never be supplemented IV at a rate over 0.5 mEq/kg/hour. Adverse cardiac effects can occur above this rate.

What is the maximum rate at which potassium can be supplemented IV? (A) 1 mEq/kg/hour (B) 20 mEq/kg/hour (C) 0.5 mEq/kg/hour (D) 2 mEq/kg/hour (E) 10 mEq/kg/hour

Answer is A: Toxic medications (e.g., aminoglycosides, NSAIDs) are the most common cause of acute renal failure in horses. Dehydration and endotoxemia can both exacerbate the renal damage caused by these medications. Leptospirosis can uncommonly cause acute renal failure in horses. Pigmenturia with hemoglobin or myoglobin can cause acute renal failure in horses secondary to hemolytic anemia or an acute myopathy, respectively.

What is the most common cause of acute renal failure in horses? (A) Toxic medications (aminoglycosides, NSAIDs) (B) Leptospirosis (C) Acute Lyme disease (Borrelia burgdorferi infection) (D) Pigmenturia (hemoglobin, myoglobin) (E) Endotoxemia

Answer is A: The most common cause of blindness in horses is recurrent uveitis. The other listed causes can cause blindness but are much less common. Recurrent uveitis (moon blindness) consists of repeated bouts of immune-mediated intraocular inflammation (uveitis). It can be unilateral or bilateral. With chronicity, the eyes develop retinal degeneration, cataracts, and synechiae. Long-term management is typically required. The inciting cause is usually unknown, though Leptospiral infection has been implicated in some cases.

What is the most common cause of blindness in horses? (A) Recurrent uveitis (B) Glaucoma (C) Head trauma (D) Pituitary pars intermedia dysfunction (E) Congenital cataracts

Answer is D: The most common cause of nonobstructive feline lower urinary tract disease (FLUTD) is feline idiopathic cystitis (FIC). FIC can be obstructive or non-obstructive; about 15-20% of cases of FIC are obstructive. FIC is a diagnosis of exclusion. Other differential diagnoses for FLUTD include urolithiasis, urethral plugs, behavioral disorders, anatomic urinary tract defects, urinary tract infection, and bladder neoplasia.

What is the most common cause of feline lower urinary tract disease? (A) Chronic renal disease (B) Urethral plugs (C) Uroliths (D) Idiopathic cystitis (E) Electrolyte imbalances

Answer is A: Atrial fibrillation is the most common clinically relevant cardiac arrhythmia in horses. The rhythm sounds irregularly irregular and the ECG shows fibrillation waves (f-waves) instead of p-waves. Horses are particularly predisposed to atrial fibrillation because of their large atria and high vagal tone. Atrial fibrillation may be an incidental finding in retired horses but presentation is often for exercise intolerance or poor performance. Treatment in horses without underlying cardiac disease includes oral, intravenous, or electrical conversion therapy. Second-degree atrioventricular (AV) block is very common in healthy, athletic horses and is not usually clinically significant. The rhythm sounds regularly irregular and should return to a normal sinus rhythm with exercise. Horses are particularly predisposed to second-degree AV block because of their high vagal tone.

What is the most common clinically relevant cardiac arrhythmia in horses? (A) Atrial fibrillation (B) Second-degree atrioventricular block (C) Ventricular premature complexes (D) Sick sinus syndrome (E) Sinus arrhythmia

Answer is D: Subcutaneous injection results in rapid absorption of most injectables in small animals. Absorption is delayed in obese animals. It can be used for vaccines, some antibiotics, and isotonic fluids. Between 50 and 100 mLs of fluid can be injected per site, depending on the size of the patient.

What is the most common route of injection for vaccines in small animals? (A) Intravenous (B) Intradermal (C) Intramuscular (D) Subcutaneous (E) Intranasal

Answer is A: Pinkeye is typically self-limiting but resolution can be hastened by treatment with tetracycline (topical or systemic) in both species. Infectious keratoconjunctivitis is usually caused by Chlamydia psittaci in sheep and Mycoplasma conjunctivae in goats. Animals can have persistent silent infection and serve as carriers for this contagious disease.

What is the most common treatment for pinkeye (infectious keratoconjunctivitis) in sheep and goats? (A) Tetracycline (B) Penicillin (C) Third eyelid flap (D) Tarsorrhaphy (E) Enucleation

Answer is A: Hypertrophic cardiomyopathy is by far the most common type seen in cats. The left ventricular wall increases (hypertrophies) in size and the left ventricular chamber gets smaller. Dilated cardiomyopathy is the most common type seen in dogs. The ventricular chambers enlarge as the ventricular walls stretch (or dilate).

What is the most common type of cardiomyopathy seen in cats? (A) Hypertrophic (B) Dilated (C) Unclassified (D) Restrictive (E) Arrhythmogenic right ventricular

Answer is E: Fever is by far the most common transfusion reaction seen. It is more common with blood that has been stored for a longer time. All of these options are types of transfusion reactions. It is suspected that fever occurs due to accumulation of pyrogenic cytokines and activity of donor leukocytes.

What is the most common type of transfusion reaction seen in veterinary patients? (A) Hemolysis (B) Piloerection (C) Transfusion-related acute lung injury (D) Urticaria (E) Fever

Answer is B: Rotavirus is the most commonly identified cause of diarrhea in foals from 2 days to 5 months (most commonly about 2 to 3 months). It causes osmotic diarrhea by damaging the enterocytes on the tips of the small intestinal villi. Transmission is via the fecal-oral route, and diagnosis is typically made using a commercial immunoassay kit designed for detection of human rotavirus. The virus is extremely contagious, and, since it is non-enveloped, resistant to most disinfectants. Phenolic disinfectants are commonly used. Prevention involves use of an inactivated vaccine in pregnant mares at months 8, 9, and 10 of gestation to maximize passage of protective antirotaviral antibodies in colostrum. Coronavirus is an emerging viral cause of diarrhea in horses of all ages. The other viruses listed as answer options for this question either do not exist or do not cause disease in horses.

What is the most common viral agent of diarrhea in horses and what age group does it typically affect? (A) Panleukopenia, 4-6 months (B) Rotavirus, 2-3 months (C) Equine distemper, 2-4 weeks (D) Parvovirus, 6-8 months (E) Equine viral diarrhea, 1-3 weeks

Answer is B: Fleas do not spend their entire life cycle on the host.

Which is true of fleas? (A) Ctenocephalides canis is the most common species (B) Fleas do not spend their entire life cycle on their hosts. (C) Fleas are more common in cool humid environments (D) Most flea species are very host specific

Answer is B: Orf is zoonotic so gloves should be worn when handling infected animals or the vaccine. Contagious ecthyma (orf) is a common viral cause of ulcerative and proliferative lesions on the udder of ewes and does and around the mouth and nose of their lambs and kids. Orf is typically self-limiting and resolves within 4-6 weeks. When necessary, supportive nursing care and antimicrobials may be given. A vaccine is available for flocks with a herd problem of orf.

What is the most important thing to remember when handling a small ruminant with contagious ecthyma (orf)? (A) Antibiotics must be administered for 4-6 weeks (B) It is zoonotic (C) Affected animals should be culled (D) Area federal veterinarian should be alerted immediately (E) The farm should be quarantined

Answer is D: Transfusion-associated circulatory overload (TACO) is the most significant nonimmune acute reaction to blood transfusions. It is most common when large volumes are given, or the blood is given rapidly, to patients who were not hypovolemic. Patients with cardiac disease and cats are at the highest risk for TACO. Clinical signs include increased respiratory rate and effort, dyspnea, and pulmonary crackles. Tx includes stopping or slowing the transfusion along with a dose of furosemide.

What is the most significant nonimmune acute reaction to blood transfusions? (A) Pruritis (B) Citrate toxicity with ionized hypocalcemia (C) Acute lung injury (D) Transfusion-associated circulatory overload (E) Hemolysis

Answer is E: This cat has icteric (a.k.a. jaundiced or yellow) mucous membranes. Icterus occurs secondary to increased bilirubin levels. Bilirubin can be elevated in cats with hemolysis, liver disease, or biliary obstruction. Hyperemia is characterized by bright red mucous membranes. Petechiations are pinpoint red spots on the mucous membranes from intradermal or submucosal capillary hemorrhages. They occur with platelet abnormalities or vascular diseases. Click here to see a dog with petechiae. Feline odontoclastic resorptive lesions (FORL) are characterized by tooth loss at the cervical neck and bright red gingiva. Click here to see an image of severe FORL. Persistent deciduous teeth ("baby teeth") are not seen in this photo.

What is the name of the problem seen in this cat gums? (A) Feline odontoclastic resorptive lesions (B) Petechiations (C) Persistent deciduous teeth (D) Hyperemia (E) Icterus

Answer is A: The normal host of P. tenuis is the white-tailed deer (who do not develop clinical signs). Camelids and small ruminants are aberrant hosts. It is a common disease in camelids, causing high morbidity and mortality. The larvae of P. tenuis migrate through the spinal cord leading to neurological deficits such as ataxia, paralysis, and stiffness. Signs typically begin caudally and progress cranially. Disease progression is variable and can last days to years. Treatment includes deworming, anti-inflammatories, and supportive care. Prognosis depends on the severity and duration of disease

What is the normal host of the meningeal worm, Parelaphostrongylus tenuis, which infects camelids? (A) White-tailed deer (B) Sheep (C) Bactrian and dromedary camels (D) Raccoons (E) Pigs

Answer is A: The normal length of gestation in swine is 114 days. It's easy to remember: 3 months, 3 weeks, and 3 days. Dogs and cats have an average gestation of 63 days. Goats have an average gestation of 150 days. Cows have an average gestation of 9 months. Horses have an average gestation of 11 months (or 344 days).

What is the normal length of gestation in swine? (A) 114 days (B) 63 days (C) 150 days (D) 9 months (E) 11 months

Answer is B: The overall survival rate of small animal patients who undergo witnessed cardiopulmonary arrest is only 4-9%. Owners of critically ill patients should be prepared and their wishes known should the pet experience cardiopulmonary arrest while hospitalized.

What is the overall survival rate of small animal patients who undergo witnessed cardiopulmonary arrest? (A) 10-20% (B) Less than 10% (C) 20-30% (D) 40-50% (E) 30-40%

Answer is D: The lateral saphenous vein is the preferred site for blood collection and IV catheter placement in rabbits. It has a more proximal position on the leg in rabbits than in dogs. The marginal ear vein can be used for blood collection but tissue necrosis can occur if the blood supply is disrupted by the procedure. Therefore this site is not recommended unless other sites are not usable.

What is the preferred site for blood collection and IV catheter placement in rabbits (A) Marginal ear vein (B) Cephalic vein (C) Femoral vein (D) Lateral saphenous vein (E) Jugular vein

Answer is A: Many cows have titers to bovine leucosis virus (BLV) but less than 5% develop lymphosarcoma. Lymphosarcoma is most common in cows 2-6 years old. Tumors can occur in the lymph nodes and tissue almost anywhere in the body. Clinical signs are dependent on tumor location. There is no treatment. Risk is minimized by preventing the transfer of blood (and therefore infected lymphocytes) between cows.

What percentage of adult cattle with bovine leukosis virus develop lymphosarcoma? (A) Less than 5% (B) Less than 1% (C) 100% (D) Less than 50% (E) Less than 25%

Answer is E: A dog's spermatozoa should be more than 70%-80% progressively motile and more than 80% morphologically normal for optimum breeding fertility. Click here to see animated examples of sperm motility.

