BCSE 20 Days Fot Test Day Flashcards

Question

What part keeps exhaled gasses moving away from the patient in a circular rebreathing anesthetic delivery system?

Answer 1

Answer: One-way valves help direct gas flow. Expired gasses pass through a CO2 scavenger canister to remove CO2. STRATEGY HINT: See how the word "valve" occurs in 3 choices? Chances are that the correct answer contains this word. In a circular rebreathing anesthetic system, one-way valves are crucial for directing the flow of gases, ensuring that exhaled gases move away from the patient. These gases pass through a CO2 scavenger canister, effectively removing carbon dioxide, thereby maintaining a clear pathway for fresh gas to reach the patient while preventing rebreathing of expired gases. This system optimizes the efficiency and safety of anesthesia delivery.

Answer 2

Answer: Tsetse fly. The tsetse fly transmits protozoa in the genus Trypanosomas to a variety of animal species. The fly resides only in sub-Saharan Africa thus trypanosomiasis is seen only in this region. Use environmental insecticides and/or topical insecticides to control the tsetse fly population and reduce disease prevalence. Mosquitoes and biting midges are important vectors for viral diseases world-wide. Ticks transmit protozoal diseases such as anaplasmosis and theileriosis. T. congolense is the most common species to affect cattle but trypanosomiasis affects all mammals (including humans). There is no available vaccine for any trypanosoma species. Link: Trypanosomiasis in Animals https://www.merckvetmanual.com/circulatory-system/blood-parasites/trypanosomiasis-in-animals

Answer 3

Answer: High ringbone This is an example of high ringbone (periostitis & osteoarthritis of the proximal interphalangeal joint leading to exostoses). Very common in horses. Can be due to chronic wear and tear, overuse, or secondary to a traumatic episode. Radiograph of arthrodesis of the proximal interphalangeal joint to resolve high ringbone. Osselets are traumatic arthritides of the metacarpophalangeal joints. Pedal osteitis is demineralization of the solar margin of the distal phalanx, usually due to inflammation. Bone spavin is osteoarthritis of the distal intertarsal, tarsometarsal, and less commonly, the proximal intertarsal joints. Ref: Pasquini and Spurgeon's Anatomy Dom An 11t ed. pp. 88, 100. Link: Osteoarthritis of the Proximal Interphalangeal Joint in Horses https://www.merckvetmanual.com/musculoskeletal-system/lameness-in-horses/osteoarthritis-of-the-proximal-interphalangeal-joint-in-horses Link: Pedal Osteitis in Horses https://www.merckvetmanual.com/musculoskeletal-system/lameness-in-horses/pedal-osteitis-in-horses Link: Osteoarthritis of the Distal Tarsal Joints in Horses https://www.merckvetmanual.com/musculoskeletal-system/lameness-in-horses/osteoarthritis-of-the-distal-tarsal-joints-in-horses Link: Lameness Exams Evaluating the Lame Horse https://aaep.org/horsehealth/lameness-exams-evaluating-lame-horse

Answer 4

Answer: Fluorosis. Chronic excessive ingestion of fluoride by cattle during the critical periods of tooth development, amelogenesis (enamel formation) and dentinogenesis (dentin formation) causes enamel hypoplasia. Exposure to excessive fluoride after teeth are fully formed does not result in dental lesions. Dental fluorosis is commonly diagnosed by examining the incisiors, although all teeth may be affected. Dental lesions observed: staining, mottling, excessive erosion, hypoplasia, hypocalcification. Osteofluorosis and lameness may also be observed. Refs: Gibbons, Bov Med & SX, p. 288-300. Link: Congenital and Inherited Anomalies of the Teeth https://www.merckvetmanual.com/digestive-system/congenital-and-inherited-anomalies-of-the-digestive-system/congenital-and-inherited-anomalies-of-the-teeth Congenital and Inherited Anomalies of the Teeth in Animals 1. Diseases: • Anodontia, Hypodontia, Oligodontia: Missing teeth. • Hyperdontia (Polyodontia): Extra teeth. • Retained Deciduous Teeth: Persistence of baby teeth. • Tooth Displacement/Rotation: Misaligned teeth. • Enamel Hypoplasia, Hypomineralization, Dysplasia: Defects in enamel formation. 2. Symptoms and Clinical Presentations: • Malocclusion, Crowding: Difficulty eating, weight loss. • Discomfort: Head shaking, inappetence. • Dental Disease: Plaque, tartar, caries, enamel discoloration. 3. Drugs: • Dentin Sealant, Bonding Agents: For enamel defects. • Resin Restoration: Enamel repair. 4. Infectious Agents: • Canine Distemper, Bovine Viral Diarrhea: Associated with enamel hypoplasia. 5. Diagnostic Methods: • Clinical Examination, Radiographs: To assess teeth and bone structure. 6. Treatment Protocols: • Extraction, Dental Cleaning: For retained teeth, dental disease. • Orthodontic Devices: To correct malocclusions. 7. Prevention and Control: • Regular Dental Check-ups: Early detection and management. • Proper Nutrition: To support healthy tooth development. 8. Other Relevant Information: • Breed Predisposition: Some breeds are more prone to dental anomalies. • Genetic Counseling: Advisable for breeding animals with known dental defects.

Answer 5

Answer: Pneumonia. A calf with its head held low and extended is a typical posture of a calf with pneumonia. Pneumonia can be viral, bacterial, or multifactorial (as in shipping fever). Otitis media/interna would cause the head to tilt toward the side of the lesion Refs: The Merck Veterinary Manual online edition. Image courtesy, Nottingham Vet School. Link: Enzootic Pneumonia of Calves and Shipping Fever Pneumonia https://www.merckvetmanual.com/respiratory-system/respiratory-diseases-of-cattle/enzootic-pneumonia-of-calves-and-shipping-fever-pneumonia Link: Otitis Media and Interna in Animals https://www.merckvetmanual.com/ear-disorders/otitis-media-and-interna/otitis-media-and-interna-in-animals?autoredirectid=14210&autoredirectid=219

Answer 6

Answer: Beta-1 receptor stimulation, increasing myocardial contractility. A beta-1 agonist, dobutamine increases the strength of myocardial contraction to increase blood pressure. Dobutamine is a very potent inotrope with a short half-life. It must be diluted and administered as an infusion to improve cardiac function in anesthetized and critical care patients. Decreased release of norepinephrine is the mechanism of action of alpha-2 receptor agonists such as xylazine and medetomidine. Muscarinic M2 receptor blockade in the heart inhibits cardiac parasympathetic tone, allowing sympathetic tone to have a greater effect and heart rate increases. See this with anti-cholinergics such as atropine and glycopyrrolate. Antagonism of alpha-1 receptors produces vasodilation and sometimes hypotension. This effect is seen with acepromazine. Refs: Grimm, Tranquilli, and Lamont's Essentials of Anes and Analgesia in SA, 2nd ed. pp. 232-3.484 Plumb's Veterinarv Drup Handbook. 7thed.. nn. 465-7

Answer 7

Answer: Mammary fibroadenoma. Benign mammary tumors (fibroadenomas) are the most common subcutaneous tumors in rats. They can occur in males or females anywhere from the inguinal area to the neck due to rats' extensive mammary tissues. Prognosis is good with surgical removal, but tumors can recur in previously unaffected mammary tissue. Chronic mechanical self-trauma on the cage is associated with alopecia and dermatitis. Chromodacryorrhea (or "red tears") occurs in stressed or diseased rats when the Harderian glands behind the eyes secrete increased porphyrins. Squamous cell carcinoma is uncommon in rats. Ref: Quesenberry, Carpenter. Ferrets, Rabbits and Rodents Clinical Medicine and Surgery, 3rd ed. p. 362. Image courtesy of Youngamerican.

Answer 8

Answer: Strain RB51 Strain RB51 is a live vaccine against B. aborts that is less virulent than other available vaccines in humans and less abortigenic in cattle. It also does not generate antibodies that cause a positive response in typical serological diagnostic tests. Strain 19 is an effective vaccine but is more virulent and results in antibodies that may confuse diagnostic testing. Rev-1 is a live vaccine used to vaccinate small ruminants against B. melitensis. Strain H38 is a killed vaccine against B. melitensis. Strain 104-M is a spontaneously attenuated vaccine against B. abortus that has been used for many years in humans in China. Link: Brucellosis in Cattle https://www.merckvetmanual.com/reproductive-system/brucellosis-in-large-animals/brucellosis-in-cattle Brucellosis in Cattle 1. General Concepts and Diseases: • Brucellosis: Caused by Brucella abortus, leading to abortion, stillbirths, retained placentas, and reduced milk production. 2. Symptoms and Clinical Presentations: • Abortion storms, stillborn or weak calves, retained placenta, decreased milk production, orchitis, epididymitis in bulls, arthritis in chronic cases. 3. Possible Drugs Used: • No practical treatment; focus is on detection and prevention. 4. Infectious Agents: • Bacteria: Brucella abortus. 5. Diagnostic Methods: • Serologic Tests: Serum agglutination, ELISA, complement fixation. • Culture: From placenta, udder secretions, fetal tissues. 6. Treatment Protocols: • No treatment; culling of infected animals, vaccination of young heifers (Strain 19 or RB51). 7. Prevention and Control: • Regular testing, culling of reactors, vaccination, isolation of new animals. 8. Other Relevant Information: • Control relies heavily on biosecurity and management practices to prevent spread.

Answer 9

Answer: Crile forceps. Kelly and Crile forceps are medium-sized hemostats, used to clamp off intermediate-sized blood vessels. Halsted "mosquito" forceps are tiny hemostats used to clamp small bleeding vessels. Adson and Brown-Adson forceps are so-called "thumb forceps" (held in a pencil grip, like chop sticks) used to hold tissue. Allis tissue forceps have teeth on the gripping end, like a horse's teeth, and can cause trauma to delicate tissue. Refs: Bassert and Thomas, McCurnin's Clinical Textbook for Veterinary Technicians, 8th ed. pp. 1139-40 and Tighe and Brown, Mosby's Comprehensive Review for Vet Techs, 2nd ed. pp. 349-53

Answer 10

Answer: Crile forceps. Kelly and Crile forceps are medium-sized hemostats, used to clamp off intermediate-sized blood vessels. Halsted "mosquito" forceps are tiny hemostats used to clamp small bleeding vessels. Adson and Brown-Adson forceps are so-called "thumb forceps" (held in a pencil grip, like chop sticks) used to hold tissue. Allis tissue forceps have teeth on the gripping end, like a horse's teeth, and can cause trauma to delicate tissue. Refs: Bassert and Thomas, McCurnin's Clinical Textbook for Veterinary Technicians, 8th ed. pp. 1139-40 and Tighe and Brown, Mosby's Comprehensive Review for Vet Techs, 2nd ed. pp. 349-53

Answer 11

Answer: This will regress within a year, and symptomatic support is needed for discomfort. Craniomandibular osteopathy (CMO) is seen in young dogs and is exemplified in this radiograph. Terrier breeds predominate, but CMO can be seen in any breed. The disease is usually self-limiting and typically regresses by 1 year old, although not always. It is thought to be a type of hypertrophic osteodystrophy (HOD) and occurs mostly in the mandible but can also affect the tympanic bulla, temporal bones, and temporomandibular joints. Treatment is supportive with nonsteroidal anti-inflammatories to control pain, similar to HOD. Prognosis is highly dependent upon whether the patient is able to open/close the mouth, prehend and chew food, and generally sustain themselves through the course of the disease. Radiographic signs will also regress with time.

