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ACVIM Reading List > ACVIM General > Flashcards

ACVIM General Flashcards

1
Q

List major signs of SLE.

A

thrombocytopenia
polyarthritis

leukopenia

skin lesions

hemolytic anemia

glomerulonephritis

polymyositis

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2
Q

Where are the skin lesions typically located in pemphigus foliaceous?

A

face, nasal planum, pinnae, foot pads, nipples

NOT typically a mucocutaneous junctions

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3
Q

A young cat presents with facial excoriations - what is the most likely diagnosis?

A

food allergy

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4
Q

Which cells express MHC I vs. MHC II?

A

MHC I = all cells
MHC II = APCs

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5
Q

What types of organisms are Th1 most active against? Th2?

A

Th1 = intracellular bacteria, protozoa

Th2 = extracellular parasites

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6
Q

What is released when eosinophils degranulate?

A

major basic protein (destroys parasites)
eosinophil peroxidase (EPO)

eosinophil derived neurotoxin (EDN)
eosinophilic cationic protein (ECP)

platelet activating factor

leukotrienes

histamines

proteases

cytokines

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7
Q

*What molecules on the endothelium help initiate migration of leukocytes?

A

E and P selectin

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8
Q

Describe the pathophysiology of anemia of inflammatory disease.

A

increased hepcidin leads to decreased iron absorption and recycling, which leads to iron sequestration

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9
Q

Describe whether the following would be increased or decreased in anemia of inflammatory disease: [Fe], TIBC, stainable Fe in bone marrow, ferritin.

A

decreased [Fe]
decreased TIBC

increased stainable Fe in BM

increased ferritin

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10
Q

Describe whether the following would be increased or decreased in iron deficiency anemia: [Fe], TIBC, stainable Fe in bone marrow, ferritin.

A

decreased [Fe]
normal or increased TIBC

decreased stainable [Fe] in BM

decreased ferritin

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11
Q

A dog becomes sick days after being bit by a snake - what type of hypersensitivity reaction is this?

A

type IV

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12
Q

*What surface antigen is important for an APC cell to express in order to activate T helper cells?

A

*MHC II

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13
Q

https://s3.amazonaws.com/classconnection/493/flashcards/7874493/png/screen_shot_2017-05-27_at_122810_pm-15C4ABCE30265022DF5.png

A

Right bundle branch block

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14
Q

https://s3.amazonaws.com/classconnection/493/flashcards/7874493/png/screen_shot_2017-05-27_at_122802_pm-15C4ABD1A5F354041BF.png

A

Left bundle branch block

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15
Q

https://s3.amazonaws.com/classconnection/493/flashcards/7874493/png/screen_shot_2017-05-26_at_121443_pm-15C458A283B31000CF4.png

A

atrial flutter

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16
Q

*What breed of dog gets DCM associated with taurine deficiency?

A

*American Cocker Spaniels

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17
Q

What are the components of tetrology of Fallot?

A

VSD
pulmonic stenosis

right venticular hypertrophy

overriding aorta

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18
Q

Should digoxin be dosed based on lean body weight or total body weight?

A

lean body weight

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19
Q

Resting membrane potential is dependent on active/passive movement of which ion?

A

passive movement of potassium

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20
Q

*Which dog breeds are predisposed to developing VSD?

A

*English Bulldog, Lakeland terrier, Westies

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21
Q

What is the MOA of dobutamine?

A

beta1 agonist

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22
Q

*What is the MOA of cisapride?

A

5HT4 agonist, also enhances release of acetylcholine at the myenteric plexus

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23
Q

What is the MOA of mirtazapine?

A

central presynaptic alpha2 antagonist –> increased norepi release

also blocks 5HT3, 5HT2, and H1 receptors

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24
Q

What is the MOA of amphotericin B?

A

binds ergosterol and forms pores –> leakage of ions causes fungal cell death

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25
Q

What is the MOA of phenylpropanolamine?

A

indirect alpha (and beta) agonist

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26
Q

What is the MOA of phenoxybenzamine? Does it have any effect on beta adrenergic receptors?

A

non-competitively blocks alpha adrenergic receptors

no effects on beta receptors

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27
Q

According to Gompertzian theory, small tumors grow faster/slower than large tumors; and larger tumors are more/less susceptible to chemotherapy.

A

smaller tumors grow faster

larger tumors less susceptible to chemo due to poor blood supply and slower cell division (chemo targets rapidly dividing cells)

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28
Q

What type of cancer is associated with glistening ventral alopecia in cats?

A

pancreatic adenocarcinoma

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29
Q

What should you do when you have a dog that is 1 week post-vincristine and has a neutrophil count of 1600, but is feeling well?

A

postpone chemo x 1wk and recheck CBC give full dose if neut count >2000

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30
Q

What drug binds to mTOR?

A

sirolimus (rapamycin)

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31
Q

Which cells are the pacemaker cells of the intestine?

A

interstitial cells of Cajal in the myenteric plexus

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32
Q

List the breakdown products of the following: lactose, sucrose, maltose.

A

lactose = glucose + galactose
sucrose = glucose + fructose

maltose = glucose + glucose

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33
Q

Which of the following can be absorbed in the intestines of the adult dog: polysaccharides, monosaccharides, disaccharides?

A

only monosaccharides

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34
Q

What is GLUT 5?

A

Fructose transporter in small intestine

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35
Q

Where in the small intestine is folate absorbed? cobalamin?

A

folate = proximal small intestine

cobalamin = ileum

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36
Q

After ingestion, cobalamin binds to ______ to transport to the duodenum, protecting B12 for degradation in the stomach.

A

R protein

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37
Q

What are homocysteine and methylmalonic acid levels used to assess?

A

cobalamin status - both will be elevated in hypocobalaminemia

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38
Q

What PAMP does TLR 5 recognize?

A

flagellin

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39
Q

In cats elevations in serum ALP are more specific for what disease and why?

A

More specific for hepatobiliary disease because cats are not susceptible to drug induced elevations.

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40
Q

What causes a false positive protein on a urine dipstick? A false negative?Term

A

False positive:

1.) Alkaline urine

2.) Contact time (too long)

3.) Detergents - ammonium compounds and chlorhexidine

4.) Active sediment

False negative:

1.) Bence-Jones proteinuria

2.) Dilute urine

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41
Q

What is the binding capacity of iron in hemoglobin?

A

Hb is a tetramer of 4 globulin chains, each globulin contains a heme group and an iron molecule, which binds one O2.

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42
Q

Ceruloplasmin, a ferroxidase that facilitates the transfer of iron in macrophages to transferrin, requires what other ion?

A

Cu++

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43
Q

What is the hallmark of iron deficiency anemia?

A

Decreased MCV (microcytosis) –> occurs before erythrocyte precursors divide in an attempt to reach their full hemoglobin content –> more divisions = smaller than normal erythrocytes. Œæ

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44
Q

Platelet antibody assay

A

Direct assay which detects antibody present on the surface of the platelets or megakaryocytes

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45
Q

What disease can result in a false positive PARR result?

A

Ehrlichiosis

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46
Q

https://s3.amazonaws.com/classconnection/725/flashcards/12190725/jpg/rbbb-v12-15C4B4DDCCC1AEE8B30.jpg

A

Right bundle branch block

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47
Q

What is isovolumetric relaxation?

A

After semilunar valves shut, ventricular pressure slowly decreases, until AV valves open up again

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48
Q

What non-acid fast staining bacteria causes a pyogranulomatous pleural effusion?

A

Actinomyces

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49
Q

Glipizide stimulates and diazoxide inhibits the __ channel on the ___ cell?

A

K channel; beta cell

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50
Q

The k channel on beta cells is stimulated by what drug? Inhibited by what other drug?

A

Stimulated: glipizide

Inhibited: diazoxide

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51
Q

What does GLUT4 do?

A

Glucose entry into all other cells (not brain, kidney, beta cells)

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52
Q

What does GLUT2 do?

A

Glucose entry into beta cells

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53
Q

What does GLUT1 do?

A

Glucose entry into the brain and kidneys

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54
Q

T/F: Cyanide toxicity is responsive to oxygen therapy.

A

False! There is enough O2 present it just cannot be used appropriately. ξ

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55
Q

What are the causes of pre-hepatic portal hypertension?

A
  1. congenital atresia
  2. fibrosis
  3. thrombus
  4. neoplasia
  5. extra-luminal compression
  6. hepatic AV-fistula
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56
Q

What are causes of post-hepatic portal hypertension?

A
  1. Right atrium (rt CHF, pulmonary hypertension, pericardial dz)
  2. Budd-Chiari syndrome (obstruction in the CVC or large hepatic veins –> obstruction of hepatic venous outflow
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57
Q

Oslerus osleri is a parasite of which species? Lives where? Is diagnosed how?

A

Lung worm in dogs
Lives and causes nodules at the tracheal bifurcation
Dx by visualizing nodules, finding ova and larva in wash, finding ova on fecal float

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58
Q

Aleustrongulylus abstrusus is a parasite of what species? Lives where? And is dx how?

A

Lung worm of the cat
Lives in the terminal and respiratory bronchioles, and alveolar ducts
Dx by finding ova and larva in wash fluid, or ova on Baermann fecal

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59
Q

What drug reverses diazepam?

A

Flumazenil

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60
Q

Most common source of transmission of Cryptosporidium homini?

A

Water with fecal contamination

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61
Q

What is often associated with superficial necrolytic dermatitis?

A

Liver disease and glucagonoma

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62
Q

What is a cohort study?

A

Groups are followed prospectively over time and evaluated for outcomes and risk. Used to estimate disease outcomes, incidence, and relative risks.

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63
Q

What is often associated with superficial necrolytic dermatitis?

A

Liver disease and glucagonoma

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64
Q

What is paradoxical aciduria?

A

Occurs when there is a metabolic alkalosis caused by gastric fluid losses –> hypoCl and hypoK. The hypoCl –> decreased NaCl reabsorption in PCT –> increased Na absorption in the DCT, but d/t hypoK, Na/H exchange predominates –> aciduria

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65
Q

In a healthy animal, uptake of oxygen across the blood gas barrier is diffusion/perfusion limited?

A

Perfusion limited

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66
Q

In a dog with pulmonary interstitial fibrosis, uptake of oxygen across the blood gas barrier is diffusion/perfusion limited?

A

Diffusion limited

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67
Q

Uptake of carbon monoxide across the blood gas barrier is diffusion/perfusion limited?

A

Diffusion limited

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68
Q

Uptake of nitrous oxide across the blood gas barrier is diffusion/perfusion limited?

A

Perfusion limited

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69
Q

What is the most common route of transmission of toxoplasmosis in cats?

A

Ingestion of bradyzoites in tissue cysts

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70
Q

Where in the body does angiostrongylus vasorum live?

A

The pulmonary arteries and right heart (french heartworm).

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71
Q

Eucoleus aerophilus

A

lung worm of dogs and cats

lives in trachea, bronchi and bronchioles

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72
Q

What stage of Eucoleus aerophilus would you expect to find in a TTW?

A

Ova

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73
Q

What factors inhibit platelet function?

A

NO, prostacyclin, ADPase, viscosity (MM)

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74
Q

Vasopressin (AHD) can cause ____ to be released from endothelial cells.

A

vWF

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75
Q

Which cell type is CD8+?

A

Cytotoxic T-cells; binds MHC I

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76
Q

Killer-cell inhibitory receptors (KIR) on NK cells bind to ___ on normal cells, protecting them from NK attack.

A

MHC I, which all normal cells express. Virus-infected and tumor cells expresses less MHC I –> NK attack.

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77
Q

Viral and bacterial infections lead to the production of this CD4+ cell, and its cytokines?

A

TH1; IL-2, IFN-y, TNF-B

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78
Q

Allergens and parasitic infections lead to the production of this CD4+ cell, and its cytokines?

A

TH2; IL-4, 5, 10, 13

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79
Q

Feline neonatal isoerythryolysis occurs in what scenario?

A

Type A or AB kittens born to a type B queen. Queen passes anti-A antibodies to kittens in colostrum, can lead to hemolytic anemia and death.

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80
Q

What cytokines are responsible for class switching?

A

IL-4, TGF-B, IFN-y

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81
Q

What is the role of TNF in the body?

A

It is the primary mediator of inflammation and fever; stimulates T-cell production. Produced by macrophages, monocytes, and NK cells.

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82
Q

What does IFNy do?

A

Activates monocytes , macrophages, and NK cells; inhibits TH2. Produced by TH1 cells.

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83
Q

IL-2?

A

T-cell growth factor; produced by TH0 and TH1 cells.

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84
Q

Where do the classical and alternative pathways of complement converge?

A

C3b (right before C5-9 form the MAC).

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85
Q

Describe the ideal canine universal blood donor.

A

DEA 1.1 negative; ideally DEA 1.2 negative.

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86
Q

What % of dogs are DEA4 positive?

A

> 98%

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87
Q

What are the 3 feline blood types? Describe their alloantibody characteristics.

A

Type A - most cats in NA, weak anti-B antibodies (~35%).
Type B - very strong anti-A antibodies (95%); severe rxn to A blood.

Type AB - very rare blood type; no antibodies to A or B.

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88
Q

Why do all cats need to be typed and cross-matched before any blood transfusion?

A

Due to their naturally occurring allo-antibodies.

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89
Q

What is the most common UA finding in a dog with IMHA?

A

Bilirubinuria

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90
Q

Which negative test rules out DIC?

A

D-dimer

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91
Q

Calculation for osmolarity

A

= (2xNa) + (Glu/18) + (BUN/2.8)

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92
Q

What is the primary cytokine secreted by NK cells?

A

IFN-y

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93
Q

What is the strongest anti-coagulative factor? What does it inhibit? What accelerates its activity?

A

Anti-thrombin (III); inhibits factors 2, 9, 10, 11, 12, plasmin, kallikrein; binding heparin accelerates activity

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94
Q

What causes dilation of the glomerular afferent arteriole?

A

Prostaglandins, bradykinin –> increased GFR

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95
Q

Where is Mg2+ reabsorbed in the kidney?

A

Thick ascending limb of the loop of Henle.

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96
Q

What is the mechanism of non-regenerative anemia in CKD?

A
  • Decreased EPO
  • Decreased RBC lifespan
  • Uremic gastropathy
  • Increased bleeding tendencies (impaired plt function)
  • Vit B deficiencies –> defective EPO (B12, 6, folic acid, niacin, 2)
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97
Q

Explain Type II RTA

A
  • AKA proximal RTA
  • Defect in HCO3- reabsorption in PCT –> HCO3- lost in urine
  • Urine becomes acidic, pH
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98
Q

Explain Type I RTA

A
  • Can’t get rid of H+; cannot reabsorb Na+
  • Cannot make enough HCO3-
  • Increased urine pH, >6.0, less acidic
  • DCT last chance to acidify urine
  • Much more k+ loss
  • Very LOW serum HCO3-
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99
Q

Acidifying diet

A

Struvites ONLY

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100
Q

Alkalinizing diets

A

Xanthine, calcium oxalate, cysteine (+ 2-MPG, D-Pen), uric acid (+ allopurinol)

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101
Q

What causes increased urine production in CKD?

A

Renal hypertension –> glomerular hyperfiltration in 30% cats, 60% dogs

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102
Q

What is the treatment for membranoproliferative glomerulonephritis?

A

Immunosuppressive therapy (corticosteroids +/- other drugs)

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103
Q

What dog breed has a hereditary PLE / PLN disease?

A

Soft-coated wheaten terriers

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104
Q

A UPC >2 indicates what?

A

Glomerular disease

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105
Q

What is oxybutynin?

A

Muscarinic receptor antagonist (prevents overactive bladder contractions).

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106
Q

What is the treatment for calcium oxalate crystalluria?

A
  • Increasing H2O intake, dilute urine
  • Potassium citrate to increase urine pH
  • Physical removal of stones
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107
Q

What is the MOA of phenoxybenzamine? And what effect does it have?

A

Irreversible, non-selective alpha antagonist.
Relaxes urethral smooth muscle, decrease urethral sphincter tone.

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108
Q

List 2 other drugs (besides phenoxybenzamine) that also antagonize alpha-1 receptors.

A

Prazosin
Phenothiazines

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109
Q

On average, how long does it take for signs of FLUTD to resolve?

A

5-7 days, in 92% of cases

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110
Q

What 2 drugs can be used to increase bladder contraction? How do they work?

A

1.) Bethanechol - direct agonist of muscarinic receptor
2.) Neostigmine - indirect muscarinic agonist - blocks AChE

  • Both increase parasympathetic activity
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111
Q

Oslerus osleri resides where in the dog?

A

tracheal bifurcation

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112
Q

Paragonimus kellicotti resides where?

A

lung fluke resides in RIGHT CAUDAL LUNG LOBE

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113
Q

How is pneumocystis carinii transmitted?

A

airborne transmission

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114
Q

Which breeds are predisposed to Pneumocystis carinii?

A

mini dachshund CKCS +/- yorkies documented to have low globulin levels (IgA, IgG, IgM) and impaired lymphocyte function

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115
Q

Where in the body does Pneumocystis carinii reside?

A

alveolar spaces

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116
Q

Which breed of cat is predisposed to disseminated mycobacterium?

A

Abyssinian

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117
Q

Which breeds are predisposed to canine leproid granuloma?

A

short coated breeds - boxers, mastiffs

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118
Q

Which stain causes Mycobacterium to appear red?

A

Ziehl-Neelsen stain (acid fast stain)

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119
Q

T/F: Blastomyces can be transmitted from animals to people or from people to people from aerosols.

A

FALSE! Can only be inhaled from the SOIL

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120
Q

The Blastomyces urine antigen test (EIA) cross reacts with what other organism?

A

Histoplasma

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121
Q

What is the main mode of transmission of Coccidiodes immitis?

A

inhalation of arthroconidia

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122
Q

Which cat breed is predisposed to disseminated histoplasmosis?

A

persians

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123
Q

How is histoplasmosis typically transmitted?

A

inhalation of microconidia from soil

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124
Q

T/F: Sporothrix schenckii is zoonotic.

A

True!

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125
Q

Which organism causes “Rose Gardeners Disease” and typically effects cats via direct inoculation of the organism into the skin? It is cigar shaped with a thin halo on methenamine silver and PAS stain.

A

Sporothrix schenckii

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126
Q

What is the minimum temperature necessary for development of Dirofilaria into the L3 stage in the mosquito?

A

57F

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127
Q

What is the Knott’s test used for?

A

to detect microfilaria of heartworm also can help differentiate heartworm (straight body with straight tail) from Acanthalonema reconditum (curved body with button hook tail)

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128
Q

How do heartworm and Acanthelonema reconditum differ in terms of motility?

A

heartworm has stationary writhing movement A. reconditum has rapid, directional movement

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129
Q

What is the definitive host for Hepatozoon?

A

it’s the tick!!! …verrry tricky

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130
Q

What is the vector for Hepatozoon canis? Hepatozoon americanum?

A

H. canis = rhipicephalus H. americanum = amblyomma

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131
Q

The dog is the definitive/intermediate host for Hepatozoon.

A

intermediate host

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132
Q

Shar Peis have been shown to frequently have a deficient in which immunoglobulin?

A

IgA

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133
Q

Weimeraners are predisposed to a deficiency in which immunoglobulin?

A

IgG

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134
Q

CKCS that are deficient in which immunoglobulin are predisposed to Pneumocystis carinii and demodicosis?

A

IgG

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135
Q

Which breed of dog has been shown to be predisposed to C3 deficiency with autosomal recessive inheritance?

A

Brittany Spaniel

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136
Q

CLAD occurs in which breed and is associated with a deficiency in which molecules?

A

Irish Setters deficiency in integrin molecules CD11b and CD18

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137
Q

Is CLAD associated with a high or low WBC count?

A

very high WBC count with a severe left shift

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138
Q

Trapped neutrophil syndrome is a condition seen in what breed? What is the pathophysiology?

A

autosomal recessive in Border Collies (widespread in the breed) results in neutropenia due to failure to release neutrophils from the bone marrow - typically die by 4mo

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139
Q

Severe combined immunodeficiency occurs in which breed? Briefly, what is the pathophysiology?

A

Jack Russells Lymphocyte development is blocked in the prolymphocyte stage –> deficiency in B and T cells –> death at 8-14wks

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140
Q

What breeds get x-linked SCID?

A

MALE Cardigan Welsh Corgis and Bassett Hounds

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141
Q

Which breed gets lethal acrodermatitis? This condition is associated with low levels of which immunoglobulin?

A

bull terriers (autosomal recessive) low levels of IgA

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142
Q

The zona glomerulosa lacks ______ (enzyme) which is why it is unable to produce cortisol.

A

17-alpha hydroxylase

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143
Q

The zona glomerulosa contains ____ (enzyme), which is why it is the only layer of the adrenal that can make aldosterone.

A

aldosterone synthase

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144
Q

Does dopamine stimulate or inhibit aldosterone release?

A

inhibits

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145
Q

What enzyme prevents cortisol from reacting with the mineralocorticoid receptor in aldosterone-target tissues?

A

11-betahydroxysteroid dehydrogenase type 2 converts cortisol–>cortisone (cortisone has decreased affinity for mineralocorticoid receptor

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146
Q

Which cells in the kidney produce erythropoietin?

A

type I renal interstitial cells

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147
Q

Transcription of EPO is regulated by _____

A

hypoxia-inducible factor hypoxia causes decrease in degradation of HIF –> activates EPO transcription element

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148
Q

Inflammation causes an increase/decrease in hepcidin levels. How does this effect iron?

A

inflammation increases hepcidin this causes serum iron levels to fall due to iron trapping within macrophages and liver cells and decreased gut iron absorption

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149
Q

What type of reticulocyte predominates in cats?

A

punctate

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150
Q

What is the lifespan of a platelet?

A

7 days

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151
Q

What is contained in alpha granules of platelets?

A

factor V fibrinogen P-selectin

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152
Q

What is the other name for the fibrinogen receptor?

A

GPIIb/IIIa

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153
Q

What is the other name for the von Willebrand receptor?

A

GPIb

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154
Q

von Willebrand factor is synthesized and stored where?

A

endothelial cells

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155
Q

Clopidogrel acts on which receptor?

A

P2Y12 (ADP receptor)

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156
Q

Platelets are cross-linked by what?

A

fibrinogen

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157
Q

Tenase is composed of which clotting factors?

A

IXa, VIIIa, VIIa, tissue factor

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158
Q

Prothrombinase is composed of which clotting factors?

A

Xa and Va

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159
Q

Which breed of dog is predisposed to PFK deficiency?

A

English Springer Spaniel (Also Cocker Spaniel, Whippet)

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160
Q

An English Springer Spaniel presents with intermittent dark urine, which commonly develops following strenuous exercise, prolonged barking, and extensive panting. What disease is most likely?

A

PFK deficiency Causes hemolysis following strenuous activity (associated with respiratory alkalosis)

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161
Q

Hematology counters count which type of reticulocyte?

A

aggregate reticulocytes

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162
Q

Which breed is predisposed to hereditary stomatocytosis with chrondrodysplasma?

A

Alaskan Malamute

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163
Q

Which breed gets hereditary stomatocytosis with hypertrophic gastritis?

A

Drentse Patrijshond

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164
Q

Which breeds have hereditary stomatocytosis with no associated clinical signs?

A

Mini and standard Schnauzers Pomeranians

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165
Q

Which breed of dog is predisposed to hereditary spherocytosis?

A

Golden Retriever due to reductions in erythrocyte membrane spectrin

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166
Q

Ghost cells are more common in extravascular/intravascular hemolysis

A

intravascular

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167
Q

Which breed is predisposed to hereditary macrocytosis?

A

toy and mini poodles +/- greyhounds

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168
Q

What are Howell-Jolly bodies?

A

small nuclear remnants within RBCs - may be seen in association with regenerative anemia or after splenectomy

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169
Q

What anesthetic has been associated with Heinz body formation?

A

propofol

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170
Q

Which heavy metal causes basophilic stippling of RBCs?

A

lead poisoning

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171
Q

Which breeds can have a hereditary microcytosis?

A

Akita, Shiba Inu

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172
Q

FeLV is associated with microcytic/macrocytic anemia

A

macrocytic

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173
Q

Chylomicrons are composed mostly of what?

A

~93% triglycerides and phospholipids (5% cholesterol, 2% apoproteins)

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174
Q

What are the biproducts of fatty acid catabolism?

A

Ketones: acetone, acetoacetate, B-hydroxybuterate

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175
Q

B-oxidation of fatty acids occurs where?

A

Mitochondria ONLY

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176
Q

What is the role of chylomicrons?

A

They facilitate transfer of exogenous lipids from the intestines to adipose tissue or the liver.

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177
Q

What is the most common cause of EPI in dogs?

A

Pancreatic acinar atrophy - secondary to immune mediated atrophic lymphocytic pancreatitis. (GSD, rough-coated collies)

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178
Q

What is the most common cause of EPI in cats?

A

Chronic pancreatitis

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179
Q

Why does EPI causes a low B12?

A

Decreased pancreatic intrinsic factor (needed for absorption); increased utilization by GI bacteria.

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180
Q

What gene mutation predisposes Schnauzers to pancreatitis?

A

SPINK1

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181
Q

What is the most sensative and specific test to dx pancreatitis?

A

cPLI (immunoassay for exocrine function); Spec cPL = same performance.

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182
Q

Why should metoclopramide be avoided in pancreatitis?

A

Pancreatic blood flow is regulated by dopaminergic receptors - metoclopramide is a dopamine antagonist –> decreased pancreatic perfusion

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183
Q

What does alpha 2 macroglobulin do? How can it be used in pancreatitis?

A

Alpha 2 macroglobulin scavanges for activated proteases in plasma; shown to be decreased in pancreatitis. Can supply with FFP - no proven benefit.

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184
Q

What is the #1 clinical sign in cats with pancreatitis?

A

Lethargy

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185
Q

When will a dog with PLE not be panhypoproteinemic?

A

Basenji enteropathy and with Histoplasmosis - globulins are normal to increased in both.

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186
Q

What is the most common cause of PLE?

A

Lymphangiectasia

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187
Q

What is the best test to confirm PLE?

A

Fecal alpha-1 proteinase inhibitor

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188
Q

What is the best test for Tritrichomonas foetus infection in cats?

A

Fecal PCR

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189
Q

What is the best test to diagnose Pythiosis?

A

ELISA for pythium antibodies - highly sensitive and specific

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190
Q

Both E. coli and Salmonella are resistant to treatment with what drug?

A

Tylosin

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191
Q

What is the role of pancreatic polypeptide? Where is it secreted from?

A

Released from the F (PP) cells of the endocrine pancreas; inhibition of pancreatic enzyme and fluid secretion - slows absorption.

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192
Q

Describe Basenji enteropathy.

A

Lymphoplasmacytic enteritis + PLE; hypoalbuminemia + hyperglobulinemia; marked elevation in IgA

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193
Q

What 3 clinical syndromes result from taurine deficiency in cats?

A

Retinal atrophy, DCM, developmental abnormalities in kittens born to deficient queens.

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194
Q

What is the role of metallothioneine in the GIT?

A

Binds to copper in enterocytes, remains until enterocyte is shed in feces; higher dietary Zn levels induce metallothioneine, reduce Cu absorbed

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195
Q

How is trypsinogen activated to trypsin in the GIT?

A

Trypsinogen initially converted to trypsin by brush border enzyme enterokinase. Trypsin is then able to catalyze all other inactive precursors, including more trypsin.

