Vet Prep
The correct answer is granulosa-thecal cell tumor. The clinical signs and palpation findings are both consistent with this diagnosis. The other choices listed may create a palpable ovarian mass but would not cause atrophy of the contralateral ovary and should not cause infertility.
A 12-year old mare presents for infertility and abnormal sexual behavior. On rectal palpation, you feel a large multicystic ovary and the other ovary feels very small. What is the most likely diagnosis? Cystic ovarian follicles Ovaritis Ovarian hematoma Granulosa-thecal cell tumor
Atenolol This case is a description of a dog with subaortic stenosis, based on the breed, radiographic findings, and auscultation findings. Beta blockers such as atenolol are beneficial in patients with subaortic stenosis because they reduce myocardial oxygen demand, lessen the frequency of ventricular arrhythmias, and provide cardiac muscle protection. Owners should also be warned that the dog should receive prophylactic antibiotics for any situation in which the dog may develop a bacteremia since subaortic stenosis is known to carry a high risk of developing infective endocarditis (i.e. prior to surgical or dental procedures).Balloon dilation by catheterization can be attempted in some patients, but the results are often not as rewarding as for pulmonic stenosis. Surgical repair is difficult, expensive, and does not give very good results either. There is no indication for furosemide unless the dog is in heart failure, which is not the case here. Occlusion by ligation or coil is the treatment for a patent ductus arteriosus but would be a catastrophic error on the aorta. A pacemaker is not needed as there are no severe conduction abnormalities in this case. Pimobendan is used for diseases with decreased cardiac contractility such as dilated cardiomyopathy. The prognosis for dogs with severe subaortic stenosis is guarded.
A 1-year old male neutered Newfoundland presents for a physical exam. Cardiac auscultation reveals a 3/6 systolic murmur at the left heart base. Thoracic radiographs show mild left-sided cardiomegaly with left atrial enlargement and segmental enlargement of the ascending aorta. Which of the following is an appropriate treatment for this patient? Pimobendan Place a pacemaker Furosemide Atenolol Occlusion by ligation or coil
Based on the more concerning clinical signs, foal heat diarrhea is the least likely cause. Foal heat diarrhea is associated with the mare's first estrous cycle after parturition, typically occurring between 8-12 days after parturition. Almost always, foal heat diarrhea is transient and not associated with clinical signs (ie. lethargy, inappetance, fever); it is also self-limiting. The cause of foal heat diarrhea is not exactly known, but hormonal changes, diet changes and/or intestinal floral changes are some possible causes. The other possible answers are all causes of diarrhea in the foal and can be associated with significant clinical signs and changes in blood parameters (CBC, biochemistry profile). This case also tests your knowledge of healthy foals. Some things to recognize in this question include: the gestation length is slightly short (normal gestational period ~ 340 days), the serum IgG is low (normal IgG > 800 mg/dL), the nursing activity is decreased (normally nurse 4-6 times/hour) and the colt has mild elevations in temperature, pulse and respiratory rate.
A 10-day old, 130 pound thoroughbred colt is presented to you for a 2-day history of watery diarrhea. The foal gestational period was 327 days with a normal parturition reported. Serum IgG concentration, measured at 1 day of age, was 550 mg/dL. The foal produces watery diarrhea during the examination (see image) and nurses once per hour. The colt appears dull but responsive. The vital parameters taken as the foal rests are as follows: Temperature 102.9F (39.4 C) Pulse 120 beats/min Respiratory Rate 80 breaths/min Based on the limited information presented here, what is the LEAST likely cause of the diarrhea noted in this case? Salmonella sp. Rotavirus Foal Heat Diarrhea Septicemia Clostridium perfringens
Doxapram is a central nervous stimulant that has effects on respiratory centers. It is thought that it may work by stimulating the reflex activation of carotid and aortic chemoreceptors. At one point, it was used in critical care patients during resuscitation efforts; however, this has fallen out of favor since doxapram results in increased work associated with respiration without an increased amount of arterial oxygenation. When performing a laryngeal exam, the goal is to have the patient just deep enough so you can perform a laryngeal exam. Injectable anesthetics such as thiopental or propofol are used. Overzealous administration of these can result in a false diagnosis of laryngeal paralysis and it is therefore recommended to administer Doxapram to help stimulate respiration and definitively confirm your diagnosis.
A 10-year old Golden Retriever has presented for a progressive onset of exercise intolerance and voice change. On physical exam the patient is noted to have a 7/9 body condition score. Mucous membranes are pink. Capillary refill time is less than 2 seconds. Lung sounds are clear bilaterally. Stridorous breathing is noted on inspiration. Laryngeal paralysis is suspected and a sedated laryngeal exam has been recommended. The owner agrees to routine blood work, chest radiographs, and a laryngeal examination. Which of the following medications will help assist in evaluation of laryngeal function? Ketamine Doxapram Propofol Dopamine Diphenhydramine
C6-T2
A 2-year old male castrated mixed breed dog presents for an altered gait after being hit by a car. On physical exam, the thoracic limbs had decreased biceps and triceps reflexes and decreased muscle tone. The pelvic limbs had hyper-reflexive patellar and gastrocnemius reflexes and increased muscle tone. Where is the spinal cord lesion? C6-T2 T3-L3 C1-C5 L4-S3
The correct answer is strangulating lipoma. Lipomas are a common cause of small intestinal obstruction in older horses. Typically, a section of the small intestine becomes intertwined with a pedunculated lipoma, resulting in obstruction and possible devitalization of the small intestine. Surgical correction is necessary to correct this problem. None of the other answer choices typically result in the clinical signs described, particularly gastric reflux. Left dorsal colon displacement typically have milder clinical signs, and the diagnosis can be made by rectal palpation and ultrasonography.