Answer 12

Answer:Isoflurane. Isoflurane has the lowest minimum alveolar concentration (MAC) of 1.2 in dogs, 1.63 in cats, and 1.31 in horses. Sevoflurane has an intermediate MAC of 2.1 in dogs, 2.58 in cats, and 2.31 in horses. Desflurane has the highest MAC at 7.2 in dogs, 9.8 in cats, and 7.6 in horses. Propofol and guaifenesin are not inhalant anesthetics. Inhalants with high potency have a lower MAC (need less drug to achieve anesthetic plane). These are also more soluble in blood and tissues; e.g., isoflurane is more soluble, desflurane is less soluble. The requirement (%) for less soluble drugs is greater, but induction is much faster. Anesthesia occurs only when the concentration of inhalant in the blood and alveoli are equal. Less soluble drugs achieve this equilibrium faster. Since there is less drug in the tissues, recovery is also faster compared to more soluble drugs. When the vaporizer is turned off, alveolar levels drop rapidly, followed by blood and tissue levels. Refs: Bassert, Beal and Samples, McCurnin's Clinical Textbook for Veterinary Technicians, 9th ed., p. 1018 and Fossum's Small Animal Surgery, 5th ed., pp. 125-39, and Auer and Stick Equine Surgery, 5th ed., p. 301.

Answer 13

Answer: Supraorbital fossa edema, hypropericardium. Swelling of the supraorbital fossa and hydropericardium would be highly suggestive of the cardiac form of African horse sickness (AHS). Click here to see supraorbital fossa swelling. Additional necropsy findings for the cardiac form might include endocardial and epicardial petechiae and ecchymoses; flaccid or edematous lungs; and yellow, gelatinou: infiltrations of the subcutaneous and intramuscular tissues. AHS is a viral foreign animal disease characterized by acute, subacute, or subclinical pulmonary and/or cardiac clinical signs. The principle vector is Culicoides spp. Refs: Merck Veterinary Manual online edition. Link: African Horse Sickness https://www.merckvetmanual.com/generalized-conditions/african-horse-sickness/african-horse-sickness?autoredirectid=16664

Answer 14

These are normal thoracic radiographs. In barrel-chested dogs, the heart appears to take up more of the thoracic volume than in deep-chested dogs. Click here to see more normal canine thoracic radiographs. https://vetmed.illinois.edu/imaging_anatomy/canine/thorax/ex02/thorax02.html Refs: Thrall, Textbook of Veterinary Diagnostic Radiology 6th ed. pp. 474-88 Radiographic interpretation and images courtesy, Dr. A. Zwingenberger and Veterinary Radiology. Link: Radiography of Animals https://www.merckvetmanual.com/clinical-pathology-and-procedures/diagnostic-imaging/radiography-of-animals?redirectid=4195?ruleredirectid=30&autoredirectid=12769 Link: Normal Thorax http://mirc.veterinaryradiology.net/storage/ss1/docs/20081210114727215/MIRCdocument.xml

Answer 15

Answer: A tubular skin lesion on the dorsal midline of dogs. Dermoid sinuses are congenital neural tube defects most frequently observed in Rhodesian Ridgeback dogs, in which they are believed to be hereditary. The sinus may be a blind-ended sac terminating just beneath the skin, or, in more serious cases, may communicate with the dura mater. Meningitis (and associated neurologic deficits) may occur in cases of infected sinuses communicating with the dura mater. Additional information about the extent of the sinus may be gathered via fistulography and myelography if necessary. Treatment involves complete surgical excision of the sinus tract. Click here to see a good summary on dermoid sinus or pilonidal sinus with images, courtesy of the American College of Veterinary Surgeons (ACVS). https://www.acvs.org/small-animal/dermoid-sinus/

Answer 16

Answer: Trigeminal. The trigeminal nerve has 3 branches: mandibular, maxillary, and ophthalmic. It is sensory to the face and motor to the muscles of mastication. The mandibular branch is motor to the chewing muscles and sensory to the oral cavity floor, the ventral arcade, and the skin of the ventro-lateral head. The ophthalmic and maxillary branches are sensory. (skin of dorso-lateral head; mucous membranes of roof of mouth, the dorsal arcade, and nasal cavity). Also sensory to the eyeball, including the cornea (pain response). Link: The Neurological Examination of Animals https://www.merckvetmanual.com/nervous-system/the-neurologic-examination/the-neurologic-examination-of-animals?mredirectid=1632

Answer 17

Answer: Von Willebrand’s disease. Suspect von Willebrand's disease, in dogs with bleeding disorders, who have a lab pattern of normal platelet counts, and across the board normal coagulation tests (except for BMBT). Von Willebrand's factor is needed for the first step in clot formation. Signs include gingival bleeding, epistaxis, and hematuria. Disease may go undetected in a puppy until an excessive bleeding episode after vaccination injection, venipuncture, or surgery (ie: tail docking, dewclaw removal). Chediak'-Higashi syndrome, caused by a congenital platelet defect, can have this lab pattern, but does not occur in dogs. Associated with dilute hair color-think of smoke- blue Persian cats and beige mice. Pelger-Huet anomaly (scroll down) is a white cell defect. Granulocytes, especially neutrophils are stuck in band form. A CBC shows an apparent left shift with a normal WBC count. Usually an incidental finding because cell function is normal. Ref: Blackwell's 5-Min. Vet Consult Canine-Feline, 4th ed. pp. 1436-67. Link: Von Villebrand Disease in Animals https://www.merckvetmanual.com/circulatory-system/hemostatic-disorders/platelet-disorders-in-animals#v3258487 Link: Chédiak-Higashi Syndrome in Animals https://www.merckvetmanual.com/circulatory-system/hemostatic-disorders/platelet-disorders-in-animals#v3258495 Link: Pelger-Huet anomaly https://www.merckvetmanual.com/circulatory-system/leukocyte-disorders/leukogram-abnormalities-in-animals?autoredirectid=17110#v3258730 https://www.merckvetmanual.com/multimedia/v12762869

Answer 18

Answer: Llamas Llamas and alpacas have fighting teethâ; i.e., the upper 3rd incisor and upper and lower canine teeth, which can grow to over 3 cm in length and cause severe trauma. These are usually ground down or removed upon eruption at 18-24 months. Anesthesia should be used for this procedure as it is quite painful. It must be repeated at intervals as these teeth continue to grow. When only the tips are cut off, this can be done without anesthesia and may be performed by the breeder. When the crown is removed, the root will be exposed. The stub of the crown can be covered with a gingival flap. However, this is not commonly done and complications are rarely seen. The canine teeth can also be completely extracted under general anesthesia. This is a fairly extensive procedure and is not often performed. Canine teeth in females are poorly developed. After castration, the canines of males will stop growing. Herd Health of Llamas and Alpacas 1. General Concepts and Diseases: • Physiological/Anatomical Considerations: Small oral cavity, three-compartment stomach, fighting teeth. • Recommendations: Regular check-ups, proper nutrition, foot care. • Precautions: Manage parasite load, avoid wet environments. • Diseases: • Gastrointestinal: Haemonchus contortus, Fasciola hepatica, Eimeria spp. • Respiratory: Cryptosporidium spp. • Skin: Sarcoptic mange, lice infestation. • Neurological: Meningeal worm. 2. Symptoms and Clinical Presentations: • Gastrointestinal: Diarrhea, weight loss, anorexia. • Respiratory: Severe diarrhea, dehydration in neonates. • Skin: Alopecia, pruritus, scaling. • Neurological: Paralysis, ataxia, head tilt. 3. Possible Drugs Used: • Anthelmintics: Ivermectin, Fenbendazole. • Antiparasitics: Amprolium, Ponazuril. • Vaccines: Clostridial vaccines, rabies, West Nile virus. • Supplements: Selenium for neonates. 4. Infectious Agents: • Bacteria: Clostridium spp. • Viruses: Rabies, West Nile virus. • Parasites: Haemonchus contortus, Fasciola hepatica, Eimeria spp. 5. Diagnostic Methods: • Fecal flotation, PCR assays, serologic tests, imaging (CT, MRI). 6. Treatment Protocols: • Gastrointestinal Infections: Anthelmintics, supportive care. • Respiratory Infections: Fluids, antimicrobials, good nursing care. • Skin Infections: Topical treatments, injectable ivermectin. • Neurological Conditions: Preventative care, symptomatic treatment. 7. Prevention and Control: • Vaccination: Regular immunizations. • Parasite Management: Strategic deworming, pasture management. • Hygiene: Proper sanitation, regular health checks. 8. Other Relevant Information: • Neonatal Care: Early colostrum intake, passive immunity transfer, congenital defect management. • Foot Care: Regular trimming, infection management. • Routine Care: Annual vaccinations, disease surveillance, dental care.

Answer 19

Answer: Llamas Llamas and alpacas have fighting teethâ; i.e., the upper 3rd incisor and upper and lower canine teeth, which can grow to over 3 cm in length and cause severe trauma. These are usually ground down or removed upon eruption at 18-24 months. Anesthesia should be used for this procedure as it is quite painful. It must be repeated at intervals as these teeth continue to grow. When only the tips are cut off, this can be done without anesthesia and may be performed by the breeder. When the crown is removed, the root will be exposed. The stub of the crown can be covered with a gingival flap. However, this is not commonly done and complications are rarely seen. The canine teeth can also be completely extracted under general anesthesia. This is a fairly extensive procedure and is not often performed. Canine teeth in females are poorly developed. After castration, the canines of males will stop growing. Herd Health of Llamas and Alpacas 1. General Concepts and Diseases: • Physiological/Anatomical Considerations: Small oral cavity, three-compartment stomach, fighting teeth. • Recommendations: Regular check-ups, proper nutrition, foot care. • Precautions: Manage parasite load, avoid wet environments. • Diseases: • Gastrointestinal: Haemonchus contortus, Fasciola hepatica, Eimeria spp. • Respiratory: Cryptosporidium spp. • Skin: Sarcoptic mange, lice infestation. • Neurological: Meningeal worm. 2. Symptoms and Clinical Presentations: • Gastrointestinal: Diarrhea, weight loss, anorexia. • Respiratory: Severe diarrhea, dehydration in neonates. • Skin: Alopecia, pruritus, scaling. • Neurological: Paralysis, ataxia, head tilt. 3. Possible Drugs Used: • Anthelmintics: Ivermectin, Fenbendazole. • Antiparasitics: Amprolium, Ponazuril. • Vaccines: Clostridial vaccines, rabies, West Nile virus. • Supplements: Selenium for neonates. 4. Infectious Agents: • Bacteria: Clostridium spp. • Viruses: Rabies, West Nile virus. • Parasites: Haemonchus contortus, Fasciola hepatica, Eimeria spp. 5. Diagnostic Methods: • Fecal flotation, PCR assays, serologic tests, imaging (CT, MRI). 6. Treatment Protocols: • Gastrointestinal Infections: Anthelmintics, supportive care. • Respiratory Infections: Fluids, antimicrobials, good nursing care. • Skin Infections: Topical treatments, injectable ivermectin. • Neurological Conditions: Preventative care, symptomatic treatment. 7. Prevention and Control: • Vaccination: Regular immunizations. • Parasite Management: Strategic deworming, pasture management. • Hygiene: Proper sanitation, regular health checks. 8. Other Relevant Information: • Neonatal Care: Early colostrum intake, passive immunity transfer, congenital defect management. • Foot Care: Regular trimming, infection management. • Routine Care: Annual vaccinations, disease surveillance, dental care.

