ACVIM Required Journals QODs - Equine

Question 1

In Dunkel (JVIM 2015; 29:644-650), regarding hepatic disease in 81 horses, which of the following is correct?
A. 90% short term and 83% long term survival
B. Non-survival had no relationship to serum bile acid levels
C. Serum bile acids had no correlation with parenchymal inflammation
D. Hemosiderin deposition had no association with long-term survival

Answer 1

A. 90% short term and 83% long term survival

Question 2

In Weber (EVJ 2015; 47:275-278) regarding sepsis scores in neonates, which of the following is NOT correct?
A. The modified sepsis score performed better than the generated regression model which has been previously used
B. The generated regression model involves: age, creatinine and total protein levels
C. The modified sepsis score had a sensitivity of 56.4%
D. The modified sepsis score had a specificity of 73.4%

Answer 2

B. The generated regression model involves: age, creatinine and total protein levels

Question 3

In Morley (EVJ 2015; 3:358-365) regarding EIPH in racehorses, which is correct?
A) 23% of horses had evidence of EIPH
B) Horses without EIPH were >2 times more likely to win
C) Horses without EIPH were no more likely to win than horses with EIPH
D) Horses without EIPH finished, on average, 0.25 lengths ahead of horses with EIPH

Answer 3

B. Horses without EIPH were >2 times more likely to win

Question 4

In Weese (EVJ 2015; 47:641-649) regarding fecal microbia in post-partum mares, which one is correct?
A. Firmicutes and Proteobacteria were present in >50% of samples
B. There was limited impact on foaling and the postpartum period on the fecal microbiome
C. 80% of horses with Firmicutes colicked
D. 100% of horses with Proteobacteria colicked

Answer 4

B. There was limited impact on foaling and the postpartum period on the fecal microbiome

Question 5

In Millerick-May (EVJ 2015; 47:410-415) regarding airborne particulates (PM10) and tracheal mucus, which is correct?
A. Tracheal mucus scores at the racetrack were >2 in >50% of horses
B. Neutrophil counts were higher during the day
C. Inflammatory cell counts were associated with PM10 concentrations throughout the day
D. Breathing zone PM10 concentrations were markedly lower than the ambient concentrations

Answer 5

C. Inflammatory cell counts were associated with PM10 concentrations throughout the day

Question 6

In Estell (EVJ 2015; 47:689-93), regarding viral loads in horses with naturally occurring Equine Herpesvirus Myeloencephalopathy, which is correct?
A. Neurological grades were mostly 1-3 out of 5
B. All were infected with herpesvirus genotype polymerase D752 genotype
C. Peak viral load was not different in horses that did or did not survive
D. In the horses that died, cause of death was loss of diaphragmatic function

Answer 6

B. All were infected with herpesvirus genotype polymerase D752 genotype

Question 7

In Davis (EVJ 2015; 47:667-74) regarding immune responses in foals being administered multivalent vaccines, which is correct?
A. There was no evidence of memory immune responses
B. Young foals are not capable of immune activation while maternal antibodies are still present
C. Foals vaccinated at 3 months of age responded in a comparable manner to foals vaccinated at 6 months of age
D. Foals vaccinated at 6 months had a significant IgG response, whereas foals vaccinate at 3 months did not

Answer 7

C. Foals vaccinated at 3 months of age responded in a comparable manner to foals vaccinated at 6 months of age

Question 8

In Williams (EVJ 2015; 47:96-100) EVJ regarding water intake in stalled horses, which is correct?
A) Water intake was higher in horses on pasture than in a stall
B) Fecal output was greater in stall horses than horses on pasture
C) Fecal dry matter content was greater in stall horses than horses on pasture
D) Stall rest had no effect on the motility of the large colon

Answer 8

C. Fecal dry matter content was greater in stall horses than horses on pasture

Question 9

In Tomlinson (JVIM 2015; 29:1410-1417), regarding fibrinous pleural effusion in cases of pneumonia, what percentage of patients with fibrinous pleural effusion survived?
A. 58%
B. 68%
C. 78%
D. 88%

Answer 9

B. 68%

Question 10

In Kilcoyne (EVJ 2015; 47:54-59), which bacteria were most commonly found in sialoadenitis?
A. Streptococcus
B. Staphylococcus
C. Fusobacterium
D. Pseudomonas

Answer 10

C. Fusobacterium

Question 11

In Gomez (JVIM 2015; 29:1395-402) regarding acid-base crap in cute foals, which is most correct?
A. Anion gap was significantly associated with plasma [L-Lac-] (should be little L at the start and a superscript negative symbol at the end)
B. Strong ion gap was significantly associated with plasma [L-Lac-]
C. Both anion gap and strong ion gap were significantly associated with plasma [L-Lac-]
D. Neither anion gap nor strong ion gap were significantly associated with plasma [L-Lac-]

Answer 11

C. Both anion gap and strong ion gap were significantly associated with plasma [L-Lac-]

Question 12

Regarding the most recent consensus statement on Equine Gastric Ulceration, which is correct?
A. ESGD occurs in 37% of TB racehorses while they are racing
B. Diarrhea has never been reported as a clinical sign of ESGD
C. The scale of 0-4 should be used for ESGD
D. There is a strong relationship between the presence of ESGD and EGGD

Answer 12

C. The scale of 0-4 should be used for ESGD

Question 13

In Tomlinson (JVIM 2015; 29:1403-9) regarding tissue plasminogen activator and pleuropneumonia, which is correct?
A. TPA was administered 3-6 times in each case
B. A degree of ultrasonographic improvement was seen in 95% of cases where rTPA was administered
C. The was no association between time of onset of rTPA administration and survival
D. 72% of horses survived to discharge