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196
Q

Which prostaglandin is protective in the stomach?

A

PGE - helps maintain mucosal blood flow, increases mucus and bicarb secretion, decreases H+ secretion, increases epithelial turnover

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197
Q

A low B12 indicates disease is what part of the GIT?

A

Ileum (distal SI) (folate = proximal SI)

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198
Q

Dog w/ large bowel diarrhea, rectal scrape reveals small, round organisms w/ light halo inside macrophages. What is the dx and tx?

A

Histoplasmosis; Itraconaole + supportive for colitis.

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199
Q

What is the best sample to culture in feline cholangiohepatitis?

A

Bile, collected via GB aspirate.

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200
Q

Ammonium biurate crystalluria

A

PSS

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201
Q

What is the difference between MVD and PSS using scintigraphy?

A

MVD has normal shunt fraction, 60%. Normal contrast should go portal vein - liver - heart; PSS: portal vein - heart - liver.

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202
Q

Which vitamins are stored in the liver?

A

A, D, B12

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203
Q

T/F: Cats with hepatic lipidosis will often be hypokalemic.

A

True: cats with underlying CKD or with renal lipid accumulation can have potassium wasting –> hypokalemia.

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204
Q

What is the role of microsomal triglyceride transport protein (MTTP)?

A

Required to transport chylomicrons into circulation from the GIT and VLDL from the liver.

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205
Q

Name an inhibitor of microsomal triglyceride protein (MTP).

A

Dirlotapide

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206
Q

What converts glucose to sorbitol?

A

Aldose reductase

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207
Q

How would you treat esophagitis?

A

Cisapride to improve LES tone, omeprazole to reduce acid, sucralfate to bind erosions

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208
Q

What cause increased LES tone?

A

Gastric pressure, gastric acidity, gastrin, histamine, Ach

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209
Q

What is the treatment for Helicobacter?

A

Amoxicillin, metronidazole, omeprazole, bismuth salicyclate

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210
Q

What is the treatment for Cu hepatitis?

A

Chelation w/ penicillamine or trientine, decreased absorption w/ Zn

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211
Q

What is the defining characteristic of a gastric ulcer?

A

Erosion affecting the muscular layer.

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212
Q

What fat soluble vitamins do cats require?

A

Vit A, D, E, K

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213
Q

Why do cats require vitamin A?

A

They are unable to convert beta carotene to retinol.

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214
Q

What maintains BG in fasting dogs? Cats?

A

Glycogenolysis in dogs; gluconeogenesis in cats.

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215
Q

What is the gold standard test for measuring SI permeability?

A

Lactulose / rhamnose test.

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216
Q

What is the primary physiologic cause of diarrhea?

A

Hypomotility.

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217
Q

What is the likely cause of hepatobiliary pu/pd?

A

Loss of renal medullary concentration gradient d/t inability to produce urea –> polyuria w/ secondary polydypsia.

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218
Q

T/F: SAS increases the risk of endocarditis.

A

True

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219
Q

What is the MOA of azothioprine? What are the most come AEs?

A

A purine analogue that inhibits DNA synthesis. AEs - pancreatitis, hepatotoxicity

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220
Q

What is the gold standard test for thyroid function?

A

TSH stimulation test

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221
Q

Who secretes calcitonin?

A

Parafollicular cells (C cells) of the thyroid.

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222
Q

Who secretes PTH?

A

Chief cells of the parathyroid.

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223
Q

What is leptin?

A

Released when fat stores reach a certain level; satiety hormone.

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224
Q

What is ghrelin?

A

A hunger hormone.

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225
Q

T/F: 80% of dogs develop cataracts w/in 16 months of diagnosis w/ DM.

A

True.

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226
Q

What kind of insulin is used in dogs?

A

NPH, Vetsulin (lente)

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227
Q

How does the liver metabolize xenobiotics?

A

Phase 1 - p450; Phase 2 - conjugation

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228
Q

What is the MOA of octreotide?

A

Somatostatin analogue - inhibits insulin, glucagon, GH

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229
Q

What is the most frequently used insulin in cats?

A

Glargine

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230
Q

What should a diet for canine DM contain?

A

Fiber

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231
Q

What is the MOA of mitotane?

A

Causes necrosis of the zona fasiculata and reticularis of the adrenal cortex –> reduced secretion.

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232
Q

What is the most common cause of hypercalcemia in cats?

A

Idiopathic

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233
Q

What is treatment for lungworm in cats?

A

Moxidectin + Imidacloprid (Advantage Multi) - single dose was 100% effective.
Mild infections are usually self-limiting; may not require tx.

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234
Q

What is the most accurate way to confirm ocular/CNS toxoplasma in a cat?

A

PCR + Abs of CSF or aqueous humor

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235
Q

Which test correlates best with clinical toxoplasmosis?

A

Elevated IgM antibodies

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236
Q

An 8 week old kitten tests positive for FIV on an antibody ELISA. Do you believe this result? What should your follow-up protocol be?

A

Don’t believe - maternal antibodies can be present at this age, causing +ve.
Recommend retesting at 12 weeks. If still positive test every 1-2 months, until 6 months old - if still +ve = infected.

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237
Q

You find a gram +ve, non-acid-fast, filamentous organism on cytology from a thoracocentesis in a golden retriever. Your culture is currently pending. What is your presumptive diagnosis, and what antimicrobial treatment would you initiate?

A

Actinomyces; start high dose penicillin.
Hope you submitted an anaerobic culture!!

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238
Q

What is the diagnostic test of choice for Mycoplasma hemofelis?

A

PCR - detects 16S rRNA gene.
May not detect asymptotic carrier state.

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239
Q

What is the treatment of choice for Mycoplasma hemofelis?

A

Doxycycline for at least 2 weeks.
Enrofloxacin is a good alternative.

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240
Q

T/F: Cats who are infected with and recover from infection with Mycoplasma hemofelis do not develop a persistent, asymptotic carrier state.

A

False - they often do become asymptotic carriers, and can exhibit recrudescence.

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241
Q

How would you treat a dog diagnosed with Neorickettsia helminthoeca?

A

Doxycycline AND praziquantel

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242
Q

A 5 yo, MN, Labrador retriever presents with anorexia, V+, D+, and marked thirst. While obtaining a history the O notes he took the dog fishing last weekend.
On examination the dog is noted to be pyrexic with enlarged lymph nodes.
What is your suspected diagnosis? How would you confirm this?

A

Neorickettsia helminthoeca

Dx: operculate trematode eggs on fecal; intracytoplasmic rickettsial bodies on LN aspirate.

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243
Q

Percentage of nosocomial veterinary ICU infections?
Most common organisms?

A

~16%
Salmonella & MRSA

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244
Q

What stage of heartworm is infectious?

A

L3

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245
Q

Streptococcus is gram +ve, catalase _______.
Staphylococcus is gram +ve, catalase _______.

A

Strep = catalase negative.
Staph = catalase positive.

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246
Q

What is the best way to dx bartonellosis? What disease might it cause in dogs?

A

Dx: ePCR + serology
Dz: endocarditis

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247
Q

What is C-peptide?

A

Peptide that connects A and B chains of proinsulin, and is cleaved in vesicle.
Secreted with insulin, in equal amounts.

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248
Q

What enzyme converts cholesterol to pregnenolone?

A

Cholesterol deamolase

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249
Q

What does cholesterol desmolase do?

A

Converts cholesterol to pregnenolone.

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250
Q

What is the mechanism of action of selegiline?

A

MOA inhibitors –> increased dopamine (blocks metabolism) –> ACTH.
Used for cognitive dysfunction.

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251
Q

What is CIRCI?

A

Critical illness-related corticosteroid insufficiency.

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252
Q

What diagnostic result would you expect to find in a pet with CIRCI?

A

A blunted response to ACTH stimulation (low delta cortisol)

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253
Q

How would you treat idiopathic hypercalcemia in a cat (stepwise)?

A
  1. Diet - high fiber, renal failure, CaOx
  2. Steroids
  3. Bisphosphonates
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254
Q

What dog breed is predisposed to primary hyperparathyroidism?

A

Keeshonds

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255
Q

What breed of dog is predisposed to congenital megaesophagus?

A

Wire haired fox terrier

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256
Q

What are the clinical signs you would see in a case of dysautonomia?

A

Bilateral mydriatic pupils and elevated 3rd eyelids, decreased anal tone, decreased tear production, ME, GI signs.

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257
Q

What tests could you perform to test for dysautonomia?

A

Pupil constriction w/ very low dose pilocarpine; no elevation in HR with atropine, no flare response to SQ histamine.

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258
Q

What is the treatment of choice for Babesia?

A

Atovaquone + azithromycin; imidocarb less effective

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259
Q

What is the treatment of choice for Leishmania?

A

Antimonials + allopurinol

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260
Q

What is the MOA of the azole drugs?

A

Prevent ergosterol synthesis by inhibiting p450 enzymes, necessary for cell wall production.

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261
Q

What amino acid is a potent stimulator of insulin secretion?

A

Arginine

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262
Q

What essential amino acid in cats is used in the urea cycle?

A

Arginine

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263
Q

What clinical signs are noted in a cat with an arginine deficiency?

A

Arginine deficiency results in hyperammonemia –> signs of HE (salivation, neuro, hyperesthesia, emesis, death)

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264
Q

How is excess copper excreted?

A

In the bile via COMMD1

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265
Q

What is the most common cause of icterus in sepsis?

A

Cholestasis

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266
Q

T/F: Ascites is most often seen in cats with suppurative cholangitis.

A

False! A high protein, low cellularity ascites is seen with lymphocytic cholangitis.

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267
Q

What blood test might help differentiate between PSS and MVD? What would you expect to see?

A

Protein C; if very low (<70%) strongly suggestive of a PSS.

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268
Q

What is the MOA of felbamate?

A

Blocks NMDA excitation, potentiates GABA inhibition.

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269
Q

What is the MOA of zonisamide?

A

T-type Ca2+ channel blocker –> prevents spread of AP

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270
Q

A young dog with myoclonus likely has what disease?

A

Distemper

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271
Q

What are the most common clinical signs associated with Neospora in a puppy?

A

LMN signs w/ spastic gait.

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272
Q

What is the treatment for Neospora?

A

TMS, pyrimethamine, clindamycin

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273
Q

Why is treatment with KBr avoided in cats?

A

Causes pneumonitis and pancreatitis in cats.

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274
Q

What antibiotics should be avoided in a dog with myasthenia gravis? Why?

A

Ampicillin and aminoglycosides. Impair neuromuscular transmission. (Phenothiazine do also!)

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275
Q

____ is an important cofactor for cerebral aerobic glycolytic metabolism.

A

Thiamine

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276
Q

What is the diagnostic test of choice for Leptospirosis?

A

MAT - look for 4x increase in Abs; may be seronegative during 1st week of dz.

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277
Q

What is the main abnormality noted in dogs and cats with Mycoplasma?

A

Anemia

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278
Q

What is the treatment for Mycoplasma?

A

Doxycycline

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279
Q

How do you diagnose Anaplasma?

A

Identification of morulae, 4Dx ELISA

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280
Q

What is the known vector for Leishmania?

A

Sand-fly

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281
Q

What is the infective stage of Leishmania?

A

Promastigote

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282
Q

Describe the histo findings in Coonhound paralysis.

A

Peripheral demyelinating neuropathy with lymphocytic radiculitis.

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283
Q

What are the diagnostic criteria for multiple myeloma?

A

1.) Atypical plasma cells in the BM; 2.) Osteolysis - punched out lesions; 3.) Monoclonal gammopathy; 4.) Bence Jones proteinuria

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284
Q

Adverse effect of pegylated liposomal doxorubicin?

A

Palmar plantar erythrodysethesia syndrome (PPES)

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285
Q

What is p53?

A

Tumor suppressor gene

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286
Q

A dog has recently been diagnosed with a thymoma, and has concurrent aspiration pneumonia. How do you explain this?

A

Megaesophagus secondary to paraneoplastic myasthenia gravis.

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287
Q

Where on the bone does osteosarcoma most commonly occur?

A

Metaphyseal region

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288
Q

What is samarium?

A

A bone seeking radionucleotide used for palliative OSA tx.

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289
Q

What drug is used for its anti-estrogenic effects in mammary neoplasia?

A

Tamoxifen

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290
Q

An exon 11 ckit mutation in a mast cell tumor carries a better/worse prognosis.

A

Worse

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291
Q

____ is important in transaminase reactions.

A

Pyridoxine (B6)

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292
Q

What is the MOA of theophylline?

A

Competitive phosphodiesterase inhibitor and adenosine antagonist –> increased Epi.

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293
Q

What test would you use to screen for Lyme disease?

A

C6 peptide snap ELISA - differentiates active infection from vaccination. If positive, should follow up with quant C6 and a UPC.

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294
Q

How do you calculate the bicarb deficit?

A

0.3 x kg x (24-bicarb)

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295
Q

Which chemotherapy agents are nephrotoxic?

A

Cisplatin, streptozotocin, CCNU (lomustine), doxorubicin (cats)

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296
Q

What is the MOA of amitriptyline?

A

tricyclic antidepressant: anticholinergic, antihistamine, analgesic, anti-inflammatory

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297
Q

How do you treat juvenile cellulitis (puppy strangles)?

A

Corticosteroids + antibiotics if secondary infection present.

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298
Q

A young puppy presents with a swollen face, numerous non-pruritic cutaneous pustules, and lymphadenopathy. What is your suspected diagnosis?

A

Puppy strangles (aka juvenile cellulitis)

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299
Q

What is the most common Lepto serovar in dogs?

A

Grippotyphosa

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300
Q

What are the pathogenic proteins of Lepto?

A

LipL32, OMP

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301
Q

How do you treat Lepto in a dog?

A

Ampicillin for the leptospiremic phase; doxycycline for the carrier phase.

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302
Q

A CKCS presents for progressive dyspnea, and radiographs show a marked interstitial pattern. A BAL reveals numerous trophozoites. What is your presumptive diagnosis? How would you treat?

A

Pneumocystosis; TMS

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303
Q

How do you treat Cytauxzoonosis?

A

Atovaquone + azithromycin; imidocarb less effective

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304
Q

What vaccine formulation provides the best antigenic response? Which vaccine should this type NOT be used for?

A

Modified live give strongest response; not ML for rabies –> encephalitis.

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305
Q

What is the 3-year mortality for Flevo?

A

80%

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306
Q

What do we know about Feline Calicivirus VSD (virulent systemic dz)?

A

Previously developed FCV vaccines are NOT protective; high feline mortality (33-60%).

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307
Q

What clinical signs are seen with organophosphate toxicity?

A

SLUD (muscarinic signs), muscle fasiculations (nicotinic signs).

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308
Q

What is the treatment for OP toxicity?

A

2-PAM, +/- atropine

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309
Q

What is the MOA of amitraz toxicity? Where would exposure occur? How would you treat?

A

MOA: alpha 2 agonist; tick collars; tx: yohimbine

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310
Q

Treatment for lead toxicity?

A

Succimer, CaEDTA, D-penicillamine, cathartics + Mg sulfate, thiamine

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311
Q

The canine parvovirus vaccine is based on which subtype?

A

CPV2b

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312
Q

Glucocorticoids induce ____ which inhibits phospholipase A2, which converts AA into ______.

A

lipocortin-1; eicosanoids

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313
Q

What are 2 striated muscle relaxants?

A

Benzodiazepines and dantrolene

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314
Q

Where does CAV1 cause disease? CAV2?

A

Liver; upper respiratory tract / lungs

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315
Q

Describe the concept of hysteresis with regards to respiration.

A

During inspiration, you need to overcome the surface tension in the lungs which is creating a collapsing force on the lungs. Lungs produce surfactant, which greatly reduces the surface tension, but it doesn’t go to zero. Therefore, when you are breathing in, the pressure increases immediately, but the volume does not increase significantly until you overcome surface tension

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316
Q

Surfactant is synthesized by _______.

A

type II alveolar cells

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317
Q

The most important stimulus controlling the level of resting ventilation is:

A

pH of CSF on central chemoreceptors (West)

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318
Q

What enzyme converts cholesterol to pregnenolone in the adrenal?

A

cholesterol desmolase (rate limiting step)

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319
Q

List 5 things that increase lower esophageal sphincter tone.

A

gastrin
histamine
ACh
gastric distention
gastric acidity

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320
Q

Describe the response to the following in patients with dysautonomia: pilocarpine response test, STT, atropine response test, intradermal histamine test.

A

pilocarpine response test - rapid miosis
STT - low or no tears
atropine response test - no increase in HR
intradermal histamine test - no flare

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321
Q

EPI in dogs is most commonly caused by ____. What about cats?

A

dogs - acinar atrophy
cats - chronic pancreatitis

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322
Q

What is the mechanism of tetanospasmin?

A

irreversibly binds to presynaptic sites in inhibitory neurons –> inhibits glycine and GABA

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323
Q

What is the MOA of amphotericin B?

A

binds with ergosterol forming pores in fungal cell membrane that cause rapid leakage of monovalent ions (K+, Na+, H+ and CläšÍ) and subsequent fungal cell death

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324
Q

What is the MOA of azole antifungals?

A

inhibit the enzyme lanosterol 14 ‘±-demethylase (P450); the enzyme necessary to convert lanosterol to ergosterol

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325
Q

What is the MOA of zonisamide?

A

blocks sodium and T-type calcium channels, which leads to the suppression of neuronal hypersynchronizationξ

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326
Q

Thiamine is an important cofactor for ______

A

cerebral aerobic glycolytic metabolism

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327
Q

Which layer must be effected for a lesion to be considered a gastric ulcer?

A

muscularis

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328
Q

Type A cats have very strong/weak anti-B antibodies, and type B cats have very strong/weak anti-A antibodies.

A

Type A cats have very weak anti-B antibodies, and type B cats have very strong anti-A antibodies.

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329
Q

Why is vasopressin used in patients with vWD?

A

induces release of vWF from endothelial cells

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330
Q

What are the components of MOPP and what types of drugs are they?

A

mechlorethamine, oncovin (vincristine), procarbazine
MP = alkylating agents
O = anti-microtubule agent

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331
Q

What should you do if your patient becomes thrombocytopenic on CCNU?

A

discontinue treatment because effects are cumulative

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332
Q

What is the nadir for CCNU?

A

14 days (compared with 7 days for most other drugs)

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333
Q

What is tamoxifen used for?

A

antiestrogenic effects in mammary neoplasia

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334
Q

What happens to ammonia levels if arginine levels are low?

A

hyperammoniemia due to the need for arginine in the urea cycle

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335
Q

Does C6 cross react with antibodies produced from vaccination for Lyme?

A

no!

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336
Q

During fasting, dogs maintain their BG in normal range via _____, whereas cats maintain their BG in normal range via _______.

A

dogs - glycogenolysis
cats - gluconeogenesis

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337
Q

What is the MOA of oxybutynin?

A

muscarinic receptor antagonist

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338
Q

Glucocorticoids induce ____ which inhibits phospholipase A2

A

lipocortin

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339
Q

For which virus is a killed vaccine always recommended?

A

rabies

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340
Q

What is the treatment for pneumocystis carinii?

A

TMS

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341
Q

What is the MOA of neostigmine?

A

blocks acetylcholinesterase

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342
Q

What is the MOA of bethanechol?

A

selectively stimulates muscarinic receptors

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343
Q

What is LipL32?

A

pathogenic outer membrane protein (OMP) of lepto

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344
Q

What is the main MOA of amitraz toxicity? What is the treatment?

A

alpha2 agonist tx: yohimbine

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345
Q

What organism can cause a false positive on PARR?

A

Ehrlichia

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346
Q

Which of the following are NOT susceptible to tylosin: Staphylococcus, E. coli, Streptococcus, Salmonella, Corynebacterium?

A

E. coli Salmonella

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347
Q

What do the following chemotherapeutics have in common: doxorubicin, cisplatin, streptozocin, lomustine?

A

potential for nephrotoxicity

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348
Q

FLUTD signs resolve in 5-7 days in ___% of cases

A

92%

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349
Q

What is the MOA of amitriptylline?

A

tricyclic antidepressant (serotonin-norepi reuptake inhibitor) also anticholinergic, antihistamine, analgesic, anti-inflammatory

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350
Q

What alpha receptor does acepromazine act on?

A

alpha 1 antagonist this is not the main mechanism though - D2 receptor antagonism is main mechanism

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351
Q

What is the MOA of dantrolene?

A

antagonizes ryanodine receptor, thereby inhibiting release of Ca from SR muscle relaxant

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352
Q

What is puppy strangles and how do you treat it?

A

juvenile cellulitis (unknown etiology) treat with pred 2mg/kg/d and antibiotics if concern for secondary infection

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353
Q

What are the treatments for lead poisoning?

A

CaEDTA, Succimer (chelating agent), D-penicillamine, thiamine (reduces tissue deposition), MgSO4 (as cathartic)

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354
Q

What is the most prevalent strain of parvovirus?

A

CPV-2b

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355
Q

What is the lactulose/rhamnose test used to assess? What does a high lactulose/rhamnose ratio represent? What about a low lactulose/rhamnose ratio?

A

test for intestinal permeability (lactulose travels paracellularly, rhamnose travels transcellularly) high lactulose/rhamnose = increased permeability because more laculose moving between cells low lactulose/rhamnose = normal permeability because less movement between cells

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356
Q

Which valve is most commonly affected in dogs with endocarditis?

A

mitral

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357
Q

Which heart conditions have been associated with an increased risk of endocarditis?

A

subaortic stenosis
PDA NOT DMVD

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358
Q

What is the osmolal gap and what is it used for?

A

difference between serum osmolality and calculated serum osmolality used to screen for possible toxins (ethylene glycol, ethanol, propylene glycol, acetone)

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359
Q

What are the two main cytokines released by NK cells?

A

TNA-alpha, IFN-gamma

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360
Q

Describe the role of perforin and granzymes upon their release from NK cells.

A

perforins create pores in the target cell’s membrane, which allow entry of granzymes, which induce apoptosis

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361
Q

What makes up the majority of the chylomicron?

A

triglycerides

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362
Q

Hyperventilation would have what effect on cerebral blood flow?

A

hyperventilation –> decreased PaCO2 –> vasocontriction –> decreased cerebral blood flow

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363
Q

What is enterokinase and where does it come from?

A

comes from duodenum converts trypsinogen to trypsin

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364
Q

T/F: Bradykinin is inactivated in the lung

A

True! Up to 80%

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365
Q

Cimetidine is a major inducer/inhibitor of P450.

A

inhibitor

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366
Q

ketoconazole is an inhibitor/inducer of P450 and an inhibitor/inducer of P-glycoprotein.

A

inhibitor of both!

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367
Q

Phenobarbital is an inducer/inhibitor of P45

A

inhibitor

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368
Q

Which antibiotic inhibits phenobarbital clearance?

A

chloramphenicol can result in sedation if used together

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369
Q

What drug interaction is a concern when enrofloxacin is used concurrently with theophylline?

A

enrofloxacin inhibits CYP1A2 metabolism of theophylline –> increased theophylline blood levels need to dose reduce theophylline in these patients

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370
Q

What should you do if enrofloxacin and theophylline need to be given concurrently?

A

Reduce the dose of theophylline by 30%

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371
Q

E. canis causes _________ ehrlichiosis.

A

Monocytic

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372
Q

What is seen with chronic E. canis infection?

A
  1. Pancytopenia from bone marrow hypoplasia Same signs as acute phase, plus
  2. Dyspnea, uveitis, retinal hemorrhage, deems, PLN, polymyositis
  3. Monoclonal gammopathy
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373
Q

What is the treatment for Bartonella?

A

Aminoglycosides +- doxycycline

Long term:
Doxycycline + Baytril - dogs
Doxycycline + pardofloxacin - cats

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374
Q

Ehrlichia ewingii causes _______ ehrlichiosis.

A

granulocytic

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375
Q

In dogs the meronts of Hepatozoon canis infect the _____ system and Hepatozoon americanum infects ______.

A

Hemolymphatic (spleen, BM, etc.)
Skeletal and cardiac muscle

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376
Q

What are the most common organisms to cause bacterial endocarditis?

A

Staph and Strep = most common; E. coli and Bartonella too

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377
Q

Osmolar gap?

A

The difference between the calculated serum osmolarity and the measured serum osmolarity. Osmolar gap = measured - calculated.

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378
Q

What is the most common presenting complaint in a hypercalcemic animal?

A

PU/PD

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379
Q

What causes PU/PD with hypercalcemia?

A

HyperCa2+ inhibits the response of renal tubules to ADH –> NDI

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380
Q

A normal PTH level in the face of hypercalcemia is consistent with what?

A

Hyperparathyroidism (should be LOW)

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381
Q

What is the best method to detect microparticles?

A

Flow cytometry

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382
Q

Drugs / toxins that limit hemoglobin production?

A

Lead, chloramphenicol, azathioprine, allopurinol, phenobarbital

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383
Q

A collie presents w/ a dx of large cell lymphoma. O want to pursue treatment w/ CHOP, but you are hesitant pending his MDR mutation status. What drugs in this protocol should NOT be given? What drugs can you give?

A

UNSAFE: vincristine, doxorubicin; SAFE: Cytoxan, CCNU (not CHOP)

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384
Q

Mixed metabolic / respiratory disorder?

A

When pCO2 and HCO3- are BOTH abnormal and in opposite directions. Low pCO2, high HCO3- = resp/met alkalosis; high pCO2, low HCO3- = resp/met acidosis

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385
Q

What is the most common finding in a dog with acetaminophen toxicity? A cat?

A

Dog = hepatotoxicity; cat = methemoglobinemia/anemia

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386
Q

What is the toxic metabolite in acetaminophen toxicity?

A

NAPQI

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387
Q

How do you treat an acetaminophen toxicity?

A

N-acetylcysteine, SAMe, supportive

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388
Q

What is the MOA of tacrolimus?

A

Calcineurin inhibitor –> inhibits IL-2 prod’n and T-cell proliferation, same as cyclosporine. Much more potent then cyclo.

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389
Q

What happens during apoptosis?

A

Caspase cascade activated –> activation of endonucleases –> disassembly of nuclear material and microtubules (cytoskeleton) –> bleb formation –> apoptotic bodies to be eaten by phagocytes.

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390
Q

What is the main role of carbonic anhydrase?

A

Converts CO2 + H2O H+ + HCO3- (carbonic acid dissociates to)

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391
Q

What is the difference between recurrent, reinfection, and relapse UTI?

A

Recurrent: presence of 3+ UTIs over a 12 month period
Reinfection: dx of UTI w/in 6 months of cessation of previous, successful treatment, with isolation of a DIFFERENT organism
Relapse: recurrence of UTI, after seemingly successful tx, and isolation of the SAME organism.

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392
Q

A mutation in TLR-4 that increases NF-KB translocation to the nucleus and increased cytokine prod’n would increase/decrease the risk of sepsis and increase/decrease susceptibility to gram negative organisms.

A

Decrease, decrease.

TLR-4 recognizes LPS on gram - bacteria –> NF-KB activation –> pro-inflammatory cytokine release.

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393
Q

What are the factors that affect vasodilation / vasoconstriction in pulmonary hypertension?

A

Vasodilation: NO, prostacyclin (PGI2)
Vasoconstriction: endothelin, thromboxane, serotonin

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394
Q

Where are NK cells made?