Answer 20

Answer: Neoplasia. This is a classic image of osteosarcoma, a common, aggressive bone tumor typically found in the appendicular skeleton. Common sites include the distal radius and proximal humerus (away from the elbow), and distal femur and proximal tibia (towards the knee), but these tumors can occur in any bones, including the mandible, maxilla, and vertebrae. Dx: Bone biopsy is typically required to differentiate between infection and neoplasia. Fine needle aspirate cytology may provide an answer in some cases Usually, does not cross the joint (unlike osteomyelitis, which usually does cross joint if bone involved is close to the joint). Look for soft tissue swelling, periosteal proliferation, sunburst periosteal reaction (33%), +/- pathologic fractures. Link: Bone Tumors in Dogs and Cats https://www.merckvetmanual.com/musculoskeletal-system/osteopathies-in-small-animals/bone-tumors-in-dogs-and-cats`\

Answer 21

Answer: Higher milliampere-seconds (mAs) Milliamperes (mA) are the QUANTITY of electrons produced by the X-ray machine and exposure time (sec) is how LONG you expose the animal to these rays. Together, milliampere-seconds equals mA multiplied by time (mA X sec=mAs), which controls the intensity of an x-ray. More mA, or longer exposure time, also means a DARKER x-ray. Kilovoltage (KVp) controls the penetrating ability of an x-ray and affects the contrast (gray scale) of the radiograph. Generally, increasing kVp decreases the radiographic contrast of an x-ray image.

Answer 22

Answer: Doxycycline This is the anemia of Mycoplasma haemofelis (a.k.a. hemotropic mycoplasmosis, feline infectious anemia), Tx with doxycycline (or a fluroquinolone) +/- prednisolone if severe hemolysis. Look for a regenerative anemia, hyperbilirubinemia and cocci/rings on edges of red blood cells on blood smear. Tx: Doxycycline for a minimum of 14 d, but will not completely eliminate infection and treated cats may remain PCR positive without clinical signs. Doxycycline can cause esophagitis/ esophageal stricture in cats, always following pilling with food/ water or use a liquid formulation. Link: Hemotropic Mycoplasma Infections in Animals https://www.merckvetmanual.com/circulatory-system/blood-parasites/hemotropic-mycoplasma-infections-in-animals?autoredirectid=17928

Answer 23

Answer: Lactated Ringer's solution (LRS) is the most appropriate isotonic, balanced crystalloid for volume replacement in most patients. The osmolality and concentration of sodium, chloride, and potassium are similar to plasma. LRS is useful for patients with metabolic acidosis as it has an alkalinizing effect. Normal or 0.9% saline has an acidifying effect and only contains sodium and chloride as electrolytes. It is not commonly used as a replacement or maintenance fluid due to the relatively high sodium concentration and acidifying effects. Link: Crystalloids in Fluid Resuscitation Plan in Animals https://www.merckvetmanual.com/emergency-medicine-and-critical-care/fluid-therapy/the-fluid-resuscitation-plan-in-animals Fluid Resuscitation Plan in Animals 1. Concepts: • Fluid Resuscitation: Restoring blood volume and correcting electrolyte imbalances in animals. • Physiological/Anatomical Considerations: Fluid compartments (intravascular, interstitial, intracellular) and maintaining perfusion. 2. Steps of Resuscitation: • Assess Perfusion Parameters: Heart rate, capillary refill time, mucous membrane color. • Calculate Deficits: Estimate dehydration percentage, calculate fluid deficits. • Fluid Administration: Bolus or continuous rate infusion depending on severity. • Reassessment: Continuous monitoring of clinical parameters. 3. Determining Deficits: • Physical Examination: Skin turgor, mucous membrane moisture, body weight changes. • Laboratory Tests: Packed cell volume (PCV), total protein, serum electrolytes. 4. Selecting Solutions: • Crystalloids: • Isotonic: 0.9% saline, Lactated Ringer’s Solution (LRS) for general fluid replacement. • Hypotonic: 5% dextrose in water (D5W) for free water replacement. • Hypertonic: 7% NaCl for rapid intravascular volume expansion. • Colloids: • Synthetic: Hydroxyethyl starch (HES), Dextrans for maintaining intravascular volume. • Natural: Plasma, albumin for volume expansion and protein replacement. 5. Characteristics of Solutions: • Crystalloids: Rapidly distribute across extracellular space, short-term volume expansion. • Colloids: Stay within intravascular space longer, provide longer-term volume support. 6. Electrolytes: • Sodium (Na+): Essential for osmolality and volume status, monitor to prevent hypernatremia or hyponatremia. • Potassium (K+): Vital for cellular function, supplement cautiously to avoid hyperkalemia. 7. Types of Colloids: • Synthetic Colloids: HES, dextrans used for hypoproteinemia, shock. • Natural Colloids: Plasma, albumin for hypoproteinemia, coagulopathies. 8. Fluid Selection Criteria: • Patient Condition: Dehydration, hypovolemia, shock. • Electrolyte Imbalance: Specific deficits or excesses. 9. Determining End Points: • Clinical Signs: Normalization of heart rate, blood pressure, urine output, mucous membrane color. • Laboratory Values: Normalization of PCV, total protein, serum electrolytes. 10. Calculating Resuscitation: • Dehydration Calculation: Body weight (kg) x % dehydration = liters of deficit. • Shock Doses: Dogs: 90 ml/kg, Cats: 60 ml/kg (initial bolus of 20-30 ml/kg). • Maintenance Fluids: 40-60 ml/kg/day.

Answer 24

Answer: Fleas do not spend their entire life cycle on their hosts. Fleas do not spend their entire life cycle on their hosts. Fleas lay eggs on their hosts, but the eggs fall to the ground where they hatch into larvae. Link: Fleas in Dogs and Cats https://www.merckvetmanual.com/integumentary-system/fleas-and-flea-allergy-dermatitis/fleas-in-dogs-and-cats?autoredirectid=3607

Answer 25

Answer: Calcium channel blocker Diltiazem is a calcium-channel blocker. The effects of calcium-channel blockers depend on the specific drug and include negative chronotropy, negative inotropy, and vasodilation. Diltiazem is used to treat atrial fibrillation, supraventricular tachycardias, and hypertrophic cardiomyopathy. (HCM). Amlodipine is also a calcium-channel blocker that has primary vasodilator effects and is used to treat hypertension. ACE inhibitors (e.g., enalapril) are vasodilators that help increase cardiac output. Beta blockers (e.g., propranolol, atenolol) are used to treat arrhythmias. Positive inotropes increase the cardiac muscular contraction strength by making more intracellular calcium available for muscle proteins. Examples of positive inotropes include: Phosphodiesterase (PDE) inhibitors (pimobendan) Beta-adrenergic agonists (dopamine, dobutamine, isoproterenol and epinephrine) Cardiac glycosides (digoxin) Link: Antiarrhythmics for Use in Animals https://www.merckvetmanual.com/pharmacology/systemic-pharmacotherapeutics-of-the-cardiovascular-system/antiarrhythmics-for-use-in-animals?autoredirectid=21720 Link: Vasoactive Drugs for Use in Animals https://www.merckvetmanual.com/pharmacology/systemic-pharmacotherapeutics-of-the-cardiovascular-system/vasoactive-drugs-for-use-in-animals?autoredirectid=21730 Link: Angiotensin-converting Enzyme Inhibitors for Use in Animals https://www.merckvetmanual.com/pharmacology/systemic-pharmacotherapeutics-of-the-cardiovascular-system/angiotensin-converting-enzyme-inhibitors-for-use-in-animals?autoredirectid=21722 Link: Positive Inotropes for Use in Animals https://www.merckvetmanual.com/pharmacology/systemic-pharmacotherapeutics-of-the-cardiovascular-system/positive-inotropes-for-use-in-animals?autoredirectid=21729 https://www.merckvetmanual.com/pharmacology/systemic-pharmacotherapeutics-of-the-cardiovascular-system/positive-inotropes-for-use-in-animals?autoredirectid=21729&qt=&sc=&alt= https://www.merckvetmanual.com/pharmacology/systemic-pharmacotherapeutics-of-the-cardiovascular-system/positive-inotropes-for-use-in-animals?autoredirectid=21729

Answer 26

Answer: 1125 mEq The addition of 1125 mEq to 10 L (or 112.5 mEq/L) of KCI is the highest safe dose this horse can receive (at 0.5 mEq/kg/hour). Calculation: Maximum rate of KCl you can give the horse is 0.5mEq/kg/hr This horse weighs 450 kg 450 × 0.5 = 225 mEq 225 mEq/hr is the maximum rate of KCI this horse can safely receive If you are making up a 10L bag of saline and running it at 2L/hr, this bag will last 5 hours 225 mEq/hr x 5 hr = 1125mEq

Answer 27

Answer: Anaerobic. Clostridium tetani spores are typically introduced into tissues through wounds and sporulate in necrotic tissue with lower oxidation-reduction potential (anaerobic conditions). Horses are extremely susceptible to the neurotoxin produced by the bacteria, which produces spasmodic, tonic muscular contractions. Spasms of muscles around the head lead to the common name of "lockjaw." Link: Tetanus in Animals. https://www.merckvetmanual.com/generalized-conditions/clostridial-diseases/tetanus-in-animals Tetanus in Animals 1. Definition and Causative Agent: • Tetanus: Caused by the neurotoxin from Clostridium tetani, an anaerobic bacterium found in soil and intestines. Introduced through wounds, particularly deep punctures. 2. Pathophysiology: • Neurotoxin: A zinc-binding protease cleaves synaptobrevin, blocking inhibitory neurotransmitters, leading to spasmodic, tonic muscle contractions and respiratory failure. 3. Clinical Signs: • Incubation: 10-14 days. • Symptoms: Stiffness, muscle spasms, “sawhorse” stance, lockjaw, respiratory distress, increased heart rate, sweating, and opisthotonos in severe cases. 4. Diagnosis: • Based on clinical signs and recent trauma history. • Confirmation: PCR assay, Gram-stain smears, anaerobic culture of wound tissue. 5. Treatment: • Early Intervention: Wound cleaning, tetanus antitoxin, muscle relaxants (e.g., diazepam), antibiotics (penicillin, metronidazole). • Supportive Care: Quiet, dark environment, high feeding/watering devices, slings for support. 6. Medications: • Tetanus Antitoxin: 300,000 IU IV every 12 hours for horses, 1,500–3,000 IU for dogs and cats. • Muscle Relaxants: Chlorpromazine, phenobarbital, diazepam. • Antibiotics: Penicillin, metronidazole. 7. Prevention: • Vaccination: Tetanus toxoid, booster vaccinations, especially for pregnant mares and foals. • Aseptic Techniques: During surgeries and wound care.