Answer 13

D. 72% of horses survived to discharge

Question 14

In Janes (EVJ 2014; 46:681-686) regarding MRI and cervical radiographs for cervical stenotic mylelopathy, which is correct?
A. No differences in spinal cord measurements were seen when normal horses were compared to CSM horses
B. Regarding cervical canal height, there were no false negatives
C. Regarding minimal sagittal diameter, there are no false negatives
D. Regarding cervical canal height and minimal sagittal diameter, there were no false positives

Answer 14

A. No differences in spinal cord measurements were seen when normal horses were compared to CSM horses

Question 15

In Borschers (EVJ 2014; 46:306-10) regarding vasopressin in neonatal foals, which is correct?
A. Admission plasma arginine vasopressin (AVP) was equivalent in septic and sick foals
B. Admission AVP was decreased in septic compared to healthy foals
C. Increased AVP was associated with decreased survival
D. Admission AVP remained significantly higher in septic foals during the first 5 days of hospitalisation

Answer 15

C. Increased AVP was associated with decreased survival

Question 16

In Slovis (EVJ 2014; 46(3):311-6) regarding foal diarrhoea, which is correct?
A. 0.8% of diarrhoea foals were infected with Lawsonia intracellularis
B. 15.6% of diarrhoea foals were infected with roatvirus
C. 63.2% of diarrhoea foals had some kind of infectious agent
D. 14.2% of healthy foals had some kind of infectious agent

Answer 16

C. 63.2% of diarrhoea foals had some kind of infectious agent

Question 17

In Menzies-Gow (EVJ 2014; 46(3):317-21) regarding inflammatory markers and laminitis, which is correct
A. Before exercise plasma adiponectin was significantly lower in previously laminitis horses compared to normal horses.
B. After exercise plasma adiponectin was significantly higher in previously laminitis horses compared to normal horses.
C. Plasma TNF alpha and fibrinogen were significantly higher in previously laminitis horses compared to normal horses.
D. Exercise had no effect on SAA.

Answer 17

A. Before exercise plasma adiponectin was significantly lower in previously laminitis horses compared to normal horses.

Question 18

In Votion et al (EVJ 2014; 46(2)146-9) regarding diagnosis of atypical myopathy, which of the following is the toxic metabolic measurable in serum of horses that have ingested box elder leaves?
A. Hypoglycin A.
B. Acer pseudoplatanus.
C. Acyl-CoA dehydrogenase.
D. Methylenecyclopropyl acetic acid-carnitine.

Answer 18

D. Methylenecyclopropyl acetic acid-carnitine.

Question 19

In Cardwell (EVJ 2014; 46(2):150-5) regarding tracheal mucus, which is correct?
A. Strep zoo isolation lead to increased tracheal mucus
B. Non-hemolytic step isolation lead to increase tracheal mucus
C. Isolation of both strep zoo and non-hemolytic strep lead to increased tracheal mucus
D. On average, a 5-fold increase in mucus occurred in the first 6 months of training

Answer 19

C. Isolation of both strep zoo and non-hemolytic strep lead to increased tracheal mucus

Question 20

In Bowser (EVJ 2014; 46(2):216-22) regarding Hereditary equine regional dermal asthesia (HERDA), which is correct
A. Horses with HERDA had significantly higher skin tensile strength than normal horses
B. Horses with HERDA had significantly lower skin tensile strength and elastic modulus than normal horses
C. Horses with HERDA had significantly higher skin elastic modulus and energy to failure than normal horses
D. The biggest differences in skin tensile strength between HERDA and normal horses occurred at skin obtained from the limbs.

Answer 20

B. Horses with HERDA had significantly lower skin tensile strength and elastic modulus than normal horses

Question 21

In Hallamaa (EVJ 2014; 46(3):322-7) regarding summer exczma, which is correct?
A. Phosphatidic acid concentrations were higher in horses with summer eczema
B. Phosphatidylcholine concentrations were higher is horses with summer eczema
C. Sphingomeylin concentrations were lower in horses with summer eczema
D. Lysophosphadidylcholine was present in greater quantities than other lipids

Answer 21

B. Phosphatidylcholine concentrations were higher is horses with summer eczema

Question 22

In Straford (EVJ 2014; 46(1):17-24) regarding strongyles in horses in Scotland, which is correct?
A. Fenbendazole resistance was present on all yards
B. Moxidectin resistance was present on all yards
C. Pyrantel resistance was present on all yards
D. Ivermectin resistance was present on all yards

Answer 22

A. Fenbendazole resistance was present on all yards

Question 23

In Koblinger (EVJ 2014; 46(1):50-55) regarding BAL and bronchial collapse, which is correct?
A. Bronchial collapse was a rare finding during the study
B. BAL fluid volume was positively correlated with neutrophil numbers
C. Bronchial collapse was associated with neutrophilia
D. The presence of bronchial collapse had no effect on the volume of BAL fluid obtained

Answer 23

C. Bronchial collapse was associated with neutrophilia

Question 24

In Rendle (EVJ 2014; 46(1):113-117) regarding adrenocorticotrophic hormone, which is correct?
A. Ultradian fluctuation in ACTH occurs in PPID horses but not control horses
B. Ultradian fluctuation in ACTH occurs in all horses
C. Circadian fluctuation in ACTH occurs in all horses
D. Circadian fluctuation in ACTH occurs in control horses but not PPID horses