What percentage of spermatozoa need to be progressively motile for the dog to be considered fertile for breeding purposes? (A) 80%-90% (B) At least 50% (C) More than 95% (D) 60%-70% (E) 70%-80%

Answer is A: Frothy bloat usually occurs after the ingestion of a lot of legumes. There are two main kinds of bloat (rumen tympany) in cattle. Free gas bloat typically occurs because the cow cannot eructate and relieve normal gas. Predisposing factors for free gas bloat include esophageal foreign body, pharyngitis, hypocalcemia, lateral recumbency, and vagal indigestion. Treatment for free gas bloat involves gas removal either via an orogastric tube or—in compromised cows—rumen trocarization. Calcium can be administered if hypocalcemia is the underlying cause. Treatment for frothy bloat first requires reduction of the surface tension of the froth with surfactants such as dioctyl sodium sulfosuccinate, poloxalen, mineral oil, or detergent. Once the froth is gone, the cow can be treated as for free gas bloat.

What predisposing factor is most commonly associated with frothy bloat in cattle? (A) Ate lots of legumes (B) Esophageal foreign body (C) Vagal indigestion (D) Lateral recumbency (E) Hypocalcemia

Answer is E: A urolith is a stone in the bladder. When animals accumulate too many uroliths due to dietary imbalances or metabolic disturbance, they can block the urethra, and the animal cannot urinate (espcially males, which have a more narrow urethra than do females). most animals can have uroliths, including horses, cows, pigs, sheep, goats dogs, cats and rabbits. Affected animals can also develop a urinary infection (cystitis) secondary to the uroliths and grit that irritate the bladder. Whenever you see the suffix "-lith", it generally means a stone or mineral accumulation of some kind. Feline urolithiasis is one of the most common forms of urolithiasis seen in small animal practice.

What problem would urolithiasis cause? (A) Trouble absorbing sodium from the diet (B) Trouble making red blood cells (C) Trouble swallowing (D) Trouble defecating (E) Trouble urinating

Answer is B: Check for and stimulate respiration in the calf. The vet must continue the surgery in the dam, your job will be to make sure the calf is breathing. Diligent postpartum care is vital to the survival of the neonate. Manually clear mucus from the calf's nose and mouth or suction if possible, hang upside down for drainage if necessary, stimulate the nostrils with strands of hay, and vigorously rub the calf with towels. Give mouth to nose resuscitation or intubate and ventilate the calf if all the above fails.

When assisting a veterinarian in a caesarian section, which one of the following choices is the most important next step once the calf is delivered? (A) Begin cleaning up bloody instruments and supplies (B) Check for and stimulate respiration in the calf (C) Express colostrum from the udder for the calf as soon as possible (D) Monitor mothers vital signs

Answer is A: It is NEVER normal for milk to drip from a pregnant mare's udder. In the last 24-48 hours of gestation, dried beads of colostrum may appear on the end of the mare's teats. This is called "waxing" and is a sign of impending parturition. The udder begins to develop in the last month of gestation but milk dripping indicates a problem. Most commonly dripping milk is a sign of placentitis, but can also be a sign of a twin pregnancy or improper calculation of the due date. Any mare with milk dripping during gestation should be evaluated by a veterinarian immediately.

When is it normal for milk to be dripping from a pregnant mare's udder? (A) Never (B) Within 1 week of birth (C) Within 24 hours of birth (D) Within 48 hours of birth (E) Within 1 month of birth

Answer is D: It is important to try to place the needle so that it enters the bladder just cranial to the trigone (the site at which the urethra and ureters meet the bladder). This allows full drainage of urine without the needle slipping out as the bladder empties and contracts. Cystocentesis is the aspiration of urine from the bladder performed percutaneously with the animal either standing or in lateral or dorsal recumbency. Ultrasound is often used to help locate the best cystocentesis site. It is critical to drain as much urine as possible to minimize extravasation of urine from the puncture site after the procedure. The needle should also be positioned at approximately 45 degrees prior to insertion so that it makes an oblique tract, minimizing leakage after the procedure.

Where is the ideal location within the urinary bladder for placement of a cystocentesis needle in dogs and cats? (A) Location in bladder does not matter (B) The ventral-most aspect of the bladder (C) Just caudal to the the ureteral orifices (D) Just cranial to the trigone of the bladder (E) Mid-body of the bladder

Answer is A: Below stifle, lateral left hind. Feline leukemia virus (FeLV) and rabies vaccinations have been associated with sarcomas. You should always keep a record of where vaccinations were given. Remember your L's and R's for feline vaccination: For FeLV, vaccinate LOW and LATERAL on the LEFT hind. For Rabies vaccinate low and lateral on the RIGHT hind. Here is a direct quote from the AAFP Feline Vaccine Advisory Panel Report (full report- see Appendix 2, p. 1440) "FeLV or FIV antigen (plus any other antigen except rabies) should be administered subcutaneously (SC) on the lateral side of the left hind limb below the stifle joint (vaccine-associated sarcomas arising in the proximal femoral area are difficult to completely excise; placement of vaccines in this area is strongly discouraged).

Where should a feline leukemia (FeLV) vaccine be injected? (A) Below stifle, lateral left hind (B) Cervical interscapular region (C) Above stifle, lateral right hind (D) Above stifle, lateral left hind (E) Below stifle, lateral right hind

Answer is D: The bovine estrous cycle is 21 days long (range 18-24 days). Behavioral estrus itself ("heat") lasts about 18 hours in cattle. The porcine estrous cycle is also 21 days long (range 16-24 days). Estrus in the sow lasts 2-3 days. Click the following link for a table of reproductive cycle features, most animals.

Which animal types typically have a 21-day estrous cycle? (A) Llamas, Guanacos, Alpacas (B) Goats, Dogs (C) Cats, Rabbits (D) Pigs, Cattle (E) Horses, Sheep

Answer is A: Below stifle, lateral right hind. Rabies and Feline leukemia virus (FeLV) vaccinations have been associated with sarcomas. You should always document where vaccinations were given. Remember your L's and R's for feline vaccination: For Rabies vaccinate low and lateral on the RIGHT hind. For FeLV and FIV, vaccinate LOW and LATERAL on the LEFT hind. Here is a direct quote from the AAFP Feline Vaccine Advisory Panel Report (full report- see Appendix 2, p. 1440) "Injectable vaccines containing rabies virus antigen (plus any other antigen) should be administered SC on the lateral side of the right hind limb below the stifle joint (vaccine-associated sarcomas arising in the proximal femoral area are difficult to completely excise; thus, placement of vaccines in this area is strongly discouraged)." Click here for a summary of feline vaccine guidelines

Where should a rabies vaccine be injected in a cat? (A) Below stifle, lateral right hind (B) Below stifle, lateral left hind (C) Cervical interscapular region (D) Above stifle, lateral right hind (E) Above stifle, lateral left hind

Answer is B: Horses cannot vomit or regurgitate, normally. Vomiting is an OMINOUS sign if you ever see it in a horse.

Which animal cannot normally regurgitate or vomit? (A) Pig (B) Horse (C) Cow (D) Ferret

Answer is C: Because pigs do not sweat very well, high temperatures, above 85F (29.4C) are stressful to adult swine.

Which animal cannot normally sweat? (A) Mouse (B) Horse (C) Pig (D) Cattle

Answer is C: Horses have the lowest heart rate (25-40) and respiration rate (10-14) of the domestic animals. Different sources use slightly different ranges of numbers, but heart rates and respiration rates are generally faster in smaller animals and slower in larger animals. Click here for a chart of resting heart rates of common domestic animals. Click here for a chart of resting respiration rates of common domestic animals.

Which animal has the lowest normal heart rate and respiration rate? (A) Dog (B) Ferret (C) Horse (D) Cow (E) Cat

Answer is C: Rabbits have extremely powerful hind legs. Restraint without proper control of the hind legs may lead to a broken back (or severe spinal cord damage) if the rabbit thrashes and kicks too much. Must restrain hinds, or wrap rabbit in a towel. Look for hind limb paralysis and incontinence in a rabbit with broken back.

Which animal is most vulnerable to severe spinal cord damage when handled improperly? (A) Cat (B) Ferret (C) Rabbit (D) Boa constrictor (E) Hamster

Answer is D: Remember that GUINEA PIGS get SCURVY: low vitamin C- Think of a guinea pig in a pirate costume to help you remember. Water soluble vitamins like vitamin C and the B complex vitamins are POORLY absorbed in all animal types, and when there is too much in the diet, it is just lost in the urine, so animals need them regularly in their diet.

Which animal is particularly vulnerable to vitamin C deficiency (Scurvy)? (A) Rabbit (B) Rat (C) Cat (D) Guinea pig

Answer is D: Cats, rabbits, ferrets, mink and South American camelids (llamas, alpacas, vicunas, guanacos) are all induced ovulators. The female needs to mate with a male before she will ovulate. Click the following link for a table of reproductive cycle features, most animals.

Which animal types are induced ovulators? (A) Pot belly pigs, Gerbils (B) Donkeys, Chinchillas (C) Rabbits, Guinea pigs (D) Llamas, Ferrets (E) New world primates, Wolf-dog hybrids

Answer is A: Cats, rabbits, ferrets, mink and South American camelids (llamas, alpacas, vicunas, guanacos) are all induced ovulators. The female needs to mate with a male before she will ovulate. Click the following link for a table of reproductive cycle features, most animals.

Which animal types are induced ovulators?: (A) Cats, Rabbits (B) Llama, Guinea pigs (C) Goats, Dogs (D) Horses, Sheep (E) Pigs, Cattle

Answer is A: Horses and cats are typically anestrus in December in North America. Horses are seasonally polyestrous, cycling regularly through the spring and summer in North America. The feline estrus cycle is controlled by day length. In North America, cats go through an anestrus period in December and January when day length is less than 12 hours. Click the following link for a table of reproductive cycle features, most animals.

Which animal types are normally anestrus in December in North America? (A) Horses, Cats (B) Goats, Dogs (C) Llamas, Sheep (D) Pigs, Cattle (E) Rabbits, Ferrets

Answer is B: The bovine estrous cycle is 21 days long (range 18-24 days). Behavioral estrus itself ("heat") lasts about 18 hours in cattle. The porcine estrous cycle is also 21 days long (range 16-24 days). Estrus in the sow lasts 2-3 days. Click the following link for a table of reproductive cycle features, most animals.

Which animal types typically have a 21-day estrous cycle? (A) Goats, Dogs (B) Pigs, Cattle (C) Horses, Sheep (D) Llamas, Guanacos, Alpacas (E) Cats, Rabbits

Answer E: According to American Animal Hospital Association (AAHA) vaccination guidelines, there are 4 canine core vaccines (scroll down to table 1): 1. Rabies 2. Canine parvovirus 3. Canine distemper 4. Canine adenovirus type 2 (CAV-2, one cause of tracheobronchitis) Attenuated live virus CAV-2 vaccine safely cross-protects against infectious canine hepatitis (CAV-1). Noncore vaccines include: measles virus, canine parainfluenza virus, canine influenza virus, Leptospira interrogans, Borrelia burgdorferi, and Crotalus atrox. Administration of these vaccines is risk-based after a discussion between the client and veterinarian

Which choice correctly lists the four core vaccines for dogs (A) Canine adenovirus-2, Leptospira interrogans, Giardia, kennel cough (B) Bordetella bronchiseptica, rabies, canine parainfluenza, canine adenovirus-1 (C) Crotalus atrox, canine hepatitis virus, canine parvovirus, canine influenza (D) Canine influenza virus, canine distemper, Leptospira interrogans, Borrelia burgdorferi (E) Canine distemper, canine parvovirus, canine adenovirus-2, rabies

Answer is C: Passive immunization occurs when a newborn animal drinks antibody-rich colostrum from the mother in the first 12-24 hours of life. During this time, the gut tissue of the baby allows these protective antibodies to be absorbed directly into the bloodstream, where they can protect the baby for 4-7 weeks, until it can start to make antibodies of its own. After 24 hours, there is "gut closure" and antibodies are no longer absorbed through the intestines.