Answer 28

Bradycardia and arrhythmias (and cardiac arrest) can occur with too rapid administration of IV calcium. If the heart rate slows down too much and/or arrhythmia develops, discontinue immediately or cardiac arrest could kill the cow. Can also see tachycardia and arrhythmia with calcium overload. Link: Parturient Paresis in Cows https://www.merckvetmanual.com/metabolic-disorders/disorders-of-calcium-metabolism/parturient-paresis-in-cows Parturient Paresis in Cows (Milk Fever) Concepts Parturient paresis, commonly known as milk fever, is an acute hypocalcemic disorder in dairy cows occurring around parturition, leading to flaccid paralysis. Etiology • Hypocalcemia: A significant drop in blood calcium levels, typically below 5.5 mg/dL, due to increased calcium demand for lactation. Symptoms and Pathogenesis • Stage 1: Hyperexcitability, mild ataxia, tremors, ear twitching. • Stage 2: Sternal recumbency, dry muzzle, tachycardia, cold extremities, gastrointestinal stasis, bloat, and head tucked into the flank. • Stage 3: Lateral recumbency, severe flaccidity, unresponsiveness, severe bloat, and possible coma. Diagnostic Methods • Clinical Signs: Observation of symptoms such as recumbency and tremors. • Laboratory Tests: Blood calcium concentration measurements. Treatment • Stage 1: Oral calcium supplements. • Stages 2 and 3: Intravenous calcium gluconate, monitoring for cardiac arrhythmias during administration. Prevention • Dietary Management: Feeding acidogenic diets prepartum to promote calcium mobilization. • Calcium Supplements: Oral or subcutaneous calcium around calving to prevent hypocalcemia.

Answer 29

Answer: Right maxillary quadrant. The right maxillary quadrant is the 100-series, the left maxillary quadrant is the 200- series, the left mandibular quadrant is the 300-series, and the right mandibular quadrant is the 400-series. Click here to see the Triadan numbering system, which is used in veterinary medicine as a universal way to rapidly and consistently identify teeth in all species. Each tooth has a 3-digit number that starts at -01 increases as you move caudally. For example, the first right maxillary incisor is 101 and the left mandibular canine is 304. Here is a nice summary of basic dental topics courtesy of the Royal Veterinary College of London. https://www.rvc.ac.uk/review/dentistry/Shared_Media/pdfs/Basics_print.pdf Refs: Bassert, Beal and Samples, McCurnin's Clinical Textbook for Veterinary Technicians, 9th ed., p. 1219. Link: Modified Triadan System: Tooth Numbering in the Dog https://www.rvc.ac.uk/review/dentistry/basics/triadan/dog.html

Answer 30

Answer: 70-75 days. An experienced practitioner can reliably feel placentomes around 70-75 days. You can reliably feel the "membrane slip" of chorioallantoic membranes rectally at 30-35 days and fremitus (vibration in uterine artery of the gravid uterine horn) between 120- 150 davs. One way to remember these is that the EARLIEST occurs in REVERSE alphabetical order ie: Slip 30-35 days Placentomes 70-75 days Fremitus 120-150 days Ref: Morrow's CurrentTx in Theriogenology 2, pp. 96-97

Answer 31

Answer: Corticosteroid - ALP. Corticosteroid-ALP (C-ALP) is unique to dogs and is induced by endogenous or exogenous corticosteroids. An inducible enzyme, ALP is produced in response to disease or by increased activity of healthy tissue. The other isoforms come from liver (L-ALP), bone (B-ALP), intestine (I- ALP), leukocytes (L-ALP) and placenta (P-ALP). Only the total amount of ALP is reported on routine blood chemistry analysis. The isoforms can be differentiated with electrophoresis. The ratio of the different isoforms present is affected by age (bone isoform in young growing animals), reproductive status (production by the placenta), stress level, liver health (cholestasis), intestinal disease, and therapy (steroids). For more information on ALP isoforms, visit Cornell University's eClinpath website. https://eclinpath.com/chemistry/liver/cholestasis/alkaline-phosphatase/ Refs: | atimer's Dunran and Prasse's Veterinary | ahratnry Medirine 5th ed n 212-7 Link: Clinical Biochemistry https://www.merckvetmanual.com/clinical-pathology-and-procedures/diagnostic-procedures-for-the-private-practice-laboratory/clinical-biochemistry#v3297857

Answer 32

Answer: Bronchial. Feline asthma classically demonstrates a bronchial lung pattern on thoracic radiographs (or bronchointerstitial). https://zukureview.com/sites/default/files/vet/bronchial_lung_pattern_zuku.jpg The hallmark of a bronchial pattern is irregularly thickened walls of bronchi that look like "donuts" end-on or "tram tracks" side-on. For an excellent visual summary of a bronchial pattern, see Dr. Allison Zwingenberger’s Vet Radiology site. http://www.veterinaryradiology.net/373/what-is-a-bronchial-pattern/ The other three basic lung patterns are: Alveolar pattern, characterized by "air bronchograms” https://zukureview.com/sites/default/files/vet/alveolar_lung_pattern_zuku.jpg 2. Interstitial pattern, characterized by decreased visualization of pulmonary vessels, cardiac and diaphragm silhouettes https://zukureview.com/sites/default/files/vet/interstitial_lung_pattern_zuku.jpg 3. Vascular pattern, which can suggest either hypervascularity or hypovascularity https://zukureview.com/sites/default/files/vet/vascular_lung_pattern_zuku.jpg Click here to see enlarged and tortuous pulmonary arteries in the lung fields of a dog with severe heartworm. https://www.merckvetmanual.com/multimedia/v49774429 Refs: Cote, Clinical Veterinary Advisor: Dogs and Cats, 4th ed., pp. 84-6. Link: Kennel Cough https://www.merckvetmanual.com/respiratory-system/respiratory-diseases-of-small-animals/kennel-cough?redirectid=4112?ruleredirectid=30

Answer 33

Answer: Scours. Both molybdenum poisoning and associated copper deficiency cause a gastroenteritis. Look for so-called "peat scours" or "teart" (severe scours with gas bubbles). Additional possible clinical signs include unthriftiness, emaciation, coat depigmentation, pica, a microcytic hypochromic anemia, joint pain/lameness, and bone fractures (osteoporosis). Ref: Osweiler's NVMS Toxicology pp. 185-86, 199-200. Link: Molybdenum Toxicity in Animals https://www.merckvetmanual.com/toxicology/molybdenum-toxicity/molybdenum-toxicity-in-animals/?autoredirectid=1529&autoredirectid=14447

Answer 34

Answer: Increase analgesia with dose of hydromorphone IV. Increase the analgesia: The cat is experiencing a sympathetic response to pain from surgical stimulation. Response during OHE is common at the skin incision, and with tension on the ovarian ligaments or uterus. Surgical stimulation raises sympathetic tone, which increases heart rate (HR), blood pressure (BP), and respiratory rate (R). This is known as nociception since the animal unconscious and therefore cannot "feel" pain. Increases in HR, RR, or BP do not necessarily mean.the patient feels pain as awareness is lost before the autonomic response to surgery. The sympathetic responses may be blunted by increasing the concentration of inhalant however, this does not address the underlying cause which is sympathetic response to pain. Refs: Bassert, Beal and Samples, McCurnin's Clinical Textbook for Veterinary Technicians, 9th ed., pp. 1035-9 and table 31.3, Thomas & Lerche Vet Anes and Analgesia for Vet Techs, 4thed. pp. 142-3, 177. Link: The Cardiovascular System in Animals. https://www.merckvetmanual.com/circulatory-system/cardiovascular-system-introduction/the-cardiovascular-system-in-animals#v4499086 Key Information on the Cardiovascular System in Animals Anatomy and Function • Heart Structure: Four chambers - right atrium, right ventricle, left atrium, left ventricle. • Valves: Tricuspid, pulmonary, mitral, and aortic valves ensure unidirectional blood flow. Electrical Conduction System • SA Node: Pacemaker of the heart, initiates the heartbeat. • Pathway: SA node → AV node → bundle of His → Purkinje fibers. • ECG: Records electrical activity; P wave (atrial depolarization), QRS complex (ventricular depolarization), T wave (ventricular repolarization). Cardiac Cycle • Systole: Ventricular contraction, blood ejected into arteries. • Diastole: Ventricular relaxation, chambers fill with blood. Hemodynamics • Preload: Volume of blood in ventricles at end of diastole. • Afterload: Resistance ventricles must overcome to eject blood. • Contractility: Force of ventricular contraction. Regulation of Heart Rate • Sympathetic Stimulation: Increases heart rate and force of contraction. • Parasympathetic Stimulation: Decreases heart rate. Common Conditions • Congestive Heart Failure: Inefficient pumping, fluid accumulation. • Arrhythmias: Irregular heart rhythms due to conduction disturbances.

Answer 35

Answer: Cows lack an accessory ligament of the femur. A horse cannot kick sideways as powerfully as a cow, because horses have an accessory ligament of the hip and femoral head, (unique to horses) and a deep acetabulum. The accessory ligament connects the prepubic ligament (base of pelvis) to the fovea capiitis on the head of the femur, essentially stabilizing the hip. The stabilizing influence of the accessory ligament is what prevents horses from kicking out to the side to the same degree that cows do. Because of the accessory ligament, coxofemoral luxation is rare in horses compared to cattle and small animals. Coxofemoral luxation in cattle may occur when bulls mount cows or cows mount each other on slippery flooring. Hip luxation in dogs and cats is usually secondary to trauma, like being hit by a car. Click here to see a radiograph of hip dislocation. https://www.merckvetmanual.com/multimedia/v50504534 Refs:Pasquinis, Jahn & Bahr, Guide to Eq Clin: LAMENESS vol. Il, p. 290 and Pasquini and Spurgeon's Anatomy Dom An 11th ed. pp. 118-19. Link: Disorders of the Hip in Horses. https://www.merckvetmanual.com/musculoskeletal-system/lameness-in-horses/disorders-of-the-hip-in-horses Link: Coxofemoral Luxation in Cattle. https://www.merckvetmanual.com/musculoskeletal-system/lameness-in-cattle/coxofemoral-luxation-in-cattle

Answer 36

Answer: Unwashed skin on the surgical team EXOgenous sources of contamination (from outside the patient) include air, surgical team, instruments, or supplies. For example, if you are not wearing a surgical mask while assisting on a spay surgery and you sneeze into the incision, you just contaminated EXOGENOUSLY. Endogenous contamination (from inside the patient) enters through the blood stream. Dermatitis, gingivitis, and bowel contents could be sources of self-contamination from endogenous microorganism. (Remember endo="IN" and Exo="OUT")