A 28 year old Paint stallion presents with an acute onset of colic. On presentation he has a rectal temperature of 99.8F (37.7 C), heart rate of 75 beats/min, respiratory rate of 24 breaths/min, and is pawing and trying to lie down. CRT is approximately 3.0 seconds, and mucous membranes are purple-red. Gastrointestinal sounds are completely absent, and gastric reflux yielded 18L of brown- to yellow-colored fluid. Peritoneal fluid analysis yielded a cloudy yellow fluid with a protein of 3.2 gm/dl and white blood cell count of 11,000/ul. Which of the following is a possible diagnosis? Strangulating lipoma Cecal volvulus Left dorsal colon displacement Strongylus vulgaris infestation Right dorsal colon displacement
Fluoxetine (Prozac) is an anti-depressant and SSRI that can be used to treat cats for anxiety related disorders at a dose of 0.5 mg/kg orally once daily.
A 3-year old male castrated DSH cat presents to you for pica. The owner reports that the cat chews and eats various fabrics including the owner's garments. The owner reports that this behavior seemed to begin shortly after her daughter was born. Which of the following drugs is a selective serotonin re-uptake inhibitor (SSRI) which you could prescribe as part of the treatment for the cat's anxiety-related behavioral problems? Clomipramine Fluoxetine Clorazepate Amitriptyline Alprazolam
The correct answer is feline panleukopenia virus. These clinical signs most closely correlate with panleukopenia. One must piece together the signalment, history, and clinical findings. Usually a cat with a foreign body will not have diarrhea and a fever. It is unlikely for a 4-month old kitten to have FIV due to maternal antibody protection. It is also unlikely for FIP to present in such a manner. With the wet form of FIP, you may see dyspnea due to pleural effusion and abdominal distention due to ascites. With the dry form of FIP it will depend on the organ that is affected. You may see a hepatopathy, splenomegaly, renal failure, etc.
A 4-month old kitten arrives at your clinic with a 3-day history of anorexia, lethargy, vomiting, and diarrhea. On physical exam the cat is 5% dehydrated and has a temperature of 103.9F (39.9 C). What is your primary differential? Feline immunodeficiency virus Feline panleukopenia virus Feline infectious peritonitis Foreign body
You should be highly suspicious of leakage at the surgery site and resultant septic peritonitis. The most common time for anastomosis failure is 3-5 days postoperative;y. This is due to the degradation of fibrin at the site prior to deposition of sufficient collagen. Abdominocentesis would likely reveal a septic inflammatory process, confirming your clinical suspicion with the finding of intracellular bacteria. A CBC and chemistry are helpful adjunct diagnostic tests but are not specific for septic peritonitis. An abdominal ultrasound would not distinguish between normal postoperative abdominal fluid and/or free gas and a septic effusion. Serum lactate, although helpful, is also not specific for sepsis. Thoracic radiographs could be useful to assess for less likely complications such as aspiration pneumonia.
A 4-year-old male Akita presents with a foreign body obstruction. You perform an intestinal resection and anastomosis surgery due to the compromised appearance of the intestine at the foreign body site. The dog recovered well after surgery. Five days postoperatively, he presents again with a history of inappetence and has a 104.8 F (40.4 C) temperature. What is the best diagnostic test to confirm your clinical suspicion? Abdominal ultrasound Thoracic radiographs Abdominocentesis Complete blood count and serum chemistry Serum lactate
Respiratory acidosis with metabolic compensation caused by neonatal encephalopathy (hypoxic-ischemic encephalopathy) This is a more complicated question that requires evaluation of the entire case. First, recognize the foal's problem list includes: lethargy, hypoventilation, intermittent seizures as well as no suckle response. Next recognize that the arterial blood gas reveals a normal PO2 in a recumbent foal but hypercarbia (respiratory acidosis) with metabolic compensation. Based on these findings, the most likely cause in neonatal encephalopathy. This disease can arise from hypoxic conditions in utero or during parturition (dystocia, premature placental separation) resulting in a cascade of biochemical derangements within the body. Clinical signs include lethargy, failure to find and nurse from the udder, seizure activity, and in more severe cases damage to the gastrointestinal system and/or kidneys from hypoxia. Many foals are hypercapnic because the respiratory center within the CNS is not operating normal. There can be evidence of infection that complicates the presentation of some foals with neonatal encephalopathy, but in this case the CBC and rectal temperature are normal, making infectious diseases (bacterial meningitis, septicemia) less likely. You should have some knowledge of what normal arterial blood gas reference intervals are: pH 7.35-7.5; PO2 variable in venous blood; PCO2 around 40 mmHg, HCO3 24-30 mEq/L, iCa++ 1.4-1.8 mmol/L. This is a general range, with each species having slight changes to this range.
A 48-hour Paint colt is presented to you for lethargy, irregular facial twitching and prolonged recumbency (see image). The owner reports that the gestation was 343 days and parturition was normal. Upon physical examination, the foal heart rate is 88 beats/min, respiratory rate is 10 breaths/min, and the rectal temperature is 101.2F (38.4 C). The foal is difficult to arouse and appears to have mild intermittent seizure-like activity. The foal can stand briefly but has no suckle response. The CBC and biochemistry analysis are within normal limits for a foal of this age; the arterial blood gas (collected while foal was in lateral recumbency) demonstrates the following results: pH 7.19 (7.35-7.5) PO2 78 mmHg (~94 mmHg) PCO2 80 mmHg (36-46 mmHg) HCO3 42 mEq/L(24-30 mEq/L) Ionized Ca++ 1.7 mmol/L (1.4-1.8 mmol/L) What is your interpretation of this arterial blood gas analysis and what is the most likely cause? A. Respiratory acidosis with metabolic compensation caused by neonatal encephalopathy (hypoxic-ischemic encephalopathy) B. Respiratory acidosis without metabolic compensation cause by neonatal septicemia C. Respiratory acidosis without compensation caused by seizures D. Respiratory alkalosis with metabolic compensation caused by bacterial meningitis E. Respiratory acidosis with metabolic compensation caused by atlantoaxial malformation (OAAM)
Doxycycline can result in delayed bone growth and discoloration of the teeth in young growing animals and is thus contraindicated. The other medications listed do not have a direct effect on young growing animals and are safe to administer; however, one must consider the likely pathogen present in the wound, what type of susceptibility pattern it has, as well as the likely penetration of your antibiotic into the area where you want it to exert its effect prior to making a choice.