A

Come from lymphocyte precursors in the BM, widespread - LN, BM, spleen; NOT found in thymus - don’t undergo thymic processing

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395
Q

How do feline seizures usually initiate?

A

Complex partial seizures - aka psychomotor seizures (maniacal running, aggression, tail chasing, etc.). Can terminate as generalized seizures.

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396
Q

What is the most important component of DKA treatment?

A

Fluid therapy!! Then correction of electrolytes, then hyperglycemia.

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397
Q

What parasite causes tracheal thickening w/ masses?

A

Eucoleus aerophilus (Oslerus osleri causes nodules at the tracheal bifurcation and bronchi)

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398
Q

T/F: Multiple myeloma can interfere with coagulation.

A

True: primarily via globulins inhibiting platelet aggregation and TF release.

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399
Q

LDDST results demonstrate suppression at 4 hours, and suppression escape at 8 hours. What is your diagnosis?

A

PDH (No suppression would be AT or PDH, and suppression at both would r/o HAC)

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400
Q

What does stimulation of the baroreceptor reflex cause?

A

Receptors detect elevated BP –> Net effect lowering arterial BP 1.) Vasodilation of peripheral veins and arterioles 2.) Decreased HR 3.) Decreased strength of cardiac contraction

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401
Q

What is the best indication/sign of an UMN spinal lesion?

A

UMN: paresis, normal to increased tone, ataxia, UMN bladder (large, difficult express), and normal spinal reflexes. LMN: decreased tone/flaccidity, reduced/absent reflexes.

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402
Q

How much bicarb is resorbed in the PCT?

A

80-90% of filtered bicarb is resorbed in PCT

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403
Q

Where in the renal tubules does gentamycin toxicity occur?

A

Proximal tubular epithelial cells –> accumulate, cause injury

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404
Q

What decreases GFR?

A

Increased glomerular oncotic pressure (more pull), decreased glomerular hydrostatic pressure (less push)

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405
Q

_____ is released by endothelial cells and inhibits Plt activation. _____ is released from dense Plt granules and is a Plt agonist (recruits and activates).

A

Nitric oxide (NO); Serotonin

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406
Q

What are ANAs? Directed against what?

A

ANAs = anti-nuclear antibodies; directed against self nuclear components.

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407
Q

What type of hypersensitivity reaction causes hemolysis after a blood transfusion?

A

Type II - antibody mediated cytotoxicity - activates classical complement cascade.

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408
Q

What do microRNA do?

A

Down regulate specific gene expression

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409
Q

How is an action potential transmitted in muscle?

A

T-tubules, which penetrate to interior muscle fibers, allow AP’s to spread all the way through the muscle fiber –> Ca2+ release –> contraction

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410
Q

What facilitates glucose transport in the PCT?

A

Early PCT: SGLT2 (apical membrane) resorbs ~90% glucose; GLUT2 (basolateral) facilitates passive transport of glucose from fell to interstitial space. Late PCT: SGLT1 (apical) resorbs ~10% filtered glucose; GLUT1 (basolateral) from cell to interstitium

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411
Q

Fragments of LPS are what?

A

PAMPS: from gram - bacteria, recognized by TLR-4 –> activation of innate immunity

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412
Q

How does peptide reabsorption occur in the GIT?

A

Pepsin and pancreatic enzymes –> digestion of proteins into small mono/di/polypeptides –> further degraded by peptidases at brush border. AA and di/tripeptides transported into enterocytes –> additional peptidases in cell break down to single AA.

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413
Q

What percentage of total body water is ECF?

A

ECF = 33% (1/4 plasma, 3/4 interstitial fluid); ICF = 66%

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414
Q

What stimulates ADH?

A

1.) Increased plasma [Na+], osmolarity
2.) decreased arterial BP
3.) decreased blood volume

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415
Q

What can be found in the empty stomach of a horse and dog?

A

Maybe intrinsic factor (cats only have it from pancreas), or maybe PGE?????

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416
Q

If you are going to euthanize an animal based on a test result, do you want it to be very specific or sensitive?

A

Specific - fewest false positives!

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417
Q

How does aspirin inhibit platelet aggregation?

A

Inhibits COX-1 (irreversible) –> decreased thromboxanes (and prostaglandins)

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418
Q

What factor most affects blood flow through a vessel?

A

Radius

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419
Q

What determines osmotic force?

A

Number of particles (not mass of particles)

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420
Q

What increases cardiac contractility (Ca, Na, K, other)?

A

Ca++ –> contraction and force of; Na+ entering causes upstroke of the AP

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421
Q

How does a neutrophil kill phagocytized bacteria?

A

Respiratory burst: NADPH oxidase creates bactericidal oxidants (H2O2); digestive enzymes: released from granules into phagolysosome.

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422
Q

Signs of a forebrain lesion?

A

Seizures, behavior changes, normal gait w/ circling/pacing/head pressing, contralateral vision impairment w/ normal PLRs

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423
Q

PLR pathway?

A

Retina, optic n. (II), chiasm –> decussate, optic tract, pretectate nucleus –> decussate back, parasympathetic nucleus oculomotor n. –> efferent down oculomotor n., ciliary ganglion, postganglionic ciliary n, iris sphincter m.

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424
Q

In the PLR pathway which CN nerve carries the afferent signal? The efferent?

A

Afferent = CN II (optic)
Efferent = CN III (oculomotor)

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425
Q

What part of the PCR determines specificity?

A

Primers

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426
Q

What test requires live organisms?

A

Lepto MAT (microscopic agglutination test)

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427
Q

MHC has high nucleotide substitution in the codon. What does this mean for selection pressure?

A

This is advantageous, allows animal to respond to wider variety of offending antigens. Increases survivability of animal.

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428
Q

When bicarbonate is secreted from the pancreas it is associated with what?

(Options ?: Hydrogen in the duct, Na in the blood, osmosis of water, CO2 in the blood)

A

Osmosis of water.

Bicarb is actively transported with Na into the ductal lumen –> creates an osmotic pressure gradient –> osmosis of water into the duct.
H+ ions move into the blood in exchange with Na.

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429
Q

What thyroid hormone acts the quickest on its target cell?

A

T3

T4 is rapidly convert to T3 inside the cell.

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430
Q

What inhibits glucagon secretion?

A

Increased BG, somatostatin

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431
Q

What stimulates insulin secretion?

A

Increased BG, FFA, AA
GI hormones: gastric, CCK, secretin, GIP
Parasympathetic stimulation
B-adrenergic stimulation
Insulin resistance; obesity
Sulfonylurea drugs (glipizide)

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432
Q

When should a Lepto PCR be used? A MAT?

A

MAT is the best test to use after 5 days of infection.
PCR should be used early in the course of dz, <5 days. Can be used up to 3 days on antibiotics.

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433
Q

How would you treat a non-compressive myelopathy?

A

Strict cage rest
Anti-inflammatories and analgesics
Fluid therapy if in shock or concerned about spinal perfusion.

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434
Q

2 examples of portal vein atresia

A

Portal vein hypoplasia and microvascular dysplasia.
usually asymptomatic
*

  • elevated total serum bile acids
  • normal protein C, AUS, scintigraphy
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435
Q

What retinal pathology is seen in cats with taurine deficiency?

A

Focal retinal atrophy at the area centrallis (pathognomonic).
Progresses to diffuse retinal degeneration.

Supplementation can stop progression, but not reverse!

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436
Q

What is the idea diet for a cat with DM?

A

High protein
Low carb

Helps maintain ideal body weight and preserve lean muscle.

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437
Q

What arrhythmia might you see on an ECG from a dog being treated with doxorubicin?

A

Right bundle branch block

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438
Q

A dog with a creatinine of 4.5 would be what IRIS stage?

A

Stage 3

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439
Q

A cat with a creatinine of 2.1 would be an IRIS stage what?

A

Stage 2

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440
Q

What causes lipemic serum?

A

Increased triglycerides
(E.g. Post-prandial, DM, HL, pancreatitis, neoplasia)

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441
Q

1.) An endogenous ACTH level above the reference range is consistent with _______.

2.) ACTH below/within the reference range is consistent with _______.

A

1.) primary hypoadrenocorticism
- adrenals not making steroids –> feedback stimulates ACTH prod’n

2.) secondary hypoadrenocorticism
- pituitary not creating enough ACTH to appropriately stimulate adrenals –> feedback has no effect on ACTH prod’n

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442
Q

What side effect of methimazole can be reduced with topical treatment?

A

GI adverse effects

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443
Q

What stain can be used to detect mast cell granules?

A

Toluidine blue

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444
Q

Besides hypokalemia, what other electrolyte abnormally can potentate digoxin toxicity?

A

Hypercalcemia

Digoxin causes increase in intracellular Ca - hyperCa adds to this effect –> toxicity

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445
Q

What percentage of dogs with cerebral infarcts are hypertensive?

A

25-30%

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446
Q

What is the most common presentation of SLE?

A

Polyarthritis

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447
Q

Where is most CSF produced?

A

Choroid plexus

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448
Q

What are the primary effects (4) of GH?

A
  1. promotes protein deposition
  2. decreases carbohydrate utilization
  3. stimulates cartilage and bone growth
  4. induces production of somatostatins
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449
Q

What are the major stimulators (6) of GH?

A
  1. starvation
  2. hypoglycemia, low blood FAs
  3. exercise
  4. excitement
  5. trauma
  6. ghrelin
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450
Q

True test + / All dz + = ?

A

Sensitivity

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451
Q

True test + / All test + = ?

A

Positive predictive value

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452
Q

What prokinetic drug causes decreased acetylcholinesterase activity

A

Neostigmine

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453
Q

What is the treatment for zinc toxicity?

A
  1. remove source
  2. PPI
  3. sucralfate
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454
Q

What channel is responsible for the automaticity of pacemaker cells?

A

Na+ channels

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455
Q

How does Na leave the basolateral and paracellular surfaces of the renal epithelial cells?

A

Via Na-K ATPase

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456
Q

What are the primary pyrogens (3)?

A

IL-1, IL-6, TNF-alpha

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457
Q

T/F: Diazepam should be given to control seizures in a dog with HE.

A

FALSE! These are metabolized by the liver - use keppra or KBr instead. If a benzo was given reverse with flumazanil.

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458
Q

Underlying causes of feline pericardial dz?

A

Left sided CHF, FIP

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459
Q

Phenotypic characterization of T regulatory cells includes expression of which two surface antigens and transcription of which gene?

A

CD4 and CD25

transcription of FoxP3

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460
Q

What are myeloid-derived suppressor cells?

A

immature cells of myeloid lineage derived from bone marrow progenitor cells

increased in cancer and contribute to global immunosuppressive state

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461
Q

What does LGI stand for in reference to epilepsy?

A

leucine-rich glioma-inactivated protein

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462
Q

What happens at the presynaptic membrane in LGI mutants?

A

potassium channel in presynaptic membrane close more rapidly –> extended depolarization and increased Ca influx –> excessive neurotransmitter release –> focal seizures

also bind presynaptic to post-synaptic proteins to shorten synaptic cleft

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463
Q

What mutation is associated with benign familial juvenile epilepsy of Lagotto Romagonolos?

A

LGI2 mutation, autosomal recessive

focal seizures starting at 6wk that usually resolves by 10wks

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464
Q

What mutation pre-disposes Belgian Shepherds to adult-onset epilepsy?

A

ADAM23 mutation

focal seizures that may or may not become generalized

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465
Q

What is the best currently-available test for diagnosis of Bartonella infection?

A

BAPGM culture + PCR (ePCR from Galaxy diagnostics)

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466
Q

The FeLV SNAP test assesses for antigen/antibody . The FIV SNAP test assesses for antigen/antibody.

A

FeLV - antigen FIV - antibody

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467
Q

How often should blood donors be screened for infectious diseases?

A

at least once a year

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468
Q

T/F: Routine blood culture is recommended as part of the screening for potential blood donors

A

False! Transfusion of blood from animals with transient bacteremia has NOT been documented to cause disease in a recipient

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469
Q

T/F: Transfusion of microfilaria from a blood donor can lead to heartworm infection in the recipient.

A

False! But it caninterfere with diagnostic testing, causing infection in mosquitos, and can carry Wolbachia

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470
Q

B. canis vogeli is most common in which breed? B. gibsoni is most common in which breed?

A

B. canis vogeli = greyhound B. gibsoni = pitbull

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471
Q

Laishmania donovani is considered endemic in which breed of dogs in North America?

A

foxhounds

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472
Q

The IFA assay for Leishmania cross-reacts with which other pathogen?

A

Trypanosoma cruzi

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473
Q

What is the vector for Trypanosomiasis in the US?

A

feces-contaminated bite from (or ingestion of) triatomine bugs (kissing bugs)

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474
Q

Which infectious disease in dogs is most associated with acute or chronic myocarditis - leishmania, trypanosoma, hepatozoon, ehrlichia?

A

trypanosoma

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475
Q

T/F: Lyme can be transmitted by transfusion

A

FALSE! (or at least it has not been documented)

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476
Q

T/F: Dogs that are seropositive for lyme should be excluded from the blood donor pool

A

FALSE! They should not be excluded since lyme does not appear to be transmitted via blood transfusion

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477
Q

Should healthy blood donors be screened for RMSF?

A

No! Infected dogs are acutely ill and no subclinical carrier state is known to exist Even seropositive dogs should not be excluded as donors if they are clinically healthy

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478
Q

What is the definitive host for bartonella?

A

cats!

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479
Q

Should Bartonella seropositive cats be excluded as blood donors?

A

Not if they are PCR negative… high seroprevalence in cats (up to 93%) would make it difficult to find suitable blood donors otherwise

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480
Q

Cytauxzoon felis undergoes schizogony in ____ cells and merogony in ____ cells.

A

schizogony in myeloid cells merogony in RBCs

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481
Q

Which stage of Cytauxzoon development is associated with clinical illness?

A

schizogony

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482
Q

T/F: Healthy cats in endemic areas do not need to be screened for Cytauxzoonosis

A

False! They should be screened (PCR) because signs do not begin until 10-21d post-infection

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483
Q

What is the diagnostic test of choice for screening blood donor cats for M. hemofelis?

A

PCR

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484
Q

T/F: Mycoplasma hemofelis can survive in stored whole blood for up to 1 month

A

False! M. hemofelis is inactivated during storage of whole blood for 1 week

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485
Q

What specific antigen does the FeLV ELISA test for?

A

p27

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486
Q

T/F: FeLV can be transmitted by blood transfusion

A

True!

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487
Q

Why would it be ideal to use PCR for FeLV screening of feline blood donors?

A

Because regressive infection can occur with undetectable antigenemia but proviral DNA still present in the blood… FeLV provirus is infected, so PCR for proviral DNA would be ideal

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488
Q

How is FIV most commonly transmitted?

A

bite wounds

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489
Q

Which proteins are used in FIV SNAP tests to detect antibodies?

A

p24 and p15

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490
Q

Which species is the reservoir host for Rickettsia felis?

A

DOGS! Tricky tricky….

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491
Q

What are the roles of the following in the cardiomyocyte: troponin T, troponin I, troponin C?

A

troponin T = secures tropomyosin to the actin filament troponin I = inhibitory subunit that inhibits hydrolysis of ATP required for actin-myosin interaction troponin C - binds calcium to allow filaments to interact

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492
Q

Why is troponin C unfit for use as a cardiac biomarker?

A

the cardiac and skeletal isoforms are completely homologous

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493
Q

List 3 mechanisms of cytosolic cardiac troponin release without cell death

A
  1. increased membrane permeability 2. intracellular proteolysis 3. release of membranous vesicles containing cytosolic troponin
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494
Q

Which troponin is released in higher concentrations after a cardiac insult - troponin T or troponin I?

A

troponin I

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495
Q

T/F: Troponin concentrations correlate with the degree of cardiac injury on histopath

A

true!

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496
Q

List some substances in the blood that can falsely increase serum troponin concentrations.

A

elevated ALP hemolysis lipemia fibrin rheumatoid factor immune complexes

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497
Q

Which breeds of dogs might have inherently higher CTnI concentrations compared with other breeds?

A

greyhounds and boxers (or do all the boxers just have ARVC?….)

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498
Q

T/F: There is overlap between troponin concentration in healthy individuals and those with cardiac disease

A

True!

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499
Q

Increased troponin concentrations in critically ill patients has been associated with higher levels of what cytokines?

A

TNF-alpha, IL-6

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500
Q

In veterinary studies an association between cardiac troponin concentrations and short-term case fatality hasbeen found in dogs with which conditions?

A

GDV parvo babesia SIDS

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501
Q

Which cardiac troponin has been noted to be elevated in azotemic dogs?

A

cTnI

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502
Q

Which troponin is the cardiac injury marker of choice in dogs and cats?

A

cTnI

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503
Q

What are criteria for initiation of anti-epileptic drug treatment?

A
  1. identifiable structural lesion or prior history of brain disease/injury 2. acute repetitive seizures (>3 in 24h) or status epilepticus (>5min) 3. 2 or more seizure events within 6mo 4. prolonged, severe, or unusual post-ictal periods
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504
Q

Why can the elimination half life of phenobarbital progressively decrease with chronic dosing?

A

because it is an auto-inducer of hepatic microsomal enzymes (p450)

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505
Q

How long is the median elimination half life of KBr?

A

15.2 days!

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506
Q

Diets high in _____ result in excess renal excretion of KBr.

A

chloride

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507
Q

What is the only anti-epileptic drug specifically approved for dogs in the US?

A

primidone

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508
Q

Primidone is rapidly metabolized to which major active metabolite?

A

phenobarbital

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509
Q

T/F: Keppra undergoes extensive hepatic metabolism.

A

False! it is not metabolized in the liver and is excreted essentially unchanged in the urine

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510
Q

What are 3 major risks of treatment with phenobarbital?

A

hepatotoxicity idiosyncratic blood dyscrasias necrolytic dermatitis

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511
Q

After starting pheno treatment, when should drug monitoring be performed?

A

2 weeks, 6 weeks, then every 6mo or 2 weeks after a dose change

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512
Q

What are 3 side effects of potassium bromide treatment?

A

pancreatitis sedation ataxia

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513
Q

The hypogastric nerve comes from which spinal segments in cats? in dogs?

A

L2-L5 in cats, L1-L4 in dogs

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514
Q

The pelvic nerve fibers to the bladder comes from which nerve segments in dogs?

A

S2-S3

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515
Q

The pudendal nerve comes from which nerve segments in the dog?

A

S1-S3

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516
Q

In cats, sensory fibers from the lower urinary tract mainly travel within which nerves? In dogs? What about for sensation of overdistension?

A

cats - pelvic and hypogastric dogs - pelvic both species sense overdistension by the hypogastric nerve

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517
Q

____ fibers in the bladder wall sense bladder distension and send information to _____ which communicates with _____ to stimulate voiding

A

a-delta fibers in the bladder wall sense bladder distension and send information to pontine micturition center and peraqueductal grey matter which communicates with the cerebral cortex to stimulate voiding

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518
Q

The pontine micturition center inhibits ___ nerve and stimulates ___ nerve. The pontine storage center stimulates _____ and _____ nerves

A

The pontine micturition center inhibits hypogastric nerve and stimulates pelvic nerve. The pontine storage center stimulates hypogastric and pudendal nerves

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519
Q

Describe LMN bladder.

A

detrusor hyporeflexia/areflexia + sphincter hypotonia/atonia •ÄÊ increased bladder capacity/residual volume, constant urine leakage

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520
Q

Describe UMN bladder

A

detrusor overactivity causes•ÄÊ periodic elevated intravesical pressure and urine leakage with detrusor-sphincter dyssynergia during attempts to empty bladder

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521
Q

Which fibers can become activated in suprasacral spinal injury and can contribute to “reflex voiding”?

A

C fibers

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522
Q

Why do dogs with spinal cord injury have an increased risk of pyelonephritis?

A

increased intravesicular pressure with detrusor overactivity leads to vesicoureteral reflux

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523
Q

What treatments can be considered for detrusor overactivity following spinal cord injury?

A
  1. antimuscarinics (oxybutynin, botox in bladder wall) 2. vanilloids (capsaicin) intravesciularly or intradetrusor 3. tramadol
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524
Q

What treatments can be considered for bladder atony in the acute phase following suprasacral spinal cord injury?

A

bethanechol alpha blockers (prazosin, tamsulosin) muscle relaxants (diazepam)

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525
Q

Fluoroquinolones and aminoglycosides are most efficacious in what urine pH?

A

alkalineåÊ

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526
Q

Tetracyclines and beta lactams work best in what urine pH?

A

acidic pH (but pH doesn’t matter for amoxicillin or clavamox)

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527
Q

Does T. foetus cause large or small bowel diarrhea in cats?

A

large bowel diarrhea

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528
Q

What is the treatment of choice for T. foetus infection in cats?

A

ronidazole

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529
Q

Why are Trichomonads capable of living as lumen dwellers in oxygen-poor mucosal environments?

A

they lack mitochondria and use hydrogenosomes for ANAEROBIC metabolism

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530
Q

T/F: Trichomonads survive for long periods outside the host.

A

False! They cannot live for long outside the host as they do not form environmentally stable cysts

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531
Q

List 4 factors contributing to T. foetus pathogenicity in cats.

A
  1. sialic-acid binding lectins 2. adhesin proteins 3. lipophosphoglycan 4. cysteine proteases
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532
Q

T/F: Infection with trichomonas in cats confers lifelong acquired immunity.

A

False!

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533
Q

Trichomonas has a sexual/asexual lifecycle and aerobic/anaerobic metabolism

A

asexual lifecycle anaerobic metabolism

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534
Q

List 3 scenarios in which surgical removal of struvite uroliths may be considered.

A
  1. medications or dissolution foods cannot be given or are contraindicated 2. urolith cannot be adequately bathed in modified urine 3. uncontrollable infection despite appropriate medical management/owner compliance
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535
Q

T/F: Struvite nephroliths should be medically dissolved.

A

True!

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536
Q

T/F: Dissolution should be attempted in cats with obstructive upper urinary tract uroliths.

A

False!

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537
Q

Uric acid is transported to the liver, where it is metabolized by _____ (enzyme) into _______.

A

metabolized by hepatic uricase to allantoin

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538
Q

What genetic mutation is associated with urate stone production in dogs?

A

SLC2A9

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539
Q

T/F: Dissolution of urate stones is typically not possible in dogs/cats with uncorrected liver disease (such as PSS)

A

TRUE

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540
Q

What is the target urine pH for dissolution of cysteine stones?

A

~7.5 thiol binding drugs efficacy is increased at this pH or higher

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541
Q

T/F: Nonclinical urocystoliths should always be removed, even if they are unlikely to cause an obstruction

A

False! recommend periodic monitoring - consider removal if clinical signs develop

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542
Q

Over 90% of nephroliths and ureteroliths in cats are composed primarily of _______

A

calcium oxalate

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543
Q

Experimental ureteral occlusion in healthy dogs results in a __% permanent decrease in GFR by 7d, __% by 14d, and __% by 40d

A

35% by 7d 54% by 14d 100% by 40d

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544
Q

In preventing calcium oxalate stone recurrence, a target USG for dogs is ____ and for cats is ____

A

dogs < 1.020 cats < 1.030

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545
Q

Diets for dogs with cystinuria should be LOW in which two amino acids, and should contain ADEQUATE amounts of what other 2 amino acids?

A

low in: methionine & cystine adequate in: taurine & carnitine

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546
Q

Which sulfur-containing amino acid is a precursor to cystine?

A

methionine

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547
Q

How does 2-MPG (Thiola) work?

A

reduces cystine to 2 cysteine molecules which bind to thiol thiol-cysteine is 50x more soluble than cystine this effect is potentiated by urinary alkalinization

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548
Q

*Which stage of toxoplasmosis infects the placenta?

A

*tachyzoite

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549
Q

*Which breed is associated with thrombocytopenia due to macroplatelets?

A

*Cavalier King Charles Spaniel

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550
Q

*Which does firocoxib inhibit - COX-1, COX-2, or both?

A

*Primarily COX-2

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551
Q

*What is the range of protein content in FIP effusion?

A

*3.9 - 9.8

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552
Q

*What is the cellularity of effusion in FIP?

A

*<5000/uL (low-moderate cellularity)

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553
Q

*What types of cells are seen in FIP effusion?

A

*macrophages, neutrophils, some lymphocytes

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554
Q

*What is the MOA of doxycycline?

A

*inhibits protein synthesis by binding 30s subunit

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555
Q

Is doxycycline bacteriocidal or bacteriostatic?

A

bacteriostatic

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556
Q

How is Hepatozoon americanum transmitted?

A

dog ingests tick (Amblyomma maculatum)

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557
Q

*Describe labwork findings in dogs infected with Hepatozoon americanum?

A
  • SEVERE neutrophilia (often 200k neut or higher)

also. .. mild-mod NR anemia, mild increase in ALP, +/- hyperglobulinemia

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558
Q

*What regulates CSF pressure?

A

*arachnoid villi

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559
Q

*Why might you get a false negative result on 2M antibody assay in a dog with masticatory myositis? What should you do if you suspect this?

A

*if patient has been treated with immunosuppressive doses of steroids for 7-10d or if end-stage/chronic disease (muscle fibrosis). Recommend muscle biopsy

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560
Q

Which muscles should be biopsied in dogs suspected of having masticatory myositis?

A

temporalis and masseter muscles (both innervated by mandibular branch of trigeminal nerve - have 2M muscle fibers)

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561
Q

*Which antibiotics have good penetration for the prostate?

A

*antibiotics that are nonionized at a neutral pH with HIGH fat solubility: enrofloxacin, clindamycin, TMS

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562
Q

*T/F: Corticosteroids are contraindicated in cases of traumatic brain injury

A

*True! Treatment with corticosteroids increases risk of death in patients with traumatic brain injury

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563
Q

Toxoplasma oocysts take how many days to become infective after being shed in feces?

A

1-5d, therefore daily scooping of litter box is important

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564
Q

What is the definitive host of Toxoplasma gondii?

A

cats

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565
Q

How can Toxoplasma gondii be transmitted?

A

consumption of oocysts passed in feces of cats

consumption of bradyzoites encysted in tissue

transplacental transmission via tachyzoites

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566
Q

T/F: Cats with clinical toxoplasmosis are likely to be shedding oocysts in their feces.

A

False! They are unlikely to be shedding during clinical infection

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567
Q

Clinical signs of toxoplasmosis are caused by…

A

proliferation of asexual stages extraintestinally (this is why cats with clinical signs are unlikely to be passing oocysts in feces)

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568
Q

*Describe the use of IgM and IgG titers in diagnosis of toxoplasmosis.

A

*IgM - active for recent infection ( 1:256

IgG - appear after 4wks of infection and remain high for years. Can use convalescent IgG titers 3-4 wks apart - 4-fold rise in titer is consistent with active infection.

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569
Q

*Aside from serum, what other samples can be analyzed for toxoplasma antibodies?

A

*CSF, aqueous humor

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570
Q

*What is the vector for Cytauxzoon felis?

A

*Lone star tick (Amblyomma americanum)

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571
Q

*What is the nautral host for Cytauxzoon?

A

*bobcat

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572
Q

*Does cytauxzoon undergo cat-cat transmission or vertical transmission?

A

*probably not either (at least not in experimental models)

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573
Q

*What is the infectious stage of cytauxzoon? What cells do they infect?

A

*sporozoites infect mononuclear phagocytes

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574
Q

*Describe the 2 major stages of development of Cytauxzoon.