Answer 37

Answer: Arsenic. When you hear arsenic, think severe Gl signs, including a hemorrhagic diarrhea. Cattle are exposed to arsenic by pesticide-contaminated foliage. Pets find arsenic in ant baits and in pressure-treated wood (like on backyard decks) or wood preservative. Urea toxicity causes wildly aberrant behavior ("bovine bonkers"), tremors, acute death.Tx, if time, with VINEGAR. Lead toxicity causes more CNS signs (encephalopathy, blind), but can see diarrhea or constipation. Cantharidin toxicity from blister beetles, is basically a horse disease. Potent irritant: see colic, renal disease, hematuria, peracute death. Follow this link to see a Merck image of hemorrhagic gastritis. Follow this link to see a Merck image of hemorrhagic cystitis. Chlorinated hydrocarbons (insecticides like lindane, methoxychlor) - look for CNS depression or stimulation (convulsive seizures). Refs: Smith, Van Metre, and Pusterla's Large Animal Internal Medicine, 6th ed., pp. 1794- Link: Inorganic Arsenical Toxicosis in Animals https://www.merckvetmanual.com/toxicology/arsenic-poisoning/inorganic-arsenical-toxicosis-in-animals?autoredirectid=16902 Link: Nonprotein Nitrogen Poisoning in Animals https://www.merckvetmanual.com/toxicology/nonprotein-nitrogen-poisoning/nonprotein-nitrogen-poisoning-in-animals?autoredirectid=14439 Link: Lead Poisoning in Animals https://www.merckvetmanual.com/toxicology/lead-poisoning/lead-poisoning-in-animals Link: Cantharidin Toxicosis in Animals https://www.merckvetmanual.com/toxicology/cantharidin-toxicosis/cantharidin-toxicosis-in-animals?autoredirectid=17116 Link: Overview of Insecticide and Acaricide (Organic) Toxicosis in Animals https://www.merckvetmanual.com/toxicology/insecticide-and-acaricide-organic-toxicity/overview-of-insecticide-and-acaricide-organic-toxicosis-in-animals?redirectid=4486?ruleredirectid=30

Answer 38

Answer: Heartbeats per minute vs palpable arterial waves per minute. Heartbeats per minute (heart rate) vs. palpable arterial waves per minute (pulse rate). Although the terms are frequently used interchangeably, they describe slightly different processes. Heart rate is the number of beats of a heart per minute, while pulse rate is the number of palpable or visible arterial waves per minute. The counts of each will usually be identical, but illness, high blood pressure and other conditions can make these differ. Click here for a chart of resting heart rates of common domestic animals. Refs: Bassert, Beal and Samples, McCurnin's Clinical Textbook for Veterinary Technicians, 9th ed. p. 214. Link: Resting Heart Rates https://www.merckvetmanual.com/special-subjects/reference-guides/resting-heart-rates

Answer 39

Answer: Behavioral estrus begins, full cornification. In the canine estrous cycle, the luteinizing hormone (LH) surge peaks at behavioral estrus (acceptance of the male) and on the same day or 2 days after full cornification as seen on vaginal cytology. Ovulation typically occurs 2 days after the LH surge. In proestrus, estrogen levels have risen to a peak just prior to the LH surge, then they drop back to baseline by the end of estrus. Rising serum progesterone can predict the H surge and help estimate ovulation. Progesterone levels are at baseline in proestrus, but start to rise at the time of the LH surge to a peak 25 days after ovulation. Refs: Current Therapy in Therio 2, Morrow pp. 460-5 and Blackwell's 5-Minute Vet Consult Canine Feline, 4th ed. pp. 180-1. Link: Breeding Management of Dogs and Cats https://www.merckvetmanual.com/management-and-nutrition/management-of-reproduction-dogs-and-cats/breeding-management-of-dogs-and-cats?redirectid=30630

Answer 40

Answer: 2-0 non absorbable, monofilament (Fluorofil). 2-0 Fluorfil is a nonabsorbable monofilament suture (other good options would be Ethilon, Prolene) and would be perfect to close equine skin; sutures should be removed in about 14 days. Monofilament is ideal for skin wounds as it is less likely to wick bacteria and lead to wound infection. Typically use nonabsorbable suture for skin wounds, as absorbable suture must be in contact with body fluids to be absorbed and a horizontal mattress pattern is not a buried subcuticular pattern. Supramid is a nonabsorbable multifilament and #3 is much too large (for example, use #2 to close equine linea alba). Vicryl is an absorbable multifilament and 5-0 is much too small (for example, may use that for equine cornea). Catgut is absorbable multifilament and is not often used in equine practice. Dexon is an absorbable multifilament and #1 is much too large for a simple skin wound. Check out this nice summary on types of suture, courtesy of vetsurgeryonline as well as this great review of selecting suture type, courtesy of the University of Saskatchewan. https://www.vetsurgeryonline.com/suture-materials/ https://wcvm.usask.ca/vsac205/Lab4/selection.php#Monofilamentormultifilamentmaterial Refs: Fossum's Small Animal Surgery, 5th ed., pp. 60-66.

Answer 41

Answer: Pergolide. Definitive treatment is daily oral pergolide, a dopamine agonist. Cushing's disease in horses is caused by pituitary pars intermedia dysfunction secondary to loss of dopaminergic inhibition. Excess ACTH produced by the hyperplastic pituitary causes the adrenal glands to produce excess steroids. The hyperplastic pituitary produces other hormones in addition to ACTH that lead to the clinical syndrome. Mitotane is used to treat hyperadrenocorticism in dogs. Methimazole is a treatment for hyperthyroidism in cats. Fludrocortisone and prednisone are steroids used to treat hypoadrenocorticism in dogs. Refs: Bassert and Thomas, McCurnin's Clinical Textbook for Veterinary Technicians, 8th edition, pp. 1371-2. Link: Hypertrichosis Associated with Adenomas of the Pars Intermedia https://www.merckvetmanual.com/endocrine-system/the-pituitary-gland/hypertrichosis-associated-with-adenomas-of-the-pars-intermedia?autoredirectid=11890

Answer 42

Answer: Sedation. Sedation. Amitraz is used to treat generalized demodicosis as a dip. The most common side effect to watch out for with amitraz is SEDATION, seen in 30% of patients within 12-36 hours after treatment. Atipamezole or yohimbine have been used as reversal agents for amitraz and xylazine. Refs: Papich, Saunders Handbook of Vet Drugs, 4th ed., Amitraz and Blackwell's 5 Minute Vet Consult Canine Feline, 4th ed. pp. 342-43. Link: Mange in Dogs and Cats https://www.merckvetmanual.com/integumentary-system/mange/mange-in-dogs-and-cats#v3279943

Answer 43

Answer: Sedation. Sedation. Amitraz is used to treat generalized demodicosis as a dip. The most common side effect to watch out for with amitraz is SEDATION, seen in 30% of patients within 12-36 hours after treatment. Atipamezole or yohimbine have been used as reversal agents for amitraz and xylazine. Refs: Papich, Saunders Handbook of Vet Drugs, 4th ed., Amitraz and Blackwell's 5 Minute Vet Consult Canine Feline, 4th ed. pp. 342-43. Link: Mange in Dogs and Cats https://www.merckvetmanual.com/integumentary-system/mange/mange-in-dogs-and-cats#v3279943

Answer 44

Answer: Enamel hypoplasia. Distemper causes enamel hypoplasia in permanent teeth if the dog is infected between two weeks and three months of age. Because distemper is a systemic disease, the entire dentition is affected. If infected between late-stage gestation and two weeks postpartum, only the deciduous teeth are affected. Dr. Brett Beckman discusses dental enamel defects in dogs. Refs: Cote, Clinical Veterinary Advisor: Dogs and Cats, 4th ed., pp. 271-3 Link: Dental enamel defect in dogs https://www.dvm360.com/view/dental-enamel-defects-dogs Dental Enamel Defects in Dogs 1. Definitions and Causes: • Dental Enamel Defects: Abnormalities in the development of enamel, leading to hypocalcification or hypoplasia. • Causative Agents: Trauma, nutritional deficiencies, infections (e.g., distemper virus), febrile events during enamel formation (2 weeks to 3 months of age). 2. Physiopathology: • Hypocalcification: Poor mineralization, resulting in soft enamel. • Hypoplasia: Thin enamel, often pitted. 3. Symptoms and Clinical Changes: • Brown-to-tan discoloration, dentin exposure, pulpitis, sensitivity, root abnormalities. 4. Diagnosis: • Clinical Examination: Visual inspection, dental radiography to assess root viability. 5. Treatment: • Medications: Not directly applicable; focus on dental procedures. • Procedures: Ultrasonic scaling, polishing, bonding, restoration, extraction in severe cases. • Prosthetics: Crown placement in severe defects. 6. Prevention and Management: • Regular Dental Care: Home care, periodic cleanings. • Follow-up: Radiographic evaluation every 6-18 months.

Answer 45

Answer: Less than 5% Many cows have titers to bovine leukosis virus (BLV) but less than 5% develop lymphosarcoma. Lymphosarcoma is most common in cows 2-6 years old. Tumors can occur in the lymph nodes and tissue almost anywhere in the body. Clinical signs are dependent on tumor location. There is no treatment. Risk is minimized by preventing the transfer of blood (and therefore infected lymphocytes) between cows. Refs: Bassert and Thomas, McCurnin's Clinical Textbook for Veterinary Technicians, gh edition, pp. 703. Link: Overview of Bovine Leukosis https://www.merckvetmanual.com/generalized-conditions/bovine-leukosis/overview-of-bovine-leukosis Bovine Leukosis: Comprehensive Information for BCSE Test Definition • Bovine Leukosis (Bovine Lymphosarcoma): A cancerous disease caused by Bovine Leukemia Virus (BLV), an oncogenic retrovirus. Etiology and Transmission • Causative Agent: Bovine Leukemia Virus (BLV), a C-type oncogenic retrovirus. • Transmission: Primarily horizontal through blood transfer (e.g., contaminated needles, dehorning tools), and rarely vertical (transplacental or via colostrum). Epidemiology • Prevalence: High in US dairy herds (~46.5%) and lower in beef herds (~10.3%). Pathogenesis • Infection Outcomes: • Asymptomatic: Most animals show no signs. • Persistent Lymphocytosis: ~29% develop this benign condition. • Lymphosarcoma: <5% develop cancerous tumors. Clinical Findings • Juvenile Lymphosarcoma: Weight loss, fever, dyspnea, bloat, and posterior paresis. • Thymic Lymphosarcoma: Cervical swelling, dyspnea, bloat, jugular distention, tachycardia. • Cutaneous Lymphosarcoma: Cutaneous plaques, enlarged lymph nodes. Diagnosis • Serology: ELISA and PCR for BLV detection. • Cytology/Histology: Biopsy for diagnosing lymphosarcoma. Treatment and Control • No Treatment: No effective treatment; symptomatic care with corticosteroids. • Control Measures: Testing and culling infected animals, disinfection of equipment, using single-use needles. Prevention • Blood Precautions: Avoiding exposure to blood from infected animals. • Colostrum Management: Using colostrum from seronegative cows. • Farm Practices: Cleaning equipment and facilities, controlling flies. Zoonotic Risk • Human Risk: Potential, but not well-established, zoonotic risk through ingestion of unpasteurized dairy products.