Which choice gives passive immunity to an animal? (A) Modified-live vaccine (B) Live vaccine (C) Colostrum (D) Killed vaccine (E) Surviving the illness

Answer is A: Alkaline urine. Feline struvite uroliths are generally sterile. Think of acidifying diets with feline urolithiasis (FUS, bladder stones). Canine struvite formation usually associated with urinary tract infection.

Which choice is generally associated with feline struvite uroliths (bladder stones, crystals)?: (A) Alkaline urine (B) Stress (C) Urinary tract infection (D) Urine acidity

Answer is A: Horse, Cow, Goat, Pig, Dog. Here is a list of gestation length for the major animal types, in order: Llama 1 year (350d), Horse 11 mo (330d), Cow 9 mo (~280 d, same as PEOPLE), Sheep/goats 5 mo (150d), Pig 4 mo (114d), Dog/ Cat 2 mo (60d), Ferret 1.5 mo (42d.). Basic questions on estrus cycle and gestation come up over and over, so commit them to memory for the major animals at LEAST (Cow, Horse, Dog, Cat, Sheep/Goat, Pig). Merck has two excellent tables: Click Here for an estrus cycles table, most animals. Click Here for a gestation table, most animals. In general, the BIGGER the beast, the LONGER the gestation ie: Mice are about 20 days, elephants are TWO YEARS (660 days)!

Which choice lists these animal types in order of gestation length, from longest to shortest pregnancy? (A) Horse, Cow, Goat, Pig, Dog (B) Llama, Pig, Sheep, Ferret, Cat (C) Cow, Horse, Pig, Goat, Dog (D) Cow, Horse, Pig, Dog, Goat

Answer is A: This is a classic description for dermatophilosis, or rainrot, caused by Dermatophilus congolensis. The double chains of D. congolensis cocci have a "railroad track" appearance under the microscope. These bacteria readily colonize wet, macerated skin. Treatment involves antibacterial shampoo and environmental management. Severely affected horses can be treated with penicillin.

Which dermatological condition in horses is associated with crusts that can be removed with an attached tuft of hair and a "railroad track" appearance on cytology? (A) Dermatophilosis (B) Ringworm (C) Sarcoid (D) Pemphigus foliaceus (E) Culicoides hypersensitivity

Answer is B: The 4 fat-soluble vitamins (K,A,D,E) are stored in the body fat, so you don't need as much in your daily diet Remember "KADE- the Kool-ADE guy on TV is FAT" A key vitamin-related problem happens with RAT POISON, which interferes with vitamin K's action, and leads to uncontrolled bleeding in animals that eat rat poison or rats that died from eating rat poison. Follow this link to see blood in the chest of an animal that died from rat poisoning.

Which group of vitamins are fat soluble? (A) vitamins C,K,A (B) vitamins A,D,E (C) vitamins K,D,B (D) vitamins E,B,C

Answer is A: Potomac horse fever is a syndrome of fever, acute diarrhea, laminitis, and abortion caused by Neorickettsia risticii. N. risticii infects parasites that infect fresh water snails, which are then eaten by mayflies and caddisflies. Horses are infected when they accidentally ingest any of these vectors or the feces of infected birds or bats. Cases are seen most often in June through October, near fresh water, east of the Mississippi River or in California

Which infectious cause of colitis in horses occurs primarily in June through October, east of the Mississippi and in California? (A) Potomac horse fever (B) Clostridiosis (C) Salmonellosis (D) Larval cyathostomiasis (E) Right dorsal colitis

Answer is D: Cats have naturally occurring alloantibodies to blood antigens they do not have. Therefore, a first-time transfusion of type A blood to a type B cat can result in potentially life-threatening hemolysis and transfusion reaction. Type A is the most common blood type in cats, type B is seen less commonly but is more common in some breeds. Type AB cats can receive blood from type A or type B cats. Blood typing cards are commercially available for in-clinic use. In addition, some cats (of any blood type) have another erythrocyte antigen that can cause an acute hemolytic reaction. There is no available test for this antigen (the Mik antigen). Cross-matching would help decrease this risk. Dogs and horses do NOT have naturally occurring alloantibodies to blood antigens.

Which of the following animals has naturally occurring alloantibodies to blood antigens? (A) None of these do (B) All of these do (C) Dogs (D) Cats (E) Horses

Answer is D: R-on-T is a life-threatening type of ventricular tachycardia and is always an emergency. With R-on-T, the QRS complex of a ventricular premature contraction originates on the T wave of the preceding beat. R-on-T can predispose patients to ventricular fibrillation. Therapy is not indicated for first-degree atrioventricluar block or sinus arrhythmia. Therapy is not typically indicated for atrial premature contractions though they may predispose to other atrial arrhythmias. Atrial fibrillation should be addressed in patients with advanced cardiac disease. It is not typically an emergency situation that requires immediate intervention to save the patient.

Which of the following arrhythmias diagnosed in a dog or cat always requires immediate intervention? (A) Atrial premature complexes (B) Sinus arrhythmia (C) First-degree atrioventricular block (D) R-on-T (E) Atrial fibrillation

Answer is D: Milk fever is not really a fever at all, it is a postparturient paresis (a post-calving flaccid (limp) weakness). Dairy cows with milk fever have used up too much of their body's calcium to make milk. Without calcium, the muscles in a cow go limp. In contrast, dogs, cats and humans go tetanic (stiff) when their blood calcium goes too low after birthing, a condition called eclampsia. Treatment in small animals and in cattle is primarily IV calcium gluconate to return calcium level to normal. CAUTION! Calcium IV is CARDIOTOXIC!!! Too much Ca too fast can cause arrhythmias and even cardiac arrest!

Which of the following causes milk fever in dairy cows? (A) Body temperature above 105F (40.5C) (B) High blood potassium (C) Allergy to milk products (whey) (D) Low blood calcium (E) Low blood iron

Answer is A: Laminitis is non-infectious inflammation of the lamina of the feet. Acute laminitis can occur subsequent to grain overload or post-partum problems. Chronic laminitis occurs with long-term dietary imbalances (i.e., high grain diets). Laminitis can lead to sole ulcers, white line disease, hoof cracks, septic arthritis, and osteomyelitis. F. necrophorum is the cause of interdigital necrobacillosis (foot rot) in cattle and small ruminants. D. nodosus also causes foot rot in small ruminants. Foot rot is highly contagious. Papillomatous digital dermatitis (hairy heel warts) is highly contagious in dairy cattle.

Which of the following causes of lameness in ruminants is NOT contagious (A) Laminitis (B) Fusobacterium necrophorum (C) Dichelobacter nodosus (D) Papillomatous digital dermatitis (E) These are all contagious

Answer is C: Laminitis is inflammation of the laminae that connect the hoof wall to the coffin bone of the foot that can result in severe lameness. Laminae are interdigitated finger-like projections of soft tissue.

Which of the following choices can be defined as inflammation of the corium of the hoof in large animals? (A) Desmitis (B) Bog spavin (C) Laminitis (D) Tendonitis

Answer is A: The correct answer is oral (also called enteral). "Enteral" means to take in via the gastrointestinal tract. Parenteral means to take into the body some way OTHER than the digestive tract, such as intravenously, intramuscularly, subcutaneously, or intradermally.

Which of the following choices is an enteral means of drug administration? (A) Oral (B) Intravenous (C) Intradermal (D) Subcutaneous (E) Intramuscular

Answer is B: All are correct. Cestodes are tapeworms; they infect dogs via fleas. Trematodes are flukes; they infect sheep via snails. The heartworm is a nematode that infects dogs via mosquitoes.

Which of the following combinations of parasite, intermediate host, and definitive host is/are correct? (A Cestode, flea, dog) (B) All are correct (C) Trematode, snail, sheep (D) Nematode, mosquito, dog

Answer is D: Mild otitits externa is treated with topical ear cleaner to remove any debris and topical medication for the infection. The other options listed are usually treated with systemic medication plus topical if needed and the tympanum is intact.

Which of the following conditions does NOT require systemic medications to treat? (A) Otitis interna (B) All options listed require systemic antibiotics to treat (C) Otitis media (D) Mild otitis externa (E) Severe otitis externa

Answer is A: An Ambu bag is a self-inflating apparatus used to provide manual ventilation for emergency patients. It should be kept in the crash cart. The bag is connected to the endotracheal tube in animals, but a facemask attachment is also used in humans. The Ambu bag has a one-way non-rebreathing valve that allows entry of room air or oxygen. It was developed by the Ambu company of Denmark over 50 years ago and is still used today.

Which of the following correctly describes an Ambu bag and its purpose? (A) Self-inflating apparatus used to provide ventilation in emergency patient (B) Pouch-like restraint device used for handling of difficult or angry cats (C) Collection of supplies used to help patients with rear limb paresis ambulate (D) Pressure bag used to deliver fluids at a high volume and pressure (E) Special inflatable pad used with recumbent patients to prevent pressure sores

Answer is D: White on right arm, black on left arm, red on left leg. A nice memory aid is "white on right and smoke (black) over fire (red)." The electrodes used to record an ECG are always attached the same way. The white colored wire is attached to right arm, black to the left arm, and red to the left leg. When 4 are used, the green wire is attached to the right leg. To record each lead (I, II, III), the ECG monitor automatically compares the electrical difference between the appropriate locations. The different leads allow measurement of activity from different angles around the heart. This is useful for monitoring, as different leads are tried till a good waveform is found. The waveforms vary with each lead, abnormal waveforms are seen with cardiac enlargement.

Which of the following correctly describes placement of the electrodes when performing an electrocardiogram on a dog or cat? (note arms = forelegs, legs = rear legs) (A) Red on right arm, green on left leg, black on left arm (B) Black on right arm, white on left leg, red on right leg (C) White on left arm, black on right arm, red on right leg (D) White on right arm, black on left arm, red on left leg

Answer is B: The dog is placed in right lateral recumbency, with the proximal limbs mostly perpendicular to the body. Ideally, the patient is relaxed and quiet as trembling and anxiety interferes with recording. Sedation is usually avoided for the same reason. Lead II is the standard lead used for screening. All leads (12) are used for a complete workup. The 3 bipolar leads (I, II, and III) are most common, with an electrode attached to left arm (black), right arm (white), left rear leg (red), right rear leg (green, if used) Lead I - compares right arm (-) to Left arm (+) Lead II - compares right arm (-) to left rear (+) Lead III compares Left arm (-) to left leg (+

Which of the following correctly describes the standard positioning used to perform a diagnostic electrocardiogram (ECG) on a dog? (A) Dorsal recumbency, front legs cranial and rear legs caudal (B) Left lateral recumbency, legs relaxed (C) Right lateral recumbency, legs perpendicular to body (D) Sternal recumbency, legs pulled out in front and behind

Answer is E: Sorting of patients into groups depending on the need for immediate intervention is Triage. It is from a french word that means to sort. The technique was developed during World War I to increase the chance of survival for as many patients as possible. Each patient receives a quick assessment of its overall condition, with attention to the most important systems - respiratory, cardiovascular, and neurologic. Patients with life-threatening problems are immediately admitted for emergency therapy. Those with non-lethal issues but in need of isolation or temporary intervention for serious problems such as hemorrhage, vomiting, diarrhea, contagious disease, etc are removed to an appropriate area. The last group consists of patients that are stable and reasonably comfortable; these remain with the owner till their scheduled appointment time if all staff is busy.