A 6-week old male intact puppy has presented to your clinic after being bitten 4 days ago. On physical examination, there is a moderate amount of purulent discharge noted from the bite wound on the left antebrachium. The wound is approximately 2 cm in length. Which antibiotic is LEAST appropriate for this patient? Doxycycline Penicillin Cephalexin Metronidazole
Surgical removal of the feather cyst and follicle Feather cysts are the avian equivalent of an ingrown hair. A growing feather is unable to protrude through the skin and curls within the follicle. Since feathers are much larger than hairs, cysts can be quite large and painful. They commonly are found in the primary feathers of the wing. The cysts contain keratinized feather material that can be expressed or excised but commonly recur. Treatment of choice is surgical removal of the involved feather follicle.
A 6-year old Sun Conure presents for evaluation of a skin lesion. The owner reports that the bird is very sensitive on the wing near the lesion. On your exam, you note an oval swelling involving the feather follicle as seen in the image below. What is the best treatment for feather cysts? No treatment is necessary as feather cysts typically resolve spontaneously Lance and drain the feather cyst, flush with saline Treat with systemic antibiotics for 4-6 weeks Surgical removal of the feather cyst and follicle Squeeze and express the material out of the feather cyst
The correct answer is it may take up to 3 days to overcome medullary washout from being polyuric and polydipsic. DDAVP is a synthetic ADH used to replace the lacking endogenous hormone. DDAVP does not induce the hypothalamus to make ADH. Medullary washout commonly occurs with CDI from prolonged PU and PD. It may take up to 3 days to get the medullary sodium concentration and concentrating mechanisms back in order. ADH receptors in the kidneys are not affected in CDI.
A 6-year old male castrated Borzoi dog presents to you with a one-year history of polyuria and polydipsia with no other clinical signs. A urinalysis confirms a specific gravity of 1.003 and no other abnormalities. Serum chemistry shows: Ca 10.1 mg/dl (9.1-11.7 mg/dl) P 3.2 mg/dl (2.9-5.3 mg/dl) bilirubin 0.l mg/dl (0-0.3 mg/dl) albumin 2.9 g/dl (2.3-3.1 g/dl) globulin 2.5 g/dl (2.7-4.4 g/dl) ALT 40 U/L (10-109 U/L) glucose 104 mg/dl (76-119 mg/dl) BUN 8 mg/dl (8-28 mg/dl) Creatinine 0.6 mg/dl (0.5-1.7 mg/dl) cholesterol 120 mg/dl (135-278 mg/dl) You tentatively diagnose central diabetes insipidus and elect to try the dog on desmopressin (DDAVP) to see if the PU/PD resolves. Which of the following reasons best explains why you might not see a response within the first 24-48 hours, even if your diagnosis is correct? A. It may take up to 3 days to overcome medullary washout from being polyuric and polydipsic B. It may take up to 3 days to reactivate the antidiuretic hormone (ADH) receptors in the kidneys C. It takes a few days for the hypothalamus to respond to DDAVP and to start making antidiuretic hormone (ADH) D. Trauma to the hypothalamus or pituitary causing CDI will never respond to antidiuretic hormone (ADH)
No P waves Based on the history and the physical exam findings of dehydration and bradycardia, you should be concerned about hypoadrenocorticism. Hypoadrenocorticism patients are typically hyperkalemic. ECG abnormalities with hyperkalemia include wide, flat, or absent P waves, widened QRS complexes, tall spiking T waves, and bradycardia.
A 7-year old female Standard Poodle presents to you for acute onset of vomiting and weakness after the owners returned from vacation. On physical exam, you estimate that the dog is 7% dehydrated, has a respiratory rate of 36 breaths per minute, heart rate of 44 beats per minute and temperature of 99 degrees F. You quickly attach ECG leads and expect to see which of the following abnormalities? No P waves Ventricular tachycardia Inverted T waves Tall, narrow QRS complexes
Pleural fissure lines are typically diagnostic for pleural effusion. The fissures are the normal divides between the lung lobes and are not visualized on radiographs unless there is fluid in the chest or the pleura is very thickened. When there is a large amount of fluid, you may begin to appreciate a loss of detail, and it is possible lung lobes will collapse as a result of an inability to properly expand in the face of the pleural effusion.A lobar sign is seen when there is a line of demarcation between a radiopaque (consolidated) lung lobe and a radiolucent (normal) lung lobe. There can be several causes for a lobar sign including hemorrhage, edema, or pus within the lobe.An air bronchogram is seen when alveolar edema occurs as a result of fluid accumulating within the alveoli. Alveolar edema will result in a sharp contrast between the fluid in the alveoli and the air in the bronchi.
A 7-year old male intact Labrador Retriever presents for an increased respiratory effort. Chest radiographs were performed which were indicative of pleural effusion. Which of the following is the most reliable radiographic sign that would be indicative of pleural effusion? Pleural fissure lines on both lateral and ventrodorsal projections Air bronchogram on both lateral and ventrodorsal projections Lobar sign on both lateral and ventrodorsal projections Retracted lung lobes on both lateral and ventrodorsal projections
The correct answer is vitamin E and selenium deficiency (white muscle disease). The clinical signs are somewhat compatible with the other answers; however the necropsy results are diagnostic for white muscle disease. There is both a cardiac form, in which animals die acutely, and a skeletal muscle form, in which animals don't die acutely but show clinical signs. In this particular question, the ranch was suffering from both forms. Remember that oleander and gossypol are both cardiotoxic and can cause acute death. Given the necropsy findings, clostridial myositis would be unlikely. Selenium is essential for glutathione peroxidase, deiodinase, and selenoprotein-P to work. Glutathione peroxidase breaks hydrogen peroxide and lipoperoxide into water or harmless alcohols.