Answer 46

Answer: Ice packs, alcohol baths. Appropriate Tx for porcine stress syndrome (PSS) includes using ice packs and alcohol baths to decrease body temperature, stopping halothane anesthesia, and administering dantrolene (a ryanodine receptor antagonist) and lidocaine (for cardiac arrhythmias). Calcium and potassium chloride are contraindicated. PSS (also called malignant hyperthermia, MH) occurs in pigs with a mutant autosomal dominant gene. Pigs with PSS cannot handle stress, such as heat, exercise, or overcrowding, and can die while under halothane anesthesia. Also reported in dogs, cats, and horses. In PSS/MH, a mutation in the ryanodine receptors on the sarcoplasmic reticulum in skeletal muscles affects the calcium release channels, resulting in significant calcium release into the myofibrils. See generalized, extensive skeletal muscle contraction (clinically = muscle rigidity or fasciculations) along with hyperthermia, tachypnea, tachycardia, arrhythmias, metabolic acidosis, and death. Refs: Bassert, Beal and Samples, McCurnin's Clinical Textbook for Veterinary Technicians, gthed. p. 715. Link: Malignant Hyperthermia in Animals (Porcine Stress Syndrome, Canine Stress Syndrome) https://www.merckvetmanual.com/metabolic-disorders/malignant-hyperthermia/malignant-hyperthermia-in-animals?autoredirectid=14270

Answer 47

Answer: Pedal and swallowing. Loss of both the pedal reflex, tested by pinching the toes and looking for withdrawal of the limb, and the swallowing reflex indicate readiness for intubation. Palpebral and corneal reflexes can be used to assess depth of anesthesia, but may still be present during intubation. A stretch reflex is contraction of a muscle in response to a lengthening stretch; the Golgi tendon reflex is the opposite reaction. Triceps and crossed extensor reflexes are mechanically tested with a reflex hammer. Ref: Bassert, Beal and Samples, McCurnin's Clinical Textbook for Veterinary Technicians, gth ed. p. 1030.

Answer 48

Answer: Facial Nerve. Think of facial nerve paralysis (CN 7) with a unilaterally droopy face. Remember the facial nerve is motor to the muscles of facial expression (explaining the right side drooped ear, lip and eyelid) and innervates the lacrimal and salivary glands. Loss of innervation can lead to a dry eye, and possibly to exposure keratitis if animal loses ability to close eyelid from damage to facial nerve innervation of the orbicularis oculi muscle. Idiopathic in 75% of canine cases (25% of cats). Can also see these signs with middle ear damage (from otitis media), from facial nerve trauma (ear surgery in dogs, or pressure from halter buckles in anesthetized horse), or neoplasia. Think more of a dropped jaw with trigeminal nerve neuropathy (CN 5-dogs, horses). Refs: Pasquini & Spurgeon's Anatomy Dom An 11th ed. pp., 552-4, 579 and Pasquini’s, Tschauner's Guide to Sm An Clin, vol 1, 2nd ed. p. 563. Link: Facial Paralysis in Animals. https://www.merckvetmanual.com/nervous-system/facial-paralysis/facial-paralysis-in-animals?autoredirectid=14324 Link: Physical and Neurologic Examinations. https://www.merckvetmanual.com/nervous-system/nervous-system-introduction/physical-and-neurologic-examinations Link: Otitis Media and Interna in Animals. https://www.merckvetmanual.com/ear-disorders/otitis-media-and-interna/otitis-media-and-interna-in-animals?redirectid=31733

Answer 49

Answer: Zinc Think of zinc (Zn) toxicosis following ingestion of U.S. pennies minted since 1982, which are composed of 97.5% Zn by weight. Other sources of Zn include batteries, car parts, paint, zinc-oxide sunscreen creams, zippers, board-game pieces, screws and nuts on pet carriers, and the coating on galvanized metals. Copper toxicity is typically associated with copper-containing drenches for sheep, or improperly formulated rations. Molybdenum poisoning is an uncommon problem of cattle. Iron poisoning is a sporadic problem of newborn piglets overdosed by iron injection. https://www.merckvetmanual.com/toxicology/zinc-toxicosis/zinc-toxicosis-in-animals?autoredirectid=14448 Zinc Toxicosis in Animals Definitions and Causative Agents: • Zinc Toxicosis: Toxic condition from ingestion of zinc-containing objects (e.g., US pennies, galvanized metals). • Sources: Contaminated pastures, dietary supplements, zinc ointments, automotive parts. Pathophysiology: • Zinc ingestion leads to the formation of caustic zinc salts in the stomach, causing GI irritation, systemic absorption, and accumulation in the liver, kidneys, pancreas, and spleen, resulting in hemolysis, organ damage, and DIC. Symptoms and Clinical Changes: • Dogs/Cats: Vomiting, diarrhea, anorexia, lethargy, hemolysis, anemia, tachycardia, icterus, hemoglobinuria, acute kidney/liver failure, pancreatitis. • Birds: Respiratory distress, anorexia, ataxia, polyuria, liver/kidney damage. • Ruminants: Weight loss, diarrhea, decreased milk production, polyuria, hepatic/pancreatic degeneration. Diagnosis: • History of Exposure: Presence of zinc-containing objects. • Laboratory Testing: CBC showing hemolysis, serum chemistry, urinalysis, radiographs, serum zinc concentration. Treatment: • Removal of Zinc Source: Surgical or endoscopic removal. • Supportive Care: IV fluids, blood transfusion, proton pump inhibitors, sucralfate for GI bleeding. • Chelation Therapy: Controversial, using Ca-EDTA if required. Prevention: • Environmental Management: Avoid zinc contamination in pastures, monitor dietary supplements.

Answer 50

Answer: Macrocytosis An increased mean corpuscular volume (MCV) means that red blood cell (RBC) size/volume is increased, which is seen as macrocytosis on a blood smear. Macrocytosis can be seen with a regenerative anemia because immature RBCs are larger than mature RBCs. Also look for polychromasia (different RBC color/staining) because immature RBC contain less hemoglobin and stain a bluish color. Note: all polychromatophils are macrocytes, but not all macrocytes are polychromatophils, and there are conditions that cause macrocytosis without polychromasia. MCV is an RBC parameter and is not influenced by white blood cell or platelet count. Spherocytosis is a change in red blood cell appearance due to immune-mediated targeting and in most cases is pathognomonic for immune-mediated hemolytic anemia (IMHA). https://www.merckvetmanual.com/clinical-pathology-and-procedures/diagnostic-procedures-for-the-private-practice-laboratory/clinical-hematology

Answer 51

Answer: Zinc Think of zinc (Zn) toxicosis following ingestion of U.S. pennies minted since 1982, which are composed of 97.5% Zn by weight.Other sources of Zn include batteries, car parts, paint, zinc-oxide sunscreen creams, zippers, board-game pieces, screws and nuts on pet carriers, and the coating on galvanized metals. Copper toxicity is typically associated with copper-containing drenches for sheep, or improperly formulated rations. Molybdenum poisoning is an uncommon problem of cattle. Iron poisoning is a sporadic problem of newborn piglets overdosed by iron injection. https://www.merckvetmanual.com/toxicology/zinc-toxicosis/zinc-toxicosis-in-animals?autoredirectid=14448 https://www.merckvetmanual.com/toxicology/copper-poisoning/copper-poisoning-in-animals?autoredirectid=14443 Zinc Toxicosis in Animals Definitions and Causative Agents: • Zinc Toxicosis: Toxic condition from ingestion of zinc-containing objects (e.g., US pennies, galvanized metals). • Sources: Contaminated pastures, dietary supplements, zinc ointments, automotive parts. Pathophysiology: • Zinc ingestion leads to the formation of caustic zinc salts in the stomach, causing GI irritation, systemic absorption, and accumulation in the liver, kidneys, pancreas, and spleen, resulting in hemolysis, organ damage, and DIC. Symptoms and Clinical Changes: • Dogs/Cats: Vomiting, diarrhea, anorexia, lethargy, hemolysis, anemia, tachycardia, icterus, hemoglobinuria, acute kidney/liver failure, pancreatitis. • Birds: Respiratory distress, anorexia, ataxia, polyuria, liver/kidney damage. • Ruminants: Weight loss, diarrhea, decreased milk production, polyuria, hepatic/pancreatic degeneration. Diagnosis: • History of Exposure: Presence of zinc-containing objects. • Laboratory Testing: CBC showing hemolysis, serum chemistry, urinalysis, radiographs, serum zinc concentration. Treatment: • Removal of Zinc Source: Surgical or endoscopic removal. • Supportive Care: IV fluids, blood transfusion, proton pump inhibitors, sucralfate for GI bleeding. • Chelation Therapy: Controversial, using Ca-EDTA if required. Prevention: • Environmental Management: Avoid zinc contamination in pastures, monitor dietary supplements.

Answer 52

Answer: Macrocytosis An increased mean corpuscular volume (MCV) means that red blood cell (RBC) size/volume is increased, which is seen as macrocytosis on a blood smear. Macrocytosis can be seen with a regenerative anemia because immature RBCs are larger than mature RBCs. Also look for polychromasia (different RBC color/staining) because immature RBC contain less hemoglobin and stain a bluish color. Note: all polychromatophils are macrocytes, but not all macrocytes are polychromatophils, and there are conditions that cause macrocytosis without polychromasia. MCV is an RBC parameter and is not influenced by white blood cell or platelet count. Spherocytosis is a change in red blood cell appearance due to immune-mediated targeting and in most cases is pathognomonic for immune-mediated hemolytic anemia (IMHA). https://www.merckvetmanual.com/clinical-pathology-and-procedures/diagnostic-procedures-for-the-private-practice-laboratory/clinical-hematology https://www.merckvetmanual.com/circulatory-system/anemia/hemolytic-anemia-in-animals https://www.merckvetmanual.com/circulatory-system/anemia/anemia-in-animals Summary of Mean Corpuscular Volume (MCV) for BCSE Test Preparation Definition • Mean Corpuscular Volume (MCV): Measures the average volume of red blood cells (RBCs). Calculation • Derived from the packed cell volume (PCV) and RBC count. Clinical Significance • High MCV (Macrocytic): Indicates larger than normal RBCs, associated with regenerative anemia, vitamin B12, or folic acid deficiency. • Low MCV (Microcytic): Indicates smaller than normal RBCs, often seen in iron deficiency anemia or chronic diseases. Artifacts Affecting MCV • Sample age, lipemia, hemolysis, underfilling tubes, and autoagglutination.