Which of the following correctly explains triage of emergency patients? (A) Evaluation of emergencies by species, age, and gender (B) Scheduling of patients in need of surgery - must go, should go, go if time allows (C) When a fireman rescues a sick cat out of a tree (D) This is a type of lavage fluid that can be used in many types of wounds - sterile, clean, or contaminated (E) Sorting of patients into groups depending on their need for immediate intervention

Answer is A: It is recommended that ferrets are vaccinated against canine distemper (NOT using a vaccine of ferret cell origin) and rabies. Canine distemper and rabies are fatal in unvaccinated ferrets. Ferrets are not susceptible to feline panleukopenia. Ferrets commonly get vaccine reactions. They should be fasted prior to vaccination and monitored for 30 minutes after vaccination.

Which of the following disease should ferrets always be vaccinated against? (A) Canine distemper (B) West Nile virus (C) Influenza (D) Feline panleukopenia (E) Parvovirus

Answer is A: Bovine viral diarrhea (BVD) can cause immunosuppression, respiratory disease, gastrointestinal disease, abortion, in utero infection, and birth defects in cattle. It is common in cattle and can cause acute, chronic, or subclinical disease. Calves infected with BVD in utero between days 80 and 125 become persistently infected and will develop mucosal disease if they are exposed to BVD virus later in life. Mucosal disease is almost always fatal. There is no specific treatment for BVD but antimicrobials and supportive care may be used for secondary infections. It is best to try to prevent disease with vaccination.

Which of the following diseases causes immunosuppression, respiratory disease, gastrointestinal disease, abortion, in utero infection, and birth defects in cattle (A) Bovine viral diarrhea (B) Johne's disease (C) Herpesvirus (D) Salmonellosis (E) Transmissible spongiform encephalopathy

Answer is A: Bovine viral diarrhea (BVD) can cause immunosuppression, respiratory disease, gastrointestinal disease, abortion, in utero infection, and birth defects in cattle. It is common in cattle and can cause acute, chronic, or subclinical disease. Calves infected with BVD in utero between days 80 and 125 become persistently infected and will develop mucosal disease if they are exposed to BVD virus later in life. Mucosal disease is almost always fatal. There is no specific treatment for BVD but antimicrobials and supportive care may be used for secondary infections. It is best to try to prevent disease with vaccination

Which of the following diseases causes immunosuppression, respiratory disease, gastrointestinal disease, abortion, in utero infection, and birth defects in cattle? (A) Bovine viral diarrhea (B) Johne's disease (C) Herpesvirus (D) Salmonellosis (E) Transmissible spongiform encephalopathy

Answer is A: Leptospirosis is zoonotic and affects virtually all mammals. Signs in humans range from subclinical to fatal; most common include headaches, fever, ocular pain, rash, myalgia, and malaise. Zoonotic diseases are those that can be transmitted from animal to humans. The other diseases listed are not zoonotic.

Which of the following diseases is zoonotic? (A) Leptospirosis (B) Parvovirus (C) West Nile virus (D) Canine influenza (E) Feline herpesvirus

Answer is C: Paradoxical abdominal breathing (i.e., abdomen moves inward with inspiration instead of outward) implies diaphragmatic paralysis. This is an emergency and requires immediate attention. Icteric mucous membranes alone do not always indicate an emergency situation if the patient otherwise appears stable. Snappy pulses (e.g., large, quick pulse pressure) occur with severe aortic regurgitation or anemia. This may not be an emergency in chronic cases. Tachycardia can indicate pain, stress, fear, and shock. It alone is not an indicator of emergency status. Fever is part of the bigger picture but is often not even assessed during the initial triage.

Which of the following findings during small animal patient triage always warrants being taken to the back for immediate treatment/evaluation? (A) Peripheral pulse quality is snappy (B) Tachycardia (C) Paradoxical abdominal breathing (D) Fever (E) Icteric mucous membranes

Answer is A: Hyperglycemia is common in the early stages of shock, and it can rapidly progress to hypoglycemia. The clinical signs of early shock can be variable. Patients may be anxious or depressed as well as tachycardic and tachypneic. The pulse quality can be increased, decreased, or normal. Altered mental status, pale mucous membranes, hypotension, hypoglycemia, and severe tachycardia are signs of progressive shock. In the final stages of shock there is significant hypotension with massive vasodilation and possible cardiac arrest. Refs: Bassert and Thomas, McCurnin's Clinical Textbook for Veterinary Technicians, 8th edition, pp. 914-5 and the Merck Veterinary Manual online.

Which of the following findings is common in a dog or cat in the early stages of shock? (A) Hyperglycemia (B) Pale mucous membranes (C) Hypotension (D) Altered mental status (E) Increased pulse quality

Answer is B: Hyperglycemia is common in the early stages of shock, and it can rapidly progress to hypoglycemia. The clinical signs of early shock can be variable. Patients may be anxious or depressed as well as tachycardic and tachypneic. The pulse quality can be increased, decreased, or normal. Altered mental status, pale mucous membranes, hypotension, hypoglycemia, and severe tachycardia are signs of progressive shock. In the final stages of shock there is significant hypotension with massive vasodilation and possible cardiac arrest.

Which of the following findings is common in a dog or cat in the early stages of shock? (A) Pale mucous membranes (B) Hyperglycemia (C) Increased pulse quality (D) Altered mental status (E) Hypotension

Answer is B: All of these items have a place in critical care, but supplemental oxygen therapy is vital to outcome in many emergency patients. No veterinary clinic is complete without a source of oxygen and a means to provide it via several techniques. Oxygen supplementation is administered via several techniques: Intubation and connection to an anesthesia machine or ventilator for manual or mechanical ventilation with 100% O2. Nasal insufflation via one or both nares can provide up to 60% O2 Oxygen cages can provide almost any O2% desired Facemask connected via hoses to an anesthesia machine or to a flowmeter, variable, 40-60% O2 should be humidified when given for more than an hour or so to avoid damage to mucosa and evaporative loss of fluid.

Which of the following has been identified as is the most important therapeutic agent that must be readily available for use in emergency situations? (A) Analgesics (B) Oxygen (C) Crystalloid fluids (D) Transfusion blood

Answer is B: 0.45% saline and 5% Dextrose are hypotonic fluids. The osmolality of half-strength or 0.45% saline is 155, Dextrose is 252 milliosmoles/L. Hetastarch and Vetstarch are colloids composed of high molecular weight starches in saline, they are isotonic. Normosol-R and Lactated ringers are a balanced isotonic crystalloid, at 296 and 272 mosm/L, respectively. Normosol-M is actually somewhat hypertonic at 364 mosm/L. It is used only for maintenance. It has low levels of sodium and chloride and more potassium than replacement type fluids.

Which of the following intravenous solutions are hypotonic? (A) Hetastarch, Vetstarch (B) 0.45% saline, 5% Dextrose (C) 5% Dextrose in 0.9% Saline (D) Plasmalyte 148, Normosol-M (E) Lactated ringers solution, Normosol®R

Answer is E: The main contraindications for arthrocentesis include an overlying lick granuloma, local cellulitis, or pyoderma overlying the joint. These factors significantly increase the risk of inoculating the joint with bacteria upon entry. Arthrocentesis, or joint fluid aspiration, is performed in cases of arthritis (of any etiology), lameness, joint effusion, and fever of unknown origin.

Which of the following is a contraindication for arthrocentesis? (A) Fever of unknown origin (B) Possible inflammatory arthritis (C) Possible septic arthritis (D) Significant joint effusion (E) Lick granuloma

Answer is D: Regurgitation is passive whereas vomiting is active. It is critical to differentiate between regurgitation and vomiting because they have different causes and diagnostic and therapeutic approaches. There is not usually nausea or abdominal contractions with regurgitation. The regurgitated food can be undigested or partially digested but does not typically contain hair, mucus, parasites, or foreign material. Hematemesis is the vomiting of fresh or digested blood. Often a thorough history from the owner can help determine which is happening.

Which of the following is a difference between regurgitation and vomiting? (A) Regurgitated contents often contain hair, mucus, or intestinal parasites (B) Nausea and abdominal contractions are common with regurgitation (C) Regurgitation is louder, vomiting is quieter (D) Regurgitation is passive, vomiting is active (E) Vomiting always contains blood

Answer is A: Pericarditis is a possible outcome. Traumatic reticuloperitonitis (also known as hardware disease) is quite common in adult cattle because they are indiscriminate eaters and are likely to ingest metallic foreign objects. These objects drop into the reticulum and can penetrate its wall, leading to peritonitis, pericarditis, liver or abdominal abscesses, and vagal indigestion. Magnets should prophylactically be given to cattle at approximately 1 year of age to help prevent this condition. Treatment involves magnet administration, broad-spectrum antimicrobials, and supportive care.

Which of the following is a possible outcome of traumatic reticuloperitonitis in cattle? (A) Pericarditis (B) White muscle disease (C) Polioencephalomalacia (D) Frothy bloat (E) Renal abscess

Answer is A:The Velpeau sling is used to prevent weight bearing and immobilize all the joints of the affected leg. It is most commonly used after reduction of medial shoulder joint luxation or significant fracture repairs. The carpal flexion sling is used when weight bearing is undesirable but the animal is able to use the shoulder and elbow joints. The Ehmer sling is used to prevent weight bearing and immobilize all the joints of the pelvic limb. It is most commonly used to protect the hip joint such as following coxofemoral joint surgery or after closed reduction of craniodorsal hip luxation. The Schroeder-Thomas splint is rarely used to facilitate traction/reduction for treatment of fractures distal to the mid-femur or mid-humerus or to immobilize joint distal to, and including, the stifle and elbow. The Robert Jones bandage can temporarily immobilize thoracic or pelvic limbs distal to the elbow or stifle.

Which of the following is a way to prevent weight bearing in the forelimb of a small animal patient after reduction of medial shoulder joint luxation? (A) Velpeau sling (B) Carpal flexion sling (C) Robert Jones bandage (D) Ehmer sling (E) Schroeder-Thomas splint

Answer is B: Puppies and kittens should be dewormed with pyrantel pamoate every 2 weeks, for 3 doses, starting at 2 weeks. This protocol should eliminate roundworm infections.

Which of the following is an appropriate deworming protocol for puppies and kittens? (A) Ivermectin every 4 weeks, for 2 doses, starting at 2 weeks (B) Pyrantel pamoate every 2 weeks, for 3 doses, starting at 2 weeks (C) Ivermectin every 1 week, for 2 doses, starting at 4 weeks (D) Fenbendazole every 3 weeks, for 2 doses, starting at 3 weeks (E) Pyrantel pamoate every 3 weeks, for 4 doses, starting at 3 weeks

Answer is A: The most definitive of the methods listed to confirm that the nasogastric tube is in the stomach or that an orogastric tube is in the rumen is to blow into the end of the tube and have an assistant auscult the stomach or rumen with a stethoscope. Most patients cough if the tube is placed into the trachea; however, this is not definitive. Sedated or very sick patients, or those in which a very small diameter tube is used, may not cough. It is not advised to attempt to suck fluid out of the stomach or rumen, as personnel can become very sick from the possible contents. Negative pressure upon aspiration is a sign of being in the stomach or rumen. However, negative pressure can also occur if the tube is up against soft tissue (in the lung or esophagus) so it is not definitive by itself. Lastly, feeling and seeing the tube pass down the esophagus in the neck is a good way to confirm that the tube is not being placed in the trachea.