Answer 24

D. Circadian fluctuation in ACTH occurs in control horses but not PPID horses

Question 25

In Nelson (EVJ 2013; (S45):8-14) regarding GI dysfunction following elective procedures, which factor was NOT associated with post-op colic?
A. Right lateral recumbency
B. Intra-operative lactate
C. Post-op temperature
D. Being a Thoroughbred

Answer 25

D. Being a Thoroughbred

Question 26

In Brennan (EVJ 2014; 46(6):718-21) regarding insulin sensitivity after cessation of a 21-day course of dexamethasone, which is correct?
A. Insulin levels remain high for 3 weeks
B. Insulin levels are initially high but return to baseline by day 3
C. Glucose levels remain high for 3 weeks
D. Glucose levels are unaffected

Answer 26

B. Insulin levels are initially high but return to baseline by day 3

Question 27

In Jellyman (EVJ 2013; 46(6):722-728) regarding sex-linked differences in pancreatic beta cells in foals, which is correct?
A. The maximum increment in plasma insulin in response to glucose administration was higher in males
B. At 2 weeks of age males have a greater insulin response than females
C. At 12 weeks of age, females have a greater insulin response than males at 45 minutes after glucose administration
D. At 2 weeks of age, females have a greater insulin response to arginine than males

Answer 27

C. At 12 weeks of age, females have a greater insulin response than males at 45 minutes after glucose administration

Question 28

In Davis (EVJ 2014; 46(6):729-33), regarding effects of quinapril on ACE, which is correct?
A. IV administration of quinapril reduced ACE activity, oral administration of quinapril had no effect
B. Both IV and oral administration of quinapril reduced ACE activaty
C. Both IV and oral administration of quinapril increased ACE activity
D. No method of administration altered ACE activity

Answer 28

B. Both IV and oral administration of quinapril reduced ACE activity

Question 29

Knych (EVJ 2014; 46(6):734-738), regarding firocoxib, at what stage after administration with firocoxib be below the level required to test positive as directed by the Racing Medication and Testing Consortium?
A. 3 days
B. 5 days
C. 7 days
D. 10 days

Answer 29

C. 7 days

Question 30

In Viljoen (EVJ 2014;46(6):739-44), regarding tetrastarch and its affect on coagulation, which concentration induced changes in coagulation?
A. 10mg/ml
B. 20mg/ml
C. 40mg/ml
D. 50mg/ml

Answer 30

C. 40mg/ml

Question 31

In Richard (JVIM 2014; 28(6):1838-44) regarding cytokine concentrations in BAL fluid, which is most correct?
A. TNF-a was significantly higher in IAD horses compared to controls
B. INF-g was not significantly different between IAD horses compared to controls
C. Neither TNF-a not INF-g were significantly different between IAD horses compared to controls
D. Both TNF-a and INF-g were significantly higher in IAD horses compared to controls

Answer 31

D. Both TNF-a and INF-g were significantly higher in IAD horses compared to controls

Question 32

In Niedzwiedz (JVIM 2014; 28(6):1845-52) regarding oxidant-antioxidant status in horses with RAO, which factors are increased in RAO?
A. Glutathione peroxidase, superoxide dismutase
B. Glutathione peroxidase, catalase
C. Glutathione peroxidase, glutathione reductase
D. Glutathione peroxidase, thiobarbituric acid-reductive substances

Answer 32

A. Glutathione peroxidase, superoxide dismutase

Question 33

In Burgess (JVIM 2014; 28(6):1853-9), regarding salmonella enterica serotypes in fecal samples in commercially available tests, which test detected the greatest percentage of serotypes?
A. qPCR
B. lateral flow immunoassays
C. DNA hybridization
D. no significant difference between the methods

Answer 33

A. qPCR

Question 34

In Abrahan (JVIM 2014; 28(5):1580-6), regarding ultrasound of Standardbred foals, which is correct?
A. Asymptomatic intususseptions were found in over 50% of foals
B. Wall thickness of the stomach was always less than 3mm
C. Wall thickness of the duodenum was always less than 3mm
D. Wall thickness of the jejunum was always less than 3mm

Answer 34

A. Asymptomatic intususseptions were found in over 50% of foals

Question 35

In Alfonso (JVIM 2013;27(5):1185-92) regarding ACE inhibitors in horses, which drug created a significantly higher ACE inhibition that the others?
A. Perindopril
B. Quinipril
C. Benazepril
D. Ramipril

Answer 35

C. Benazepril

Question 36

Synthetic colloids have recently fallen out of favour in human critical care medicine due to their links with renal failure and increased mortality in septic patients. In a prospective study of 100 horses with colic and a PCV ≥46% prior to anaesthetic induction, what were the short term and long term effects of pre-operative administration of pentastarch to horses when compared to the group which received hypertonic saline?
A. Significantly greater reduction in PCV and TP following fluid resuscitation; increased mortality in the 12 months following surgery.
B. Significantly lower reduction in PCV and TP following fluid resuscitation; decreased survival to discharge from hospital.
C. Significantly greater reduction in PCV and TP following fluid resuscitation; no difference in long term survival.
D. Significantly lower reduction in PCV and TP following fluid resuscitation; no difference in long term survival.

Answer 36

D. Significantly lower reduction in PCV and TP following fluid resuscitation; no difference in long term survival.

Ref: Dugdale et al, JAVMA 2015; 246(10):1104–1111.

Question 37

Which of the following factors is negatively associated with survival in foals less than 180 days old with septic joints?
A. Number of affected joints.
B. Plasma fibrinogen concentration.
C. Positive blood culture.
D. Culture of a gram negative organism from the affect joint/s.