A

*schizogony - asexual reproduction that occurs in WBC

merogony - sexual reproduction that occurs when WBC rupture and release piroplasms, which infect RBC

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575
Q

*What is the predominant cause of clinical disease and death in cats with cytauxzoonosis?

A

*schizont-infected WBC occlude blood vessels, causing “parasitic thrombi” resulting in ischemia and tissue necrosis

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576
Q

How is cytauxzoonosis diagnosed?

A

detection of piroplasms in RBCs on bloodsmears, or less commonly detection of schizonts on blood smears (feathered edge) or on FNA of LNs, liver, or spleen

PCR can also be performed

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577
Q

What are the most common bloodwork findings in cats with cytauxzoonosis?

A

leukopenia with toxic neutrophils, thrombocytopenia, NN anemia, hyperbilirubinemia, hypoalbuminemia

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578
Q

What medications have been associated with the highest survival rates in cats with cytauxzoonosis?

A

combinationof atovaquone and azithromycin

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579
Q

*Drop jaw is caused by paralysis of which nerve? Which muscles would be atrophied?

A

*mandibular branch of trigeminal nerve

temporalis, masseter, pterygoid

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580
Q

*What bacteria are the most common cause of diskospondylitis in dogs?

A

*coagulase-positive Staphylococcus spp. (aureus, intermedius)

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581
Q

*The presence of what bacteria in a tracheal wash specimen would be indicative of oropharyngeal contamination?

A

*Simonsiella

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582
Q

What are these organisms seen on endotracheal wash? What do they represent?

A

Simonsiella, representative of oropharyngeal contamination

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583
Q

*Which aflatoxin is most commonly encountered in food-related toxicosis?

A

*aflatoxin B1 (AFB1) - associated with corn, grains, peanuts, soybeans, treenuts, cottonseed

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584
Q

*What fungus commonly produces aflatoxins found in foods?

A

*Aspergillus

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585
Q

*How does aflatoxin cause hepatotoxicity?

A

due to low glutathione levels for neutralization of aflatoxins

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586
Q

*Why are dogs so sensitive to aflatoxicosis?

A

*due to low glutathione levels for neutralization of aflatoxins

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587
Q

*What is the treatment of choice for tritrichomonas infection?

A

*ronidazole

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588
Q

*What is the most important extracellular buffer?

A

*HCO3-

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589
Q

*What activates pepsinogen to pepsin?

A

*low pH in stomach

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590
Q

*List adverse effects of misoprostol.

A

*GI distress

uterine contractions & vaginal bleeding in female dogs (uncommon)

abortion if given during pregnancy

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591
Q

*What is a microRNA?

A

*a small non-coding RNA molecule (containing about 22 nucleotides) found in plants, animals and some viruses, that functions in RNA silencing and post-transcriptional regulation of gene expression

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592
Q

*What is the most potent stimulator of aldosterone secretion? List 2 other stimulators of aldosterone secretion.

A

*Strongest stimulus = hyperkalemia

2 other stimuli = angiotensin II, ACTH

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593
Q

*Describe stage A DMVD

A

*At high risk for developing DMVD but without a murmur (such as all Cavaliers without murmurs)

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594
Q

*Describe stage B DMVD.

A

*Patients with structural heart disease that have never developed clinical signs of CHF

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595
Q

*What is the difference between stage B1 and stage B2 in DMVD?

A

*Stage B1 - asymptomatic patients with no evidence of cardiac remodeling

Stage B2 - asymptomatic patients with hemodynamically significant regurgitation resulting in left heart enlargement

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596
Q

*Describe stage C DMVD.

A

*Patients with past or current clinical signs of CHF

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597
Q

*Describe stage D DMVD

A

*Patients with end-stage CHF, refractory to standard therapy

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598
Q

*Would you expect hyper- or hyponatremia in cases of nephrogenic diabetes insipidus?

A

*hypernatremia due to pure water loss

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599
Q

What is the main stimulus for ADH release?

A

Increased serum osmolality

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600
Q

Which 2 electrolyte abnormalities have been determined to be a CAUSE of nephrogenic diabetes insipidus?

A

hypercalcemia and hypokalemia

both situations interfere with action of ADH in collecting ducts

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601
Q

How do thiazide diuretics reduce polyuria in dogs with NDI?

A

Inhibit resorption of Na+ in distal tubule –> decreased total body sodium –> increased resorption of Na+ and water in proximal tubule –> decreased Na+ concentration in distal tubule –> increased WATER resorption in distal tubule

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602
Q

*Secretion of glucagon is inhibited by…

A

*insulin
somatostatin

FFAs

ketoacids

urea

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603
Q

*How do you calculate odds ratio using this chart?

A

*odds ratio = ad/bc

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604
Q

In what type of study would you calculate an odds ratio?

A

case control study

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605
Q

*Extracellular fluid accounts for what proportion of total body water? What proportion is interstitial and vascular?

A

*1/3 of total body water is ECF-

3/4 of that is interstitial, 1/4 vascular

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606
Q

*Which inflammatory mediator is the strongest chemokine?

A

*leukotriene B4

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607
Q

*Define functional residual capacity

A

*The volume of air present in the lungs at the end of passive expiration

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608
Q

*Which 2 cardiac abnormalities will result in hyperkinetic pulses?

A

*aortic insuffiency and PDA

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609
Q

*How do cardiac glycosides (digoxin, ouabain, foxglove) work?

A

*inhibit Na-K-ATPase pump

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610
Q

*What nerve innervates the external urethral sphincter? What type of innervation is it?

A

*pudendal nerve, somatic acting on nicotinic receptors

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611
Q

What nerves innervates the detrusor? What types of innervation are they?

A

hypogastric - sympathetic acting on beta3 receptors (stimulation results in detrusor relaxation)

pelvic - parasympathetic acting on muscarinic receptors (stimulation results in detrusor contraction)

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612
Q

Which nerve innervates the internal urethral sphincter? What type of innervation is this?

A

hypogastric nerve - sympathetic (acts on alpha1 receptors to contract internal sphincter)

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613
Q

*What constitutes the largest pool of iron in the body?

A

*hemoglobin

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614
Q

*What type of immunoglobulin is involved in type I hypersensitivity reactions?

A

*IgE

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615
Q

*Which cells stimulate B cells to produce IgE in type I hypersensitivity reactions?

A

*CD4+ Th2 cells

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616
Q

*Glomerulonephritis is an example of what type of hypersensitivity reaction?

A

*type III (immune complex)

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617
Q

Describe type II hypersensitivity reactions.

A

cytotoxic hypersensitivity - antibodies produced by B cells bind to antigens on patient’s own cells and activate complement

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618
Q

What types of immunoglobulins are involved in type II hypersensitivity reactions?

A

IgG and IgM

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619
Q

Describe type III hypersensitivity reactions.

A

Immune-complex reaction - excess amounts of antigen bind antibodies and form complexes, which deposit in small vessels, joints, and glomeruli

620
Q

Describe type IV hypersensitivity reactions.

A

Cell-mediated (delayed) - CD4 Th1 cells recognize antigen on MHCII and activate CD8 T cells which destroy affected cells

621
Q

NK cells are what type of lymphocytes?

A

large granular lymphocytes

622
Q

*NK cells contain granules, which release what?

A

*perforin and granzymes

623
Q

Is enrofloxacin bacteriocidal or bacteriostatic?

A

bacteriocidal

624
Q

Is enrofloxacin concentration- or time-dependent?

A

concentration dependent

625
Q

*What is the mechanism of action of enrofloxacin?

A

*inhibits DNA gyrase, which prevents DNA coiling and DNA synthesis

626
Q

*What is the mechanism of TMS?

A

*inhibits bacterial folate synthesis

627
Q

*Long term use of TMS can result in what endocrine condition in dogs?

A

*hypothyroidism, with consistent clinical signs

628
Q

*Cryptosporidium hominis is an obligate parasite of what species?

629
Q

*List 2 major endogenous pyrogens. List a few minor endogenous pyrogens as well.

A

*Major: IL-1 and IL-6

Minor: TNF-beta, TNF-alpha, IL-8, IFN-alpha, IFN-beta, IFN-gamma

630
Q

*Which lipoproteins contain the highest triglyceride content?

631
Q

Which lipoprotein contains the highest cholesterol content in dogs and cats? What about in other species?

A

HDL in dogs and cats (Ettinger)

LDL in all other species

632
Q

*Dexamethasone is how many times more potent than prednisone?

A

*7x more potent

633
Q

What is the large form of Babesia in dogs?

634
Q

What is the small form of Babesia in dogs?

A

B. gibsoni

635
Q

What is the main tick vector for Babesia?

A

Rhipicephalus sanguineus (brown dog tick)

636
Q

Which stage of Babesia INFECTS the RBC?

A

sporozoites

637
Q

*Which stage of Babesia causes HEMOLYSIS of RBCs?

A

*merozoites

638
Q

Which Babesia species is associated with pitbulls?

A

B. gibsoni

639
Q

*Which immunoglobulin is primarily associated with mucosal surfaces?

640
Q

*Which amino acid deficiency is associated with retinal degeneration in cats?

A

*taurine deficiency

641
Q

*List common signs of hepatic encephalopathy in cats.

A

*hypersalivation , seizures, head pressing, ataxia, weight loss, GI signs

642
Q

*What cell type does metronomic chemotherapy target?

A

*endothelial cells lining the blood vessels that supply tumors

643
Q

*What is the MOA of diazoxide?

A

*directly inhibits pancreatic insulin secretion by inhibiting closure of K channels on beta cells, preventing depolarization

also stimulates beta adrenergic system to enhance hyperglycemia

644
Q

*FeLV and FIV infection results in decreased numbers of what cell type?

A

*CD4 lymphocytes

645
Q

*A hypoglycemic patient is noted to have a gastric mass. What is the most likely type of tumor?

A

*leiomyosarcoma

646
Q

*Which NSAID has been shown to be effective in treatment of lymphoplasmacytic rhinitis?

A

*piroxicam

647
Q

*Tetanus antitoxin binds what form of the tetanus toxin in the body?

A

*Free toxin

648
Q

*In what cases is treatment of salmonellosis indicated?

A

*Only in severe cases or in SEPTIC salmonellosis. Treatment of intestinal salmonellosis can result in development of antibiotic-resistant strains and prolonged shedding

649
Q

*Which toll-like receptor is responsible for recognizing lipopolysaccaride?

650
Q

*What is the ligand for TLR-4?

A

*lipopolysaccaride (LPS)

651
Q

*What percentage of sodium is reabsorbed in the proximal convoluted tubule?

652
Q

*List 3 drugs in which intralipid therapy could be useful

A

ivermectin, permethrin, baclofen

653
Q

*What dose of steroids is used in dogs with PLE?

A

*immunosuppressive doses (2mg/kg/d)

654
Q

*Why is polydipsia associated with steroid administration an especially important issue in dogs being treated for PLE?

A

*Because increases in free water can result in dramatic worsening of edema/ascites

655
Q

*What is the initial treatment of choice for dogs with idiopathic PLE?

A

*Immunosuppressive doses of steroids. Cyclosporine can also be considered as monotherapy

656
Q

*Which breed is predisposed to development of idiopathic head tremors?

A

*English Bulldogs

657
Q

*IMHA is most commonly associated with what immunoglobulin binding to erythrocytes?

A

*IgG, however some dogs will have IgG and IgM (more common in intravascular hemolysis)

658
Q

*What is the Baermann fecal test used for?

A

*Detection of nematode larvae (typically used to diagnose lungworm)

659
Q

*What electrolyte abnormality exacerbates digoxin toxicity?

A

*hypokalemia

660
Q

*Why does hypokalemia exacerbate digoxin toxicity?

A

*Digoxin binds the Na/K/ATPase pump in the position normally occupied by K+. If potassium levels are low, then more digoxin can bind to the pumps, precipitating toxicity

661
Q

*Which worsens hepatic encephalopathy - acidosis or alkalosis?

A

*Alkalosis… shifts reaction equilibrium [NH3 + H+ NH4+] left, towards production of nonionized ammonia, which is the form that penetrates neuronal membranes

662
Q

*Which worsens hepatic encephalopathy - hypokalemia or hyperkalemia?

A

*Hypokalemia because it causes potassium to shift extracellularly in exchange for H+ moving intracellularly –> alkalosis, which results in more nonionized ammonia, which penetrates neuronal membranes

663
Q

Which worsens hepatic encephalopathy - hypoglycemia or hyperglycemia?

A

Hypoglycemia - because it potentiates the activity and production of other neurotoxins

664
Q

*What exacerbates release of ALP from hepatocyte cell membranes in cholestasis?

A

*Bile acids

665
Q

*Why does effusion form in cats with FIP?

A

*Immune-complex vasculitis, and FIP infected monocytes releasing VEGF and other factors, increasing permeability and causing effusion

666
Q

*What is the MOA of cyclosporine?

A

*binds to T-cell cyclophilin & blocks calcineurin-mediated T-cell activation at G0 phase of cell cycle (mainly T helper cells). Also inhibits cytokine production and release (especially IL-2)

667
Q

*What is the largest pool of iron in the body?

A

*Hemoglobin (66% of iron stores)

668
Q

*What oral immunosuppressive is the treatment of choice for perianal fistulas in dogs?

A

*cyclosporine

669
Q

*What is the MOA of phenylpropanolamine?

A

*sympathomimetic - alpha and beta adrenergic agonist

670
Q

*Why is cisplatin use contraindicated in cats?

A

*Results in fatal pulmonary edema

671
Q

*List clinical signs of marijuana toxicity in dogs.

A

*depression, hypersalivation, mydriasis, hypermetria, vomiting, urinary incontinence, tremors, hypothermia, bradycardia

At high doses: nystagmus, agitation, tachycardia, ataxia, seizures, hyperexcitability

672
Q

*T/F: Intralipid therapy can be used in marijuana toxicity.

A

*True! Marijuana is highly lipophilic

673
Q

*T/F: Marijuana undergoes enterohepatic recirculation

A

*True! Therefore, re-dose activated charcoal at 4-8hr intervals

674
Q

*What characteristics of marijuana result in slow elimination from the body?

A
    1. highly lipophilic
      1. highly protein bound
      2. large volume of distribution
      3. enterohepatic recirculation
675
Q

*What muscles are innervated by cranial nerve 3?

A

*dorsal rectus
ventral rectus

medial rectus

ventral oblique

levator palpebrae

contains parasympathetic fibers for pupillary constriction

676
Q

*What is mesna?

A

*A chemoprotectant medication used to prevent cyclophosphamide-induced hemorrhagic cystitis

677
Q

Which chemotherapeutic agent is associated with hemorrhagic cystitis?

A

cyclophosphamide

678
Q

*Why is liposomal amphotericin B less nephrotoxic than regular amphotericin B?

A

*Liposome prevents the medication from early degradation/inactivation, while also enhancing drug delivery to diseased tissue and decreasing the amount of free drug

679
Q

*What is the MOA for maropitant?

A

*neurokinin-1 receptor antagonist. Acts in CNS to inhibit action of substance P, a major neurotransmitter involved in vomiting. Suppresses central AND peripheral emesis

680
Q

*How does glargine work to provide long-acting glycemic control?

A

*Following SQ injection, the acidic solution is neutralized & microprecipitates are formed that slowly release small amounts of insulin glargine

681
Q

*What is the MOA of clopidogrel?

A

*Inhibits both primary AND secondary platelet aggregation.

Active metabolite binds selectively to platelet surface ADP-receptors & inhibits ADP binding, thereby reducing platelet aggregation. Irreversibly alters ADP receptor so the platelet is affected for its lifespan.

682
Q

*How does metoclopramide improve GI motility?

A

*sensitizes upper GI smooth muscle to the effects of acetylcholine

683
Q

What is the MOA of metoclopramide’s anti-emetic effects? Why is it less effective in cats?

A

Dopamine antagonist, weak inhibitor of 5HT3

Less effective in cats because they have few dopamine receptors in the CNS

684
Q

What are the vitamin K dependent clotting factors?

A

II, VII, IX, and X

also protein C and protein S

685
Q

*What is the recommended test for diagnosing heartworm infection in cats?

A

*Heartworm antibody test – cats often have very few worms, if they are all male then the antigen test will be negative!

686
Q

What is the tradename for oclacitinib?

687
Q

*What are adverse effects associated with oclacitinib?

A

*GI side effects
Polydipsia

Lethargy

Lymphadenopathy

Increase susceptibility to infection (pneumonia, demodicosis)

Neoplasia?

688
Q

*List effects of TNF-alpha on adipose tissue.

A

*inhibition of:
carbohydrate metabolism, lipogenesis, & thermogenesis

stimulation of lipolysis

689
Q

*What electrolyte causes the upstroke of the action potential in nerve cells?

A

*Na+… opening of voltage-gated Na channels results in inward Na+ current

690
Q

*At the neuromuscular junction, what causes release of neurotransmitter?

A

*Influx of calcium

691
Q

*List the essential fatty acids for dogs.

A

*Linoleic
Alpha-linolenic

Gamma-linoenic

+/- eicosapentaenoic

+/- docosahexaenoic

692
Q

*List the essential fatty acids for cats

A

*Arachidonic
Linoleic
Alpha-linolenic

Gamma-linoenic

+/- eicosapentaenoic

+/- docosahexaenoic

693
Q

*Which fatty acid is considered essential in cats, but not dogs? Why is this true?

A

*Arachidonic acid… Dogs can convert linoleic acid to arachidonic acid, but cats cannot

694
Q

*In early goal-directed therapy of patients in shock, what is the target MAP?

A

*65-90mmHg

695
Q

*In early goal-directed therapy of patients in shock, what is the target CVP?

696
Q

*In early goal-directed therapy of patients in shock, what is the target UOP?

A

*at least 0.5mL/kg/hr)

697
Q

*In goal-directed resuscitation of shocky patients, what is the sequence recommended for pressors, pRBCs, fluids, and inotropic agents in most cases?

A

fluids –> pressors –> pRBCs –> inotropic agents

698
Q

*List the 4 categories of causes of pulmonary hypertension.

A
    1. left-sided CHF (most common)
      1. primary lung disease (fibrosis, chronic bronchitis, tracheal collapse)
  1. diseases affecting pulmonary arteries (heartworm, L–>R shunts)
  2. chronic thrombotic/embolic disease (heartworm, PTE)
699
Q

*A split S2 sound has been associated with what condition?

A

*pulonary hypertension

700
Q

*What are typical clinical signs associated with pulmonary hypertension?

A

*cough, exercise intolerance, syncope, tachypnea, respiratory distress

701
Q

*Which prostaglandin is decreased in patients with pulmonary hypertension?

A

*Prostacyclin (also known as PGI2)

702
Q

*A notched QRS is seen in what congenital cardiac condition?

A

*tricuspid valve dysplasia

703
Q

*What results in constriction of the pulmonary arteries?

A

*Hypoxemia, endothelin

704
Q

*What results in dilation of the pulmonary arteries?

A

*prostacyclin, nitric oxide, increased PO2

705
Q

What is the MOA of dirlotapide?

A

dirlotapide = slentrol.

microsomal triglyceride transfer protein (MTTP) inhibitor. Blocks assembly & release of lipoproteins into bloodstream, thereby reducing fat absorption. Also elicits satiety signal from lipid-filled enterocytes

706
Q

*What are the most common bloodwork findings in dogs with hemophagocytic histiocytic sarcoma?

A

*Coombs negative regenerative anemia
hypoalbuminemia

thrombocytopenia

hypocholesterolemia

mildly prolonged PTT

mild hyperbilirubinemia

707
Q

*For what types of glomerular disease may steroids be most indicated?

A
    1. fulminant cases where immediate immunosuppression is required, or
      1. multi-systemic immune-mediated diseases where their use has proven beneficial (i.e. concurrent IMPA or IMHA)
708
Q

*When pancreatic bicarbonate is secreted, what follows?

A

*sodium and water (via osmosis)

709
Q

*Pancreatic bicarbonate is secreted in exchange for _____.

710
Q

https://s3.amazonaws.com/classconnection/493/flashcards/7874493/png/screen_shot_2016-12-28_at_41521_pm-1594749DCB62A1DE507.png

A

*Atrial fibrillation

711
Q

*What is the most potent stimulator of hydrogen secretion in the distal tubule?

712
Q

What is the lifespan of an erythrocyte in a dog? cat?

A

dog: 110 days
cat: 70 day

713
Q

*Which WBC has the shortest half life in the dog?

A

*eosinophil (T1/2 = 10hrs)

714
Q

*T/F: Staphylococcus aureus from horses and dogs can be transmitted to people.

715
Q

*CD36 deficiency is linked to what conditions?

A

*hyperlipidemia, hypertension, insulin resistance

716
Q

*T/F: CD36 plays an important role in fatty acid metabolism.

717
Q

*Why might you see an elevated T3 or T4 in a dog with thyroiditis?

A

*Anti-thyroid hormone antibodies can produce a spurious increase in these hormones unless free T4 is measured by equilibrium dialysis

718
Q

*What disease might you suspect if you had a dog with an elevated TT4 and TSH?

A

*Thyroiditis resulting in hypothyroidism. Anti-T4 antibodies can cause spuriously increased TT4 concentrations. Would expect free T4 (by equilibrium dialysis) to be low

719
Q

*What is the most common primary brain tumor in dogs?

A

*Meningioma (~50%), second would be glioma

720
Q

*What is the most common secondary brain tumor in the dog?

A

*Hemangiosarcoma

721
Q

*Cholecystokinin (CCK) is secreted from what cells?

A

*I cells of duodenum and jejunum

722
Q

*List 2 stimuli for secretion of CCK.

A

*1. small peptides and amino acids 2. fatty acids

723
Q

*List 5 functions of CCK.

A

*1. stimulate panc enzyme secretion 2. stimulate panc HCO3 secretion 3. stimulate contraction of gallbladder and relaxation of sphincter of oddi 4. stimulates growth of exocrine pancreas and gallbladder 5. inhibits gastric emptying

724
Q

*Secretin is secreted from what cells?

A

*S cells of duodenum

725
Q

*List 2 things that stimulate secretion of secretin.

A

*1. H+ in the duodenum 2. fatty acids in the duodenum

726
Q

*List 4 functions of secretin.

A

*1. stimulate panc HCO3 secretion 2. stimulate biliary HCO3 secretion 3. inhibit gastric acid secretion 4. inhibit trophic effects of gastrin on gastric mucosa

727
Q

*What is the main breakdown product of carbohydrates in the small intestine?

728
Q

*What is the MOA of mitoxantrone?

A

*type II topoisomerase inhibitor - disrupts DNA synthesis and repair by intercalation between DNA bases

729
Q

*What drug is used in dogs with polycythemia vera?

A

*Hydroxyurea

730
Q

What 3 factors are used to determine the appropriate dose of a given drug?

A
  1. C max (maximum concentration)
  2. volume of distribution (V d )
  3. bioavailability (F)

dose = (C max x V d ) / F

731
Q

*What surface antigen is important for an APC cell to express in order to activate and stimulate T helper cells?

732
Q

What is secreted in the bile that aids in iron absorption?

A

*apotransferrin

733
Q

*What is the lifespan of a neutrophil in normal tissue?

734
Q

In generation of the respiratory burst in neutrophils, oxygen combines with _____ to produce superoxide.

735
Q

*What is the first step in the classical complement pathway?

A

*C1 initiates classical complement pathway by binding to Ag-IgG and becomes activated –> cleaves C2 and C4 –> cleave C3

736
Q

Which complement factors form the MAC?

737
Q

What type of organisms are targeted by defensins?

A

organisms with cholesterol-free, negatively charged membrane (bacteria, fungi, viruses)

738
Q

Where are perforins located? Where are defensins located?

A

perforins = cytotoxic T cells, NK cells

defensins = neutrophil granules, epithelial cells

739
Q

*What are Heinz bodies and how are they formed?

A

*Hemoglobin remnants in RBC form from oxidative damage

740
Q

Where are L-selectins found? Where are P-selectins found? Where are E-selectins found?

A 
L-selectin = WBCs
P-selectin = platelets and endothelium

E-selectin = endothelium

741
Q

Glanzmann’s thrombasthenia is seen in which breed? It is associated with absent or reduced ______.

A

Otterhound, Great Pyrenees

absent or reduced GPIIb-IIIa complex –> abnormal platelet adhesion

742
Q

What is Chediak-Higashi syndrome and which breed is predisposed?

A

Blue smoke persian cats

Results in disordered lysosomal trafficking and impaired lysosome degranulation, neutroenia, reduced # dense granules in platelets

743
Q

What are contained within dense granules of platelets?

A

ADP, ATP, calcium, serotonin

744
Q

What is different between aspirin’s effect on thromboxane and other NSAIDs’ effect?

A

aspirin’s effect is irreversible whereas others are transient

745
Q

What breed is predisposed to cyclic neutropenia?

A

grey collies

746
Q

*What is the defect seen in dogs with CLAD? Which breed is predisposed?

A

Irish Setters

autosomal recessive –> missense mutation in ITGB2 gene coding for beta2 integrin CD18

also have deficiency in CD11 integrin

decreased neutrophil adherence

747
Q

*What would be seen in the following parameters with iron deficiency anemia? - [Fe], TIBC, stainable BM iron, [ferritin]

A

*decreased [Fe], increased/normal TIBD, decreased BM iron, decreased ferritin

748
Q

*What would be seen in the following parameters with anemia of inflammatory disease? - [Fe], TIBC, stainable BM iron, [ferritin]

A

*decreased [Fe], decreased TIBC, increased BM iron, increased ferritin

749
Q

*What do the following test: ACT, PT, PTT?

A

*ACT and PTT - intrinsic and common pathways

PT - extrinsic and common pathways

750
Q

Are there such thing as Y-linked diseases?

A

yes, but very rare

751
Q

*If you breed 2 affected animals with an autosomal recessive disease, will there be normal offspring?

A

*no! all will be homozygous affected

752
Q

Which of the following is in the GI tract: apotransferrin, transferrin, ferritin?

A

apotransferrin

753
Q

T/F: EPO is made exclusively in the renal epithelial cells.

A

False! 90% made in kidney, 10% made in the liver

754
Q

What features of the endothelium are antithrombotic?

A
  1. smooth surface
  2. layer of NEGATIVELY-charged glycocalyx which repels clotting factors and platelets
  3. thrombomodulin (binds thrombin and activates protein C)
755
Q

Protein C inactivates which factors?

A

factor V and VIII

756
Q

*Which ILs are absent in x-linked SCID?

A

*IL-2, IL-2, IL-7, IL-9, IL-15

757
Q

What is the most common cause of death in x-linked SCID?

A

overwhelming bacterial or viral infection

758
Q

Describe levels of IgM, IgG, and IgA in x-linked SCID.

A

normal IgM level
reduced/absent IgG

absent IgA

759
Q

T/F: High shear stress induces expression of GPIIb/IIIa.

760
Q

Which complement factor plays an important role in opsonization?

761
Q

Which complement component is important for WBC chemotaxis?

762
Q

Is immune complex deposition more likely when there are equal numbers of antigens and antibodies or when there is an absolute elevation in antibodies?

A

equal numbers

763
Q

What is type I vWD?

A

most common form (Dobies)

low plasma vWF but normal multimer distribution

clinical signs if 15% or lower vWF:Ag

764
Q

What is type II vWD?

A

causes moderate to severe bleeding

disproportionate loss of high-MW multimers

german short and wire haired pointers

765
Q

What is type III vWD?