Which of the following is the best way to confirm that an orogastric or nasogastric tube has been successfully placed in the rumen or stomach in a cow or horse, respectively? (A) Blow into tube and auscult bubbling in stomach or rumen (B) Feel loss of resistance as passes into stomach (C) Patient does not cough when tube is being passed (D) Aspirate on the tube and detect negative pressure (E) Place mouth over end of tube and suck to draw out fluid

Answer is D: Triage. which literally means, "to sort", is the common name for the primary survey performed on emergency patients. Patients are prioritized into groups according to their need for immediate intervention. Each patient receives a quick assessment of its overall condition, with attention to respiratory, cardiovascular, and neurologic systems. Patients with life-threatening problems are immediately admitted for emergency therapy. Those with non-lethal issues but in need of isolation or temporary intervention for serious problems such as hemorrhage, vomiting, diarrhea, contagious disease, etc; are taken to an appropriate area. The last group consists of patients that are stable and reasonably comfortable; these remain with the owner till their scheduled appointment time if all staff is busy.

Which of the following is the common name for the primary survey performed when patients present to an emergency or critical care facility? (A) Quick critical review (B) Emergency assessment (C) XYZ protocol (D) Triage

Answer is A: The cause of both chronic and acute pancreatitis in dogs and cats is most commonly unknown. Acute disease is more common in dogs and chronic disease is more common in cats. The other answers listed are risk factors for acute pancreatitis.

Which of the following is the most commonly identified cause of chronic pancreatitis in dogs and cats? (A) Unknown (B) Dietary indiscretion (C) Blunt force trauma (D) Pancreatic hypoperfusion (E) Pancreotoxic drugs

Answer is B: Cardiac compressions are the most important component of BLS during resuscitation of a patient in cardiac arrest. They must be performed quickly, correctly, and consistently for the best outcome. The most recent CPCR guidelines emphasize that compressions should not be interrupted, even for endotracheal intubation, intravenous catheterization, etc. Restoration of coronary blood flow is vital to success, as the heart actually restarts on its own, once it is able. CPCR tries to provide suitable conditions for cardiac contraction to resume. Ventilation with oxygen is important in animals, especially when arrest was not witnessed, but the quality of compressions is associated with the best outcome. Click here to download a free issue of Journal of Vet Emergency and Critical Care with CPCR guidelines for animals.

Which of the following is the most important component of basic life support (BLS) during cardiopulmonary cerebral resuscitation (CPCR)? (A) Electrical defibrillation (B) Cardiac compressions (C) Oxygen supplementation (D) Endotracheal intubation for ventilation

Answer is E: Central venous pressure (CVP) is measured via a long catheter placed into the jugular vein and positioned just outside the right atrium in the cranial vena cava. Trends in CVP are a useful way to evaluate volume status and response to fluid therapy because 70-80% of a patient's blood volume is in venous circulation.

Which of the following is the most useful way to evaluate for fluid overload in a hospitalized patient? (A) Twice daily evaluation for peripheral edema (B) Doppler pressure monitor (C) Direct arterial catheterization (D) Serum lactate levels (E) Central venous pressure

Answer is A: The recommended way to disinfect a stethoscope is to use 70% isopropyl alcohol.

Which of the following would be the best way to disinfect a stethoscope? (A) 70% Isopropyl alcohol (B) Glutaraldehyde (C) Autoclave (D) Ethylene oxide (E) 7.5% hydrogen peroxide

Answer is B: Epinephrine, atropine, dobutamine, and vasopressin are used in the treatment of emergency patients, especially those in cardiac arrest or in shock. Endotracheal tubes, intravenous catheters and fluids, syringes and needles, clippers, tape, and other supplies needed for emergency therapy are kept in the crash cart. Oxygen, an electrocardiogram machine, and a defibrillator should be close by. A chart with drug dosages and emergency protocols should be posted on the wall in full view. Morphine and ketamine are controlled substances that must be kept in a double locked box. Antibiotics are needed for some emergency patients but are not usually kept in the crash cart.

Which of the following lists of drugs are all normally found in the crash cart for use with emergency patients? (A) Glycopyrrolate, catheters, morphine, ketamine (B) Epinephrine, atropine, dobutamine, vasopressin (C) Penicillin, enrofloxacin, saline, heparin (D) Isoflurane, sevoflurane, desflurane, methoxyflurane (E) Pentoxyfilene, polymixin B, amikacin, meloxicam

Answer is C: The primary survey (initial assessment) of a critical patient involves evaluation of the Airway, Breathing, Circulation, and Disability (ABCD). This is similar to the protocol for cardiopulmonary cerebral resuscitation (CPR). Disability includes assessment of the level of consciousness, ability to move and use each limb, and an evaluation for pain. A fifth step is an exam for external evidence of disease/injury, such as hemorrhage, bruising, lacerations, swelling, painful areas, hernias, obvious anatomical deformity, etc. ABCDE is the complete acronym for the primary survey. Necessary emergency therapy is instituted prior to the secondary survey, which includes a complete physical exam.

Which of the following most correctly describes the focus of the initial evaluation of a critically ill or injured patient upon arrival at the emergency room? (A) Heart rate, temperature, respiratory rate, evaluation for pain (B) Consciousness, mucous membrane color, perfusion time, ambulation (C) Airway, breathing, circulation, disability (D) External assessment, auscultation, pulse strength

Answer is D: This cat has icteric (a.k.a. jaundiced or yellow) mucous membranes, often due to hepatic disease. Icterus occurs secondary to increased bilirubin levels. Bilirubin can be elevated in cats with liver disease, biliary obstruction, or hemolysis.

Which of the following organ systems is most likely involved with jaundice? (A) Respiratory (B) Gastrointestinal (C) Renal (D) Hepatic (E) Endocrine

Answer is B: Any of these findings could occur, but bradycardia (slow heart rate) is not common in critically ill patients. Electrolyte changes, especially hyperkalemia, dysrhythmias associated with abnormal cardiac conduction such as atrioventricular block or sick sinus syndrome, neurologic disease that results in increased intracranial pressure, and high doses of opioid analgesics are some causes of bradycardia. An electrocardiogram should be performed in any critical patient whose heart rate is slower than expected. Cats may develop bradycardia and/or hypothermia just before cardiac arrest. Dogs with Addison's disease often have heart rates lower than expected from their clinical status, a "relative" bradycardia

Which of the following physical examination findings is uncommon in most critical care patients? (A) Sinus tachycardia (B) Bradycardia (C) Abnormal mucous membrane color (D) Tachypnea

Answer is E: An animal with pneumothorax would likely have decreased oxygen saturation on pulse oximetry and hypoxemia on arterial blood gas evaluation due to poor ventilation. Pulse oximetry measures the percentage oxygen saturation of hemoglobin in arterial blood. Oxygen saturation does not accurately reflect the oxygen content of the blood or the partial pressure of oxygen. If an animal is severely anemic but pulmonary function is good, the oxygen saturation reading will be normal since the hemoglobin molecules that remain are appropriately saturated. Carbon monoxide poisoning and smoke inhalation lead to abnormal forms of hemoglobin. These animals can have normal oxygen saturation on the pulse oximeter in the face of severe hypoxia. The pulse oximeter can have falsely low readings due to hypothermia, poor tissue perfusion where the probe is placed, pigmentation of the tissue or hair where the probe is placed, and patient movement.

Which of the following presentations is most likely to have a low oxygen saturation on pulse oximetry and decreased PaO2 on arterial blood gas analysis? (A) Anemia due to hemoabdomen (B) Hypothermia (C) Smoke inhalation (D) Carbon monoxide poisoning (E) Pneumothorax

Answer is A: Antibiotics are routinely administered to those cases with internal abscesses (i.e., bastard strangles), guttural pouch empyema (infection), or those with complications. Strangles (e.g., S. equi subspecies equi infection) is a highly contagious disease in horses that causes abscesses of the submandibular and retropharyngeal lymph nodes. Horses can initially present with fever, anorexia, depression, and nasal discharge. As the disease progresses, the affected lymph nodes enlarge and eventually rupture and drain purulent exudate. If the retropharyngeal lymph nodes are affected, they can rupture and drain into the guttural pouches. Antibiotics are not typically administered to routine cases until after the abscesses have opened and drained.

Which of the following presentations of a horse with strangles (e.g., Streptococcus equi subspecies equi infection) should routinely be treated with antibiotics? (A) Intra-abdominal abscess (bastard strangles) (B) High fever and nasal discharge (C) Depression, anorexia, and fever (D) Submandibular or retropharyngeal lymph node enlargement (E) All horses with strangles should receive antibiotics

Answer is A: Hypoproteinemia is best treated with a colloid. A natural colloid source such as albumin, plasma, or blood is best. However, synthetic colloids are also useful to help maintain osmotic pressure and prevent fluid loss from the circulation. Synthetic colloids are solutions with high osmotic pressure due to the presence of high molecular weight compounds, usually starches or dextrans. Examples of synthetic colloids are Hetastarch, Hextend, Vet Starch, etc.

Which of the following problems is best treated with the intravenous infusion of a colloid? (A) Hypoproteinemia (B) Cardiogenic shock (C) Hyperglobulinemia (D) Hemorrhagic hypotension

Answer is C: Horses. Oxyuris spp (pinworms) are found in horses.

Which one of the following domestic animals is affected by pinworms? (A) Cattle (B) Cats (C) Horses (D) Dogs

Answer is A: There is no recommended way that works for every technician and every patient. Some work in some situations and others work in others, depending on the temperament of the horse and the technician's comfort. All of the ways listed are utilized to help desensitize horses to intramuscular injections. It is not always necessary to desensitize a horse prior to giving an intramuscular injection.

Which of the following techniques should always be used to locally desensitize a horse prior to giving an intramuscular injection? (A) No consistent method; use what is best for you (B) Tap the site with a fist just before injection (C) Rub the injection site vigorously with gauze then immediately inject (D) Pinch the skin and insert the needle adjacent to the tented skin (E) Cover the eye on the same side as from which you approach the animal

Answer is A: In general, chemotherapy is most appropriate for systemic cancers because it treats the entire body. Chemotherapy causes tumor cell death by injuring DNA or other protective cell mechanisms. Radiotherapy, cryotherapy, and surgical removal are all ways to address local cancers. Radiation disrupts cellular DNA or destroys other important cellular molecules, leading to cell death. Lasers can be used to facilitate surgical removal. Sometimes a multimodal approach is utilized.

Which of the following therapies would be appropriate for a systemic cancer? (A) Chemotherapy (B) Radiotherapy (C) Cryotherapy (D) Laser therapy (E) Surgical resection

Answer is D: An oscillometric blood pressure monitor senses the motion of the arterial wall as a blood pressure cuff deflates. The arterial wall tends to 'oscillate' up and down as pulsatile blood flow is restored, this oscillation is transferred to the blood pressure cuff. The oscillations change as flow and pressure change. The signals are interpreted by the monitor and systolic, mean, and diastolic pressures are calculated.