Answer 37

A. Number of affected joints.

Ref: Hepworth-Warren et al, JAVMA 2015(7);246:785–793.

Question 38

A mare presents to your hospital with colic. On physical examination you notice very pale, icteric mucous membranes, tachycardia (HR=68bpm), tachypnoea (RR=40bpm), fever (T=102.5F/39.2C) and minimal borborygmi. Her PCV is 19% and her total protein is 8.3g/dL (83g/L). You question the owner and find that 3 other horses on his property have died over the past 5 days and last week he observed them eating fallen leaves from Pistacia trees. What metabolite could you expect to find in the urine of the mare that would confirm your suspected diagnosis?
A. 2,3-dihydro-3,5-dihydroxy-6-methoxy-4H-pyran-4-one.
B. Pyrogallol.
C. Hypoglycin A.
D. Gallic acid.

Answer 38

B. Pyrogallol.

Ref. Bozorgmanesh et al, J Vet Intern Med 2015;29:410–413.

Question 39

Early detection and treatment of pulmonary abscesses or areas of consolidation presumed to be attributed to R. equi infection has become common practice at many large breeding farms. As a result, resistance to macrolides, the main antibiotic class used in treatment of this infection, is increasing. Gallium maltolate, a semimetal compound, has been investigated as an alternative treatment for subclinical rhodococcus infection in foals, and in terms of treatment success was shown to be:
A. Superior to clarithromycin and rifampin.
B. Inferior to azithromycin and rifampin.
C. Non-inferior to azithromycin and rifampin.
D. Similar to clarithromycin and rifampin.

Answer 39

D. Similar to clarithromycin and rifampin.

Ref. Cohen et al, J Vet Intern Med 2015;29:932–939.

Question 40

Which of the following parameters measured on an echocardiogram 24 hours post-conversion of atrial fibrillation to normal sinus rhythm in horses can be used to predict future recurrence of atrial fibrillation?
A. Increased maximal left atrial diameter from four-chamber view.
B. High active left atrial fractional shortening.
C. Low active left atrial fractional area change.
D. Slow peak velocity during atrial contraction.

Answer 40

C. Low active left atrial fractional area change.

Ref. Decloedt et al, J Vet Intern Med 2015;29:946–953.

Question 41

Many clinicians rely on measurement of blood values to predict prognosis in cases of liver disease in horses due to their non-invasive nature. In a retrospective study comparing serum bile acid (SBA) concentrations and liver biopsy histopathology scores, which of the following was found to be true:
A. 83% of horses with liver disease survived short term and 72% survived long term.
B. SBA >20 µmol/L are sensitive but not specific indicators of non-survival.
C. SBA were positively associated with portal and parenchymal inflammation but not with portal or bridging fibrosis.
D. SBA were associated with short and long term non-survival.

Answer 41

D. SBA were associated with short and long term non-survival.

Ref. Dunkel et al., J Vet Intern Med 2015;29:644–650.

Question 42

Equine coronavirus has been reported to have high morbidity and low mortality in outbreaks in horses. In a case series in which coronavirus was associated with a high case fatality rate, which of the following was true?
A. High faecal viral loads of equine coronavirus were associated with non-survival.
B. Faecal viral load had no association with severity of clinical signs.
C. High serum ammonia concentration was positively associated with survival.
D. Serum ammonia concentration had no association with severity of clinical signs.

Answer 42

A. High faecal viral loads of equine coronavirus were associated with non-survival.

Ref. Fielding et al, J Vet Intern Med 2015;29:307–310.

Question 43

Flecainide has been used to convert horses with experimentally induced atrial fibrillation to a normal sinus rhythm. What is its mechanism of action and to what class of anti-arrhythmic medications does it belong?
A. Potassium channel blocker; class III.
B. Sodium channel blocker; class IC.
C. Calcium channel bocker; class IIB.
D. ß-adrenergic blocker; class IV.

Answer 43

B. Sodium channel blocker; class IC.

Ref. Haugaard et al, J Vet Intern Med 2015;29:339–347.

Question 44

Critical illness-related corticosteroid insufficiency (CIRCI) has been reported in horses with colitis, pleuropneumonia and colic. Tissue resistance is one mechanism by which CIRCI occurs in sick people. Which of the following statements is true regarding peripheral glucocorticoid resistance in healthy horses and horses with SIRS?
A. Glucocorticoid receptor density and plasma cortisol concentration are positively correlated in healthy horses.
B. Glucocorticoid receptor density and plasma cortisol concentration are positively correlated in horses with SIRS.
C. Glucocorticoid receptor binding affinity is significantly lower in survivors with SIRS.
D. Glucocorticoid receptor binding affinity is significantly lower in non-survivors with SIRS.

Answer 44

D. Glucocorticoid receptor binding affinity is significantly lower in non-survivors with SIRS.

Ref. Hoffman et al, J Vet Intern Med 2015;29:626–635.

Question 45

A 15 year old Australian Stock horse mare is presented to your hospital with botulism. You examine her and record your exam results. Which of these initial exam results is associated with the best prognosis for survival?
A. HR = 54bpm, RR = 12bpm, T = 103F (39.4C), recumbent in trailer but able to stand and walk into stall, able to drink water but unable to prehend and swallow grass.
B. HR = 36bpm, RR = 8bpm, T = 100.3F (37.9C), recumbent in trailer and stall, able to drink water and prehend and swallow grass.
C. HR = 36bpm, RR = 8bpm, T = 100.3F (37.9C), recumbent in trailer but able to stand and walk into stall, able to drink water but unable to prehend and swallow grass.
D. HR = 60bpm, RR = 36bpm, T = 99.6F (37.6C), standing in trailer and in stall, increased respiratory effort, able to drink water and prehend and swallow grass.