A beef ranch has suffered 12 acute deaths of 2-4 month old calves in the past six months. The owner of the ranch states that the animals appeared severely weak and depressed just before dying. On some of them, he noticed that they were having trouble breathing and had a frothy nasal discharge. You perform a necropsy on a calf that died yesterday. Findings included bilaterally symmetric muscular atrophy. The skeletal muscle appears pale and dry in appearance with white streaks running along muscle bundles. You also notice that there are several calves in the ranch which are having trouble rising, and their musculature appears swollen, hard, and painful. What is the most likely diagnosis? Vitamin E and selenium deficiency Oleander toxicity Gossypol toxicity Clostridial myositis Septicemia
The correct answer is exercise-induced pulmonary hemorrhage. This has multiple other names, and horses with this condition are sometimes referred to as bleeders or as bobbling, chocking, or gurgling. It is thought to be extremely common in Thoroughbreds. In this condition, following exercise at speed and large efforts from the lungs, pulmonary damage occurs and bleeding starts, usually in the caudal dorsal lung lobes. Common clinical signs are excessive swallowing after exercise because the horse is swallowing blood that was brought up. They may also cough to clear blood from their airways. Epistaxis is actually only seen in about 10% of horses with exercise-induced pulmonary hemorrhage. The other options in this question such as airway disease and heart failure would not be consistent with this horse's excessive swallowing after racing.
A Thoroughbred racehorse presents to you for having poor performance, stopping at the ends of races, and having labored breathing. After races, the horse swallows excessively and will sometimes cough. What is your most likely diagnosis? Exercise-induced pulmonary hemorrhage Large airway obstruction Congestive heart failure Dynamic airway collapse
Free gas bloat secondary to chronic bronchopneumonia Cattle have relatively poor collateral ventilation (as compared to a horse for example) so they tend to get pulmonary consolidation with chronic bronchopneumonia. The inflammation and enlarged lymph nodes associated with chronic infection of the lungs can affect the vagus nerve as it passes through the chest, resulting in type 1 vagal indigestion, or free gas bloat.Type 2 vagal indigestion is failure of omasal transport and appears as an enlarged fluid-filled rumen. It is most often associated with traumatic reticuloperitonitis. Bovine respiratory syncytial virus pneumonia tends to occur in younger calves and be much more acute and with different auscultation findings than described here. The signs and physical exam do not fit either frothy bloat or acute bovine pulmonary emphysema.
A beef steer in a feedlot has moderate chronic bloat, and is eating poorly and losing weight (see image). He was treated a month ago for bovine respiratory disease complex with antimicrobials given for 3 days. You examine him and find a temp=104F (100- 102.6F) (40 C), HR=95/min (60-70), RR=64/min (37-36), and the rumen is gas-filled and has only weak motility. When you pass a stomach tube, the gas is readily removed from the rumen. The lung sounds are harsh ventrally on inspiration and expiration, with some crackles and wheezes also auscultable. On percussion, the ventral thorax is dull. The steer coughs several times while being examined. What is your diagnosis? Bovine respiratory syncytial virus pneumonia Type 2 vagal indigestion Acute bovine pulmonary edema and emphysema Free gas bloat secondary to chronic bronchopneumonia Frothy bloat
The correct answer is aspergillosis. This is caused by Aspergillus fumigatus. It is common among raptors, penguins, and waterfowl but not psittacines except under poor husbandry, stress, or immunodeficiency. Transmission is by inhalation of spores. There may be a history of respiratory signs (acute or chronic). Findings include fungal plaques on the air sacs and thickening of the air sacs. Antemortem diagnosis can be made by transtracheal wash with culture and cytology. Treatment is with antifungals such as amphotericin B or -azole antifungal agents.
A deceased adult Red Tailed Hawk presents to you for necropsy after long standing respiratory disease. You find white plaques on the air sacs and caseous plugs in the distal trachea. What disease do you suspect? Aspergillosis Trichomoniasis Internal papillomatosis Candidiasis
The correct answer is infectious bursal disease, also sometimes called gumboro disease. This disease is caused by a birna virus and is most readily isolated from the bursa of fabricius. It is highly contagious and difficult to eliminate from the environment. Subclinical infections commonly occur in chicks less than 3 weeks of age and are of most economic significance. In clinical infection, the signs and necropsy findings are as described. There is no effective treatment, but a vaccine is available.
A farmer arrives with a dead 5 week old chicken and many of his chickens have been doing poorly. Clinical signs include watery diarrhea, incoordination, prostration, and vent picking. Necropsy on the dead chick reveals a swollen cloacal bursa that is edematous and yellow with hemorrhage. There is also congestion and hemorrhage of the pectoral, thigh, and leg muscles. What is the most likely diagnosis? Avian influenza Marek's disease Infectious bursal disease Salmonella
The correct answer is an increased risk for uterine adenocarcinoma. Though all the other choices are potential concerns, uterine adenocarcinoma affects greater than 55% of intact females at 3 years of age and older.
A first-time rabbit owner brings in his one-year old doe for a routine physical examination. He wants his rabbit to live longer than him. Though you know this isn't possible, you know that to increase her chances of a longer life, you recommend an ovariohysterectomy. What is your primary concern? The increase in the number of bucks in the neighborhood that will appear in his yard waiting for the doe to escape An increased risk for uterine adenocarcinoma An increased risk for pyometra An increased risk for mastitis
The correct answer is physostigmine. Scopolamine is an atropine-like alkaloid and causes depression and is parasympatholytic to the autonomic nervous system. It can cause convulsions, respiratory failure, incoordination, mydriasis, and constipation. Treatment consists of activated charcoal, laxatives, diazepam to control convulsions and physostigmine (a parasympathomimetic).
A horse presents for ingestion of Jimsonweed which contains scopolamine. Which of the following is the treatment of choice against such an intoxicant? Atropine Diphenhydramine Acetazolamide Epinephrine Physostigmine
The correct answer is pigment nephropathy. Pigment nephropathy occurs as a result of myositis (tying up), which this presentation is consistent with. Nephrosis and subsequent renal failure is caused by large amounts of myoglobin being filtered by the kidney. This usually occurs in horses that have been subjected to extreme conditions such that the animal breaks down a substantial amount of muscle. The same condition can occur with intravascular hemolysis. In this case, the hemoglobin pigment is the culprit. However, this scenario seems to be less common in the horse.