Which of the following types of blood pressure monitors relies on the transfer of motion of the arterial wall to a cuff placed over a peripheral artery? (A) Capnograph (B) Doppler (C) Photoplethysmography (D) Oscillometric

Answer is D: The facial artery is located on the ventromedial aspect of the mandible. The transverse facial artery, the dorsal metatarsal arteries, and the digital arteries may also be used to obtain a pulse rate in the horse.

Which of the following vessels is commonly palpated to count the pulse rate in the horse? (A) Lingual artery (B) Palatine artery (C) Jugular artery (D) Facial artery (E) Mandibular artery

Answer is E: APCs have a P wave. Atrial premature contractions (APCs) are abnormal myocardial impulses that originate from outside the sinoatrial node in the atrial myocardium. On an ECG, they look like premature, normal QRS complexes. These complexes are preceded by a P wave, which is often buried in the previous T wave. Ventricular premature contractions (VPCs) are abnormal myocardial impulses that originate from the ventricular myocardium. On an ECG, they look like premature, wide and bizarre QRS complexes that are NOT preceded by a P wave.

Which of the following, determined from an ECG strip, helps differentiate between atrial premature contractions (APCs) and ventricular premature contractions (VPCs)? (A) APCs have wide and bizarre QRS complexes (B) It is not possible to tell on ECG (C) APCs have F waves (D) APCs do not have a P wave (E) APCs have a P wave

Answer is D: Homoethermic animals, commonly referred to as warm-blooded, are animals that can regulate their body temperature regardless of the ambient temperature. Adult mammals are homeothermic. The opposite of homeothermic is poikilothermic. Poikilothermic animals are those whose body temperature is the same as the ambient temperature-if the environment gets hot, so does the poikilotherm. Common examples include reptiles and amphibians, but neonatal puppies and kittens are also poikilothermic because they cannot regulate their internal body temperature yet.

Which of these animals are homeothermic? (A) Hatchling chick (B) Neonatal kitten (C) Red-tail boa (D) Adult cat

Answer is E: Poikilothermic animals are those whose body temperature is the same as the ambient temperature-if the environment gets hot, so does the poikilotherm. Common examples include reptiles and amphibians, but neonatal puppies and kittens are also poikilothermic because they cannot regulate their internal body temperature yet. An adult mammal, (like a dog or horse) is homeothermic-they can regulate their own body temperature regardless of the ambient temperature.

Which of these is poikilothermic? (A) Adult cats (B) All of these (C) Adult dogs (D) Adult Horses (E) Week-old puppy

Answer is C: Small animals coming out of surgery are at risk of hypothermia. Electric heating pads however, should not be used for recumbent patients because they concentrate heat and can cause thermal burns. The other methods listed are much safer for the patient. Orphaned birds and mammals are at risk for hypothermia and the same methods can be used to warm them.

Which of these is the poorest method for preventing hypothermia in a recumbent patient? (A) Microwaved rice bags (B) Wrapped hot water bottles (C) Electric heating pads (D) Wrapping paws or body in plastic wrap

Answer is A: Alcohol is flammable and if present on the skin during the electrical shock used for defibrillation, explosion or fire may result. No one should contact the dog or the table during defibrillation as they may be shocked as well. Cardiac arrhythmia can result in shocked humans. The person in charge of the defibrillator must announce their intention by calling out 'clear' or another warning, prior to applying the electrical shock.

Which one of the following agents should NOT be used when electrical defibrillation is performed on a patient with cardiac arrest? (A) Alcohol (B) Contact gel (C) KY Jelly (D) Chlorhexidine solution

Answer is C: The guttural pouches are paired symmetric expansions of the eustachian tubes in all equids. They are located just behind and lateral to the pharynx and above and lateral to the larnyx. They are sometimes subject to infection, called guttural pouch empyema. The hyoid bone is a small bone that is part of the attachment of the larynx to the tongue. The intercostal space is the space between the ribs where the intercostal muscles are located. The ethmoid turbinates are found in the dorsal meatus of the nasal passages.

Which one of the following anatomical structures is found caudal to the pharynx and above larynx in a horse? (A) Intercostal space (B) Hyoid bone (C) Guttural pouch (D) Ethmoid turbinates

Answer is D: Rabbit Cuterebrae are less host-specific than other types and are usually associated with dog and cat infestations. Dogs, cats, ferrets all can get these opportunistic skin parasites, caused by the rodent or rabbit botfly, Cuterebra spp. Don't confuse these with the larger Hypoderma spp. (cattle grubs). Rarely, these can affect dogs and cats. Click here to see Hypoderma larvae and a pathology image of Hypoderma under the skin of a cow.

Which one of the following animals may have transmitted the organism found in this cat? (A) Sheep (B) Cow (C) Horse (D) Rabbit (E) Deer

Answer is C: In ticks, the mouthpart that penetrates the skin is a called the hypostome. It also enables the parasite to suck blood from the host

Which one of the following parasites has a hypostome? (A) Horseflies (B) Roundworms (C) Ticks (D) Flukes

Answer is A: Parturient paresis, or milk fever, is treated with intravenous (IV) calcium gluconate. Lactating cows with milk fever have overwhelmed their body's calcium stores in the production milk. Without calcium, the muscles in a cow cannot contract normally, the cow becomes weak and is unable to stand. In contrast, dogs and cats become stiff or tetanic when their blood calcium gets too low after birth, a condition called eclampsia. Hypocalcemia alters the membrane potential of muscle such that it contracts more and more easily and eventually cannot relax. This is a life-threatening condition in all animals. However, IV Calcium is CARDIOTOXIC and must be administered carefully. Giving too much calcium too fast can cause arrhythmias and even cardiac arrest!

Which one of the following choices is the treatment for parturient paresis in cattle? (A) Calcium gluconate intravenously (B) Intramuscular and subcutaneous calcium (C) Calcium supplementation of the feed (D) Removal of the calf from the dam

Answer is D: The Staphylococcus aureus (SA) bacterium is part of the normal bacterial flora especially in birds and humans. SA is found on the skin and mucus membranes and is a very important cause of opportunistic infection in these animals. Wounds or other damage to tissues is usually required for infection to develop in otherwise healthy individual, however infection can be seen in immunosuppressed patients without prior injury. Resistance to antibiotic therapy has become widespread in strains of SA. These strains are called "methicillin-resistant" or MRSA. Previously found primarily in hospitalized humans, it is now increasingly found in humans not exposed to the healthcare system. It is also becoming a problem in animals.

Which one of the following choices most correctly describes Staphylococcus aureus? (A) Rarely seen in practice (B) Common in catteries (C) Invasive flora (D) Normal flora

Answer is D: Warts are caused by the papilloma virus.

Which one of the following conditions is caused by the papilloma virus? (A) Mange (B) Ringworm (C) Pyoderma (D) Warts

Answer is A: Cardiomyopathy is a pathological lesion of heart muscle.

Which one of the following conditions is defined as a pathological defect of heart muscle? (A) Cardiomyopathy (B) Sick sinus syndrome (C) Congestive heart failur (D) Subaortic stenosis

Answer is B: Interdigital hyperplasia or fibroma is a thickening of the skin between the digits of cattle's feet. More common in the rear feet, it is usually secondary to chronic irritation in the area secondary to trauma or infection. A "splayed toe" conformation predisposes cows to this problem. If it is seen in several animals, warts may be the cause. Also called a "corn", the condition can be quite painful and must be removed surgically.

Which one of the following conditions of cattle involves thickening of the skin between the claws? (A) Sole ulcer (B) Interdigital hyperplasia (C) Laminitis (D) Pododermatitis

Answer is D: Brucellosis is a disease of the reproductive tract in many animals.

Which one of the following diseases affects the reproductive tract? (A) Choanal atresia (B) Lyme disease (C) Cauda equina syndrome (D) Brucellosis

Answer is B: Transmissible gastroenteritis (TGE), a diarrheal disease of pigs caused by a coronavirus. It can be enzootic (endemic) or epizootic (epidemic) in herds. An enzootic disease is one that is seen from time to time, and affects a few animals at a time, while an epizootic disease is one that is not often seen, develops suddenly in many different animals at once and is spreading. The epizootic form of TGE can affect entire herds of pigs and result in high mortality. All the other diseases are diseases of individual animals.

Which one of the following diseases can be epizootic? (A) Demodex canis, demodectic mange (B) Transmissible gastroenteritis in swine (C) Clostridium tetani infection, Tetanus (D) Gastric dilatation volvulus in dogs

Answer is C: Polioencephalomalacia, or polio, is a neurologic disease associated with thiamine deficiency. It occurs in all ruminants. Although it usually occurs sporadically, outbreaks can be seen. Thiamine is necessary for production of glucose in the brain. Clinical signs range from ataxia and depression to head pressing, opisthotonus, and coma. "Star-gazing" is a common sign caused by dorsomedial strabismus of the eyes due to dysfunction of the trochlear nerve (cranial nerve IV). Blindness is also common.

Which one of the following diseases is caused by a lack of thiamine, vitamin B1? (A) Pernicious anemia (B) Degenerative myelopathy (C) Polioencephalomalacia (D) Meningitis

Answer is C: Leptospirosis is a zoonotic bacterial disease that can be transmitted via urine. Canine distemper is caused by a paramyxovirus and spread via aerosol. Kennel cough or tracheobronchitis, is caused by a bacteria, Bordetella bronchiseptica is spread via aerosol. Foothills abortion or epizootic abortion of cattle occurs primarily in California and occasionally Nevada, and is caused by an unknown organism that is spread by ticks.

Which one of the following diseases is caused by bacteria and transmitted via the urine? (A) Foothills abortion (B) Canine Distemper (C) Leptospirosis (D) Kennel Cough

Answer is C: Diabetes mellitus is diagnosed by fasting hyperglycemia and glucosuria

Which one of the following diseases is diagnosed by hyperglycemia and glucosuria? (A) Addison's disease (B) Diabetes insipidus (C) Diabetes mellitus (D) Cushing's disease

Answer is B: Hardware disease, or traumatic reticuloperitonitis, is caused by perforation of the reticulum by a metallic foreign body ingested by the cow. Unlike small ruminants and camelids, cattle are not particular when grazing, and since they do not chew their feed completely at first, many foreign substances can be ingested.

Which one of the following diseases of cattle is associated with the ingestion of a metallic foreign object such as baling wire, nails, or metal fencing? (A) Wooden tongue (B) Hardware disease (C) Lumpy Jaw (D) Bloat

Answer is A: English bull dogs are brachycephalic which means that they have broad short head, and pushed in faces. Dolichocephalic dogs are the long narrow headed dogs. Doberman pinschers are typical. Cephalic index is the ratio of the maximum width of the head to its maximum length.

Which one of the following dog breeds is classified as brachycephalic? (A) English bull dog (B) Greyhound (C) Great Dane (D) Golden retriever

Answer is C: Dolichocephalic dogs are the long narrow headed dogs. Doberman pinschers are typical. Cephalic index is the ratio of the maximum width of the head to its maximum length. English bull doga and Shih Tzu are brachycephalic which means that they have broad short head.

Which one of the following dog breeds is classified as dolichocephalic? (A) Shar Pei (B) English bull dog (C) Doberman pinscher (D) Shih Tzu

Answer is A: The two main distinguishing factors between recurrent airway obstruction (RAO, heaves) and inflammatory airway disease (IAD) are that horses with heaves have increased respiratory rates at rest while horses with IAD do not. Second, horses with IAD do not typically have abnormal lung sounds on auscultation. Both can be characterized by chronic cough, exercise intolerance, and nasal discharge. Both can have excessive airway secretions after exercise. Both can have inflammatory cells identified in bronchoalveolar lavage samples. In general, horses with heaves tend to be older whereas IAD is more common in performance horses of all ages.