Answer 45

A. HR = 54bpm, RR = 12bpm, T = 103F (39.4C), recumbent in trailer but able to stand and walk into stall, able to drink water but unable to prehend and swallow grass.

Ref: Johnson et al, J Vet Intern Med 2015; 29:311-319.

Question 46

Narrow band imaging (NBI) is a recently developed, noninvasive technique allowing an enhanced visualization of submucosal vessels during endoscopy. It employs filters producing light of specific blue and green wavelengths instead of the white light used during conventional endoscopy, which correspond to the peak light absorption of haemoglobin. Which of the following findings might you expect in a horse with recurrent airway obstruction on NBI endoscopy?
A. Increased volume density of deep submucosal vessels in the trachea, carina and intermediate bronchi of horses versus controls.
B. Increased volume density of superficial submucosal vessels in the trachea, carina and intermediate bronchi of horses versus controls.
C. Increased volume density of superficial submucosal vessels in the trachea, but no significant increase in superficial or deep vessels in the carina and intermediate bronchi versus controls.
D. Increased volume density of deep submucosal vessels in the carina and intermediate bronchi versus but no different in volume density of vessels in the trachea versus controls.

Answer 46

C. Increased volume density of superficial submucosal vessels in the trachea, but no significant increase in superficial or deep vessels in the carina and intermediate bronchi versus controls.

Ref: Herteman et al, J Vet Intern Med 2016;30:671–674.

Question 47

A 2 year old AQH mare that has recently been broken in presents to your hospital. She has areas of severe skin loss over her dorsum and under her halter with evidence of secondary infection and ulceration, is a BCS 2/9 and is 4/5 lame in her right forelimb following a hoof bulb laceration 1 week prior to presentation. The owners have a budget of $400 and elect euthanasia. You perform a complete post mortem including histologic and biomechanical evaluation of skin, ligaments, tendons and great vessels. Which of the following statements could be correctly applied to this mare?
A. The mare has an autosomal dominant disorder in which there is a missense mutation in peptidyl-prolyl cis-trans isomerase B (PPIB) gene.
B. The mare is more likely to have been bred for halter classes than for cutting.
C. The tensile strength and energy to failure was significantly lower in skin from the mare’s abdomen than her withers.
D. The tensile strength and elastic modulus of her tendons and great vessels were significantly lower than those of the 24 year old TB gelding with a strangulating lipoma you also necropsied that day.

Answer 47

D. The tensile strength and elastic modulus of her tendons and great vessels were significantly lower than those of the 24 year old TB gelding with a strangulating lipoma you also necropsied that day.

Ref: Bowser et al, Equine Vet J 2014, 46: 216–222.

Question 48

You go out to an animal sanctuary to perform endocrine testing on the older members of their herd. Spook, a 17 year old Thoroughbred gelding was housed overnight in a stable and had not received his morning meal prior to your farm visit. Molly, a 27 year old Arabian mare, was housed in a paddock overnight with free access to pasture and lucerne hay. Which of the following results are likely from these two horses?
A. Molly’s and Spook’s baseline ACTH concentrations will not be significantly different.
B. Molly’s and Spook’s baseline insulin concentrations will not be significantly different.
C. Molly’s 10 minute-post TRH ACTH concentration will be significantly lower than Spook’s.
D. Spook’s baseline ACTH will be significantly higher than Molly’s.

Answer 48

A. Molly’s and Spook’s baseline ACTH concentrations will not be significantly different.

Ref: Restifo et al, AJVR, July 2016, Vol. 77, No. 7, Pages 738-74.

Question 49

Which of the following statements is true regarding the use of tramadol as an analgesic for laminitis?
A. The oral bioavailability of tramadol in horses is widely variable, ranging from 54-89%, resulting in varied analgesic effect in laminitic horses.
B. 5mg/kg tramdadol PO q12h results in decreased heart rate, but not a change in limb off-loading frequency, in horses with chronic laminitis.
C. 10mg/kg tramdadol PO q12h results in decreased limb off-loading frequency, but no change in heart rate, in horses with chronic laminitis.
D. No adverse effects have been reported with oral administration of tramadol in healthy or laminitic horses.

Answer 49

C. 10mg/kg tramdadol PO q12h results in decreased limb off-loading frequency, but no change in heart rate, in horses with chronic laminitis.

Ref: Guedes et al, Equine Vet J 2016; 48:528-531.

Question 50

Which of the following statements is true regarding the usefulness of the acute phase proteins serum amyloid A (SAA) and haptoglobin as prognostic indicators in acute colic cases in the horse?
A. Haptoglobin > 70 mg/dl is positively associated with the need for surgical intervention in colic patients.
B. SAA > 5 ug/ml is positively associated with the presence of thrombophlebitis in colic patients.
C. SAA is significantly lower in horses with a small intestinal lesion than those with a large intestinal lesion.
D. Haptoglobin > 70 mg/dl is positively correlated with euthanasia due to a poor prognosis in colic patients.

Answer 50

B. SAA > 5 ug/ml is positively associated with the presence of thrombophlebitis in colic patients.

Ref: Westerman et al, J Am Vet Med Assoc 2016; 248:935-940.

Question 51

Which statement is true regarding neonatal sepsis in North American foals?
A. The prognosis for survival is better in foals treated in North America than those treated in Europe.
B. You are more likely to grow Klebsiella in a blood culture from a septic foal now than you were in the 20th century,
C. The prognosis for septic foals can be significantly improved by squeezing their thorax on days 1-3 of life.
D. Gram positive sepsis is more prevalent in neonatal foals now than it was in the 20th century.