A race horse that has been overworked for the past week presents for a stiff gait, lethargy, anorexia, and oliguria. What is the most likely diagnosis? NSAID toxicity Pyelonephritis Ischemic renal failure Pigment nephropathy
Less than 40 mmHg pressure PAP testing done at elevations 6000 ft. or above on animals over 12 months of age is a reliable predictor of genetic susceptibility to high mountain disease (the BMPR2 gene is involved). The lowest pulmonary artery pressure readings are the least susceptible animals. Using local anesthesia, a catheter is inserted into the jugular vein and threaded into the right heart and pulmonary artery where the pressure is taken while the animal is restrained in a squeeze chute. The condition is caused by a genetic predisposition to developing pulmonary hypertension when oxygen tension is reduced. The pulmonary hypertension leads to pulmonary artery hypertrophy, cor pulmonale, and right heart failure. The hallmarks are lethargy, distended jugular vein, and ventral edema (see image), as well as diarrhea, pulmonary edema, and pleural effusion. Ingestion of toxic plants such as locoweed worsen the disease by causing additional pathology. Cold weather, pregnancy and other stresses can also predispose animals and cause borderline susceptible animals to develop the condition.
A rancher who lives at 8000 ft. elevation in Colorado is planning to buy good bulls and wants you to test them for susceptibility to high mountain disease (pulmonary hypertension and cor pulmonale). See image for what high mountain disease looks like. You recommend doing pulmonary artery pressure (PAP) testing in the squeeze chute to measure their susceptibility to pulmonary hypertension. Which of the following PAP measurements, taken at 6000 ft. elevation, would be satisfactory for this ranch to purchase? Less than 40 mmHg pressure 45 to 50 mmHg pressure None, the testing must be done below 5000 ft. elevation to be reliable 55 to 60 mmHg pressure None, there is no reliable way to predict susceptibility to high mountain disease
The correct answer is this horse most likely has aortic regurgitation due to degeneration of the aortic valve and should have no impact on performance. Given the location of the murmur and signalment, this should be the logical answer to choose. The thing you need to know is that aortic regurgitation in the horse is usually a degenerative change and there isn't much that can be done about it. Horses are rarely impaired by development of the murmur. In a true pre-purchase exam, you would be wise to recommend a full cardiac work-up to definitively diagnosis the source of the heart murmur. The potential buyer may decline further diagnostics, but at least you will have offered the choice and have provided the proper information to the client.
During a routine pre-purchase exam of a 24 year old Peruvian Paso, a harsh and decrescendo holodiastolic 3/6 murmur is auscultated with a point of maximum intensity at the left base of the heart. There were no other abnormal physical exam findings. What is the most likely diagnosis based on clinical exam and prognosis of this horse? This horse most likely has aortic stenosis due to turbulent flow resulting in severe stenosis, which will limit the ability to perform This horse most likely has aortic regurgitation due to degeneration of the aortic valve and should have no impact on performance This horse most likely has pulmonic stenosis due to turbulent flow resulting in severe stenosis, which will limit the ability to perform This horse most likely has pulmonic regurgitation due to degeneration of the pulmonic valve and should have no impact on performance
The best answer is 2400 mEq. The formula you need to know to calculate how much sodium bicarbonate you need (depending on your reference source) is 0.4 x BW x Base Deficit. Plug and chug (using 0.4) and you get 2444, which is the closest answer.In practice, you may choose to fix only part (often half) of the total calculated bicarbonate and reassess, but this question asks how much is needed to completely correct the deficit.If you need a reminder, the base deficit is the amount of base that you would need to add to a solution (i.e. plasma) to achieve a pH of 7.4. In general, the normal HCO3 concentration in blood is around 22-24 mEq/L. The base deficit is simply calculated by subtracting the patient's HCO3 concentration (i.e. 10 from the normal concentration [23]).
How much sodium bicarbonate must be given to a 470kg horse that has a base deficit of 13 to completely correct this deficit? 900 mEq 1100 mEq 4500 mEq 2400 mEq 600 mEq
The correct answer is goiter. Also known as thyroid hyperplasia, classic signs include stertor or wheezes due to pressure of the thyroid on the syrinx. Regurgitation can be seen and engorgement of the right jugular vein may occur in severe cases.
Iodine deficiency in a budgerigar can lead to which of the following? Egg binding Squamous metaplasia of the mucous membranes Goiter Hepatic lipidosis
Milk Fever A cow with a history of recent parturition with clinical signs such as these should be considered as having hypocalcemia until proven otherwise. The cow needs treatment to restore normal calcium levels.
One cold December morning you are presented with a 5-year old Holstein dairy cow which freshened the day before. This morning she was found down in the corral and unable to rise. On physical examination you find T=98F, 36.7C, HR=90 (and the heart is difficult to hear), and RR=10. She has her neck turned back toward her thorax, and it has an "S" shaped curve in it. Her nose is dry, she is non-responsive to being handled, and her rumen motility is absent. The rectal exam shows that her bladder is full. The mammary glands and the uterine lochia appear normal. Based on these findings, which of the following disorders is most likely? Left displaced abomasum (LDA) Spinal lymphoma Hypothyroidism Coliform mastitis Milk fever
Thelazia Thelazia is a genus of nematode worms (eyeworms) which are found in the ocular tissues. Adults are usually found in the eyelids, tear glands, tear ducts, or the nictitating membrane. They may be found in the eyeball itself under the conjunctiva or in the vitreous. Thelazia are transmitted by Diptera (flies) which do not bite but feed on tears. Toxocara, which causes ocular larval migrans, usually causes granulomas which may be seen in the retina and appear more circular.
You are doing a summer externship in South America and performing physical exams on a variety of animals. You are performing a fundic exam on the eye of a horse and note what appears to be a worm migrating through the conjunctiva (see image). Because of the location and appearance of this parasite, you suspect this is which of the following? Thelazia Oxyuris Dirofilaria Toxocara
The correct answer is copper deficiency. The giveaway is achromotrichia or loss of hair color. Dilution of the coat color is due to dysfunction of tyrosinase which converts L-tyrosine to melanin. In addition, copper deficient animals will have spontaneous fractures, secondary respiratory disease, diarrhea, ill thrift, decreased immunity, anemia, and poor reproduction. Selenium deficiency and BVD are actually pretty good differentials and if achromotrichia was not present either of those two are reasonable choices. Molybdenum deficiency would not result in achromotrichia. On the other hand, if there had been excess molybdenum, then the Cu:Mo ratio would be off and copper deficiency could be observed.