A

total loss of vWF, severe bleeding

dutch kookiers, scotties

766
Q

*Can animals with hemophilia A survive to a reproductive age?

A

*Yes, but can die at birth from umbilical hemorrhage

767
Q

*What is the definition of an autoimmune disease?

A

*Loss of immune tolerance to your own tissues

768
Q

*What is contained in granules of basophils?

A

*heparin, histamine, serotonin, bradykinin

769
Q

Are basophils precursors of mast cells?

770
Q

Which enzyme in fat metabolism is stimulated by heparin?

A

lipoprotein lipase

771
Q

By binding to and activating ____, heparin inhibits which 5 clotting factors?

A

binds to and activates antithrombin-3

inhibits II, IX, X, XI, XII

772
Q

Why might hyperkalemia occur in patients treated with heparin?

A

due to suppression of aldosterone by heparin

773
Q

*Which immunoglobulin is most abundant in the body?

774
Q

Which immunoglobulin can cross the placenta?

775
Q

*Which immunoglobulin is found in secretions?

776
Q

T/F: IgA works by activating complement

A

False! IgM activates complement, IgA does not

777
Q

What is the half life of IgE, IgM, and IgG?

A 
IgE = 2d
IgM = 5d

IgG = 23d

778
Q

What is the inheritance pattern of Pelger-Huet anomaly? Which breeds are affected?

A

autosomal dominant

Australian shepherds (also heelers, cockers, foxhounds, GSDs, others)

779
Q

*What causes a rightward shift in the O2-Hgb dissociation curve? What does a rightward shift mean?

A

decreased pH
increased CO2

increased temp

increased 2,3-DPG

rightward shift means O2 is released at tissues more easily!

780
Q

*What is the most common form of CO2 in the blood?

781
Q

*What is the primary stimulus of the respiratory center in the medulla?

782
Q

How does CO2 stimulate the respiratory center in the medulla?

A

Since H+ is the main stimulus, but cannot cross BBB, CO2 crosses BBB and combines with H2O to form H2CO3, which dissociates into H+ and HCO3- and H+ then activates the respiratory center

783
Q

Peripheral chemoreceptors are located _____ and respond to _____

A

located in aortic and carotid bodies

respond to decreased O2 (and less-so to increased CO2 and increased H+)

784
Q

*What is the definition of tidal volume?

A

*The volume of air inspired/expired in a normal breath

785
Q

What is functional residual capacity?

A

The amount of air that remains in the lungs after normal expiration

786
Q

What is residual lung capacity?

A

The amount of air remaining in the lung after the most forceful expiration

787
Q

*What is the limiting factor in terms of how much air can be expelled during maximal expiration?

A

compression of the airways by intrathoracic pressure

788
Q

*What part of the airways presents the LEAST resistance to airflow?

A

*Terminal bronchioles - because there are so many of them that the cross-sectional area of the terminal bronchioles is much higher than that of the larger airways

789
Q

*What form of iron binds oxygen in the RBC?

A

*ferrous iron (Fe2+)

790
Q

List one substance that is activated in the lung and one that is inactivated in the lung.

A

angiotensin I activated to angiotensin II by ACE

bradykinin inactivated in the lung (also by ACE)

791
Q

List 5 substances that are cleared by the lung

A

serotinin
norepi (up to 30%)

PGE2

PGF2a

leukotrienes

792
Q

*Where is the pneumotaxic center and what does it do?

A

*located in the pons, controls rate and depth of breathing

793
Q

What is the difference between the ventral and dorsal respiratory groups in the medulla?

A

dorsal - causes inspiration

ventral - causes expiration

794
Q

What are the 5 causes of hypoxemia?

A
  1. low FiO2
  2. V/Q mismatch
  3. R–>L shunt
  4. Diffusion impairment
  5. hypoventilation
795
Q

Which cause of hypoxemia does NOT improve with oxygen supplementation?

A

R–L shunt

796
Q

What causes of hypoxemia result in an INCREASED A-a gradient?

A

diffusion barrier
V/Q mismatch

R–L shunt

797
Q

Which causes vasodilation - endothelin or bradykinin?

A

bradykinin causes vasodilation

endothelin causes vasoconstriction

798
Q

Is NO a vasodilator or vasoconstrictor?

A

vasodilator via increase in cGMP

799
Q

How does sildenafil work in the lungs?

A

inhibits PDE-5, which is an enzyme that degrades cGMP –> increased cGMP (prolonging effects of NO to cause vasodilation)

800
Q

Which is a more powerful vasoconstrictor - angiotensin II or vasopressin?

A

vasopressin

801
Q

Describe the signaling pathway from baroreceptors in response to increased BP.

A

Increased BP –> increased stretch –> signal from carotid sinus transmitted through Hering’s nerve ( CN IX ), signal from aortic arch transmitted through CN X –> tractus solitarius in medulla

802
Q

What happens with each heart sound - S1-S4?

A

S1 - AV valves close
S2 - semilunar valves close

S3 - rapid ventricular filling

S4 - atrial kick

803
Q

What causes a split S2?

A

inspiration (large dogs)
pulmonary hypertension

L-R shunts

pulmonic stenosis

RBBB

ectopic beats

ventricular pacing

804
Q

What does wandering pacemaker look like on ECG?

A

transient changes in the size, shape, and direction of P waves

taller P waves when HR is fast, shorter when HR slow

805
Q

What is the difference between Mobitz type I and II AV block?

A

type I = gradually prolongs PR interval until block occurs

type II = fixed PR interval, then suddenly blocks (more commonly pathologic)

806
Q

What are the points on the body to use for a vagal maneuver?

A

ocular pressure on both eyes

carotid sinus massage at the upper neck

807
Q

Describe effects of PGI2 at the following receptors: IP receptor, EP1 receptor, EP 2 receptor

A

IP receptor - vasodilation, inhibit platelet aggregation, bronchodilation

EP1 - bronchoconstriction, smooth muscle contraction

EP2 - bronchodilation, smooth muscle relaxation

808
Q

What happens in the stomach when PGE2 binds to the EP3 receptor?

A

decreased gastric acid secretion, increased gastric mucous secretion, increased gastric HCO3 secretion

809
Q

Differentiate class Ia, Ib, and Ic anti-arrhythmics and when you use them

A

Ia - intermediate Na ch. blockers - quinidine, procainamide - SVT, VT

Ib - fast - lidocaine, mexilitine - VT

Ic - slow - propafenone, flecainamide - SVT

810
Q

Class II antiarrhythmics are what types of drugs?

A

beta blockers - used for supraventricular tachycardias

811
Q

Which of the following is a nonselective beta blocker? atenolol, propanolol, esmolol, metoprolol, carvedilol

A

propanolol - nonselective beta blocker

carvedilol - nonselective beta blocker and alpha1 blocker

812
Q

What is the MOA of class III antiarrhythmics? Give 2 examples.

A

prolong action potential duration and refractory period by inhibiting the repolarizing potassium channel

amiodarone, sotalol

813
Q

Which drug exhibits properties of ALL 4 classes of antiarrhythmics?

A

amiodarone

814
Q

Calcium channel blockers are used to control what types of arrhythmias?

A

supraventricular tachycardias

815
Q

What is the MOA of type IV anti-arrhythmics? What are the 2 types?

A

inhibit slow inward Ca channel currents (L-type) to slow sinus rate and AV conduction

dihydropyridines = act on vasculature (amlodipine)

non-dihydropyridines = act on SA & AV nodes (diltiazem, verapamil)

816
Q

*What are the typical clinical signs of heartworm in cats?

A

*Asthma-like signs, vomiting, +/- CNS signs (aberrant migration), or no signs

817
Q

What is the most common congenital heart disease in cats?

818
Q

What is the most common congenital heart disease in dogs?

819
Q

A young cat has a grade IV/VI heart murmur with the PMI on the right side and large pulmonary arteries on rads - what is the most likely diagnosis?

820
Q

*T/F: Right to left PDAs should be surgically repaired

A

*FALSE!!! Reverse PDA means that pulmonary hypertension is BAD. Fixing shunt will worsen PH and cause death

821
Q

Eisenmenger’s physiology refers to what?

A

right to left shunting (shunt reversal) with PDA

822
Q

T/F: A right to left shunting VSD results in differential cyanosis

A

False! Only a R-L PDA causes differential cyanosis because the shunt occurs in the descending aortal after the vessels to the front end branch off. R-L VSD would cause cyanosis of cranial AND caudal MM

823
Q

Sepsis results in what type of shock?

A

distributive

824
Q

What is the shock organ in the dog? cat?

A 
dog = GI tract
cat = lung
825
Q

*On what part of the kidney does mannitol act?

A

*proximal tubule by decreasing water reabsorption via osmotic diuresis

826
Q

Loop diuretics act on what part of the loop of henle?

A

thick ascending limb - inhibit Na/K/2Cl cotransporter

827
Q

What is the MOA of thiazide diuretics?

A

inhibit Na-Cl cotransport in early distal tubule

828
Q

Where in the kidney do carbonic anhydrase inhibitors act? What do they do?

A

proximal tubule - inhibits H+ secretion and HCO3- resorption, which leads to decreased Na+ resorption as a result of lack of Na-H counter transport –> osmotic diuresis by Na+ and HCO3-

829
Q

Which diuretic can cause ototoxicity - spironolactone, mannitol, furosemide, hydrochlorothiazide?

A

furosemide

830
Q

*Where is the most Mg reabsorbed by the kidney?

A

In the thick ascending limb of the LOH - backleak of K+ from Na/K/2Cl cotransporter leads to positive luminal charge, which drives Mg and Ca to diffuse from lumen via paracellular route

831
Q

*What would be the expected fractional excretion of Na in pre-renal azotemia?

A

*FE<1% because in an effort to restore volume status, more Na will be reabsorbed, reducing the amount in urine

832
Q

*How will the following effect GFR: chronic hypertension, PGE2, norepi, endothelin, angiotensin II?

A

chronic hypertension - decrease
PGE2 - increase

norepi - decrease

endothelin - decrease

angiotensin II - stays the same (prevents decrease)

833
Q

What form of glomerulonephritis is associated with lyme disease?

A

membranoproliferative glomerulonephritis

834
Q

What are the 3 layers of the glomerular filtration membrane?

A

endothelial cells, basement membrane, podocytes

835
Q

What is type I renal tubular acidosis? How can it be diagnosed?

A

DISTAL RTA - failure to excrete H+

dx: urine cannot be maximally acidified because occurs in distal tubules - ammonium Cl test (normal dogs will drop urine pH<5)

836
Q

What electrolyte abnormalities would you expect with type I RTA?

A

hyperchloremic metabolic acidosis

hypokalemia

increased urine calcium

837
Q

What is type II renal tubular acidosis?

A

PROXIMAL RTA

failure to reabsorb HCO3 in proximal tubule

urine can still be maximally acidified due to compensation by the rest of the kidney

838
Q

What electrolyte abnormalities would you fine in type II RTA?

A

hyperchloremic metabolic acidosis, +/- hypokalemia, +/- glucosuria form Fanconi’s

839
Q

T/F: You need to biopsy both cortex and medulla of the kidney in order to diagnose glomerulonephritis in the kidney.

A

False! Only need cortex

840
Q

*T/F: Renal tubular acidosis causes a high anion gap acidosis

A

False! Causes a non-anion gap acidosis (hyperchloremic metabolic acidosis)

841
Q

Which type of renal tubular acidosis requires more bicarbonate supplementation?

A

type II (proximal)

842
Q

What is the major route of calcium reabsorption in the proximal tubule?

A

paracellular route (most calcium)

20% moves transcellular by diffusing into the cell, then pumping across basolateral membrane with CaATPase or NaCa counter transporter

843
Q

In the proximal tubule, phosphate reabsorption occurs primarily via what mechanism?

A

transcellular movement with a transport maximum (which can be adjusted by PTH levels)

844
Q

Can you dissolve struvite stones in a cat if the urine osmolality is high?

845
Q

*What defect in Dalmatians results in urate stone formation?

A
  • reduced transport of uric acid into hepatocytes for conversion to allantoin leading to hyperuricemia AND absent uric acid reabsorption in the proximal tubule following glomerular filtration
846
Q

What is the inheritance pattern of the urate transporter defect in Dalmations? What percent of Dalmations are affected?

A

autosomal recessive

100% of dalmations are affected (homozygous)

847
Q

*At what age are Dalmatians with urate uroliths most commonly affected?

A

*median age is 3.5y

848
Q

Polyuria is defined as >___mL/kg/d

Polydipsia is defined as >___mL/kg/d

A

polyuria >50mL/kg/d

polydipsia >100mL/kg/d

849
Q

If there is no concentration of urine during a desmopressin response test, what is the diagnosis?

A

nephrogenic DI

850
Q

Which ketones are detected on urine dipsticks?

A

acetoacetate (mainly), also acetone

NOT BHB

851
Q

Which protein is the urine dipstick more sensitive to - hemoglobin or myoglobin?

A

hemoglobin

852
Q

Can cysteine stones be dissolved?

A

Yes - low protein alkalinizing diet + thiol-containing drugs (2-MPG or D-penicillamine)

853
Q

Can urate stones be dissolved?

A

Yes - purine-restricted diet, urinary alkalinization, allopurinol (xanthine oxidase inhibitor)

854
Q

What is the most common side effect in pituitary dwarves treated with GH?

A

diabetes mellitus

also hypersensitivity reactions, carbohydrate intolerance

855
Q

How do glucocorticoids affect carbohydrate, lipid, and protein metabolism?

A

stimulate glycogen deposition and gluconeogenesis

stimulate lipolysis

catabolism of protein

856
Q

How does insulin affect carbohydrate, fat, and protein metabolism?

A

stimulates glycogen deposition and gluconeogenesis

inhibits lipolysis

anabolic of protein

857
Q

How does glucagon affect carbohydrate and fat metabolism?

A

stimulates glycogenolysis and gluconeogenesis

stimulates lipolysis

858
Q

Where are hormone receptors typically located for steroids?

A

in the cytoplasm

also nucleus

859
Q

Where are hormone receptors typically located for peptide hormone and catecholamines?

A

cell surface

860
Q

Where are hormone receptors located for thyroid hormones?

861
Q

*What is the MOA of methimazole?

A

blocks thyroid hormone synthesis by inhibiting thyroid peroxidase

862
Q

T/F: Thyroid nodules may enlarge in response to treatment with methimazole

A

true - because TSH will stimulate the thyroid

863
Q

What percent of dogs with hypothyroidism have a normal TSH?

864
Q

A normal TT4 in a dog with hypothyroidism may be due to _____

A

anti-T4 antibodies

865
Q

In which breeds might you want to look at TT3 when testing for hypothyroidism?

A

sighthounds - they NORMALLY have low fT4 and TT4, but TT3 is not normally low

in other breeds, TT3 is not very useful

866
Q

In hypothyroid dogs, what SINGLE value has the highest Sn, Sp, and accuracy for detection of hypothyroidism?

867
Q

What would be expected on muscle biopsy in a dog with hypothyroidism?

A

type II myofiber atrophy

868
Q

*Ketone bodies are formed in the liver when there are decreased levels of _____

A

*oxaloacetate

869
Q

T/F: During starvation or DKA, the liver uses ketones as an energy source

A

False! The liver CANNOT use ketones for energy because it lacks succinyl-CoA transferase (AKA beta-ketoacyl CoA transferase)

870
Q

What is the MOA of glipzide?

A

sulfonurea that increases insulin secretion

binds potassium channels on beta cells & closes them –> depolarizes cell –> Ca influx –> insulin release

871
Q

What is the best course of action to treat a diabetic once a Somogyi has been recognized?

A

reduce insulin dose by at least 50%

872
Q

What are SGLTs and where are they located?

A

Na-glucose cotransporters

SGLT1 - small intestines, and a little in proximal tubule

SGLT2 - proximal tubule

873
Q

Insulin activates/inhibits glucokinase

874
Q

When insulin is absent, glucose phosphatase is activated/inhibited

A

activated to release glucose base into circulation

875
Q

T/F: High concentrations of amino acids stimulate glucagon release

A

true - particularly in response to arginine.

glucagon promotes conversion of AAs to glucose

876
Q

*What is the MOA of trilostane?

A

*inhibits 3-beta hydroxysteroid dehydrogenase

877
Q

What are the most common clinical signs in a dog with a macroadenoma?

A

listlessness, mental dullness, inappetance

878
Q

*What would you expect renin levels to be in hyperaldosteronism?

A

*low or normal

879
Q

What would the urine and serum osmolality be in SIADH?

A

high urine osmolality, low serum osmolality

880
Q

What would you see on vaginal cytology during anestrus?

A

mostly acellular - scant small parabasal cells, occasional neutrophils, few bacteria

881
Q

What would you see on vaginal cytology during proestrus?

A

shift from small parabasal cells to large intermediate cells to cornified superficial cells

882
Q

What would you see on vaginal cytology during estrus?

A

80-100% superficial cornified cells, pyknotic nuclei

NO neutrophils

883
Q

What would you see on vaginal cytology during diestrus?

A

parabasal cells, neutrophils

884
Q

Describe hormone levels in canine anestrus

A

basal estrogen levels, progesterone nadir, high FSH

towards end - pulsatile GnRH secretion and elevation in LH

885
Q

Describe hormone levels in canine proestrus

A

increase in estrogen levels to peak, decreased FSH levels, basal progesterone levels

886
Q

Describe hormone levels in canine estrus

A

LH surge –> declining estrogen and increasing progesterone

887
Q

Descrube hormone levels in canine diestrus

A

low estrogen, steady increase in progesterone which decreases 24 hours prior to parturition

888
Q

Most dogs whelp ___ days after the onset of diestrus

889
Q

*Which of the following would NOT be useful as to terminate pregnancy from a mismating? Bromocriptine, misoprostol, progesterone, estrogen, mifepristone

A

progesterone

890
Q

*If a dog has a large flaccid bladder that is easily expressed, what is the most likely neurolocalization in the spinal cord?

891
Q

A dog presents with a left head tilt, circling to the left, with right-sided CP deficits, right strabismus - where is the lesion?

A

RIGHT central vestibular

this is paradoxical central vestibular (associated with central pontine lesion or lesion in flocculonodular lobe) causing head tilt and circling contralateral, but other signs ipsilateral

892
Q

Can a dog with vertical nystagmus have peripheral vestibular disease?

A

Nope! vertical nystagmus is only seen in central vestibular disease

893
Q

In peripheral vestibular disease, the fast phase of nystagmus is towards/away from the lesion.

A

fast phase away

894
Q

*What is the major source of CSF in the brain?

A

*choroid plexus

895
Q

*What drug would be useful if there was overstimulation at BOTH nicotinic and muscarinic receptors?

A

2-PAM

atropine/glyco only work at muscarinic receptors

896
Q

*What nerve innervates the external urethral sphincter?

A

*pudendal nerve (S1-S3)

897
Q

*An 8mo boxer presents febrile with neck pain and CSF analysis shows 80% neutrophils and increased protein levels - what is the most likely diagnosis?

A

*SRMA

GME/NME typically cause a MONOnuclear pleocytosis

898
Q

*A dog presents with tetraparesis, normal peripheral reflexes, and decreased palpebral reflexes. Which of the following is most likely - MG, botulism, tick paralysis, polyradiculoneuritis?

A

MG

all others would cause decreased peripheral reflexes

899
Q

Which of the following may cause hyperesthesia: botulism, tick paralysis, polyradiculoneuritis?

A

polyradiculoneuritis

900
Q

Which tick most commonly causes tick paralysis in the US? Australia?

A

dermacentor in US, ixodes in australia

901
Q

What is the mechanism of tick paralysis? Does it affect cranial nerves?

A

neurotoxin from female tick interferes with acetylcholine release at NMJ

usually does NOT affect cranial nerves

902
Q

*What is the mechanism of botulinum toxin?

A

*cleavage of SNARE proteins, which mediate docking of ACh-containing vesicles to the presynaptic endplate for release of ACh

903
Q

*Where is the most CSF drained from?

A

*arachnoid villi

904
Q

Which muscles are innervated by the mandibular branch of CN V? Which does NOT have 2M muscle fibers?

A

masseter
temporalis

pterygoid

tesnor tympani

tensor veli palatini (eustachian tube)

digastricus (does NOT have 2M fibers)

905
Q

T/F: The digastricus muscle is affected by masticatory myositis.

A

False! it does NOT contain 2M muscle fibers

906
Q

What is the initial response to decreased cerebral blood flow in head trauma?

A

increased blood pressure –> reflex bradycardia (Cushing’s reflex)

907
Q

Which of the following would contribute to increased intracranial pressure: increased CO2, decreased CO2, hypoxemia?

A

hypoxemia and hypercapnia would contribute because both would cause vasodilation

908
Q

*Is Horner’s syndrome a disease of the sympathetic or parasympathetic system?

A

*sympathetic - loss of sympathetic innervation

909
Q

Describe location of lesions for 1st, 2nd, and 3rd order localizations of Horner syndrome.

A

1st order = central lesions involved hypothalamospinal tract (transection of cervical spine)
2nd order - preganglionic lesions (compression of sympathetic chain)

3rd order - post-ganglionic (lesion at the level of the internal carotid)

910
Q

*Which cranial nerves contain sympathetic and parasympathetic fibers?

A

*CN III, VII, IX, X

911
Q

From which spinal segments do preganglionic neurons of sympathetic nerves originate?

912
Q

ACh typically inhibits/excites GI activity, Norepi typically inhibits/excites GI activity

A

ACh excites

Norepi inhibits

913
Q

Where does osteosarcoma typically metastasize to first?

A

lungs

NOT local lymph nodes

914
Q

*What is the most common oral neoplasia in cats?

915
Q

What locations of canine melanoma tend to carry a better or worse prognosis?

A

haired skin - often benign
digit - worse prognosis

oral - worse prognosis

916
Q

How does the melanoma vaccine work?

A

uses human tyrosinase to induce antibodies to tyrosinase, which is necessary for melanin synthesis

917
Q

*What is the major side effect of cisplatin in cats?

A

*fatal pulmonary edema

918
Q

*What is the major side effect of 5-fluoroacil in cats?

A

*neurotoxicity, cerebral hemorrhagic necrosis

919
Q

*What two factors have the strongest association with prognosis in dogs with lymphoma?

A

*T cell associated with worse prognosis than B cell

substage B (clinically ill) has worse prognosis than not clinically ill

920
Q

T/F: For mast cell tumors and soft tissue sarcomas in dogs - tumor grade carries prognostic significance

921
Q

*What forms of lymphoma are most common in cats with FeLV?

A

*mediastinal, multicentric

922
Q

What markers are associated with T cell vs. B cell lymphoma?

A

T cell = CD3

B cell = CD21, CD79a

923
Q

List 4 alkylating agents. MOA?

A

cyclophosphamide, CCNU, mustargen, chlorambucil

insert an alkyl group and change DNA structure - NOT cell phase specific

924
Q

List 2 antitumor antibiotics. MOA?

A

mitoxantrone, doxorubicin

cause cross-linking (intercalation) of DNA. NOT cell phase specific

925
Q

List 4 antimetabolite drugs. MOA?

A

methotrexate (folic acid antagonist)
5-FU (pyrimidine analog)

cytosar (pyrimidine analog)

azathioprine (purine analog)

masquerade as (or inhibit production of) chemicals needed for DNA synthesis, thereby disrupting synthesis by incorporation into DNA. Affect S phase of cell cycle

926
Q

List 2 platinum drugs. MOA?

A

cisplatin, carboplatin

cross-links DNA at guanine residues.

NOT cell cycle specific

927
Q

List 3 plant alkaloids. MOA?

A

vincristine, vinblastine, paclitaxel

inhibit mitotic spindle (tubulin). Acts on M phase of cell cycle

928
Q

How does Elspar work?

A

Breaks down asparagine, which is an essential amino acid for the cancer cells

929
Q

What is the MOA of hydroxyurea?

A

inhibits RNA and DNA by destruction of RNA reductase

S phase specific

930
Q

List 3 receptor tyrosine kinases. MOA?

A

toceranib, mastinib, imatinib

block receptor tyrosine kinases thereby downregulating angiogenesis and signaling cascades

931
Q

Which 3 chemo drugs cross the BBB?

A

CCNU, cytosar (cytarabine), procarbazine

932
Q

Which antibiotics cross the BBB?

A

“TOM’S CD”
TMS, ofloxacin, metronidazole, sulfas, chloramphenicol, doxycycline

(intermediates - most penicillins, imipenem, aminoglycosides, some higher cephalosporins)

933
Q

What is the difference in distribution of AgNOR in normal animals vs. in cancer?

A

normal - tight and in nucleus

cancer - dispersed in cytoplasm

(prognostic in LSA, STS, mammary carcinoma)

934
Q

Which of the following is NOT an expected side effect of radiation therapy for SCC in a cat: epilation, lip erythema, vomiting, desquamation?

935
Q

___% of dogs with osteosarcoma are thought to have micrometastasis at the time of diagnosis.

936
Q

*What is the most common skin tumor in the cat?

A

*basal cell tumor

937
Q

*Which drug inhibits platelet derived growth factor activity in vaccine-associated sarcoma in cats?

A

*imatinib (Gleevec)

938
Q

What is the predominant route of transmission of neospora in dogs?

A

transplacental transmission via tachyzoites

also ingestion of bradyzoites in tissue

939
Q

What are the definitive hosts for neospora?

A

dog and coyote

940
Q

*How is cryptococcus diagnosed?

A

Latex agglutination test for P21 capsular antigen

can also identify on cytology with Romanowsky stain

941
Q

How is Campylobacter diagnosed?

A

gram stain + culture on selective media +/- PCR

all in conjunction with clinical signs since healthy dogs can have campy

942
Q

How is anaplasma infection diagnosed?

A

detection of morulae in neutrophils + positive antibody titer (IFA or Western Blot), or

4-fold increase or decrease in antibody titer in 4wks, or

positive PCR result

943
Q

T/F: Botulism is associated with hyperesthesia

A

False! Botulism does NOT cause hyperesthesia (but polyradiculoneuritis can)

944
Q

T/F: Botulism does not involve the cranial nerves

A

False! Botulism can involve the cranial nerves

945
Q

*What is the MOA of tetanus?

A

*tetanospasmin block release of inhibitory neurotransmitters glycine and GABA –> prevents inhibitory action of Renshaw cells leading to muscle tetany

946
Q

T/F: Tetanus causes clinical signs within 24 hours of infection

A

False! Clinical signs typically occur 5-10 days after a wound is infected, but can occur weeks later after the wound has healed

947
Q

*What is the most commonly used diagnostic for Ehrlichia? What is the best diagnostic for Ehrlichia?

A

*Most common = ELISA SNAP

Best = Indirect IFA

948
Q

*What is the treatment of choice for Ehrlichia? What are other drugs that can be used?

A

doxycycline

others: chloramphenicol, imidocarb, amicarbalide

949
Q

*Which of the following would be resistant to Unasyn: Staph aureus, Bacteroides, Pseudomonas?

A

*Pseudomonas are not sensitive to Unasyn or Clavamox because they have beta-lactamase activity that is not well inhibited by beta-lactamase inhibitors, also have drug efflux pumps

950
Q

What protein is responsible for methicillin resistance in Staphylococcus species?

A

penicillin-binding protein 2A (PBP2A)

951
Q

*What is the most common clinical sign associated with Borreliosis?

A

*polyarthritis and fever

952
Q

What is the best treatment for giardia?