Answer 51

D. Gram positive sepsis is more prevalent in neonatal foals now than it was in the 20th century.

Ref: Theelen et al, Equine Vet J 2014; 46:169-173.

Question 52

Both intravenous and enteral fluid therapy are frequently used when treating colic patients. You treat six horses with the following fluid regimes for 24 hours: A. 50ml/kg isotonic fluids IV, B. 100ml/kg isotonic fluids IV, C. 150ml/kg isotonic fluids IV, D. 50ml/kg water via NGT (divided into 4 equal doses given every 6h), E. 100ml/kg water via NGT (divided into 4 equal doses given every 6h) and F. 150ml/kg water via NGT (divided into 4 equal doses given every 6h). Which of the following statements is most likely to be true regarding these horses?
A. Horse C will have a higher percentage of water in his faeces than horse B at the end of the 24 hours.
B. Horse D will have a higher percentage of water in his faeces and greater urine output than horse A.
C. Horse C will have an equivalent percentage of water in his faeces as horse B but will have greater urine output and sodium loss than horse B.
D. Faecal water percentage will increase in horses D, E and F but not horses A, B and C from baseline.

Answer 52

C. Horse C will have an equivalent percentage of water in his faeces as horse B but will have greater urine output and sodium loss than horse B.

Ref: Lester et al, JVIM 2013; 27:554-566.

Question 53

Which of the following options is associated with development of EIPH >/= grade 1 post-race in Thoroughbred racehorses?
A. Increasing number of lifetime starts.
B. Higher ambient humidity.
C. Lower ambient temperature.
D. Wearing aluminium race plates.

Answer 53

C. Lower ambient temperature.

Ref: Crispe et al, Equine Vet J 2016; 48:438-441.

Question 54

Equine gastric glandular disease (EGGD) is a term used to classify erosive and ulcerative diseases of the glandular mucosa of the equine stomach. This syndrome has recently been distinguished from equine gastric squamous disease (EGSD). Which of the following horses is at greatest risk of EGGD?
A. A Thoroughbred mare used for polocrosse kept at pasture and fed a mixture of oats and alfalfa hay.
B. A Warmblood gelding half-leased and used by one rider for dressage and the other for jumping, kept at pasture and fed free choice oaten hay.
C. An Arabian stallion used for breeding purposes, kept stalled and fed a mixture of a pelleted stud-mix and Coastal Bermuda hay.
D. A Standardbred mare used for racing that presented to your hospital for chronic diarrhoea and was found to have sand in her colon on radiographs, kept stalled and fed a mixture of barley, oats, sunflower seeds and Peanut hay.

Answer 54

B. A Warmblood gelding half-leased and used by one rider for dressage and the other for jumping, kept at pasture and fed free choice oaten hay.

Ref: Monki et al, J Vet Intern Med 2016; 30:1270-1275.

Question 55

Which of the following statements is correct regarding the pathogenesis of bilateral dynamic laryngeal collapse (DLC) associated with poll flexion?
A. There is no neuromuscular component to the pathogenesis of DLC.
B. DLC-affected horses have a greater proportion of T1 fibres within their right cricoarytenoideus muscle.
C. DLC-affected horses have a lesser proportion of T1 fibres within their right cricoarytenoideus muscle.
D. Neurogenic atrophy occurs in the right cricothyroid, cricoarytenoideus lateralis and cricoarytenoideus dorsal muscles of DLC-affected horses.

Answer 55

A. There is no neuromuscular component to the pathogenesis of DLC.

Ref: Fjordbakk et al, Equine Vet J, 2015; 47:603-608.

Question 56

Levalbuterol is the (R)-enantiomer of racemic albuterol. It is commonly administered to human patients with asthma via use of a metered dose inhaler. What is the advantage of using levalbuterol over albuterol in equine patients with recurrent airway obstruction?
A. Wider parenchymal distribution of bronchodilation.
B. Shorter duration of action.
C. Greater magnitude of bronchodilation.
D. Longer duration of action.

Answer 56

D. Longer duration of action.

Ref: Arroyo et al, J Vet Intern Med 2016; 30:1333-1337.

Question 57

Which of the following statements is true regarding the presence of toxic/band neutrophils in the peripheral blood of horses presenting to hospital emergency departments for evaluation of acute illness?
A. The presence of band neutrophils is associated with a poor outcome.
B. The percentage of band neutrophils is less indicative of disease severity that the total neutrophil count.
C. The presence of band neutrophils is indicative of the presence of systemic inflammatory response syndrome (SIRS) but is not prognostic in terms of survival to discharge.
D. The presence of a neutrophil toxic grade higher than 2 is associated with SIRS and death.

Answer 57

A. The presence of band neutrophils is associated with a poor outcome.

Ref: Lambert et al, J Vet Intern Med 2016; 30: 1284-1292.

Question 58

Which is true regarding reactivation and shedding of EHV-1 in horses hospitalised with acute abdominal disease?
A. Horses with acute colic are 1.35 times as likely to shed EHV-1 nasally than age-matched controls without colic.
B. Horses with acute colic are 4.5 times as likely to shed EHV-1 than age-matched control with colic, therefore in areas in which EHV-1 is endemic isolation of acute colic cases should be considered until a nasal PCR has been returned negative.
C. EHV-1 viraemia is more common in horses with acute colic than age-matched controls, however nasal shedding is no more common in these horses.
D. EHV-1 viraemia and nasal shedding are extremely uncommon in horses with acute colic compared to age-matched controls, therefore instituting biosecurity measures for these horses if hospitalised is unnecessary.