The owner of a new beef ranch on poor volcanic soil asks you to evaluate 2 steers. They are representative of an ongoing herd problem of chronic diarrhea and respiratory disease that is unresponsive to antibiotic treatment. On physical exam, you notice achromotrichia, ill thrift, and a temperature of 103F (39.4 C) in both steers. You perform a transtracheal wash in one of the steers and it comes back positive for Pasteurella multocida. What is your diagnosis? Selenium deficiency Pasteurella pneumonia Copper deficiency Bovine viral diarrhea
The correct answer is Johne's disease (Mycobacterium avium ssp. paratuberculosis). You should have been able to make this your answer without the help of the finding of acid-fast rods but that makes the answer a 'slam dunk'. Johne's is typically a disease of chronic wasting, affecting animals 2 years and older. Cryptosporidium and Clostridium perfringens are causes of diarrhea but tend to be more acute and in lambs. Cryptosporidium does also stain acid-fast but is not a rod and would not be found in a lymph node; it is usually seen in fecal smears.
There are many adult sheep in a flock that are experiencing chronic weight loss. Some have diarrhea and submandibular edema. You perform a necropsy on an affected sheep and find thickened, corrugated intestines around the ileum. You find numerous acid-fast rods when you stain an ileocecal lymph node. What is the most likely diagnosis? Caseous lymphadenitis (Corynebacterium pseudotuberculosis) Johne's disease (Mycobacterium avium ssp. paratuberculosis) Clostridium perfringens type D Cryptosporidium parvum
The correct answer is xanthine stones. Allopurinol is used in the treatment of urate stone forming Dalmatians. It acts by inhibiting the enzyme, xanthine oxidase, which metabolizes xanthine. The idea is that by stopping the purine metabolism pathway at this point, uric acid will not be formed in high quantities. However, if given at too high of a dose, xanthine will accumulate to levels where xanthine stones will form.
What type of urinary stone is likely to form in an animal being treated with too much allopurinol? Cysteine Urate Xanthine Calcium oxalate Struvite
A. diethyl stilbestrol, chloramphenicol, nitroimidazoles, clenbuterol, fluoroquinolones, vancomycin, nitrofurans
Which group of drugs cannot legally be used in an extra label manner in the United States on food producing cattle? A. diethyl stilbestrol, chloramphenicol, nitroimidazoles, clenbuterol, fluoroquinolones, vancomycin, nitrofurans B. monensin, ivermectin, fenbendazole, moxidectin, lasalocid, decoquinate C. neomycin, gentamicin, sulfamethazine, estradiol, sodium iodide, prostaglandins D. tetracycline, penicillin, florfenicol, sulfas, ampicillin, estradiol, prostaglandins
The answer is opioids. NSAIDS and corticosteroids compromise the mucus-bicarbonate protection of the stomach. Renal disease and the corresponding uremia cause decreased mucosal blood flow and gastric hypersecretion. Liver disease causes gastric ulcers by decreasing mucosal blood flow secondary to portal hypertension and thrombosis. Liver failure is also associated with increased histamine and gastrin levels leading to gastric hypersecretion.
Which is not a common cause of gastric ulcers in dogs and cats? Liver Failure Corticosteroids Renal Failure NSAIDS Opioids
The correct answer is Polyoma virus. The virus usually results in lethargy, anorexia, depression, and death. The death may be acute in nature, and it is likely that there will be no beak abnormalities. Whenever you observe beak abnormalities, you should rule out liver disease. Cnemidocoptes infestations lead to a honeycomb-like beak.
Which of the following diseases is not commonly associated with beak abnormalities? Liver failure Cnemidocoptes infestation Psittacine beak and feather disease Polyoma virus
The correct answer is mannitol. Mannitol is filtered at the glomerulus and osmotically pulls water into the tubules. Furosemide is a loop diuretic, acting at the loop of Henle. Enalapril is an angiotensin-converting enzyme (ACE) inhibitor. Spironolactone is an aldosterone antagonist. Acetazolamide is a carbonic anhydrase inhibitor.
Which of the following is an osmotic diuretic? Acetazolamide Furosemide Enalapril Mannitol Spironolactone
The correct answer is glucocorticoids. Restriction of dietary protein decreases the formation of nitrogenous wastes and helps to palliate hyperphosphatemia. Phosphate binding agents prevent the absorption of phosphorus from the intestines. H2 blockers decrease gastric acid secretion helping to prevent vomiting and the formation of gastric ulcers. Calcium channel blockers, like amlodipine, are used to palliate hypertension. Glucocorticoids are not usually indicated in chronic renal failure patients.
Which of the following is not a component of therapy for chronic renal failure? Calcium channel blocking agents Restricted dietary protein Glucocorticoids Oral phosphate binding agents H2 receptor antagonists
The correct answer is swine. The infection is frequently asymptomatic in swine. In ruminants, clinical signs are usually acute to peracute. When the progression is slower, the first clinical signs are often paresthesia (mad-itch) at the site of inoculation. Signs include ataxia, proprioceptive deficits, circling, nystagmus, and strabismus. Sometimes aggression is seen, but usually the animals become depressed. This disease must be differentiated from rabies, polioencephalomalacia, salt poisoning, lead poisoning, hypomagnesemia, and meningitis. Currently, the US commercial swine is free of pseudorabies.