Which one of the following is seen in a horse with heaves but not a horse with inflammatory airway disease? (A) Increased respiratory rate at rest (B) Chronic cough (C) Chronic nasal discharge (D) Exercise intolerance (E) Excessive airway secretions after exercise

Answer is B: Selective media are used to encourage the growth of specific types of bacteria. They have ingredients that inhibit the growth of some types of bacteria and only allow certain bacteria to grow, selecting for a particular type. For example, MacConkey's agar adds bile salts to the media to encourage growth of gram negative intestinal organisms such as E. coli.

Which one of the following is the best explanation of the use of selective media in bacteriology? (A) Allows growth of isolated colonies of bacteria (B) Encourages the growth of certain types of bacteria (C) Inhibits growth of gram positive strains of bacteria (D) Supports growth of gram negative strains of bacteria only

Answer is D: Dipterans, or two-winged flies, are called periodic parasites because they do not live on their host but return frequently to feed.

Which one of the following is the correct explanation of why Dipterans are called periodic parasites? (A) Have larvae about the size of the head of a pin (B) Are only active during the night (C) Feed primarily during spring and summer seasons (D) Do not live on hosts but visit often to feed.

Answer is A: Ischemia and reperfusion injury (IRI) develops with restoration of blood flow in patients following cardiac arrest. When oxygen returns to hypoxic tissue, some is converted into oxygen radicals and peroxides, which cause further cellular damage. Chemical mediators of inflammation and products of white blood cells are also produced in the heart and other tissues, exacerbating the IRI damage. To minimize damage, oxygen supplementation is provided at a level that maintains blood levels of O2 in the normal range. Blood pressure and perfusion are also important to maintain energy stores and facilitate removal of toxic substances. Download a free issue of the Journal of Vet Emergency and Critical Care with CPCR guidelines for animals.

Which one of the following is the most important cause of myocardial damage in the post-cardiac arrest patient? (A) Ischemia and reperfusion injury (B) Hypoglycemia and lack of energy sources (C) Metabolic acidosis caused by tissue hypoxia (D) Azotemia and hyperkalemia due to renal dysfunction

Answer is D: Viral, limb edema, abortion. Equine viral arteritis (EVA) is a contagious viral disease that causes limb swelling, abortions, conjunctivitis, and respiratory disease. Stallions can carry the disease and transmit it during breeding. There is a vaccine available that can be used during outbreaks except in pregnant mares and young foals.

Which one of the following lists correctly describes Equine Viral Arteritis? (A) Protozoan, urticaria, infertility (B) Bacterial, respiratory disease, conjunctiviti (C) Bacterial, joint effusion, infertility (D) Viral, limb edema, abortion (E) Viral, hemorrhagic, diarrhea

Answer is E: Vitamin E. Equine degenerative myelopathy (EDM) is a diffuse degeneration of axons, myelin, and neurons in the spinal cord and brainstem thought to be caused in part by vitamin E deficiency. A progressive symmetrical ataxia of all four limbs is the main clinical sign. Most common in younger horses. Primary rule outs are trauma and the "wobbler" syndrome. The disease is incurable, but treatment with vitamin E can slow progression. Not as commonly seen nowadays as most rations are supplemented with vitamin E.

Which one of the following medications is indicated for treatment of Equine degenerative myelopathy? (A) Amoxicillin (B) Sodium iodide (C) Potassium iodide (D) Clindamycin (E) Vitamin E

Answer is C: The motility of sperm is the first characteristic evaluated microscopically because motility decreases quickly, especially with environmental changes in temperature and pH.

Which one of the following microscopic characteristics is evaluated first when examining sperm in a semen sample? (A) Morphology (B) Number present (C) Motility (D) Concentration

Answer is D: A pH of 7.5 is most likely to be associated with anorexia associated with simple indigestion. This pH is too high and indicates that the rumen fluid is alkalotic. Normal pH of the rumen fluid is around 6.0, depending on the diet; 5.5 or so with high grain diet, 6.5 with high roughage diet. Changes in pH of the rumen fluid indicate a change in the rumen environment. The amount and type of feed (roughage versus concentrates) in the diet and the types of microorganisms (bacteria and protozoa) present in the rumen are very important to normal digestion and energy production in the cow. With simple indigestion, the cow stops eating, rumen activity slows, less fermentation occurs, and the pH rises. This is seen when poor quality hay is fed, relatively indigestible feed (straw) or spoiled feed is given, urea is added to the diet, or a sudden change in the diet occurs. Simple indigestion usually only lasts 1-2 days and can be treated with a large volume of oral fluids and transfaunation if necessary.

Which one of the following pHs measured on rumen fluid is most consistent with anorexia? (A) 4.5 (B) 6.5 (C) 5.5 (D) 7.5

Answer is C: A pH of 4.5 in rumen fluid is too low and indicates the presence of acidosis, which is seen in cows with grain overload. The normal environment of the rumen is maintained by the types of bacteria and protozoa present and the type of feed given. These organisms help digest the feed ingested by the cow; by-products of microbial activity include substances necessary for energy production in the cow. Normal pH of the rumen fluid is around 6, depending on the diet; 5.5 or so with high grain diet, 6.5 with high roughage diet. When a lot of grain is ingested at one time, especially cows not accustomed to grain, the bacterial population changes to favor gram-positive bacteria that produce lactic acid. As the acid level increases, the normal flora dies, the rumen mucosa is damaged, fluid shifts occur, and systemic acidosis develops. Without treatment, dehydration, shock, and cardiovascular collapse follow and eventually, death of the cow.

Which one of the following pHs measured on rumen fluid is most consistent with grain overload? (A) 6.8 (B) 5.8 (C) 4.5 (D) 7.5

Answer is C: Empyema is an accumulation of purulent exudate within a body cavity. A septic process is usually present. Guttural pouch empyema, a not uncommon disease of horses, specifically refers to a bacterial infection most often associated with strangles caused by Streptococcus spp. Guttural pouch mycosis is a fungal infection of the guttural pouch. Intermittent epistaxis is a common compliant prior to this diagnosis. Guttural pouch tympany is accumulation and trapping of air in the guttural pouches. This occurs most often in foals from inflammation or malformation of the opening of the pouch into the pharynx

Which one of the following phrases is the most correct description of guttural pouch empyema? (A) Air has accumulated and is trapped (B) Complication of viral disease with influenza (C) Bacterial infection is present (D) Fungal infection has developed

Answer is A: Empyema is an accumulation of purulent exudate within a body cavity. A septic process is usually present. Guttural pouch empyema, a not uncommon disease of horses, specifically refers to a bacterial infection most often associated with strangles caused by Streptococcus spp. Guttural pouch mycosis is a fungal infection of the guttural pouch. Intermittent epistaxis is a common compliant prior to this diagnosis. Guttural pouch tympany is accumulation and trapping of air in the guttural pouches. This occurs most often in foals from inflammation or malformation of the opening of the pouch into the pharynx. Refs: McCurnin and Bassert's, Clin Textbook for Vet Technicians, 7th ed. pp. 714-5, and the Merck Veterinary Manual online edition.

Which one of the following phrases is the most correct description of guttural pouch empyema? (A) Bacterial infection of the guttural pouch (B) Fungal infection of the guttural pouch (C) Air trapped in the guttural pouch (D) Viral infection of the guttural pouch

Answer is C: IgE is the principal antibody produced during an allergic reaction.

Which one of the following phrases most correctly describes immunoglobulin E (IgE)? (A) First antibody made in response to a new antigen (B) Most prevalent antibody in the blood (C) Principal antibody involved in allergic reactions (D) Principal antibody in bodily secretions

Answer is C: Specific gravity compares the density of a substance to that of water. Substances with a specific gravity less than water will float. The fecal flotation test relies on the fact that the specific gravity of the flotation solution used is greater than that of the parasite eggs or oocysts. The eggs or oocysts will float and can be found more easily. A fecal sample is mixed in a vial with a concentrated solution of a salt or sugar in water. The vial is covered with a coverslip and then left undisturbed. The eggs will float to the top and are examined using the low power objective of a microscope.

Which one of the following physical properties of parasite eggs allows the fecal floatation method to work? (A) Cell wall structure (B) Weight (C) Specific gravity (D) Temperature

Answer is D: A. suum does not migrate through the kidneys. Ascaris suum is a large roundworm found in swine; it is the largest nematode of the small intestine in pigs. Infestations of A. suum can stunt a piglet's growth permanently from lung and liver damage. Migration of larval stages through the liver can cause enough damage to require condemnation at slaughter. Life cycle - eggs ingested, hatch into larvae in the large intestine, penetrate the intestinal wall, enter the portal circulation, where they travel to the liver. From the liver, they reenter the circulation and travel to the lungs, where they are coughed up, swallowed and arrive at the small intestine.

Which one of the following statements about Ascaris suum is false? (A) Primarily live in small intestine, sometimes in bile ducts and stomac (B) Heavy infestations can cause intestinal obstruction (C) Can permanently stunt growth of young pigs (D) Migration through the kidney causes renal failure

Answer is D: Mild cases of angular limb deformity will improve without treatment.

Which one of the following statements about angular limb deformity in foals is correct? (A) Valgus deformity is medial deviation of the distal limb (B) Most foals are lame and reluctant to play (C) The tarsus is the joint most frequently involved (D) Mild cases may correct on their own

Answer is C: Fleas do not spend their entire life cycle on their hosts. Fleas lay eggs on their hosts, but the eggs fall to the ground where they hatch into larvae.

Which one of the following statements about fleas is correct? (A) Fleas are more common in cool humid environments (B) Most flea species are very host specific (C) Fleas do not spend their entire life cycle on their hosts. (D) Ctenocephalides canis is the most common species

Answer is A: Tetanus antitoxin carries a risk of fatal serum hepatitis so it should ONLY be given to patients at high risk for tetanus. Tetanus antitoxin should only be administered to horses with unknown vaccine status that are at risk due to a wound or surgery. The causative agent of tetanus, Clostridium tetani, is common in the environment and can enter wounds or breaks in the skin or hoof. Clinical signs of tetanus include a stiff and spastic gait, hyper-reactivity to sound and touch, prolapsed third eyelids, seizures, and death. Tetanus is highly fatal and is easily prevented with annual vaccination with tetanus toxoid. The vaccine should be given annually or if a wound (or other risk factor) occurs more than 6 months since the last vaccination. It can be given concomitantly with the tetanus toxoid vaccine.

Which one of the following statements about tetanus antitoxin in horses is correct? (A) It should only be administered to horses with wounds with unknown vaccine status (B) It should be administered to every injured horse, regardless of vaccination history (C) It should never be administered to horses with open lacerations (D) It cannot be administered at the same time as tetanus toxoid (E) It should be administered annually, unless if an injury occurs and last dose was >6 months prior

Answer is D: Proteus does not form discrete colonies when grown on blood agar. They tend to "swarm", spreading all over the culture media. Colonies of other bacteria may be obscured and some are inhibited.