A

fenbendazole

metronidazole reportedly less effective than fenbendazole

953
Q

What is the best treatment for Cryptosporidiosis?

A

azithromycin, but dz is usually self-limiting in immunocompetent animals

also paramomycin, but this is nephrotoxic

954
Q

What part of the intestines does Cryptosporidium most commonly inhabit?

955
Q

Alabama Rot is also known as ____, and occurs almost exclusively in which breed?

A

cutaneous and renal glomerular vasculopathy

racing or training greyhounds

956
Q

Describe labwork findings in Alabama rot.

A

mod-severe thrombocytopenia
hypoalbuminemia

proteinuria

anemia - microangiopathic hemolysis

elevated ALT (mild)

957
Q

Alabama rot is most similar to what condition affecting children?

A

Hemolytic uremic syndrome (HUS) caused by E. coli shiga-like toxin

958
Q

Which of the following organism has been implicated in canine infectious tracheobronchitis: Pasteurella, Acinetobacter, Mycoplasma, Staphylococcus?

A

Mycoplasma

also Bordetella, viruses, etc

959
Q

*Which tick carries Hepatozoon americanum? Which carries H. canis?

A

*H. americanum - amblyomma

H. canis - rhipicephalus

960
Q

What is the most sensitive test for Mycoplasma hemofelis?

A

PCR

cytology has poor sensitivity (organisms only visible during peak parasitemia)

961
Q

*What factors would you look for in choosing an antibiotic to give to an FIV infected cat with a UTI?

A

bactericidal

MIC as far from breakpoint as possible

narrowest spectrum possible

962
Q

*What is the most common cause of diskospondylitis in dogs?

A

staph intermedius - treat with Clavamox or 1st generation cephalosporin

963
Q

*A weakly acid-fast gram positive bacteria is seen on a cytology from a cat lung - what it is and which antibiotic should you use?

A

Likely Nocardia - use TMS

964
Q

*What would you see on histopath of the brain in rabies?

A

*NONSUPPURATIVE inflammation, acute polioencephalitis, necrotizing encephalitis

965
Q

*What test is used to definitively diagnose Rabies?

A

*demonstration of viral antigen by direct fluorescent antibody on medulla, cerebellum, hippocampus

966
Q

*What is the name of the intracellular inclusions seen in Rabies? Where are they most consistently found?

A

*Negri bodies. Most consistently found in the hippocampus

967
Q

*What would you see on skin biopsy in a dog with RMSF?

A
  • necrotizing vasculitis with perivascular polymorphonuclear and lymphoreticular cell infiltrates
968
Q

RMSF is transmitted by which tick?

A

dermacentor

969
Q

*What are the most common clinical manifestations of Hepatozoonosis?

A

*polymyositis and fever

970
Q

What might you see on limb radiographs in a dog with Hepatozoonosis?

A

periosteal reaction

971
Q

What is the diagnostic of choice for diagnosis of Hepatozoonosis?

A

muscle biopsy with visualization of organisms (biceps femoris or semitendinosus)

972
Q

What is the treatment for Hepatozoonosis?

A
  1. treat with all 3 - TMS, clindamycin, pyrimethamine x 2wks (kills extracellular bugs)
  2. start decoquinate (coccidiostat) in food once daily for at least 2yrs to life to prevent asexual reproduction
973
Q

T/F: No treatment has been shown to successfully eliminate the intracellular merozoites in Hepatozoonosis.

A

True! So you need to keep on decoquinate lifelong

974
Q

*When should a pregnant woman scoop the litter to avoid toxoplasmosis?

A

*daily! because at least 24 hours is required for oocysts to reach the infective stage

975
Q

*The Baermann fecal is used to detect ______

A

nematode larvae - Aelurostrongylus (cat lungworm) and Crenosoma vulpis (dog lungworm)

Filaroides hirthi and Oslerus osleri are better detected using flotation techniques

976
Q

*The test for FeLV detects which protein?

977
Q

*Western blot is used to detect ______

978
Q

Which disinfectant has residual activity after washing hands?

A

chlorhexidine??

979
Q

T/F: Leptospirosis causes disease by intracellular replication

980
Q

*What is the best way to treat polyps in cats with the least likely chance of recurrence?

A

*ventral bulla ostetomy

981
Q

*What is the mechanism of beta lactams? Cidal or static? Concentration or time dependent?

A

*inhibits bacterial cell wall synthesis by inhibiting penicillin binding proteins

bactericidal, time dependent

982
Q

What is the mechanism of vancomycin?

A

inhibits synthesis of peptidoglycan in cell wall of gram POSITIVE bacteria

983
Q

What is the mechanism of aminoglycosides? Cidal or static? Concentration or time dependent?

A

inhibits 30s ribosomal subunit to inhibit protein synthesis

cidal, concentration dependent

984
Q

Why are beta lactams considered synergistic with aminoglycosides?

A

beta lactams enhance entry of aminoglycosides into bacteria

985
Q

What is the mechanism of clindamycin? Cidal or static? Concentration or time dependent?

A

inhibits protein synthesis by binding 50s ribosomal subunit

static, time dependent

986
Q

What is the mechanism of macrolides? Cidal or static? Concentration or time dependent?

A

inhibits protein synthesis by binding to 50s ribosomal subunit

static, time dependent

987
Q

What is the mechanism of tetracyclines? Cidal or static? Concentration or time dependent?

A

inhibits protein synthesis by binding 30s ribosomal subunit

static, time dependent

988
Q

What is the mechanism of fluoroquinolones? Cidal or static? Concentration or time dependent?

A

inhibits DNA gyrase

cidal, concentration dependent

989
Q

What is the mechanism of sulfonamides? Cidal or static?

A

inhibits bacterial folate synthesis

static, but cidal when combined with trimethoprim

990
Q

What is the mechanism of chloramphenicol? Cidal or static?

A

inhibits protein synthesis by binding to 50s ribosomal subunit

static, cidal at high doses

991
Q

Will cefazolin kill pseudomonas?

992
Q

*What type of signs would be seen with neurotoxicity from metronidazole? What is the treatment?

A

*central vestibular signs

discontinue drug and treat with diazepam

993
Q

Which aminoglycosides are toxic to the cochlear nerve? vestibular nerve?

A

cochlear = amikacin, neomycin (MOST oto/nephrotoxic), kanamycin

vestibular = stroptomycin, gentamycin

994
Q

*What is the half-life of potassium bromide?

A

*2-3 weeks

995
Q

*Which of the following would phenobarbital interfere with: gabapentin, KBr, ampicillin, cimetidine?

A

cimetidine?

996
Q

*Which NSAID causes irreversible inhibition of COX?

997
Q

Which of the following is NOT effective against coccidians: monensin, TMS, docoquinate, ivermectin?

A

ivermectin

998
Q

Which of the following could NOT be treated with carbonic anhydrase inhibitors: glaucoma, metabolic alkalosis, Addison’s, hyperkalemia, for diuresis?

A

Addison’s

999
Q

What is the mechanism of mycophenolate?

A

inhibits inosine monophosphate dehydrogenase (enzyme for purine biosynthesis) –> inhibits B and T cell proliferation during S phase

1000
Q

What is the MOA of leflunomide?

A

inhibits pyrimidine biosynthesis

1001
Q

*What is the stimulus for the enterocolic reflex?

A

*stretch in the stomach leads to increased motility in the colon

1002
Q

What activates pepsinogen to pepsin?

A

low pH in the stomach

1003
Q

What is the most important function of pepsin?

A

protein digestion - specifically collagen (which is affected little by other digestive enzymes)

1004
Q

What is the most potent substance that causes release of exocrine pancreatic enzymes?

1005
Q

How does MgSO4 cause diarrhea?

A

osmotic diarrhea

1006
Q

What is secreted by delta cells of the pancreas?

A

somatostatin

also gastrin in fetal life

1007
Q

Describe location and effects of activation of 5HT3 and 5HT4 receptors. What is the ligand for these receptors?

A

serotonin is ligand

5HT3 = in CRTZ, vomiting center, duodenum. Activation causes vomiting/nausea

5HT4 = in intestines. Activation causes increased motility

1008
Q

What are the mechanisms of metoclopramide?

A

inhibits D2 receptors on CRTZ

5HT4 agonist, 5HT3 antagonist (?), increases sensitivity to ACh and increases release of ACh

1009
Q

How does ranitidine act as a prokinetic?

A

acetylcholinesterase activity

1010
Q

Explain how histamine, ACh, and gastrin activate the parietal cells.

A

histamine - binds H2 receptor –> G protein –> increased cAMP

gastrin - binds CCK B receptor –> IP 3 –> increased calcium… ALSO stimulates histamine release

ACh - binds M3 receptor –>IP3 –> increased calcium

1011
Q

Treatment with omeprazole will result in increased/decreased/normal gastrin levels.

A

increased gastrin levels

1012
Q

T/F: omeprazole binds irreversibly.

1013
Q

How does ursodiol work?

A

hydrophilic bile acid that induces cholehepatic shunting, thereby increasing water and HCO3 in the bile

also has immunomodulatory effects (inhibits IL-1, IL-2, immunoglobulins from beta cells

1014
Q

How does zinc inhibit hepatic fibrosis?

A

inhibits prolyl hydroxylase, thereby suppressing collagen production

(colchicine and steroids also do this)

1015
Q

How does D-penicillamine treat hepatic fibrosis?

A

inhibits lysyl hydroxylase thereby disrupting cross-linking of collagen

1016
Q

Why can zinc be used as a treatment for copper toxicity?

A

because it upregulates metallothionein production, thereby binding copper and keeping it in the cells - minimizes GI absorption

1017
Q

Copper is a component of which important enzymes?

A

superoxide dismutase
cytochrome C oxidase

monoamine oxidase

1018
Q

Copper is transported from the liver to other sites in the body primarily by what?

A

ceruloplasmin

1019
Q

A genetic defect in which protein is repsponsible for defective biliary copper excretion in Bedlington terriers?

1020
Q

Which lipoprotein has the highest amount of protein?

1021
Q

*Which enzyme breaks down triglycerides in chylomicrons?

A

*lipoprotein lipase

1022
Q

Which amino acid is needed for update of fatty acids into the mitochondria for beta oxidation?

1023
Q

What is required for entry of acetyl CoA into the TCA cycle?

A

oxaloacetate

1024
Q

*What are signs of thiamine deficiency in cats?

A

*central vestibular signs

cervical ventroflexion

1025
Q

Is TPN still good after 48 hours?

A

yep - good for 5 days in the fridge

1026
Q

*What is better for a dog with an insulinoma - high or low glycemic index foods?

A

*low glycemic index foods

1027
Q

How can you differentiate between post-prandial lipidemia and true hyperlipidemia?

A

separate serum and put in refridgerator

post-prandial - cream layer on top (chylomicrons)

hyperlipidemia - cloudy throughout (triglycerides)

1028
Q

*Is refeeding syndrome more likely with a high carbohydrate diet or a high protein diet?

A

*high carbohydrate diet

1029
Q

List the essential amino acids for dogs and cats.

A

phenylalanine, valine, tryptophan, methionine, arginine, threonine, taurine (CATS!), histidine, isoleucine, leucine, lysine

PVT MATT HILL

1030
Q

What are the signs of niacin (vitamin B3) deficiency?

A

oral/tongue ulceration in dogs, uncontrolled drooling, growth problems

pellagra = dermatitis, diarrhea, dementia, death

1031
Q

What are the most common causes of thiamine deficiency?

A

feeding fish with thiaminases

feeding meat preserved with sulfites

1032
Q

Vitamin B6 (pyridoxine) acts as a coenzyme for ____ in the liver

A

transamination of amino acids

1033
Q

What enzyme is inhibited by anticoagulant rodenticides?

A

vitamin K epoxide reductase, which converts vitamin K back to its active form for use in activation of clotting factors

1034
Q

Cats require taurine for what purpose?

A

bile acid conjucation

1035
Q

*Which protein source has the lowest purine content - glandular tissue, animal protein, vegetable protein?

A

vegetable protein

1036
Q

A cat is fed a homecooked diet has megaloblasts on a blood smear. What is the cat likely deficient in?

A

cobalamin or folate

1037
Q

What happens to the following levels in ethylene glycol toxicity: glucose, phosphate, calcium?

A

hyperglycemia
hyperphosphatemia

hypocalcemia

1038
Q

What type of urine crystals are seen in ethylene glycol toxicity?

A

calcium oxalate monohydrate

1039
Q

How does strychnine cause toxicity?

A

inhibits glycine (inhibitory neurotransmitter) –> increased excitability

1040
Q

What is the MOA of cyanide toxicity?

A

inhibits cytochrome oxidase in electron transport chain in mitochondria –> cannot use oxygen and cannot produce ATP

most severely effects heart and brain (because they rely most on aerobic metabolism

1041
Q

What is the antidote for cyanide toxicity?

A

hydroxycobalamin - reacts with cyanide to form cyanocobalamin, which is excreted by the kidney

1042
Q

What is the rate limiting step in metabolism of ethylene glycol?

A

alcohol dehydrogenase converts EG to glycoaldehyde

1043
Q

Which metabolite of ethylene glycol contributes most to the increased anion gap acidosis?

A

glyoxylic acid

1044
Q

What is the MOA of ivermectin?

A

binds to glutamate-gated chloride channels in membranes of invertebrate nerve & muscle cells, causing increased permeability to chloride ions

1045
Q

Clinical signs of ivermectin toxicity result by what mechanism? What are typical signs?

A

agonism of CNS GABA

depression, ataxia, weakness, recumbency, coma

(also NOT from GABA effects - mydriasis, hypothermia, vomiting, salivation, shallow breathing)

1046
Q

What is the MOA of organophosphates?

A

inhibits acetylcholinesterase —>parasympathetic overload

1047
Q

List the strong ions

A

Na, K, Mg, Ca, Cl, lactate, ketones, SO4

1048
Q

What disinfectants will kill lepto?

A

1:1 10% bleach
iodine

quaternary ammonium

accelerated H2O2

1049
Q

When does urinary shedding of lepto start?

A

7-10d after infection

1050
Q

Doxycycline clears lepto from ______

A

ALL sites (blood and kidney)!

1051
Q

Ampicillin clears lepto from ______

A

blood, but NOT kidney (doxy needed to clear carrier state)

1052
Q

T/F: chloramphenicol is effective in treating lepto

1053
Q

T/F: 3rd generation cephalosporins are effective in treating lepto

1054
Q

T/F: 1st generation cephalosporines are effective in treating lepto

1055
Q

T/F: fluoroquinolones are effective in treating lepto

1056
Q

T/F: MAT does NOT accurately predict the infecting serogroup for lepto

1057
Q

What is the recommendation for treating exposed dogs that live in the same household as a dog infected with lepto?

A

treat with 14d course of doxy

1058
Q

What is the recommended treatment for clearance of lepto from the renal tubules?

A

doxycycline 5mg/kg PO BID x 14d

1059
Q

Lepto serovars differ from eachother based on what?

A

the carbohydrate component of LPS

1060
Q

Which 2 serogroups of lepto most commonly affect dogs?

A

L. interrogans (ictohemorrhagiae, pomona, canicola)

L. kirschneri (grippotyphosa)

1061
Q

What is seen on renal histopath in cases of lepto AKI?

A

acute interstitial nephritis/necrosis

1062
Q

T/F: MAT testing for lepto is seroVAR specific, but not seroGROUP specific

A

False! MAT is seroGROUP specific, but seroVARs within the same serogroup can cross-react

1063
Q

During what period is lepto PCR more sensitive when performed on blood compared with urine?

A

During the first 10d of infection the highest # of organisms are present in blood… after that, the highest # are present in urine

1064
Q

On a molecular level, the endotoxins produced by lepto inhibit ____ within the nephron.

A

Na/K/ATPase pumps

1065
Q

What are 2 findings you might see on AUS in a dog with lepto AKI?

A
  1. medullary band of increased echogenicity

2. renomegaly

1066
Q

T/F: Lepto is inactivated by freezing, but not UV radiation

A

False! it is inactivated by both!

1067
Q

What type of microscopy can be used to identify leptospires?

A

darkfield microscopy

1068
Q

T/F: Lepto vaccines cause more reactions than other routinely administered vaccinations in dogs.

1069
Q

Low levels of which specific GAG might play a role in FLUTD pathogenesis in cats?

1070
Q

Expression of substance P is increased/decreased in the bladder in cats with FLUTD

1071
Q

Abnormalities in the dorsal/ventral root in the lumbosacral region have been noted in cats with FLUTD.

A

dorsal root ganglion

30% larger, altered neuropeptide profiles, slowly desensitizing capsaicin currents

1072
Q

Where in the brain is the origin of the excitatory pathway to the bladder?

A

locus coeruleus (located within the pons)

1073
Q

Which part of the brain contains the largest number of noradrenergic neurons and is the most important source of norepinephrine in the CNS?

A

locus coeruleus

1074
Q

Describe changes found in the adrenals of cats with FLUTD.

A

small adrenals with decreased size of the zona fasciculata and zona reticularis

1075
Q

Which is more pronounced in cats with FLUTD: sympathetic or adrenocortical response?

A

sympathetic > adrenocortical

1076
Q

Tyrosine hydroxylase is increased/decreased in the brain in cats with FLUTD

1077
Q

Tyrosine hydroxylase is the rate limiting step in synthesis of what?

A

catecholamines

1078
Q

Describe type I and type II idiopathic cystitis.

A

type I - nonulcerative (most common), possibly neuropathic in origin

type II - ulcerative (uncommon), related to intrinsic inflammatory bladder pathology

1079
Q

How might maternal stress contribute to FLUTD development in cats?

A

stressed out mom cat –> stress hormones cross placenta –> impaired adrenal development

1080
Q

List positive effects of environmental enrichment in cats with FLUTD.

A

decreased LUT signs, decreased catecholamines, decreased bladder permeability, increased cardiac function, decreased acoustic startle response

1081
Q

What types of portal hypertension would be expected to result in transudative ascites?

A

prehepatic and presinusoidal

1082
Q

What type of portal hypertension would result in a modified transudate ascites?

A

sinusoidal, post-sinusoidal, post-hepatic

1083
Q

What is the recommended diuretic for control of ascites in dogs with portal hypertension?

A

spironolactone

1084
Q

What is more SPECIFIC for diagnosis of multiple acquired shunts - ammonia levels or bile acids?

A

ammonia levels

1085
Q

What is most sensitive for diagnosis of multiple acquired shunts - pre- or post-prandial bile acids?

A

post-prandial bile acids

1086
Q

A portal vein to aorta ratio of _____ is supportive of pulmonary hypertension.

1087
Q

What percentage of ascites is safe to remove in a single tap?

1088
Q

Describe the liver’s blood supply and the proportional contribution of each vessel.

A

25% of cardiac output goes to liver

hepatic artery = 10-15%

portal vein = 75-80%

1089
Q

Portal vein pressure = _____ - _____

A

portal blood flow - intrahepatic resistance

1090
Q

Define Budd-Chiari syndrome.

A

Obstruction in the hepatic venous outflow in the caudal vena cava or larger extrahepatic arteries due to intraluminal (tumor, thrombus, webbing) or extraluminal (tumor) compression

1091
Q

A hepatic venous portal gradient of > _____mmHg is suggestive of multiple acquired shunts.

1092
Q

What types of portal hypertension would lead to the formation of multiple acquired shunts?

A

pre-hepatic and hepatic, but NOT post-hepatic

1093
Q

Right heart failure is an example of what type of portal hypertension - pre-hepatic, hepatic, or post-hepatic?

A

post-hepatic

1094
Q

Budd-Chiari is an example of what type of portal hypertension - pre-hepatic, hepatic, or post-hepatic?

A

post-hepatic

1095
Q

Non-cirrhotic portal hypertension is an example of what type of portal hypertension - pre-hepatic, hepatic, or post-hepatic?

A

hepatic, pre-sinusoidal

1096
Q

Chronic hepatitis causes hepatic portal hypertension which is pre-sinusoidal, sinusoidal, or post-sinusoidal?

A

sinusoidal

1097
Q

Portal thrombus is an example of what type of portal hypertension - pre-hepatic, hepatic, or post-hepatic?

A

pre-hepatic

1098
Q

What is hepatorenal syndrome?

A

reversible renal failure due to profound renal vasoconstriction secondary to release of vasoactive factors in response to splanchnic vasodilation

1099
Q

What is hepatopulmonary syndrome?

A

release of nitric oxide results in microvascular pulmonary vasodilation, leading to V/Q mismatch

1100
Q

List 4 factors that decrease portal venous pressure.

A

anesthesia
exercise

inspiration

fasting

1101
Q

List 4 factors that increase portal venous pressure.

A

post-prandial
expiration

increased intraabdominal pressure (barking, defecation)

increased sodium intake/blood volume expansion

1102
Q

What is the most important vasodilator in the liver?

A

nitric oxide

1103
Q

What do hepatic stellate cells transform into when stimulated by hepatic injury?

A

fibrogenic myofibroblasts

1104
Q

In dogs with portal hypertension, there is vasodilation/constriction in the intrahepatic vasculature, and vasodilation/constriction in the splanchnic vasculature

A

vasoconstriction in intrahepatic vasculature

vasodilation in splanchnic vasculature

1105
Q

Is hypo- or hypernatremia expected in dogs with portal hypertension? Why?

A

Hyponatremia due to increased ADH release in response to decreased effective circulating volume

1106
Q

List 3 breed predisposed to noncirrhotic portal hypertension.

A

Rottweilers
Dobermans

Cocker Spaniels

1107
Q

What is the only hepatic encephalopathy toxin that can be measured?

1108
Q

Which enteric pathogen is a gram positive anaerobic spore-forming rod?

A

Clostridium

1109
Q

What are the 2 forms of C. difficile?

A
  1. vegetative cells - actively growing form that CAUSE INTESTINAL DISEASE. Will die outside the body
  2. spores - highly resistant, survive years in the environment, responsible for TRANSMISSION
1110
Q

Which form of C. diff causes disease? Which is responsible for transmission?

A

vegetative cells cause disease, spores cause transmission

1111
Q

What are the toxins involved in C. diff infection?

A

toxin A (TcdA) and toxin B (TcdB)

1112
Q

What is the treatment for C. difficile infect?

A

metronidazole 10mg/kg BID x 5d

1113
Q

What is the gold standard for diagnosis of C. difficile?

A

cell culture cytotoxicity assay to detect TcdB - but not commonly used because very time consuming test

1114
Q

What are the 5 bioptypes of C. perfringens? What is the most common biotype causing infection?

A

biotypes A-E

type A is most common

1115
Q

What virulence factor causes diarrhea in C. perfringens infection?

A

CPE (C. perfringens enterotoxin)

1116
Q

T/F: C. perfringens is isolated from ~80% of dogs with and without diarrhea.

1117
Q

What is the best way to diagnose C. perfringens infection?

A

ELISA for CPE in combination with PCR for enterotoxigenic strains of C. perfringens

1118
Q

T/F: Spore count in C. perfringens infection predicts the severity of diarrhea.

1119
Q

List 4 risk factors for C. difficile infection in dogs?

A
  1. immunocompromised owner
  2. owner or dog on Abs
  3. exposure to children
  4. visiting human hospital
1120
Q

Describe the microbial characteristics of Salmonella.

A

gram negative, ubiquitous, facultative anaerobe

1121
Q

T/F: Salmonella has a similar prevalence in dogs with and without diarrhea.

1122
Q

When are antibiotics indicated in treatment of Salmonella?

A

in systemically ill or immunocompromised patients

1123
Q

What antibiotics are recommended for use in systemically ill or immunocompromised patients with Salmonella?

A

ampicillin + enrofloxacin

1124
Q

Is antibiotic therapy indicated in a patient with Salmonella if the OWNER is immunocompromised but the patient is not systemically ill or immunocompromised?

1125
Q

Describe the microbial characteristics of Campylobacter.

A

Gram negative, microaerophilic motile rods

1126
Q

T/F: Campylobacter infection seems to be more prevalent in adult dogs/cats as opposed to puppies/kittens

A

False! Clinical disease more common in dogs/cats <1yo

1127
Q

Which Campylobacter is most frequently isolated from dog feces?

A

C. upsaliensis

1128
Q

List 3 factors associated with increased risk of Campylobacter carriage.

A

Stress, crowded housing, concurrent disease, age <1yr, home cooked diet, feeding table scraps

1129
Q

T/F: Identification of gull-wing shaped bacteria on gram stain of feces is diagnostic for Campyolbacter.

A

False! This is suggestive of Campylobacter, but not diagnostic, because other bacteria (Arcobacter) and nonpathogenic Campy have similar morphology

1130
Q

In what cases is antibiotic treatment for Campylobacter infection warranted?

A

systemic illness/fever, immunocompromised, hemorrhagic diarrhea

1131
Q

What antibiotic is used for Campylobacter infection?

A

erythromycin or azithromycin (but no published studies on azithromycin)

can use fluoroquinolone, but higher rate of resistance

1132
Q

What is the rate of response to antibiotic treatment for dogs with Campylobacter? Cats?

A

dogs - 50-73%

cats - 50%

1133
Q

T/F: A direct link has been made between C. jejuni infection in people and the presence of a dog in the household

A

True! Especially if the dog is <6mo

1134
Q

Describe the microbial characteristics of E. coli

A

gram negative non-sporeforming rods

1135
Q

List 3 dog breeds predisposed to granulomatous colitis.

A

Boxer, Border collie, Frenchie

1136
Q

Describe clinical signs of granulomatous colitis in Boxers

A

Severe large bowel diarrhea, weight loss, inappetance

1137
Q

Describe histopath lesions in granulomatous colitis in Boxers.

A

pathognomonic - mucosal infiltration with large # PAS-positive macrophages, & evidence of mucosal ulceration and loss of goblet cells

1138
Q

What diagnostic should be submitted if you suspect granulomatous colitis in a boxer?

A

biopsies with FISH and culture

1139
Q

What is the treatment of choice for adherent-invasive E. coli?

A

enrofloxacin 10mg/kg SID x 8 weeks - do not stop before 8 weeks because this precipitates resistance to antibiotics

1140
Q

Why is hand washing preferred over alcohol-based hand sanitizers when handling dogs with enteropathogenic bacteria?

A

Clositrial spores are resistant to alcohol-based hand sanitizers

1141
Q

What disinfectants are effective against Clostridial spores?

A

1:10 bleach or accelerated H2O2

1142
Q

What is the definition of cachexia?

A

A complex metabolic syndrome associated with underlying illness and characterized by loss of muscle with or without loss of fat mass

1143
Q

How does weight loss in healthy animals differ from weight loss in animals with chronic disease?

A

healthy animals - metabolic adaptations result in fat being used as energy source

chronic disease - no metabolic adaptations occur, resulting in amino acids being used as energy source

1144
Q

In cardiac cachexia, there is a shift from type I/II muscle fibers to type I/II muscle fibers

A

Shift from type I (oxidative) muscle fibers to type II (glycolytic)

1145
Q

Which type of muscle fibers is more resistant to atropy - type I or type II?

A

type I is MORE resistant

1146
Q

T/F: Total body weight is a sensitive measure of muscle loss

A

False! duh

1147
Q

Cardiac cachexia effects about __% of humans and dogs with CHF

1148
Q

T/F: Cardiac cachexia tends to be worse in dogs with left-sided CHF, as opposed to right-sided

A

False! worse in right-sided CHF

1149
Q

What is the obesity paradox with regards to cardiac cachexia?