Which of the following is the primary host for pseudorabies? Goats Sheep Cattle Swine Horses
The correct answer is Sporotrichosis. All of these fungal diseases can infect both animals and people. However, they are not considered contagious (not to be confused with infectious) with the exception of Sporothrix. This is because they are mainly acquired from the environment, and transmission from animal to animal is rare. Sporothrix, especially in cats, is a high risk to veterinarians and care should be taken to limit contact with exudates and lesions in cats.Aspergillus is generally considered a ubiquitous fungus that causes infection due to host factors such as immunosucceptibility or certain breed predilections. Cryptococcus is also not a contagious disease (do NOT confuse this with cryptosporidium, which is very contagious and zoonotic as several of my colleagues can attest to profusely). Cryptococcus infection occurs from inhalation of the yeast from the environment, frequently avian habitats, as it survives ideally in pigeon droppings. Essentially, histoplasma, blastomyces, and Coccidioides are also all environmental diseases as well and not considered contagious. Incidentally, there is a true story of a pathologist who did acquire Coccidioides from an animal that was having a necropsy. It is likely that the fungus reverted to the mycelial phase and produced infectious arthroconidia at the low temperatures achieved in the dead animal. This is also a risk when changing bandages for the same reason. These fungi are also potentially infectious when they are being grown on culture plates. So even though they are not technically contagious (at least in terms of how the board examiners view them), there are still risks.
Which of the fungal infections is considered contagious, either to other animals or to man (zoonotic)? Cryptococcosis Blastomycosis Sporotrichosis Aspergillosis Coccidioidomycosis
The correct answer is Great Dane. Large and giant breed pure-bred dogs, particularly with deep chests, are very predisposed to developing GDV. Great Danes are a classic example; other common breeds include Weimaraner, Saint Bernard, and Irish Setters.
Which of these breeds of dog is most predisposed to development of gastric dilatation and volvulus? Cocker Spaniel Chihuahua Great Dane Dalmatian
The correct answer is apomorphine. Apomorphine is an opioid dopaminergic agonist that acts on the chemoreceptor trigger zone to induce vomiting in dogs. In can be administered IM, SC, IV, or in the conjunctival sac. Xylazine is a fairly effective emetic in the cat but is not used in the dog for this purpose. Azathioprine is an immunosuppressive drug not used to induce vomiting. Magnesium hydroxide or Milk of Magnesia is a cathartic but is not used for vomiting
Which of these is an effective drug to induce emesis in the dog? Xylazine Apomorphine Magnesium hydroxide Azathioprine
Acute oak toxicosis The reason that oak toxicosis may occur in this scenario is as follows: the snow knocks down the budding oak limbs which are eaten by curious calves who cannot reach the grass. The calves develop both renal and GI signs as the tannins damage the mucosa. Many develop hemorrhagic diarrhea and renal tubular necrosis. Some tannins are hydrolyzed in the rumen to gallic acid and pyrogallol, which are both very toxic to the renal tubules. Treatment is aimed at flushing out the toxins (intravenous fluids) and protecting the gastrointestinal tract. Prevention is best; and the animals will avoid eating the oak if they are offered hay immediately during the storm.
You are called by a beef rancher located in the northern California oak foothills one day in March after an unusual spring snowstorm that dumped a foot of wet snow two days earlier. You are asked to diagnose and treat several calves in the 3- to 5- month old age range which are listless and weak. You do a physical exam and find elevated heart and respiratory rates, but normal rectal temperatures. The most remarkable finding is marked edema of the perineum and vulva of the calves (see image).What is the best diagnosis based on these signs and history? Clostridium hemolyticum infection (redwater) Bovine virus diarrhea Acute oak toxicosis Malignant catarrhal fever Lead toxicity
Your next question for the farmer should be "When are pigs vaccinated for ileitis?" The clinical presentation of diarrhea, extremely thickened small intestines, and wasting pigs is highly suggestive of Lawsonia intracellularis infection, commonly called ileitis. In modern pig production, ileitis vaccine is usually administered in the mid-to-late nursery stage (6 - 8 weeks of age) as clinically the disease becomes apparent when pigs are >12 weeks of age. In this case, because the farmer raised the pigs without antibiotics and most likely they are outdoors (organic production), these pigs are exposed to heavy doses of Lawsonia intracellularis organisms very early in life. This results in clinically affected pigs even as early as 3 weeks of age. Since the farmer is using a vaccine it is important to know right away if the timing of the vaccine is appropriate (at least 3 weeks before clinical signs are noted).In this case, there is no need to ask about antibiotic use around vaccination as the farmer produces organic pigs and thus no antibiotics are allowed. PRRS does not cause thickening of intestines. PCV2 can cause wasting of pigs, but clinically affects pigs in the finishing phase (usually > 12 weeks of age). Ileitis is endemic in most, if not all, farms and therefore herd additions would not be a significant contributor to an acute outbreak.
You are called to an organic swine farm to address a problem with piglet performance. The owner reports he is losing a large number of pigs due to wasting. The pigs seem to do fine for about 3 weeks and then will start losing weight. Pigs are left on the sow for 4-5 weeks before they are weaned. Many of the pigs are in such bad shape by the time they are weaned they are not able to recover in the nursery phase. As you visit the farm you find one dead piglet. It appears to weigh just over 10 lbs. You perform a necropsy and notice the small intestines to be extremely thickened. The owner thinks the pig is about 4 weeks old. As you look for other pigs you find 40% of them are thinner than expected. Several of them have a loose stool. No blood is noted on any stools. Sows seem to be eating well. All pigs are vaccinated for ileitis. What question should you ask the owner? Have there been any new additions to the herd in the past 3 months? Do you remove all antibiotics from the feed 3 days before and 3 days after vaccinating for ileitis? Are pigs vaccinated against PCV2? What is the PRRS status of the herd? When are pigs vaccinated for ileitis?
Pituitary pars intermedia dysfunction This disorder used to be called equine Cushing's. This condition is a result of hypertrophy, hyperplasia, and micro- or macroadenoma of the pituitary pars intermedia that secretes increased amounts of propiomelanocortin peptides. Adjacent pituitary tissues are compressed and secrete less of some other peptides. Data suggest that horses with this disease have hypothalamic dysfunction and decreased amounts of dopamine.
You are called to examine an 18-year old horse with the complaint of not shedding out this spring and having less energy. The horse is hirsute, has loss of muscle mass, and has evidence of chronic laminitis. The owner also complains that the animal drinks twice as much as her other horses and seems to urinate a lot. Based on this history and these signs, what diagnosis should be at the top of your list of differential diagnoses? Hypervitaminosis D Adrenal hyperplasia Parathyroid gland malfunction Pituitary pars intermedia dysfunction Hyperthyroidism
The correct answer is right atrial enlargement. This ECG finding is known as P pulmonale and is characterized by tall slender peaked P waves greater than 0.4mV. Many times these patients have a history of chronic pulmonary disease. Left atrial enlargement on an ECG is known as P mitrale. In this case, an increase in duration of the P wave is seen. Usually they will last at least 0.05 seconds. The reason you see these electrical changes is because of the resulting vectors that are produced by having a certain portion of the heart enlarged.