Which one of the following statements best explains why Proteus organisms can be a problem when using blood agar for bacterial cultures? (A) There is no problem with using agar to grow Proteus species (B) Proteus species will inhibit Streptococci colonies (C) They are fastidious do not grow well on the media (D) Proteus swarms and obscures other colonies of bacteria

Answer is E: According to the American Association of Feline Practitioners (AAFP) vaccination guidelines, there are 3 "core" vaccines recommended for ALL cats, plus other vaccines to use depending on the circumstances (ie: household pet, shelter). Here is how it breaks down: The 3 core feline vaccines for all cats are: 1. Feline viral rhinotracheitis (feline herpesvirus-1, FHV-1) 2. Feline panleukopenia (feline parvovirus, FPV) 3. Feline calicivirus (FCV).

Which three vaccines should household pet cats routinely receive, in addition to rabies and feline leukemia vaccinations? (A) Bordatella bronchiseptica, feline immunodeficiency virus, dermatophyte (B) Intranasal feline herpesvirus, feline parvovirus, pneumonitis (C) Feline viral rhinotracheitis, Mycoplasma felis, Chlamydophilia felis (D) Feline infectious peritonitis, dermatophyte, calicivirus (E) Panleukopenia, feline herpesvirus-1, calicivirus

Answer is E: Passive, or hypostatic pneumonia is found in older or debilitated animals. Lack of movement allows fluids to accumulate in the lungs which may lead to dyspnea, cyanosis and a wet, productive cough. Animals should be repostioned hourly. If the patient is able to exercise, the movement will help them recover. Dextromethorphan is an antitussive, which suppresses coughs. Patients with hypostatic pneumonia need to cough to help clear their lungs. Sedating or restraining an animal with HP will discourage movement, which is contraindictated with hypostatic pneumonia.

Which treatment is best for hypostatic pneumonia? (A) Dextromethorphan for the cough (B) Restraints to keep movements to a minimum (C) Sedative to relieve pain of respiration (D) Supplemental oxygen (E) Re-positioning every hour

Answer is D: Passive, or hypostatic pneumonia is found in older or debilitated animals. Lack of movement allows fluids to accumulate in the lungs which may lead to dyspnea, cyanosis and a wet, productive cough. Animals should be repostioned hourly. If the patient is able to exercise, the movement will help them recover. Dextromethorphan is an antitussive, which suppresses coughs. Patients with hypostatic pneumonia need to cough to help clear their lungs. Sedating or restraining an animal with HP will discourage movement, which is contraindictated with hypostatic pneumonia.

Which treatment is best for hypostatic pneumonia? (A) Restraints to keep movements to a minimum (B) Supplemental oxygen (C) Dextromethorphan for the cough (D) Re-positioning every hour (E) Sedative to relieve pain of respiration

Answer is E: You can see canine parvovirus in any breed (and you will) but think of the big common purebreds as your most common parvo patients in practice: Rottweiler; Doberman pinscher; Pit bull; German shepherd; Labrador Retriever; Also Alaskan sled dogs and English springer spaniel. Prognosis varies between ~70% and 90% for recovery, depending on treatment and disease severity in confirmed cases of parvoviral enteritis. Most pups that survive the first 3-4 days of illnes will recover fully.

Which trio of breeds are most predisposed to clinical parvovirus disease? (A) German shepherd, Brittany spaniel, Australian shepherd (B) Dachshund, Cocker spaniel, Miniature poodle (C) Standard poodle, Jack Russell terrier, Beagle (D) Alaskan sled dogs, Weimaraner, Newfoundland (E) Rottweiler, Doberman pinscher, Pit bull

Answer is E: Sheep and dogs. The definitive host of Echinococcus granulosus is the dog and other canids. Intermediate hosts include herbivores such as sheep, goats, deer, moose, kangaroos, and wallabies. Humans can also be infected by the ingestion of food contaminated with dog feces. In the intermediate host, ingested eggs hatch into larvae that travel via the circulation to form hydatid cysts in the liver, brain, and lungs. Ref: The Merck Veterinary Manual online edition.

Which two animals are hosts associated with zoonotic transmission of Echinococcus granulosus tapeworm larvae? (A) Opossums, horses (B) Raccoons, llamas (C) Cats, rodents (D) Pigs, cattle (E) Sheep, dogs

Answer is D: Hypotonic crystalloids should never be given for resuscitation because they quickly diffuse out of the intravascular space and are therefore ineffective at expanding vascular volume. Crystalloids are fluids that contain electrolytes in water. They are divided into hypotonic (more water than electrolytes), isotonic (equal water and electrolytes), and hypertonic (more electrolytes than water). Isotonic fluids have similar osmolality to blood. Hypotonic and hypertonic fluids have decreased and increased osmolality compared with blood, respectively. Natural colloids are not crystalloids. They can are often a very useful part of a resuscitation plan because they stay in the vascular space and provide extended volume expansion.

Which type of crystalloid fluid should never be used to resuscitate a dehydrated patient? (A) Natural colloids (B) No type of crystalloid should be used for resuscitation (C) Hypertonic (D) Hypotonic (E) Isotonic

Answer is B: RAT POISON interferes with vitamin K and leads to uncontrolled bleeding in animals that eat rat poison or rats that died from eating rat poison. Follow this link to see blood in the chest of an animal that died from rat poisoning.

Which vitamin does anticoagulant-based rat poison interfere with? (A) vitamin A (B) vitamin K (C) vitamin B (D) vitamin E

Answer is C: The dorsal neck and intrascapular region should be avoided because it is very difficult to treat any abscess or mass that may occur in that location in reaction to the injection. Most subcutaneous injections should be given dorsolaterally between the neck and the hips. Cats are at risk for feline injection-associated fibrosarcoma, so vaccines should be given as low as possible on the limbs (facilitates amputation if needed later). An estimated 1 to 10 in 10,000 cats develop injection associated sarcomas following vaccination with FeLV and Rabies vaccines. Click here to see a cat with an injection site sarcoma (also called vaccine-associated sarcoma). Insulin has relatively poor absorption from the intrascapular region, and fibrosis can occur if it is repeatedly injected in one location

Why is it NOT recommended to administer subcutaneous injections in the intrascapular area or on the dorsal neck? (A) Presence of blood vessels (B) Proximity to the spinal column (C) Difficult to treat of reactions (D) Painful for the animal (E) Cannot raise enough skin for injection

Answer is A: The brachioradialis muscles runs adjacent to the cephalic vein on the medial aspect of the forearm, and may be mistaken for the vein during venipuncture. A brachial plexus avulsion may be seen after shoulder trauma, esp. being hit by a car. Patellar luxation is a hindlimb problem. Follow this link to see a radiograph of patellar luxation.

Why is the brachioradialis muscle clinically significant in dogs and cats? (A) Can be mistaken for cephalic vein in venipuncture (B) Associated with brachial plexus avulsion (C) Adjacent to the tibial nerve (D) Implicated in medial patellar luxation (E) Lies above axillary artery

Answer is D: This is the prefrred site because it is associated with a decreased risk of carotid puncture. Horses have a muscle layer that lies between the jugular vein and the carotid artery in the cranial half of the neck that helps protect against this complication.

Why is the cranial half of the neck the preferred site for jugular venipuncture in horses? (A) Increased ease of access (B) Less chance of esophageal puncture (C) Improved visualization (D) Decreased risk of carotid puncture (E) This is not the preferred site in horses

Answer is B: Prevent esophageal irritation

Why should the oral administration of some tablets to dogs or cats be followed by liquid administered via syringe? (A) Improve the animal's experience (B) Prevent esophageal irritation (C) Decrease risk of tablet rejection (D) Minimize oral ulceration (E) Alter the pH of the stomach

Answer is A: Hospitalized foals with feeding tubes in place are at risk of developing oral candidiasis because their mouth is not being continually rinsed during nursing. It is even more likely in foals receiving oral antimicrobials. With this disorder, a white plaque develops on the tongue that should be wiped off daily with a dry 4x4 gauze sponge. Oral or topical antifungals are also often administered.

Why should the tongue of a neonatal foal with a feeding tube in place be checked daily? (A) Check for oral candidiasis (B) Check for tongue lacerations (C) Check for pharyngeal aspergillosis (D) Check tongue strength (E) This is unnecessary

Answer is C: Mineral oil should never be given via a dosing syringe because aspiration of mineral oil invariably causes fatal pneumonia.

Why shouldn't mineral oil be given via drench (i.e., a dosing syringe) to large animals? (A) Possibility of puncturing the back of the mouth (B) It clogs up the dose syringe (C) Risk of fatal aspiration pneumonia (D) Poor gastrointestinal absorption (E) It is easily spit out

Answer is E: IV fluids should be STOPPED IMMEDIATELY until the vet is able to make a determination of how to proceed. IV fluid therapy can result in volume overload, especially in compromised patients (and those with renal disease), and especially in CATS. Signs of pulmonary edema secondary to overload of the left side of the heart include increased respiratory effort, more than 20% increase in respiratory rate, and crackles on auscultation.

You are doing a re-evaluation on a 6-year-old female spayed domestic long hair cat being treated with IV fluids for acute renal failure. You note her respiratory rate is now 28 breaths per minute (bpm) and it was 20 bpm last time you checked her several hours ago. You can auscult pulmonary crackles bilaterally. What should you do? (A) Place in oxygen cage and decrease IV fluid rate (B) Decrease fluid rate by 50% and recheck in 20 minutes (C) Administer furosemide IV and continue fluids (D) Gather equipment for transtracheal wash (E) Stop IV fluids and call vet

Answer is A: The quantity of vaccine is not dependent on age or size of an animal. A full dose should be given to all animals.

You are giving a vaccine to an adult Shih Tzu and an 11 month old Mastiff. Which choice is most appropriate? (A) Give each dog a full dose (B) Give them both a half dose (C) Give the Shih Tzu a half dose and the Mastiff a full dose (D) Give the Mastiff a half dose and the Shih Tzu a full dose

Answer is D: Another name for dilated pupils is mydriasis. Two commonly used pre-anesthetics, atropine and glycopyrrolate, both cause mydriasis. When both pupils are small, that is called miosis. Meiosis is a form of cell division. Myiasis is a name for invasion of tissue by parasitic fly larvae, like screwworm fly larvae.

You are presented with a cat who looks like this (dilated pupils). What is the name of this condition? (A) Myiasis (B) Meiosis (C) Miosis (D) Mydriasis

Answer is C: When both pupils are small, that is called miosis. Another name for dilated pupils is mydriasis. Two commonly used pre-anesthetics, atropine and glycopyrrolate, cause mydriasis. Meiosis is a form of cell division. Myiasis is a name for invasion of tissue by parasitic fly larvae, like screwworm fly larvae.

You are presented with a cat who looks like this: What is the name of this condition? (A) Meiosis (B) Myiasis (C) Miosis (D) Mydriasis

Answer is B: 10% dehydration equals a 10% loss in body weight in a non-obese animal. Expect dry mucous membranes, marked loss of skin turgor (skin stays tented up longer than normal after you pinch it), and sunken eyes with 8-10% dehydration. Remember that the total body water (TBW) in a healthy non-obese animal is about 60% of its body weight

You are presented with a non-obese dog that is 10% dehydrated. What change do you expect in the body weight (A) 20% decrease (B) 10% decrease (C) 5% decrease (D) No change (E) Cannot tell with this information

Answer is C: Silver nitrate is used for chemical cauterization to stop bleeding.

hen the "quick" is accidentally cut during a nail trim, which one of the following choices can be used to stop the bleeding? (A) Acetylsalicylic acid (B) Pyrethrin (C) Silver nitrate (D) Acid citrate dextrose