Answer 53

Answer: Supplement dietary Zinc Supplement these pigs with zinc to resolve clinical signs. Zinc deficiency causes parakeratosis. Starter diets should contain 125 ppm zinc (and 0.9% calcium). Grower diets should contain 75 ppm zinc (and 0.60-0.65% calcium). Finisher diets should contain 50 ppm zinc (and 0.45 to 0.50% calcium). Parakeratosis may resemble exudative epidermitis ("greasy pig disease"), caused by Staphylococcus hyicus. Exudative epidermitis is more typically seen in younger piglets (one to ten weeks old) and is treated with antimicrobials. Sarcoptic mange (Sarcoptes scabiei var suis) is typically pruritic and treated with antiparasitics like ivermectin or pigs may be sprayed with lindane (0.05-0.1%) or malathion (0.05%). https://www.merckvetmanual.com/integumentary-system/parakeratosis/parakeratosis-in-pigs?autoredirectid=16692 https://www.merckvetmanual.com/integumentary-system/exudative-epidermitis/exudative-epidermitis-in-pigs?mredirectid=836 https://www.merckvetmanual.com/integumentary-system/mange/mange-in-pigs Parakeratosis in Pigs Definitions and Causes: • Parakeratosis: Nutritional deficiency disease in pigs, characterized by superficial epidermal lesions. • Causative Agents: Zinc deficiency or poor absorption due to excess calcium, phytates, or other chelating agents in the diet. Rapid growth and malabsorption due to gastrointestinal disease are predisposing factors. Physiopathology: • Zinc is crucial for proper keratinization. Deficiency leads to abnormal keratinization and epidermal lesions. Symptoms and Clinical Changes: • Lesions: Symmetrical, excessive keratinization, horny scales, fissures. Lesions start as brown spots or papules on the ventral abdomen, inner thighs, and legs. • Additional Signs: Mild lethargy, anorexia, delayed growth. Rarely pruritus. Diagnosis: • Clinical Signs: Visible skin lesions. • Laboratory Tests: Low serum zinc, decreased alkaline phosphatase activity. • Differential Diagnoses: Sarcoptic mange, B vitamin deficiency, iodine deficiency. Treatment and Medications: • Dietary Adjustment: Increase zinc intake, reduce calcium levels. • Nursery pig diets: 0.8%-0.85% calcium, 100 mg/kg zinc. • Grower diets: 0.6%-0.65% calcium, 60 ppm zinc. • Finisher diets: 0.45%-0.5% calcium, 50 ppm zinc. • Sow/boar diets: 0.9% calcium, 150 ppm zinc. Prognosis: • Rapid recovery with dietary correction.

Answer 54

Answer: Gasterophilus spp These are the eggs from botflies (Gasterophilus spp.). The fly lays eggs on the hairs of the horses forelimbs or shoulders and are stimulated to hatch by the horse licking. The larvae (bots) become embedded in the horse's mouth for a month then pass to the stomach. The bots can be asymptomatic or cause a mild gastritis. Harvest mites (trombiculidiasis), or chiggers, cause pruritus, papules, and wheals. Pruritus can be treated with glucocorticoids, and repellents may also be useful. https://www.merckvetmanual.com/digestive-system/gastrointestinal-parasites-of-horses/gasterophilus-spp-infection-in-horses?redirectid=27858 https://www.merckvetmanual.com/integumentary-system/mange/mange-in-horses

Answer 55

Answer: Excessive utilizable protein The milk urea nitrogen is a measure of nitrogen metabolism (protein) in the dairy cow. The normal value is about 14 mg/dl. Samples from at least 8 cows are measured and the values are averaged to reflect a mean. Significant increases indicate that an excessive amount of rumen utilizable protein is being fed. Substantial excess of protein (more than 19%) in the ration may prolong days open and service per conception after parturation. Milk urea nitrogen levels could also rise if the amount of fermentable carbohydrate becomes sub-optimal, because energy is required to determinate the normal amount of amino acids in the liver and excrete the products in the kidney. Thus, if the diet has insufficient carbohydrate or excess fiber, the milk urea nitrogen could also increase. Do not confuse excess protein in a ration with non-protein nitrogen poisoning, an acute, convulsive, rapidly fatal toxicity typically due to excess urea or other NON-protein nitrogen sources. https://www.merckvetmanual.com/management-and-nutrition/nutrition-dairy-cattle/nutritional-requirements-of-dairy-cattle

Answer 56

Answer: Mare is pregnant The mare is pregnant - this ultrasound image shows a 25-day-old conceptus. The yolk sac (dorsal) and allantoic cavity (ventral) are nearly the same size, divided by the embryo. The heart beat is visible beginning at day 25 (and was visible here on video). A 2-week pregnancy is imaged as a small, round, anechoic structure with bright hyperechoic dashes on the dorsal and ventral aspect of the yolk sac (called "specular reflectors"), located within the lumen of the uterus. This image is not consistent with uterine trauma, endometritis, or a twin pregnancy. https://www.merckvetmanual.com/management-and-nutrition/management-of-reproduction-horses/pregnancy-determination-in-horses

Answer 57

Answer: Waxing These are the waxing teats of a mare about to foal in 6 to 48 hours. "Waxing" happens in about 95% of mares before foaling. This can fall off or get knocked off so it's possible to miss seeing it. In the final two to three days of pregnancy, the teats of most mares distend with colostrum. Colostrum drips and dries on the nipples to make a waxy coating at each teat orifice. In approximately 85% of bitches the body temperature drops to 99ºF (37.2°C) about 24 hrs before the onset of stage Il labor. Take a bitch's temperature at a consistent time each day for this to be a reliable indicator. Will see relaxation of the pelvic ligaments associated with impending parturition in mares and cows - this gives the newborn more space to pass through the pelvic canal. Most mammals (including sows) become restless and show signs of nesting. Often the respiratory rate increases. Queens will often experience a decrease in appetite prior to parturition. https://www.merckvetmanual.com/management-and-nutrition/management-of-reproduction-horses/parturition-in-horses https://www.merckvetmanual.com/management-and-nutrition/management-of-reproduction-dogs-and-cats/whelping-and-queening-in-dogs-and-cats https://www.merckvetmanual.com/management-and-nutrition/management-of-reproduction-dogs-and-cats/labor-and-delivery-in-dogs-and-cats

Answer 58

Answer: Infectious bursal disease Infectious bursal disease (IBD) is caused by a birnavirus. Click here to see an enlarged, balloon-like hemorrhagic bursa of Fabricius, characteristic of IBD. IBD is shed in feces and transferred barn to barn via fomites. Very stable. Difficult to eradicate from premises. Signs include clinical picture given above in older birds, or MORE IMPORTANT subclinical form in young birds, which causes immunosuppression via destruction of immature lymphocytes in bursa, thymus, spleen. Immunosuppressed birds do not respond well to vaccination and are predisposed to infections with normally nonpathogenic viruses and bacteria. Common diseases usually exacerbated by IBDV infections. See large economic losses. Ref: The Merck Veterinary Manual online edition. Link: Infectious Bursal Disease in Poultry https://www.merckvetmanual.com/poultry/infectious-bursal-disease/infectious-bursal-disease-in-poultry Infectious Bursal Disease (IBD) in Poultry Definition: • IBD: A viral disease affecting young chickens, also known as Gumboro disease. Causative Agent: • Infectious Bursal Disease Virus (IBDV): Double-stranded RNA virus, Avibirnavirus genus, family Birnaviridae. Symptoms: • Clinical Signs: Listlessness, watery diarrhea, ruffled feathers, dehydration, severe prostration, incoordination, soiled vent feathers, vent picking, inflammation of the cloaca. • Lesions: Enlarged, edematous cloacal bursa with possible hemorrhages. Diagnosis: • Observation: Gross and microscopic lesions in cloacal bursa. • Molecular Testing: RT-PCR for viral RNA, virus isolation. Treatment and Control: • No Treatment: Focus on control through rigorous disinfection and vaccination. • Vaccination: Live attenuated and vectored vaccines for active immunity, vaccination of breeder flocks to induce maternal immunity in chicks. Important Points: • IBDV causes immunosuppression by targeting immature B lymphocytes. • High morbidity, variable mortality depending on strain and breed.

Answer 59

Answer: Rectal prolapse. Tails of lambs are docked to reduce fecal soiling and fly strike but making it too short is associated with increased risk of rectal prolapse. Fly strike occurs when blowflies lay eggs on sheep. When the maggots then burrow into the sheep they secrete ammonia and poison the sheep. It's a self-perpetuating cycle because the skin irritation attracts additional flies. It is very painful and death can ensue within 3-6 days. Tail docking has welfare implications because it is painful for the lambs. Reported benefits include increased weight gain, feed efficiency, and reproductive capacity; and improved tolerance of heat. The AVMA notes that excessively short docking is inappropriate from a welfare point of view. Appropriate docking at the level of the distal end of the caudal tail fold, using analgesia and appropriate procedures, is recommended. Click here to read the AVMA's Position of the Docking of Lambs Tails and check out the Welfare Implications of Tail Docking of Lambs by the AMA. https://www.avma.org/resources-tools/avma-policies/docking-lambs-tails https://www.avma.org/resources-tools/literature-reviews/welfare-implications-tail-docking-lambs The Canadian Veterinary Medical Association (CVMA) has similar guidelines regarding appropriaté and humane Tail Docking of Sheep. Refs: The American Veterinary Medical Association (AMA) Policy Resources and the CVMA, Policy Statement. Link: Facultative Myiasis-producing Flies https://www.merckvetmanual.com/integumentary-system/flies/facultative-myiasis-producing-flies

Answer 60

Answer: Canids. Dogs. The definitive host of Echinococcus granulosus is the dog and other canids. They pass eggs in the feces. Intermediate hosts include omnivores and herbivores such as humans, sheep, goats, deer, moose, kangaroos, and wallabies. Humans can also be infected by the ingestion of food contaminated with dog feces. In the intermediate host, ingested eggs hatch into larvae that travel via the circulation to form hydatid cysts in organs such as the liver, brain, and lungs. Echinococcosis is more common in rural populations that raise sheep. It is endemic in parts of South America, east Africa, central Asia, and China. Check out this nice webiste on the lifecycle and biology of echinococcosis, courtesy of the U.S. Centers for Disease Control (CDC). https://www.cdc.gov/parasites/echinococcosis/biology.html Link: Zoonotic Diseases https://www.merckvetmanual.com/public-health/zoonoses/zoonotic-diseases Link: Cestodes Causing CNS Disease in Animals https://www.merckvetmanual.com/nervous-system/central-nervous-system-diseases-caused-by-helminths-and-arthropods/cestodes-causing-cns-disease-in-animals?autoredirectid=18675#v3289542

Answer 61

Answer: Metabolism of orally administered drugs before entering tissues. The first-pass effect refers to metabolism of orally administered drugs by the liver before they enter the tissues. Drugs are absorbed from the Gl tract through the portal vein to the liver, where they are broken down (metabolized) before they can be distributed to the needed tissues. Drugs with a large first-pass effect should NOT be given enterally (orally) because too much medicine is lost by this route. Instead, administer drugs with large first-pass effect parenterally (not orally) to avoid this breakdown. Butorphanol is an example of a drug that undergoes significant first-pass effect. When given IV, it is 100% bioavailable, whereas when given orally it is only 20% bioavailable. Ref: Bassert, Beal and Samples, McCurnin's Clinical Textbook for Veterinary Technicians, othod n 054