A

obesity may be associated with a protective effect once CHF is present (likely due to increased lean body mass reserve)

1150
Q

What is the definition of sarcopenia?

A

muscle loss seen during aging, in the ABSENCE of disease (and whether or not obesity is present)

1151
Q

T/F: Both cachexia AND sarcopenia are associated with increased mortality rates.

1152
Q

List the 4 major mechanisms of cachexia.

A
  1. increased energy requirement
  2. decreased nutrient absorption
  3. decreased energy intake
  4. altered metabolism
1153
Q

Ghrelin is an endogenous ligand for what receptor?

A

growth hormone secretagogue receptor

1154
Q

Ghrelin is secreted by ____ cells in response to _____.

A

secreted by gastric endocrine cells in response to fasting –> increased food intake

1155
Q

What are the main 3 cytokines involved in cachexia?

A

TNF, IL-1, IL-6

1156
Q

How do cytokines contribute to cachexia?

A

cause anorexia, increase energy metabolism, accelerate LBM loss

1157
Q

Which 2 cytokines are involved in cardiac myocyte hypertrophy and fibrosis and have negative inotropic effects?

A

TNF and IL-1

1158
Q

Which cytokine signaling pathway is involved in cachexia?

1159
Q

T/F: Omega-3s have been shown to decrease inflammatory cytokines and improve muscle mass in dogs with CHF.

1160
Q

What is the most important proteolytic patyway in cachexia?

A

ubiquitin-proteosome pathway

1161
Q

The ubiquitin proteosome pathway is activated by _____.

1162
Q

The catabolic effects of glucocorticoids appear to occur via activation of what proteolytic pathway?

A

ubiquitin-proteosome pathway

1163
Q

Myostatin levels are increased/decreased in CHF

A

increased (myostatin negatively regulates skeletal muscle)

1164
Q

T/F: atrial natriuretic peptide inhibits lipolysis.

A

False! it stimulates lipolysis

1165
Q

Which adipokine is found in highest concentrations within the adipocyte?

A

adiponectin

1166
Q

What are two effects of adiponectin?

A
  1. anti-inflammatory effects

2. decreases body weight

1167
Q

T/F: IGF-1 concentrations are a predictor of survival in dogs with CHF

1168
Q

Ghrelin increases/decrease growth hormone

1169
Q

Omega-3 fatty acids work to decrease amounts of which two cytokines involved in cachexia?

A

TNF and IL-1

1170
Q

What are two types of pre-neoplastic DNA mutations in cells?

A

increased expression of oncogenes (myc, ras, abl, bcl-2)

decreased expression of tumor-suppressor genes (Rb, p-53)

1171
Q

Ingestion of coat-associated particular carcinogens (such as tobacco smoke) and flea collar exposure are associated with what type of cancer in cats?

1172
Q

Ocular trauma/chronic uveitits can predispose to what type of cancer in cats?

A

ocular sarcoma

1173
Q

Prolonged solar exposure can predispose to what type of cancer in cats and dogs?

1174
Q

Chronic myositis can predispose to what type of cancer in dogs?

A

lymphosarcoma

1175
Q

Injections/vaccinations can predispose to what type of cancer in cats (and dogs)?

1176
Q

Implanted medical devices can predispose to what types of cancer in dogs?

A

myxosarcoma, osteosarcoma

1177
Q

Spirocirca lupi is associated with development of what type of cancer in dogs?

A

esophageal osteosarcoma/fibrosarcoma

1178
Q

In dogs and cats, papillomavirus can predispose to what type of cancer?

1179
Q

Describe the two polarization states of macrophages and their role in cancer.

A

M1 = produce IL-12 –> tumoricidal

M2 = produce IL-10 –> promote tumor progression

1180
Q

List 2 major signaling pathways involved in cancer promotion.

A

NF-kB

Mitogen activated protein kinase (MAPK) pathway

1181
Q

How do free radicals promote cancer development?

A

oxidative damage and nitration of DNA bases –> increased risk for DNA mutations that may be nonrepairable and persist in subsequent generations

1182
Q

What is the primary mediator of pathologic angiogenesis (associated with cancer and chronic inflammation)?

1183
Q

Strains of H. pylori that secrete a protein known as CagA are invariably associated with ____ in humans

A

gastric cancer

1184
Q

Asbestos exposure is associated with development of what type of neoplasia?

A

mesothelioma

1185
Q

Macrophages in injection-site sarcomas often contain a bluish-gray foreign material identified to be _____

A

aluminum, likely remnants of vaccine adjuvants

1186
Q

Carcinomas of the urothelium in cattle have been associated with enzootic hematuria caused by grazing on pastures rich in _____

A

bracken fern!

1187
Q

What is the only nutraceutical noted to have a significant effect on OA based on a systematic review of the literature?

A

omega-3 fatty acids

1188
Q

What are the two major classes of bactericidal antimicrobial peptides in the mammalian immune system?

A

defensins and cathelicidins

1189
Q

What are the major targets of pattern recognition receptors (PRRs)?

A

pathogen-associated molecular patterns (PAMPs) or microbial-associated molecular patterns (MAMPs)

PAMPs and MAMPs are the same thing

1190
Q

T/F: PAMPs are generally invariant molecules shared by an entire class of microorganisms.

A

True - this allows for a relatively small number of PRRs recognizing vast numbers of potential pathogens

1191
Q

What are DAMPs?

A

danger-associated molecular patterns = markers of endogenous cell damage

1192
Q

Type I acute phase proteins are induced by which two cytokines?

A

IL-1 and TNF

1193
Q

List 3 type I acute phase proteins.

A

serum amyloid A
CRP

C3

C4

1194
Q

Type II acute phase proteins are induced by which cytokine?

1195
Q

List 3 type II acute phase proteins.

A

fibrinogen
ferritin

alpha1-antitrypsin

alpha2-macroglobulin

1196
Q

What is the role of C-reactive protein in acute phase reactions?

A

enhances microbial phagocytosis and complement binding

1197
Q

What is the role of serum amyloid A in acute phase reactions?

A

leukocyte recruitment and activation

1198
Q

What are the two main types of pattern recognition receptors?

A

toll like receptors (TLRs)

NOD-like receptors (NLRs)

1199
Q

TLR2 recognizes what? TLR2 forms heterodimers with which other two TLRs?

A

recognizes diverse array of PAMPs (lipotechoic acid from gram + bacteria, peptidoglycan, hemagglutinin, polysaccharides, lipoproteins)

Forms heterodimers with TLR1 and TLR6

1200
Q

Which TLR is responsible for recognizing LPS on gram negative bacteria?

1201
Q

Which TLR is expressed in epithelial cells of respiratory and intestinal tract and recognizes flagellin?

1202
Q

Which caspase is thought to be the “executioner caspase” in inflammation?

1203
Q

Which two cell types are the main sources of TNF-alpha?

A

macrophages and T cells

1204
Q

T/F: Decreased concentrations of TNF-alpha correlate with increased mortality in dogs with parvovirus.

A

False! Increased concentrations of TNF alpha correlate with increased mortality in canine parvo, but NOT in septic cats

1205
Q

What is the difference between TNFR1 (TNF receptor 1) and TNFR2 in function?

A

TNFR1 = proinflammatory and apoptotic

TNFR2 = promotes tissue repair and angiogenesis

1206
Q

Which cytokines are involved in the “hyperacute” period after innate immune stimulation in sepsis?

A

TNF-alpha and IL-1

1207
Q

Which cytokine is the major endogenous pyrogen in fever?

1208
Q

Which interleukin is anti-inflammatory?

1209
Q

What is MIF, and what is its role in sepsis?

A

Macrophage migratory inhibitory factor - produced by anterior pituitary in SIRS/sepsis… delays apoptosis of activated monocytes/macrophages

1210
Q

Acute phase proteins are released from which organ?

1211
Q

Describe the effects of bradykinin.

A

Enhances vasodilation, increases vascular permeability, and reduces platelet function

1212
Q

Which factor plays a major role in initiation of coagulation in SIRS/sepsis?

A

tissue factor

1213
Q

Conventional T cells are transformed into T regulatory cells by exposure to which cytokines?

A

IL-10 and TGF-beta

1214
Q

What is the role of Tregs?

A

interact with immune cells to suppress development of autoaggressive responses and maintain the population of periphera CD4+ T cells

1215
Q

TSH is secreted from which cells?

A

thyrotrophs in adenohypophysis (anterior pituitary)

1216
Q

Adiponectin and IGF-1 are positive/negative acute phase proteins in canine endotoxemia.

A

negative acute phase proteins

1217
Q

In the acute phase response, G-CSF is released from what cells?

1218
Q

Which clotting factor is expressed by microparticles?

A

tissue factor

1219
Q

vWF is higher/lower in dogs with sepsis.

1220
Q

Kallikrein plays what role in coagulation associated with sepsis?

A

accelerates fibrinolysis by converting plasminogen to plasmic, also activates factor XII to activate the complement pathway

1221
Q

Hyperthyroidism in cats resembles what condition in humans?

A

toxic nodular goiter

1222
Q

High plasma concentrations of ____ are needed for appropriate iodine uptake by thyroid cells for 131I scanning

1223
Q

What type of transporter is responsible for iodine uptake into thyroid follicular cells? How is it activated?

A

Na-I symporter, activated by cAMP as a result of TSH binding TSH receptor

1224
Q

What transporter is responsible for iodine efflux from the thyroid follicular cell into the follicular lumen?

1225
Q

What enzyme iodinates tyrosil residues of thyroglobulin?

A

thyroid peroxidase - in the presence of hydrogen peroxide

1226
Q

What is the main use for recombinant human TSH in people?

A

pre-treatment with TSH prior to 131I therapy increases thyroidal uptake of 131I –> decreased dose and deliver of 131I to extrathyroidal tissues

1227
Q

In what circumstances would a TSH stimulation test be useful in dogs?

A

When hypothyroidism is suspected by a diagnosis cannot be made based on TT4 and TSH concentrations alone

1228
Q

What is a major risk of high dose 131I therapy?

A

fatal myelosuppression

1229
Q

What would you expect on a TSH stimulation test in a euthyroid cat vs. a cat with hyperthyroidism?

A

euthyroid cat - marked increase in TT4 after 6h

hyperthyroid cat - little change in TT4 due to decreased thyroid functional reserve, but can be similar to euthyroid cats if borderline T4 to start with, so not that useful

1230
Q

Are type IV hypersensitivity reactions B cell or T cell mediated?

A

T cell mediated

1231
Q

TEN is an example of what type of hypersensitivity reaction?

1232
Q

Urticaria is an example of what type of hypersensitivity reaction?

1233
Q

What are the cell types involved in type I hypersensitivity responses?

A

B cells producing IgE, which activates mast cells and basophils

1234
Q

Define anaphylactoid reaction. Given an example of a drug that can cause this.

A

Drug directly induces release of proinflammatory molecules without involvement of immune system. DIFFERENT FROM ANAPHYLAXIS!

ex. morphine - stimulates histamine release directly from mast cells

1235
Q

Drug-induced pemphigus is an example of what type of hypersensitivity reaction?

1236
Q

SLE is an example of what type of hypersensitivity reaction?

1237
Q

Type III hypersensitivity reactions involve which immunoglobulin?

1238
Q

What is the mean time of onset for a delayed hypersensitivity reaction?

1239
Q

Erythema multiforme is what type of hypersensitivity reaction?

1240
Q

What are haptens?

A

chemically reactive small molecules

1241
Q

What types of cells are classically seen in cases of pemphigus foliaceus?

A

acantholytic cells

1242
Q

Describe lesions in Sweet’s syndrome

A

severe neutrophilic dermatosis with painful erythematous plaques/nodules

1243
Q

What test can be performed to assess whether a drug may have resulted in a delayed hypersensitivity reaction?

A

lymphocyte transformation test

1244
Q

Superficial suppurative necrolytic dermatitis has been described in which breed, in association with treatment with what?

A

Mini Schnauzers in association with treatment with shampoos

1245
Q

Which type of drug hypersensitivity reactions DO NOT resolve with discontinuation of the drug - drug associated, drug-induced, or drug-triggered?

A

drug triggered

1246
Q

List three protective mechanisms that help to prevent pancreatitis from occurring in normal animals.

A

pancreatic enzymes stored as zymogens (inert)

zymogen granules stored separately away from lysosomal granules

pancreatic secretory trypsin inhibitor

antiproteases in circulation which inactivate trypsin

1247
Q

What is cathepsin B?

A

a major lysosomal protease involved in trypsin activation

1248
Q

Which interleukin is known as the neutrophil chemotactic factor?

1249
Q

Substance P binds to what type of receptors?

1250
Q

Which cells of the intestine is most susceptible to changes in the microcirculation?

A

epithelial cells (due to decreased pO2 gradient at the tip of the villi) –> more susceptible to hypoxia

1251
Q

T/F: Cyclophosphamide confers a survival benefit when used in patients with IMHA

A

False! No benefit over pred alone, and may actually increase mortality

1252
Q

T/F: The use of individually adjusted doses of heparin is associated with improved survival in IMHA

1253
Q

What is the overall mortality rate for dogs with IMHA?

1254
Q

T/F: IVIG confers a survival benefit in dogs with refractory IMHA.

1255
Q

T/F: Use of low-dose aspirin in IMHA is associated with improved survival.

1256
Q

What has been identified as a negative prognostic indicator in IMHA most consistently in dogs?

A

hyperbilirubinemia

1257
Q

Why might it be a good idea to combine silymarin with phosphatidylcholine?

A

phosphatidylcholine is a solubilizing substance that improves bioavailability of silymarin

1258
Q

Why is silymarin bioavailability enhanced in cats?

A

because it undergoes glucuronidation in the liver and cats have limited glucuronidation capacity

1259
Q

Why are bile concentrations of silymarin 100x higher than serum?

A

because it undergoes enterohepatic circulation

1260
Q

What is the main MOA for silymarin?

A

increases glutathione levels in hepatic/intestinal tissue –> free radical scavenging and inhibition of lipid peroxidation

1261
Q

How does silymarin suppress hepatic fibrosis?

A

silibinin (active metabolite) disrupts stellate cell DNA synthesis and migration –> decreased conversion to myofibroblasts

1262
Q

T/F: Silymarin increases bile flow.

A

True - dose-dependent increase in bile flow due to stimulation of bile salt synthesis

1263
Q

T/F: The use of silymarin in dogs with Amanita intoxication results in an increased mortality rate

A

False! Decreases mortality rate

1264
Q

What is the active ingredient in milk thistle?

1265
Q

Name the two fish oil omega 3 fatty acids

A

eicosapentaenoic acid (EPA)

docosahexanoic acid (DHA)

1266
Q

EPA and DHA are short/long chain mono/poly -unsaturated fatty acids.

A

long-chain polyunsaturated fatty acids (PUFAs)

1267
Q

What type of fatty acid is alpha-linolenic acid?

A

omegat 3 fatty acid found in plant products (canola oil, flaxseed, etc)

1268
Q

Which is more potent - alpha-linolenic acid or EPA?

A

EPA

alpha-linolenic is a much less potent source of omega-3s than fish oils

1269
Q

T/F: In mammals, alpha-linolenic acid can be efficiently converted to EPA and DHA.

A

False! Mammals cannot efficiently convert ALA to EPA and DHA

1270
Q

Which omega-6 fatty acid is considered essential for all mammals?

A

linoleic acid

1271
Q

Linoleic acid is efficiently converted to _____ in dogs, but not in cats

A

arachidonic acid - this is why AA is essential in cats

1272
Q

Why do cats require arachidonic acid?

A

because they have limited delta-6 desaturase activity, which converts linoleic acid to arachidonic acid

1273
Q

Why are EPA and DHA less proinflammatory than arachidonic acid?

A

EPA & DHA serve as substrate for production of 3-series prostaglandins & 5-series leukotrienes, which are less proinflammatory compared with the 2-series prostaglandins & 4-series leukotrienes produced from AA

1274
Q

The presence of arachidonic acid in phospholipid membranes results in production of what platelet activator?

A

thromboxane A2

1275
Q

How does supplementation with EPA and DHA result in altered platelet function?

A

results in production of thromboxane A3, a less potent platelet activator compared with thromboxane A2

but does not cause a clinically relevant effect

1276
Q

Why should you discontinue high doses of omega-3s before surgery?

A

because the first stage of wound healing involves inflammation and omega-3s might blunt this phase of wound healing

1277
Q

Why should vitamin E be added to omega-3 supplements?

A

prevents lipid peroxidation of omega-3s

1278
Q

How does vitamin E act as an antioxidant?

A

acts as a hydrogen donor to free radicals

1279
Q

What are manifestations of vitamin E deficiency in cats?

A

muscular degeneration, retinal degeneration, steatitis

1280
Q

What is the role of leukotriene B4?

A

initiates neutrophil chemotaxis, recruitment, and degranulation

1281
Q

What is the difference between leukotriene B4 and B5?

A

B4 is more potent and B5

1282
Q

Omega-3 fatty acids induce production of which leukotriene?

1283
Q

T/F: Omega-3s cause hyperglycemia in cats

A

False! They might actually improve glycemic control and insulin sensitivity

1284
Q

What is the difference between aspirin and omega3s in terns of effects on thromboxane A2?

A

aspirin = irreversibly inhibits thromboxane A2,

omega 3s = competitive inhibition of thromboxane A2 with arachidonic acid

1285
Q

What are the two most common agents implicated in healthcare-acquired infection in veterinary facilities?

A

Salmonella and MRSA

1286
Q

The renal cortex receives __% of renal blood flow.

1287
Q

Which cells of the kidney are most susceptible to ischemic injury?

A

cells of the proximal tubule and thick ascending limb of the loop of Henle

1288
Q

What are the 3 parameters that determine the IRIS AKI grade?

A 
creatinine
urine production (oliguric/nonoliguric)

need for dialysis

1289
Q

Describe grade I AKI based on the IRIS grading scheme.

A

AKI patients that are nonazotemic or those with creatinine concentrations that are immediately responsive to adequate volume therapy

1290
Q

An increase in creatinine by ____ within 48 hours can be considered confirmatory evidence of AKI.

1291
Q

The ideal biomarker for kidney injury should be able to:

A
  1. detect kidney injury at early stage
  2. localize kidney injury (glomerular, tubular)
  3. differential pre-, post, and nonrenal injury
  4. predict severity of injury
  5. monitor effects of intervention
1292
Q

Positively/negatively charged proteins pass through the glomerular filtration barrier more easily.

A

positively charged

1293
Q

Retinol-binding protein is a blood/urinary biomarker used to detect dysfunction in which part of the nephron?

A

urinary biomarker

detects proximal tubular dysfunction

1294
Q

For dogs, what defines “borderline proteinuria” according to IRIS staging of CKD?

1295
Q

The presence of high molecular weight proteins (such as IgG) in the urine suggests damage to what part of the nephron?

A

glomerulus

1296
Q

Urinary cystatin C is a renal biomarker that reflects damage to what part of the nephron?

A

renal tubules

1297
Q

Serum cystatin C is a biomarker that is used to assess what?

1298
Q

Describe the flow of cystatin C through the kidney

A

freely filtered by the glomerulus, reabsorbed and catabolized by renal tubules (does NOT re-enter bloodstream or get excreted in urine) - no tubular secretion occurs

1299
Q

Where in the kidney are the following enzymes located? NAG, GGT, ALP, AAL, LDH

A

NAG, ALP: lysosomes
GGT, AAP: brush border

LDH: proximal tubular cells

1300
Q

Urinary NAG, ALP, and GGT reflect damage to what part of the nephron?

A

proximal tubules

1301
Q

What cells make Tamm-Horsfall protein?

A

cells in the thick ascending limb of LOH

1302
Q

What makes up the matrix of all urinary casts?

A

Tamm Horsfall protein

1303
Q

Increased/decreased Tamm-Horsfall protein is indicative of tubular dysfunction in dogs.

1304
Q

KIM-1 stands for what and is located where in the nephron?

A

KIM-1 = kidney injury molecule-1

transmembrane protein expressed on luminal surface of proximal tubules during acute or chronic tubular injury

1305
Q

What are the 2 most common side effects of NSAIDs in dogs?

A

vomiting and diarrhea

1306
Q

T/F: NSAIDs suppress bicarbonate secretion and mucus production in the stomach.

1307
Q

What is the most common predisposing factor for GI ulceration in dogs?

A

NSAID treatment

1308
Q

Hepatotoxicity from NSAIDs is thought to be dose-dependent/idiosyncratic?

A

idiosyncratic

1309
Q

Nephrotoxicity from NSAID administration is typically dose-dependent/idiosyncratic.

A

dose dependent

1310
Q

What types of cells product microparticles?

A

platelets, endothelial cells, RBCs, WBCs

1311
Q

Are microparticles pro- or anti-inflammatory?

A

proinflammatory

1312
Q

Are microparticles pro- or anti-coagulant?

A

procoagulant

1313
Q

What 4 transporters are responsible for maintaining the distribution of phospholipids in the membrane bilayer of eukaryotic cells?

A

flippases
floppases

scramblases

aminophospholipid translocase

1314
Q

In Scott Syndrome, there is a deficiency in which membrane transporter?

A

scramblase. This leads to deficient phosphatidyl serine exposure and microparticle release

1315
Q

Scott Syndrome affects what breed?

1316
Q

What ion is responsible for initiating the cascade of enzymatic events that rapidly changes the expression of phospholipids in the membrane bilayer, resulting in a rise in procoagulant activity?

A

cytosolic calcium

1317
Q

T/F: Microparticles can transfer genetic material to target cells

A

True! Target cells can acquire new surface antigens and biological activity via these mechanisms

1318
Q

How is microparticle formation a defense mechanism against the complement cascade?

A

allows membrane shedding of complement components from the cell surface

1319
Q

Production of platelet-derived microparticles is triggered by what 3 things?

A

thrombin
collagen

exposure to high shear

1320
Q

How can erythrocyte-derived microparticles result in severe vasoconstriction?

A

via scavenging of nitric oxide

1321
Q

What happens to microparticle concentrations in stored blood products?

A

increased concentration of microparticles with increased storage time

1322
Q

What can be done to decrease microparticle production in stored blood products?

A

leukodepletion

1323
Q

Describe the changes in RBC morphology that occur ex vivo during RBC storage.

A

initially - reversibly change shape to echinocytes (ATP depletion)

later - irreversible spheroechinocytes are formed (complete depletion of ADT, ATP, AMP) –> rigid membranes, microparticle generation

1324
Q

What diagnostic is the gold standard for detection of microparticles?

A

flow cytometry

1325
Q

What may be seen on functional MRI during a migraine?

A

activation (hyperoxia and blood volume increase) of the red nucleus and substantia nigra

increased photoreceptor activity in the occipital cortex during the interictal period

1326
Q

T/F: The brain parenchyma is insensate.

1327
Q

Intracranial structures rostral to the tentorium cerebelli are innervated by _____.

A

trigeminal nerve

1328
Q

What is cortical spreading depression (CSD)?

A

a phenomenon that proceeds migraines and is associated with visual aura

intracellular Ca++ rises –> depolarization –> vasodilation and inflammation

1329
Q

T/F: Migraines in people are typically hereditary

A

True! polygenic inheritance

1330
Q

Blood serotonin levels increase/decrease at the onset of a migraine

1331
Q

What is the MOA of topiramate?

A
  1. inhibits voltage-gated Na channels
  2. inhibits high voltage-gated calcium channels
  3. inhibits glutamate-mediated neurotransmission
  4. enhances GABA chloride flux
  5. modulates trigeminovascular signaling
1332
Q

What group of neurons is implicated in primary headaches?

A

trigeminal cervical complex (TCC) - formed from neurons of trigeminal nucleus caudalis (TNC) and cervical extension

1333
Q

T/F: In immune-complex GN, typically ALL glomeruli are affected.

1334
Q

What lesions would you expect in the glomerular basement membrane in dogs with immune-complex GN?

A

spikes, holes, and/or double or irregular contours

1335
Q

Renal amyloidosis is diagnosed with what stain?

A

Congo red stain –> green birefringent material

1336
Q

Where in the nephron amyloid typically deposited in renal amyloidosis?

A

mesangium and glomerular basement membrane

1337
Q

Which stain is used to assess collagen deposition in renal biopsies?

A

Masson’s trichrome

1338
Q

Immune-complex GN is diagnosed by finding staining for what antibodies?

A

antibodies against C3, and AT LEAST 1 class of immunoglobulin

1339
Q

What type of staining identifies immunoglobulins in immune-complex GN?

A

immunofluorescence staining

1340
Q

What is tier I with regards to glomerular disease in dogs? Tier IA and IB?

A

persistent renal proteinura without hypoalbuminemia or azotemia

IA = no discernible sequellae

IB = with hypertension

1341
Q

What is tier II with regards to dogs with glomerular dz? IIA vs. IIB?

A

renal proteinuria with hypoalbuminemia but not azotemia

IIA = without hypertension

IIB = with hypertension

1342
Q

What is tier III with regards to dogs with glomerular disease? IIIA, IIIB, and IIIC?

A

renal proteinuria with renal azotemia

IIIA = no hypertension or hypoalbuminemia

IIIB = with hypertension, without hypoalbuminemia

IIIC = with hypoalbuminemia +/- hypertension

1343
Q

What is C6?

A

peptpeptid associated with the VIsE gene of B. burgdorferi, which is ONLY expressed in the mammalian host and not within the tick or the Lyme vaccine - indicates natural infection

1344
Q

How long after infection are antibodies to C6 detected?

A

3-4 weeks post-infection

1345
Q

T/F: Light microscopy alone can be used to diagnose immune-mediated glomerular disease

A

False! Need transmission electron microscopy and immunostaining

1346
Q

Which should be dosed based on lean body weight - lipid-soluble drugs or water-soluble drugs?

A

water soluble drugs… obesity leads to lower volume of distribution and higher plasma concentration b/c decreased ECF volume

1347
Q

Obesity leads to a higher/lower volume of distribution for fat-soluble drugs, which results in a higher/lower plasma concentration

A

higher volume of distribution –> lower plasma concentration

therefore DO NOT dose based on LBW

1348
Q

What is the goal of hepatic drug metabolism?

A

to make the drug more water soluble for renal excretion

1349
Q

What are the two phases of hepatic drug metabolism?

A

phase I = oxidation, reduction, and hydrolysis (may inactivate or create an active metabolite

phase II = conjugation (with glucuronide, sulfate, glutathione or acetyl group) - cats have low capacity for glucuronidation

1350
Q

Almost all of a drug has been eliminated after how many half lives?

A

5-7 half-lives

1351
Q

Which receptor is blocked by angiotensin receptor blockers?

A

angiotensin II type I receptor

1352
Q

In normal dogs, which drug more effectively blocks the pressor response of angiotensin I: enalapril or telmisartan?

A

telmisartan

1353
Q

When could spironolactone be used in dogs with glomerular disease?

A

in animals with high aldosterone concentrations and persistent proteinuria despite ACEi, ARB, or both

1354
Q

What is kayexelate?

A

intestinal POTASSIUM binder - can use with hyperkalemia secondary to ACEi therapy

1355
Q

Potassium levels greater than ___ during ACEi/ARB treatment warrant a modification in treatment.

A

> 6.5mmol/L

1356
Q

What are the therapeutic targets for treatment of proteinuria with ACEi in dogs?

A

UPC<0.5 or reduction in UPC of 50% or greater without inappropriate worsening of renal function

1357
Q

In proteinuric dogs with stage I or II CKD, an increase in creatinine up to ___ is acceptable following ACEi therapy.