You are in the process of performing an ECG on a Charolais cow with chronic pulmonary disease and notice that the P wave is tall and slender and measures 0.48mV ( normal <0.4 mV), a condition known as P pulmonale. What conclusion as to the nature of the cardiac abnormality can you make from this finding? Left atrial enlargement Right atrial enlargement Congestive heart failure Left ventricular enlargement
Amprolium has zero withdrawal time. Sulfaquinoxoline has a 10 day withdrawal time. Sulfadimethoxine has a 5 day withdrawal period. Nicarbazin has a 4 day withdrawal. Robenidine has a 5 day withdrawal period
You are managing a poultry flock that has had problems with coccidiosis. In choosing an appropriate prevention plan, you need to consider drug withdrawal times. Which of the following agents has the shortest withdrawal time? Nicarbazin Robenidine Sulfaquinoxoline Amprolium Sulfadimethoxine
Muscle tremors and seizures Early clinical signs associated with lidocaine toxicity include neurological symptoms such as seizures and tremors. Nausea and vomiting may occur, but is usually transient. Cardiovascular and respiratory depression can also occur, but usually later on in the course of clinical signs.
You are treating an 8-year old mix breed terrier for ventricular tachycardia post splenectomy. You determine that you've given too much lidocaine to the patient. What clinical signs or laboratory findings are you most likely to see initially? Increased respiratory rate and difficulty breathing Bradycardia and hypotension Diarrhea Muscle tremors and seizures Methemoglobinemia
The correct answer is Neospora caninum, a protozoan parasite. The definitive host is the dog (or coyote or other canidae) which acquires the infection by eating infected meat and spreads it to cows by shedding oocysts in the pasture or feed. Although clinical signs are mainly seen as abortions and abnormal calves in herbivores, dogs may suffer from neurologic and muscular abnormalities. Infection to other dogs is usually as a result of transplacental spread. IFA is usually performed to make the diagnosis.
You get called to a farm that is having trouble with mid-term abortion in their cows. As you are driving up to the farm you see one of the farm dogs and you notice that the dog appears to be suffering from diffuse muscle atrophy and has trouble ambulating in the hindlimbs. You immediately make an association between the dog and the abortions. What is your primary differential? Brucella bovis Toxoplasma gondii Chlamydophila felis Neospora caninum Epizootic bovine abortion
Change genetics for his next matings The correct answer is to talk to the owner about changing his genetics for his next mating. The sudden rigor mortis of the pig as well as the soft pale muscle on a pig that just died is very suggestive of porcine stress syndrome (PSS). PSS is a simple recessive genetic myopathy. Pigs with heavy muscling and fast growth (desired characteristics in show pigs) can many times carry this gene. This condition can be eliminated from a herd through the selection of genetics. In this case at least one of the sows must be a carrier that was bred to a carrier boar. Antibiotics, water, and mycotoxins have no effect on the clinical presentation of the condition. This genetic condition often results in death of the pig when triggered by excitement, stress or placed under some anesthetics (especially halothane).
You receive a call from a small family farmer who would like to blood test 5 pigs for the upcoming county fair. The county fair is in just 10 days. They bred their 2 sows to 2 high value boars. They purchased the semen from a national boar stud. All pigs have been growing quite well, to the point they were concerned the pigs will be too heavy for the fair. As the second pig is snared and you start to collect your blood sample, it starts shaking uncontrollably. It turns blotchy and goes into respiratory distress. As the pig is released, you try some chest compressions but are not successful. The pig dies. The owner grants permission to necropsy the pig. You perform the necropsy immediately. It is difficult to position the pig for necropsy as it is still stiff. Necropsy reveals pulmonary edema and pale soft musculature often containing hemorrhages. Which of the following should be your recommendation to the owner? Treat all remaining pigs with injectable procaine penicillin Water supply should be checked for adequate flow Change genetics for his next matings Check feed for mycotoxins Add 10 mg/lb of chlortetracycline to the feed
D. Feline infectious peritonitis is not contagious and because her other cat died of FIP does not mean this cat will succumb to the disease Feline infectious peritonitis is not a contagious disease. It is a disease that is caused by a mutation of feline enteric coronavirus. It is unknown why in some patients this virus mutates and causes the FIP syndrome. It is most likely to occur in young or immunocompromised cats. Her other cat is not necessarily going to get FIP just from exposure. In fact, the majority of the cat population has been exposed to the feline enteric coronavirus. Because most cats in the general population have been exposed, it makes interpretation of coronavirus titers difficult. The titers can be elevated due to prior exposure and not from FIP. The titers can only be interpreted in lieu of clinical signs, blood results, etc.L-lysine is an anti-viral medication that may have some benefit for suppression of herpes virus but would not be a prevention or treatment choice for coronavirus. The coronavirus is shed in the cat's feces during active infection with coronavirus. Some infected cats do not shed the virus. The virus attacks the intestinal tract and causes GI upset. PCR on the feces would detect coronavirus, but does not distinguish between the enteric coronavirus and the mutated FIP form of the virus.
You see an 8-month old kitten with the effusive form of feline infectious peritonitis and perform euthanasia. The kitten was having severe diarrhea around the house when it became ill. The owner has a 2 year old cat at home and wants to know what this cat's prognosis is since it has been exposed to the sick kitten. Currently this cat is clinically healthy. What do you tell her? A. Perform a PCR on the cat's feces to see if the virus is being shed B. Place the cat on L-lysine to prevent or suppress any infection with FIP C. You recommend a coronavirus titer to determine it the cat is actively infected D. Feline infectious peritonitis is not contagious and because her other cat died of FIP does not mean this cat will succumb to the disease E. Her other cat may develop symptoms within the next two weeks because FIP is highly contagious