Answer 58

D. EHV-1 viraemia and nasal shedding are extremely uncommon in horses with acute colic compared to age-matched controls, therefore instituting biosecurity measures for these horses if hospitalised is unnecessary.

Ref: Carr et al, J Vet Intern Med 2011; 25:1190-1193.

Question 59

A 4 year old Standardbred stallion presents to your clinic for evaluation of poor racing performance. You recommend pulmonary function testing, bronchoalveolar lavage, dynamic endoscopy and an exercising ECG. The owner doesn’t want to spend the money and instead asks you to do a blood test for inflammatory airway disease. What do you tell him?
A. Elevated serum amyloid-A and decreased serum iron concentrations are associated with inflammatory airway disease in horses, so measuring these might help reveal a cause of his poor performance, if followed by a bronchoalveolar lavage or pulmonary function testing.
B. Elevated serum amyloid-A and decreased serum iron concentrations are associated with exercise induced pulmonary haemorrhage in horses, so measuring these might help reveal a cause of his poor performance, if followed by a bronchoalveolar lavage.
C. There is no correlation between serum amyloid A, haptoglobin or serum reactive protein C concentrations and incidence of inflammatory airway disease in horses.
D. Measuring inflammatory markers might indicate the presence of inflammatory airway disease but definitive diagnosis requires pulmonary function testing.

Answer 59

C. There is no correlation between serum amyloid A, haptoglobin or serum reactive protein C concentrations and incidence of inflammatory airway disease in horses.

Ref: Leclere at al, J Vet Intern Med, 2015; 29:940-945.

Question 60

Which of the following statements is true regarding the effects of furosemide in horses that have been previously diagnosed with equine induced pulmonary haemorrhage (EIPH)?
A. It decreases pulmonary venous and pulmonary wedge (left atrial) pressures and hence pulmonary capillary and transmural pressure during intense exercise.
B. It decreases the severity of EIPH by one or more grades when given pre-race.
C. It does not have any effect on the incidence or severity of EIPH when given pre-race.
D. It decreases the fibrosis associated with chronic bleedings within the lungs.

Answer 60

B. It decreases the severity of EIPH by one or more grades when given pre-race.

Ref: Sullivan et al, Equine Vet J, 2015; 47:341-349.

Question 61

Which of the following factors increases the risk of a positive nasal qPCR result for equine influenza?
A. Performance horse in competition.
B. Co-infection with equine herpes virus-1.
C. Infrequent vaccination against equine influenza.
D. Increasing age.

Answer 61

D. Increasing age.

Ref: Pusterla et al, J Vet Intern Med, 2015; 29:417-422.

Question 62

A large breeding farm in Kentucky experiences an abortion storm and submits placentas and aborted foetuses to you for investigation. You rule out viral infection and Mare Reproductive Loss Syndrome on the basis of placental pathology and diagnostic test results, and so decide to test for leptospirosis. Which of the following statements is true regarding the diagnostic tests available to diagnose this condition?
A. Foetal kidney is the best sample for diagnosis of leptospirosis via qPCR.
B. Placenta is the best sample for diagnosis of leptospirosis via fluorescent antibody test.
C. qPCR has advantage over fluorescent antibody testing as it can detect genetic material of leptospira organisms regardless of post-mortem autolysis.
D. Fluorescent antibody testing has advantage over qPCR as it enables identification of the responsible serovar.

Answer 62

C. qPCR has advantage over fluorescent antibody testing as it can detect genetic material of leptospira organisms regardless of post-mortem autolysis.

Ref: Erol et al, Equine Vet J, 2015; 47:171-174.

Question 63

Melanomas account for 15% of skin tumours in horses. Which of the following type of melanoma is reported to occur predominantly in grey horses (as opposed to being equally likely in horses of any colour, age or breed)? 
A. Melanomatosis.
B. Melanoctic nevi.
C. Anaplastic malignant melanoma.
D. Basal cell melanoma.

Answer 63

A. Melanomatosis.

Ref: Teixeira et al, J Vet Intern Med, 2013; 27:1201-1208.

Question 64

Which of the following electrolyte abnormalities could be expected to be found on serum biochemistry taken from a horse with anhydrosis following participation in a three day event?
A. Hypokalaemia.
B. Hyperchloraemia.
C. Hyponatraemia.
D. Hyperphosphataemia.

Answer 64

C. Hyponatraemia.

Ref: MacKay et al, Equine Vet Educ, 2015; 27:192-199.

Question 65

You are collecting blood samples as part of a study comparing normal variations in clinicopathologic variations in adult horses of specific breeds residing in France and Costa Rica. All horses enrolled in the study are healthy horses owned by members of local equestrian sporting clubs. A sample from Ratatouille, a 17 year old Selle Francais gelding, returns a triglyceride concentration of 39mmol/L (3,451mg/dL)! What do you tell the owner?
A. Ratatouille is seriously ill! It is likely he will go into liver failure if his severe hypertriglyceridaemia is not immediately managed in an intensive care unit.
B. The best course of action is inaction as this is likely just a lab error.
C. Ratatouille should be treated with metformin and placed on a fat-restricted diet until his triglycerides return to below 6mmol/L (530mg/dL).
D. Ratatouille’s serum/plasma should also be measured for ACTH and insulin concentrations as this finding is likely secondary to a primary endocrine disease.

Answer 65

D. Ratatouille’s serum/plasma should also be measured for ACTH and insulin concentrations as this finding is likely secondary to a primary endocrine disease.