1358
Q

In dogs with CKD, how do omega-6 PUFAs effect GFR?

A

increase GFR

1359
Q

What effects do omega-3 PUFAs have in CKD?

A
  1. decreased glomerular capillary pressure
  2. altered urinary excretion of eicosanoids
  3. delayed progression of CKD
1360
Q

What ratio of omega6:omega3 fatty acids should be targeted in dogs with glomerular disease?

1361
Q

T/F: Reduction in protein intake helps to reduce proteinuria

1362
Q

Which type of thromboembolism is more common in glomerular disease - venous or arterial?

1363
Q

In glomerular disease, there is an increase in which PROcoagulant factors?

A

V, VIII, fibrinogen

1364
Q

Changes in vessel wall and platelet activation appear to be of greater importance for venous OR arterial thromboembolism?

A

arterial thromboembolism

1365
Q

Blood stasis and changes in pro/anticoagulant factor levels appear to be more important for arterial or venous thromboembolism?

A

venous thromboembolism

1366
Q

What drug is recommended for thromboprophylaxis in dogs with glomerular disease?

A

1-5mg/kg aspirin daily

1367
Q

Describe the variation in blood pressure seen in sight hounds.

A

tend to have BP ~20mmHg higher than other breeds

1368
Q

Target organ damage from hypertension is known to affect what body systems?

A

ocular, CNS, cardiovascular

1369
Q

Antihypertensive medications should be instituted in dogs with glomerular disease when systolic BP exceeds ____ or diastolic BP exceeds _____

A

systolic >160

diastolic >100

1370
Q

If hypertension is identified in a dog with glomerular disease that is not receiving an ACE inhibitor, what is the first drug that should be started to control the hypertension?

A

ACEi… then a calcium channel blocker can be added later to control the hypertension

1371
Q

Why is it recommended to only use amlodipine in conjunction with an ACE inhibitor in dogs with glomerular disease?

A

amlodipine preferentially dilates the afferent arteriole, which can further promote proteinuria if not used in conjunction with an ACEi

1372
Q

Volume contracted patients would be expected to have higher/lower fractional excretion of sodium compared with volume-expanded patients

A

lower fractional excretion of sodium

1373
Q

When should diuretics be used in dogs with nephrotic syndrome?

A

only in situations where organ function is critically impaired (i.e. ascites/pleural effusion that impairs respiration)

1374
Q

Red granular staining on the capillary walls of the glomerulus with Masson’s trichrome stain is most suggestive of ____

A

immune complex deposition

1375
Q

When should glucocorticoids be used in dogs with glomerular disease?

A

short-term administration for fulminant cases in need of immediate immunosuppression OR in multisystemic immune-mediated diseases (such as lupus, IMHA) where glucocorticoids are indicated

1376
Q

How does mycophenolate work?

A

inhibits inosine monophosphate dehydrogenase –> selective inhibition of T cell and B cell proliferation by inhibiting synthesis of purines

1377
Q

What drug is recommended as the first choice for treatment of dogs with peracute or rapidly progressive immune-mediated glomerular disease in dogs?

A

mycophenolate

1378
Q

Cyclosporine exerts its activity by binding to what cytosolic protein?

A

cyclophilin

1379
Q

The cyclosporine-cyclophilin complex inhibits ____, which is essential for transcription of _____.

A

inhibits calcineurin, which is essential for the transcription of IL-2

1380
Q

What interleukin is responsible for activation of T cells?

1381
Q

What is the MOA of cyclophosphamide?

A

alkylating agent -

interferes with DNA replication, RNS transcription and replication and disrupts nucleic acid function

1382
Q

What type of drug is chlorambucil?

A

alkylating agent

1383
Q

What is the MOA of azathioprine?

A

purine analog that interferes with normal cell DNA and RNA synthesis –> cytotoxicity to lymphocytes

1384
Q

How long does it typically take for azathioprine to be fully effective in dogs?

A

2-5 weeks or more

1385
Q

What are the adverse effects associated with azathioprine?

A

myelosuppression, GI upset, hepatic disease/failure, acute panreatitis

1386
Q

What immunosuppressive drug protocols are recommended for dogs with peracute or rapidly progressive glomerular disease?

A

mycophenolate +/- pred

or, cyclophosphamide +/- pred

1387
Q

T/F: In glomerular disease, response to treatment with immunosuppressives is reflected in histopath changes in renal biopsies

1388
Q

Why might the magnitude of proteinuria decrease in animals in the late stages of progressive kidney disease?

A

because of a reduction in the number of remaining nephrons through which protein loss can occur

1389
Q

T/F: prednisone activates phospholipase A2

A

False! porednisone inhibits phospholipase A2

1390
Q

T/F: Renal biopsy is recommended for dogs with glomerular disease and IRIS CKD stage 4.

A

False! renal biopsy should NOT be performed in dogs with IRIS Stage 4 CKD

1391
Q

T/F: Immunosuppressive treatment is recommended for dogs with familial nephropathy.

1392
Q

T/F: Immunosuppressive treatment is recommended for dogs with amyloidosis.

1393
Q

T/F: immunosuppressive drugs are ONLY indicated for glomerular causes of proteinuria, not tubular causes

1394
Q

What type of familial GN do Bernese Mtn Dogs get?

A

membranoproliferative GN - this is one of few familial nephropathies that MAY respond to immunosuppressive treatment

1395
Q

What is the reported survival time for dogs with azotemia and/or nephrotic syndrome as a result of glomerular disease?

1396
Q

What are the major adverse effects of methotrexate?

A

bone marrow suppression, hepatotoxicity

1397
Q

T/F: Even in the absence of compatible clinical signs, testing for Cushing’s should be pursued prior to adrenalectomy for treatment of an adrenal mass.

1398
Q

T/F: Measurement of a single basal cortisol concentration has no value in diagnosis of HAC in dogs

1399
Q

What are the 3 most commonly used SCREENING tests for HAC?

A

LDDST, UCCr, ACTH stim

1400
Q

How long do you need to wait after administering prednisone to be able to accurately measure serum cortisol levels?

A

24 hours

…but there will still be some risk for adrenal suppression secondary to steroid administration during this time.

1401
Q

List 4 drugs (aside from corticosteroids) that effect the HPA axis in dogs.

A

reglan
buprenorphine

codeine

desmopressin

clomipramine

1402
Q

What is the screening test of choice for HAC in dogs?

1403
Q

What types of drugs may cause false positive results on a LDDST?

A

agents that increase P450 (phenobarbital) because they accelerate dexamethasone clearance

1404
Q

With the LDDST, a diagnosis of HAC is based on cortisol measurement at which time point?

A

8 hour timepoint

1405
Q

What is the sensitivity and specificity of the LDDST in diagnosing HAC in dogs?

A 
Sn = 85-100%
Sp = 44-73%
1406
Q

What is the criteria for identification of PDH based on LDDST?

A

4hr [cortisol] below lab cut-off or <50% of basal [cortisol] OR 8hr [cortisol] <50% baseline but above lab cut-off

1407
Q

What test is the gold standard for diagnosis of IATROGENIC HAC in dogs?

1408
Q

What is the sensitivity and specificity of the ACTH stim for diagnosis of spontaneous HAC in dogs?

A 
Sn = 57-95%
Sp = 59-93%
1409
Q

What is the sensitivity and specificity of the UCCr for diagnosis of spontaneous HAC in dogs?

A

Sn = 75-100%, Sp = 20-25%

1410
Q

What is the most accurate stand-alone differentiating test for types of HAC?

A

endogenous [ACTH]

not often performed due to difficulty with sample handling

1411
Q

What percentage of dogs with PDH will suppress on a HDDST?

1412
Q

What percentage of dogs with PDH that do NOT suppress on a LDDST will suppress on a HDDST?

1413
Q

The HDDST uses a dose of dexamethasone ___ times the dose needed for the LDDST

1414
Q

List 3 features that are associated with the presence of a malignant adrenal tumor.

A

adrenal width >4cm
vena cava invasion

metastasis

1415
Q

What is the pituitary flush on CT? What happens to the pituitary flush in PDH?

A

in a normal pituitary gland, the posterior gland will light up first with IV contrast (due to arterial blood supply).

…pituitary flush is absent or displaced/distorted in dogs with PDH

1416
Q

What is the purpose of a noninferiority clinical trial?

A

to show that an investigational drug is at least as effective as an established treatment within a predetermined margin

designed because of ethical concern of comparing the a placebo in situations where established treatment exists

1417
Q

What are type I and type II error?

A

type I = false positive. incorrect rejection of a true null hypothesis

type II = false negative. incorrect retaining of a false null hypothesis

1418
Q

What is a main mechanism of IVDD development in chondrodystrophoid dogs?

A

premature senescence of notochordal cells and replacement of by chondrocyte-like cells

1419
Q

What type of IVDD typically effects chondrodystrophic dogs?

A

Hansen type I - dehydration of nucleus pulposus, dystrophic calcification, stress on annulus fibrosus, extrusion of disk material

1420
Q

Non-chondrodystrophic dogs more commonly get what type of IVDD?

A

Hansen type II (fibroid degeneration) - thickening of the annulus –> protrusion into vertebral canal

1421
Q

Nuclear extrusion in IVDD results in what types of lesions?

A

contusive and compressive

1422
Q

Annular protrusion in IVDD results in what type of spinal injury?

A

compressive

1423
Q

Why should we not use the term “type III IVDD” to describe traumatic disc extrusion?

A

because no pre-existing disc degeneration is present in these cases

1424
Q

Influx of which ion into neuronal cell bodies following contusive spinal injury results in activation of autodestructive pathways leading to apoptosis and necrosis?

1425
Q

Which 3 cytokines are released from microglial cells following spinal cord injury?

A

IL-1, TNFalpha, NO

1426
Q

What would you find on neuro exam in a case with spinal shock?

A

depressed spinal reflexes caudal to the lesion… which may confuse you and make you think the lesion is in the intumescence

1427
Q

T/F: Myelomalacia occurs as a consequence of ischemia

1428
Q

Where in the spinal cord can IVDD cause peripheral nerve compression?

A

vertebral canal in the LS region

foramina at any intervertebral space (with lateral herniation)

1429
Q

Most thoracolumbar disc herniations occur between ___ and ___ disk spaces. Most cervical disc herniations occur between ___ and ___ disk spaces.

A

T11-L1

C2-C4

1430
Q

Chronic IVDD is most common in which 3 locations?

A

caudal cervical
thoracolumbar junction

L7/S1

1431
Q

What mutation is associated with degenerative myelopathy in dogs?

1432
Q

What is the advantage of MRI over CT in compressive spinal lesions?

A

ability to detect nonmineralized compressive material such as hemorrhage with MRI

1433
Q

What are the recovery rates for type I IVDD with and without surgery?

A

50% with conservative management

90% with surgery

1434
Q

What types of type II IVDD cases are candidates for surgery?

A

moderate-to-severe compression that may be exacerbated by a dynamic component (especially in the cervical region)

1435
Q

How do anti-inflammatory doses of steroids benefit dogs with chronic compressive spinal lesions?

A

decrease vascular permeability –> decreased edema

1436
Q

Anaplasma phagocytophilum infects ____ (cell) and is transmitted by what type of tick?

A

granulocytes

ixodes

1437
Q

Anaplasma platys infects ____ (cell) and is transmitted by what type of tick?

A

platelet

rhipicephalus

1438
Q

What type of tick can transmit Bartonella?

A

ixodes… also fleas and other ticks

1439
Q

Borrelia burgdorferi is transmitted by what type of tick?

1440
Q

All species of Babesia are transmitted by ____ (tick), except B. microti, which is transmitted by _____ (tick)

A

rhipicephalus

B. microti = ixodes

1441
Q

Cytauxzoon felis infects ____ (cells) and is transmitted by what type of tick?

A

RBC, schizonts in macrophages

amblyomma and dermacentor

1442
Q

Ehrlichia canis infects ____ (cell) and is transmitted by what type of tick?

A

monocytes

rhipicephalus

1443
Q

Ehrlichia chaffeensis infects ____ (cell) and is transmitted by what type of tick?

A

monocytes

amblyomma

dermacentor

1444
Q

Ehrlichia ewingii infects ____ (cell) and is transmitted by what type of tick?

A

granulocytes

amblyomma

1445
Q

Hepatozoon americanum is transmitted by what type of tick?

A

INGESTION of amblyomma

1446
Q

Leishmania infects ____ (cell) and is transmitted by what bug?

A

macrophages

sandfly, also vertical transmission

1447
Q

Rickettsia rickettsii infects ____ (cell) and is transmitted by what type of tick?

A

endothelial cells

dermacentor, rhipicephalus

1448
Q

What breeds are predisposed to lyme nephritis?

A

goldens and labs

1449
Q

How do you define successful treatment of lyme based on C6?

A

> or = 50% decrease in C6 from pre-treatment values

1450
Q

What drugs are used to treat leishmania infection?

A

allopurinol
miltefosine

antimonials (meglumine)

paromomycin (aminocidine)

1451
Q

Treatment with allopurinol predisposes to formation of what type of urolith?

1452
Q

What is the MOA of cyclosporine?

A

binds cyclophilin –> cyclosporine-cyclophilin complex inhibits calcineurin which is involved in transcription of genes for cytokines ( IL-2, IL-4, TNFa, INFgamma) –> inhibition of T cell function and cell mediated immunity, inhibition of T cell proliferation

1453
Q

T/F: Oral bioavailability of cyclosporine is very consistent from patient to patient

A

False! High degree of variability from 23-45% bioavailability

1454
Q

Cyclosporine has a small/large volume of distribution

A

large volume of distribution (accumulates in skin, liver, kidneys, fat)

1455
Q

Which is higher - cyclosporine tissue concentrations or serum concentrations?

A

tissue concentrations

1456
Q

T/F: Cyclosporine is metabolized by cytochrome P450 enzymes

1457
Q

List drugs that INCREASE cyclosporine concentrations by inhibition of P450

A

ketoconazole, azithromycin, chloramphenicol, fluoroquinolones, macrolides, reglan, omeprazole, metronidazole, cisapride, cimetidine, steroids

1458
Q

List drugs that DECREASE cyclosporine concentrations by induction of P450

A

phenobarbital, clindamycin, famotidine, TMS, steroids

1459
Q

T/F: Glucocorticoids may EITHER decrease or increase blood concentrations of cyclosporine

A

true! can do either

1460
Q

What is the major site of metabolism of cyclosporine? How is it excreted?

A

liver (also kidneys and small intestine to a lesser degree)

excreted in bile (minimal renal excretion)

1461
Q

T/F: Compounded formulations are adequate and inexpensive alternatives to brand name cyclosporine

A

False! DO NOT use compounded formulations due to variable bioavailability

1462
Q

What type of cancer has been associated with cyclosporine treatment?

1463
Q

During treatment with cyclosporine, what type of vaccines are recommended?

A

only killed vaccines

1464
Q

What is the only condition in dogs for which systemic use of cyclosporine is approved?

1465
Q

T/F: Therapeutic drug monitoring is recommended for dogs with atopy being treated with cyclosporine.

A

False! Therapeutic drug monitoring is NOT recommended as blood concentrations do not correlate with clinical improvement

1466
Q

Cyclosporine can be used in conjunction with ____ to reduce dose/cost of cyclosporine treatment.

A

ketoconazole

1467
Q

T/F: Therapeutic drug monitoring IS recommended if using cyclosporine in conjunction with ketoconazole.

A

True - need to make sure not achieving toxic cyclosporine level

1468
Q

T/F: Cyclosporine is NOT effective in treatment of pemphigus foliaceus

1469
Q

What is the MOA of paclitaxel?

A

suppression of microtubule spindle dynamics –> blockage of metaphase-anaphase transitions –> inhibition of mitosis and induction of apoptosis

1470
Q

Where is paclitaxel metabolized?

1471
Q

T/F: Paclitaxel is a substrate for ABC-transporter cellular drug efflux pumps (MDR1)

1472
Q

What are the most common adverse effects in dogs on Paccal Vet (paclitaxel)?

A

transient neutropenia, inappetance, mild V/D, mild hypersensitivity reactions

trials for mammary tumors and SCC

1473
Q

What are the 4 stages of seizure?

A

prodrome –> aura –> ictus –> post-ictal

impossible to differentiate prodrome and aura in animals

1474
Q

What breed of cat appears to be overrepresented for idiopathic epilepsy?

A

european shorthair

1475
Q

Necrosis of the hippocampus and piriform lobe in cats is associated with what clinical signs?

A

acute cluster seizures, salivation, aggression

1476
Q

What is “basic epileptogenicity level”?

A

inherent tendency to generate seizures - different for different regions of the brain

1477
Q

What part of the brain is thought to have the highest basic epileptogenicity level (BEL) in cats?

A

temporal lobe

1478
Q

T/F: Plasma concentrations of buprenorphine correlate with level of analgesia in cats

A

False! plasma concentrations DO NOT correlate with level of analgesia in cats (negative hysteresis)

1479
Q

Which is the preferred route of buprenorphine administration in cats: IV, IM, SC, transmucosal?

A

IV or IM

SC route does not provide adequate analgesia

Transmucosal may be best when combined with an NSAID or other form of pain control

1480
Q

T/F: Buprenorphine has a rapid onset of action when given IV

A

False! Onset of analgesia is typically ~30-45mins

1481
Q

What are the two main pathophysiologic mechanisms thought to contribute to MODS/

A

immune system dysregulation and subsequent mitochondrial dysfunction

1482
Q

In reference to MODS/sepsis, what does CARS stand for? What is the main cytokine associated with CARS?

A

compensatory anti-inflammatory response syndrome

IL-10

1483
Q

Oxidative stress and proinflammatory cytokine signaling lead to uncoupling of oxidative phosphorylation via what mechanism in MODS?

A

MPT (mitochondrial permeability transition), in which a pore is opened on the inner mitochondrial membrane which results in an inappropriate proton gradient and uncoupling of oxidation from phosphorylation

1484
Q

What are the 2 stages of hepatic damage caused by sepsis/SIRS?

A
  1. hepatic hypoperfusion –> decreased protein synthesis, lactate clearance, gluconeogenesis, glycogenolysis
  2. Kupffer cell activation –> proinflammatory cytokines cause further damage
1485
Q

What happens to the gut flora after a severe insult such as polytrauma or cardiac arrest?

A

gut flora is immediately destroyed and the number of intestinal pathogenic bacteria gradually increases

1486
Q

T/F: Endotoxin given IV causes an increase in the number and strength of jejunal contractions

A

False! Decreases number/strength of jejunal contractions

1487
Q

Cardiovascular dysfunction in MODS is characterized by what structural change in the heart?

A

biventricular dilatation

1488
Q

How does NO production lead to decreased cardiac contractility in dogs with MODS?

A

downregulation of beta adrenergic receptors and decreased cytosolic calcium

1489
Q

Cardiovascular dysfunction occurring secondary to sepsis is referred to as ____

A

septic shock!

1490
Q

What are the 2 main forms of AKI associated with MODS? Which is more common?

A
  1. acute tubular necrosis, hypoperfusion, ischemia

2. histopathologically normal kidneys - apoptosis caused by inflammatory cytokines and endotoxin (MOST COMMON)

1491
Q

T/F: Corticosteroid tissue resistance increases in acute inflammatory diseases such as sepsis

A

True! This may contribute to CIRCI

1492
Q

T/F: Prognosis in dogs with MODS does not correlate with the number of dysfunctional organ systems.

A

False! Survival is inversely proportional to the number of dysfunctional organ systems

1493
Q

What would you expect to see in a dog with CIRCI on an ACTH stim?

A

basal cortisol within or above reference interval with dampened cortisol secretion after ACTH administration - difference between pre and post < 3ug/dL

1494
Q

Urinary cystatin C can be used as a marker for damage where in the nephron?

A

proximal tubule

1495
Q

What is considered the gold standard for GFR measurement?

A

inulin clearance

1496
Q

Cystatin C levels increase/decrease as GFR decreases

1497
Q

T/F: Serum cystatin C appears to be a good marker for kidney damage in dogs.

A

False! There is overlap between healthy dogs and dogs with CKD

1498
Q

Astrocytomas and oligodendrogliomas are overrepresented in what types of dogs?

A

brachycephalic breeds

1499
Q

Choroid plexus tumors are overrepresented in what breed?

A

Golden retrievers

1500
Q

What are the most common secondary brain tumors in cats?

A

lymphoma and pituitary tumors

1501
Q

What is the typical CSF finding in dogs with intracranial neoplasia?

A

moderately increased TNCC (predominantly mononuclear) and increased TP

(or can be normal)… most tumors not diagnosed on CSF

1502
Q

CSF of most dogs with meningiomas has what TNCC?

A

<5 cells/uL

1503
Q

Most brain tumors in dogs are hypo/iso/hyper intense on T1 and hypo/iso/hyper intense on T2

A

hypo or iso intense on T1, hyperintense on T2

1504
Q

The presence of a “dural tail” on MRI is associated with what type of tumor?

A

meningioma

1505
Q

The presence of ring enhancement on an MRI is suggestive of what type of tumor?

A

glioma, but can happen with a variety of other intracranial diseases

1506
Q

Diffusion weighted imaging might be useful in differentiating what types of conditions on MRI?

A

differentiation of neoplasia from bacterial abscessation/infarction (which would cause restricted diffusion)

1507
Q

What are the 2 main components of palliative care for intracranial tumors?

A
  1. corticosteroids to target peritumoral edema

2. anti-epileptics

1508
Q

T/F: Adjunctive radiation therapy has been shown to be beneficial compared with surgery alone in treatment of meningiomas in dogs.

1509
Q

Why might an animal with a hereditary disease (such as congenital myasthenia gravis in Dachshunds) appear to “grow out of” the disorder?

A

replacement of defective neonatal protein with the adult form

1510
Q

Which set of hereditary diseases is characterized by a neonatal to middle-aged onset, clinical signs of ataxia, blindness, weakness, dementia, or seizures, a progressive course, and is diagnosed based on necropsy, liver or leukocyte inclusions, or urine or CSF metabolites?

A

lysosomal storage disorders

1511
Q

Why might not all animals with a particular genetic mutation develop clinical signs of disease?

A

variable penetrance

1512
Q

What is the most common type of DNA variant?

A

SNP (single nucleotide polymorphism)

1513
Q

What is the result of a missense mutation?

A

change the codon so a different amino acid is specified

1514
Q

What is the result of a nonsense mutation?

A

changes amino acid-specifying codon to a premature stop codon

1515
Q

Why do demyelinating disorders often produce cerebellar signs?

A

Because the cerebellum depends on fast conduction of proprioceptive information during movement and demyelination shows conduction velocity

1516
Q

In which dog breeds has spinocerebellar ataxia been identified as a genetic disease?

A

Jack Russell and Parson Russell Terriers

1517
Q

Exercise-induced collapse occurs in which breed?

1518
Q

Episodic falling is a genetic condition in which breed?

1519
Q

What is the ABCB1 gene?

A

also known as MDR1 gene - encodes the drug transporter P-glycoprotein from the ABC (ATP-binding cassette superfamily)

1520
Q

How does P-glycoprotein cause drug resistance?

A

using energy derived from ATP hydrolysis to transport substrates across the plasma membrane (from in cell to extracellular space), often against a steep concentration gradient

1521
Q

Which of the following has been shown to be a P-glycoprotein substrate - alkylating agents, doxorubicin, platinum compounds, vinca alkaloids, tyrosine kinase inhibitors, mitoxantrone?

A

vinca alkaloids, doxorubicin, tyrosine kinase inhibitors

1522
Q

Which cardiac drugs are P-glycoprotein substrates?

A

digoxin, diltiazem, verapamil

1523
Q

Which immunosuppressants are P-glycoprotein substrates?

A

cyclosporine, tacrolimus

1524
Q

Which opioids are P-glycoprotein substrates in dogs?

A

butorphanol, loperamide

1525
Q

Which antiparasitics are P-glycoprotein substrates?

A

ivermectin, mibemycin, moxidectin, selamectin, doramectin

1526
Q

Which commonly used sedative is a P-glycoprotein substrate?

A

acepromazine

1527
Q

Which anti-emetic is a P-glycoprotein substrate?

A

ondansetron

1528
Q

Which antifungals are P-glycoprotein substrates?

A

ketoconazole

itraconazole

1529
Q

Which antibiotics are P-glycoprotein substrates?

A

erythromycin
tetracycline

doxycycline

levofloxacin

sparfloxacin

1530
Q

In what types of locations is P-glycoprotein expressed in normal cells?

A
  1. at barriers to drug absorption (apical border of intestinal epithelium)
  2. at drug elimination site (biliary canaliculi, renal tubular epithelial cells)
  3. capillary endothelial cells at “sanctuary sites” (BBB, testes, placenta)
1531
Q

T/F: Heterozygotes for the MDR1 mutation have decreased P-gp function

A

True! intermediate phenotype with decreased P-gp function

1532
Q

P-glycoprotein plays an important role in what type of drug excretion?

A

biliary excretion - this increases their sensitivity to myelosuppressive and GI effects of certain chemotherapeutics

1533
Q

Which antimicrobials act as P-glycoprotein INHIBITORS?

A

erythromycin
ketoconazole

itraconazole

1534
Q

Which antidepressants act as P-glycoprotein INHIBITORS?

A

fluoxetine

paroxetine

1535
Q

Which cardiac drugs act as P-glycoprotein INHIBITORS?

A

diltiazem
quinidine

verapamil

nicardepine

1536
Q

Which immunosuppressives act as P-glycoprotein INHIBITORS?

A

cyclosporine

tacrolimus

1537
Q

Why are P-glycoprotein inhibitors not currently used for anti-cancer treatment?

A

because they cannot discriminate btetween P-gp expressed by normal tissues (which protects the patient) and P-gp in cancerous tissue

1538
Q

Why might ketozonazole exacerbate ivermectin toxicosis?

A

ketoconazole inhibits P-glycoprotein mediated biliary excretion

1539
Q

T/F: Compounding antimicrobials from bulk chemicals is reasonable if other routes of drug delivery are not practical

A

False! compounding of antimicrobials from bulk chemicals should be abolished

1540
Q

What is cascade reporting with regards to bacterial culture and sensitivity results?

A

secondary antimicrobial agents are only automatically reported if an organism is resistant to primary agents

1541
Q

T/F: For most bacterial organisms a minimum duration of antibiotic treatment is necessary to prevent emergence of resistance.

A

False. This is a common misconception and there is no foundation to this

Antibiotics should never be continued once there is clinical and microbiological evidence that an infection has been eliminated

1542
Q

T/F: Animals with subclinical bacteruria should always be treated with antibiotics to clear the bacteria.

A

False! These cases should not be treated

1543
Q

What is the age distribution of dogs with osteosarcoma?

A

median age 7y, bimodal age distribution with smaller peak at 18-24mos

1544
Q

What percent of dogs with osteosarcoma present with detectable lung mets? What percent develop distant mets within 1yr without chemo?

A

15%

90% develop mets without chemo within 1yr

1545
Q

T/F: Dogs that experience acute bacterial infection secondary to limb-salvage surgery for osteosarcoma have increased survival times

1546
Q

The Fas receptor is associated with what cellular process?

1547
Q

Phenotypic characterization of T regulatory cells includes expression of which two surface antigens and transcription of which gene?

A

CD4 and CD25

transcription of FoxP3

ACVIM Reading List (27 decks)

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