Ref: Dunkel et al, Equine Vet J, 2014; 46:118-122.

Question 66

A 7yo Costarricense mare presents to your hospital for treatment of aspiration pneumonia 2 hours after the referring vet has relieved an oesophageal impaction. She has a mildly elevated respiratory rate and heart rate on presentation and occasional comet tails on thoracic ultrasound exam. You collect a serum sample on arrival and 5 days later, at which point her clinical condition has deteriorated despite broad spectrum antibiotic therapy, pleural drainage and lavage and administration of intravenous fluids and intranasal oxygen. What findings might you expect if you measured thyroid hormones in the serum samples?
A. Sample 1: decreased TT4, fT4, elevated TSH, normal TT3 and fT3.
B. Sample 1: decreased TT3, fT3, elevated TSH, normal TT4 and fT4.
C. Sample 2: decreased TT3, fT3, TT4 and fT4, elevated TSH.
D. Sample 2: decreased TT3, fT3, TT4, fT4 and TSH.

Answer 66

B. Sample 1: decreased TT3, fT3, elevated TSH, normal TT4 and fT4.

Ref: Hilderbran et al, J Vet Intern Med 2014; 28:609-617.

Question 67

Which of the following histopathologic changes are most likely to be present in a 6 month old Australian Stock Horse filly that presents to your New York hospital in October, 2016 for evaluation of weight loss, lethargy, peripheral oedema, fever and colic?
A. Infiltration of the jejunal lamina propria with macrophages and plasma cells.
B. Neutrophilic infiltrates in the walls of major blood vessels.
C. Hyperplasia of the crypt glands of the ileum with an increased number of mitotic figures and marked reduction or absence of goblet cells.
D. Eosinophilic inclusion bodies in the colonic submucosa.

Answer 67

C. Hyperplasia of the crypt glands of the ileum with an increased number of mitotic figures and marked reduction or absence of goblet cells.

Ref: Pusterla and Gebhart, Equine Vet J, 2013; 45:403-409.

Question 68

A client calls you panicking that her horse has cut its femoral artery on a star picket and is bleeding to death!! You tell her to apply pressure to the area and send out your intern ASAP to the farm to perform first aid. In the meantime, you prepare to perform a blood transfusion. You have a frozen blood sample from when this horse presented to the clinic three weeks ago for evaluation of weight loss and wonder whether or not you should use it to assess immunologic compatibility of the patient with your hospital blood donor horses. Your resident has just read a bunch of articles for boards and tells you:
A. Repeatability of equine blood crossmatching is lower for frozen than fresh blood, and if you use this sample you are more likely to exclude compatible donors than mistakenly administer incompatible blood.
B. You can use the blood to perform a major cross match, but the sensitivity will be low if you use it to perform a minor cross match.
C. Equine blood crossmatching is just as repeatable when using fresh as frozen blood, so long as it has not been stored for greater than 4 weeks, so you are fine to go ahead and test before the horse gets to the clinic.
D. There is no point in using frozen blood for crossmatching as the results are completely incomparable to those obtained using fresh blood from the same patient.

Answer 68

A. Repeatability of equine blood crossmatching is lower for frozen than fresh blood, and if you use this sample you are more likely to exclude compatible donors than mistakenly administer incompatible blood.

Ref: Harris et al, J Vet Intern Med 2012; 26:662-667.

Question 69

A 3 year old Tennessee Walking Horse gelding presents to your hospital after breaking into the feed shed and eating an entire bag of chicken feed 48 hours prior to presentation. On clinical exam you note injected mucous membranes with a toxic line, tachycardia, malodorous faeces, increased pulses and sensitivity to hoof testers in all four limbs and moderate forelimb lameness at the walk. The owner is very concerned about founder as this horse is a valuable plantation horse and requests ice boots; you tell her:
A. Ice boots will help to prevent further damage to the laminae in all limbs and may prevent complete lamellar failure, even though clinical signs of laminitis are already present.
B. Ice boots will help to prevent further damage to the laminae of the hindlimbs, however will have limited effect in the forelimbs, as the lameness is consistent with pre-existing dermoepidermal separation.
C. It is too late for ice boots as clinical signs of laminitis are already present, but you can administer intravenous fluids, intravenous flunixin meglumine, intravenous polymixin B and oral biosponge to prevent the laminae from further damage.
D. It is too late for ice boots as clinical signs of laminitis are already present, but you can perform therapeutic trimming and application of foot pads and boots to prevent the laminae from further damage.

Answer 69

A. Ice boots will help to prevent further damage to the laminae in all limbs and may prevent complete lamellar failure, even though clinical signs of laminitis are already present.

Ref: van Eps et al, Equine Vet J, 2014; 46:625-630.

Question 70

Which of the following statements is true regarding changes to gastric health in horses receiving non-steroidal anti-inflammatory drugs at the recommended anti-inflammatory dose for 14 days?
A. Neither phenylbutazone nor meloxicam alter gastric permeability to sucrose.
B. Meloxicam increases the risk of gastric glandular mucosal ulceration, whereas phenylbutazone increases the risk of gastric squamous mucosal ulceration.
C. Phenylbutazone increases gastric permeability to sucrose but meloxicam does not.
D. Phenylbutazone increases the risk of gastric glandular mucosal ulceration, whereas melxicam increases the risk of gastric squamous mucosal ulceration.

Answer 70

C. Phenylbutazone increases gastric permeability to sucrose but meloxicam does not.

Ref: D’Arcy-Moskwa et al, J Vet Intern Med, 2012; 26:1494-1499.