Answer 62

Answer: Glucoronyl transferase deficiency. Cats are deficient in glucuronyl transferase, the hepatic enzyme needed to conjugate most NSAIDs and acetaminophen with glucuronic acid for normal metabolization. This means even small doses of NSAIDs can cause toxicosis in cats. Acetaminophen (Tylenol®) is toxic at any dose and should never be used in cats. Common NSAIDs include ibuprofen, carprofen (Rimady|®), aspirin, and naproxen. Clinical signs of NSAID toxicosis include Gl ulceration and acute renal failure. CNS effects, such as seizures and coma, can be seen at higher doses. Ref: Cohn and Cote, Clinical Vet Advisor-Dogs and Cats, 4th ed. pp. 10-11. Link: Analgesics (Toxicity). https://www.merckvetmanual.com/toxicology/toxicities-from-human-drugs/analgesics-toxicity

Answer 63

Answer: Zearalenone. All of these choices are mycotoxins. Click here to see a table of mycotoxicoses in domestic animals. https://www.merckvetmanual.com/toxicology/mycotoxicoses/overview-of-mycotoxicoses-in-animals?autoredirectid=16886 Think of reproductive dysfunction (estrogenism, vulvovaginitis) with zearalenone, the only known mycotoxin with primarily estrogenic effects. https://www.merckvetmanual.com/toxicology/mycotoxicoses/mycotoxin-associated-estrogenism-and-vulvovaginitis-in-animals?autoredirectid=16889 Zearalenone is produced by Fusarium spp. molds on plants and common feed grains like corn, barley and wheat. Often a second mycotoxin called deoxynivalenol is also prduced which causes decreased feed intake. The presence of deoxynivalenol may limit exposure to zearalenone if the animal eats less. Fumonisin is another Fusarium spp. mycotoxin associated with moldy corn. https://www.merckvetmanual.com/toxicology/mycotoxicoses/fumonisin-toxicosis-in-animals?autoredirectid=16893 In equids, look for CNS disease (equine leukoencephalomalacia). In pigs, see hypertension and pulmonary edema (porcine pulmonary edema-PPE). Ergotism is caused by ingestion of alkaloids in a parasitic fungus, Claviceps purpurea, that infects small grains (rye, wheat) and forage plants like bromes, bluegrass, and ryegrass. https://www.merckvetmanual.com/toxicology/mycotoxicoses/ergotism-in-animals?autoredirectid=16888 Look for vasoconstriction with terminal necrosis of the extremities due to thrombosis-affected animals are predisposed to frostbite and gangrene. May have CNS effects, potent oxytocic action or pituitary effects (decreased prolactin leading to agalactia). Slaframine toxicosis causes profuse salivation, primarily in horses and occasionally in cattle. https://www.merckvetmanual.com/toxicology/mycotoxicoses/slaframine-toxicosis-in-animals?autoredirectid=16896 Due to the fungus Rhizoctonia leguminocola (black patch disease) on red clover (Trifolium pratense) especially in wet, cool years. Trichothecenes are a group of related cytotoxic mycotoxins associated with many fungi. https://www.merckvetmanual.com/toxicology/mycotoxicoses/trichothecene-toxicosis-in-animals?autoredirectid=16897 Think of vomitoxin (and vomiting) and also of immunosuppression. Refusal to eat contaminated feed is a typical sign, due to taste aversion. Macrocyclic trichothecene-related diseases have several specific names, including the best known, stachybotryotoxicosis. Refs: The Merck Veterinary Manual online edition.

Answer 64

Answer: Toxocara canis Roundworms (Toxocara spp., Toxasacaris spp.) can cause visceral and ocular larva migrans in people. Infection with Toxocara spp is, in fact, the most common cause of human visceral and ocular larval migrans. Hookworms (Ancylostoma spp.) may cause cutaneous larva migrans in people. Habronema spp. in horses can cause tumorlike stomach nodules and sometimes cutaneous lesions. Spirocerca lupi makes nodules in the esophageal, gastric, or aortic walls of affected small animals. Typically asymptomatic. Fasciola hepatica may be asymptomatic in cattle but fatal to sheep. Link: Roundworms in Small Animals. https://www.merckvetmanual.com/digestive-system/gastrointestinal-parasites-of-small-animals/roundworms-in-small-animals Link: Hookworms in Small Animals. https://www.merckvetmanual.com/digestive-system/gastrointestinal-parasites-of-small-animals/hookworms-in-small-animals Link: Habronema spp infection in Horses. https://www.merckvetmanual.com/digestive-system/gastrointestinal-parasites-of-horses/habronema-spp-infection-in-horses?redirectid=27859 Link: Cutanoeus Habronemiasis in Animals. https://www.merckvetmanual.com/integumentary-system/helminths-of-the-skin/cutaneous-habronemiasis-in-animals#v3279412 Link: Spirocerca Lupi in Small Animals. https://www.merckvetmanual.com/digestive-system/gastrointestinal-parasites-of-small-animals/spirocerca-lupi-in-small-animals Link: Fasciola Hepatica in Ruminants. https://www.merckvetmanual.com/digestive-system/fluke-infections-in-ruminants/fasciola-hepatica-in-ruminants

Answer 65

Answer: Simple continuous oversewn with Cushing Simple continuous oversewn with a Cushing. The uterus may be closed in a single layer (full thickness) with a simple continuous appositional pattern or double layer (mucosa and submucosa followed by muscularis and serosa) appositional closure. Alternatively, the second layer may be closed with an inverting pattern (Cushing, Lembert). Refs: Fossum, Sm An Surg 3rd ed., pp. 718-720

Answer 66

Answer: Controlled exercise program. A controlled conditioning exercise program is often the first recommendation in horses with intermittent delayed patellar release (a.k.a. intermittent upward fixation of the patella). This helps strengthen the quadriceps (and biceps femoris) muscles of the thigh and therefore removal of the patella from its "locked" position over the medial trochlear ridge. This condition occurs when the medial patellar ligament stays hooked over the medial trochlear ridge of the femur, thereby locking the reciprocal apparatus with the limb in extension. Horses with intermittent delayed patellar release are slow to release the patella during limb protraction, which is visible when transitioning from canter to trot. Horses with severe disease stand with the hind limb in extension and fetlock flexed. Those horses may not be able to move forward, or only do so with a sudden jerking flexion of that limb. Tx for horses who do not respond to conservative therapy, are lame, or who have severe disease: medial patellar ligament desmotomy or medial patellar ligament splitting procedures. It is important to provide good farriery care to ensure the foot is well balanced. Shoes with a beveled edge (and possibly a lateral heel wedge) may be helpful. Arthroscopy would not be an initial treatment for this condition. The tibial plateau leveling osteotomy is performed in dogs with cranial cruciate injuries. Link: Intermittent Upward Fixation of the Patella and Delayed Patella Release in Horses https://www.merckvetmanual.com/musculoskeletal-system/lameness-in-horses/intermittent-upward-fixation-of-the-patella-and-delayed-patella-release-in-horses Link: Cranial Cruciate Ligament Disease. https://www.acvs.org/small-animal/cranial-cruciate-ligament-disease/ Intermittent Upward Fixation of the Patella and Delayed Patella Release in Horses - Comprehensive Veterinary Information Definitions and Terminology: • Intermittent Upward Fixation of the Patella: Medial patellar ligament locks over the medial trochlear ridge of the femur, causing the hind limb to remain extended. • Delayed Patella Release: Jerky movement of the patella during limb protraction, often seen in young, poorly muscled horses or older horses with stifle trauma. Physiopathology: • Mechanism: Medial patellar ligament fails to release, causing the limb to be locked in extension. Clinical Findings: • Symptoms: Sudden locking of the hind limb, jerky patellar movement, low-grade lameness, reluctance to work on soft surfaces or inclines. Diagnosis: • Clinical Signs: Observation of limb fixation, induced by pushing the horse backward or manually manipulating the patella. • Radiography: Used if there is effusion or lameness to identify secondary pathology. Treatment: • Non-surgical: Conditioning program (daily lungeing or riding), good nutrition, balanced foot trimming, shoeing. • Surgical: Medial patellar ligament desmotomy for severe or non-responsive cases. Prognosis: • Generally Good: With conservative treatment or surgery, although recurrence is rare after desmotomy.

Answer 67

Answer: They are created during the process of creating blood smears. Smudge cells are cells that have been damaged when excessive pressure is used on the spreader slide, during the process of creating blood smears for CBCs.

Answer 68

Answer: 0.5-1mm Normal depth of the gingival sulcus in cats is less than 1 mm, in dogs 1-3 mm. The gingival sulcus is the crevice between the tooth and the gum line where plaque collects. It is important to know that this crevice is not very deep in normal cats when you are cleaning teeth. Dr. Jan Bellows explains the Role of Dental Probes and Explorers. https://www.dvm360.com/view/dental-probes-and-explorers-musts-examination

Answer 69

Answer: Excess scatter radiation. Too much scatter (i.e., from radiographing a thick body part more than 10 cm without a grid) can cause gray films. If developing film and the temperature in the tanks is uneven, look more for uneven bands and/or reticulation on the film. Static electricity production (from very low humidity) can cause artifacts on the film (e.g., linear dots, a tree pattern). A light leak into the dark room, or accidentally turning on the lights while undeveloped film is out, would make a gray, fogged film.

Answer 70

Answer: Lactated Ringer’s Solution Isotonic crystalloids should be administered to help improve perfusion and then the rate of correction of the hypernatremia can be determined. This cat is likely hypernatremic due to hypotonic fluid loss from the Gl tract. After 24 hours of hypernatremia, the brain produces idiogenic osmoles to prevent its dehydration secondary to systemic hyperosmolality. Therefore, hypernatremia needs to be corrected slowly to prevent cerebral edema. It is best to restore tissue perfusion with an isotonic fluid first and then reassess the Na concentration in the blood - it may even be necessary to add Na to the fluids once perfusion is restored. In acute cases, fluids should be administered such that the decrease in serum sodium concentration does not exceed 1 mEq/L/ h and does not exceed 24 mE/L/day, and in more chronic cases fluids should be provided at a rate such that the decrease in serum sodium concentration does not exceed 0.5 mEq/L/h and does not exceed 12 mEq/L/day.

Answer 71

Pilocarpine is a topical miotic agent (pupil constrictor) used mainly to diagnose cranial nerve lil lesions. It is also used in the treatment of glaucoma to open the iridocorneal angle and decrease intraocular pressure. It is a muscarinic receptor agonist. Expect mydriasis (dilated pupils) with atropine and glycopyrrolate. These anticholinergic drugs are primarily used as preanesthetics to prevent bradycardia and decrease airway secretions. Topical atropine is used in the treatment of anterior uveitis and painful corneal diseases. Tropicamide is a topical mydriatic agent. Dantrolene is a muscle relaxant used for post-anesthesia myositis in horses and in dogs and cats with functional urethral obstruction. Refs: Cote, Clinical Veterinary Advisor: Dogs and Cats, 4th ed., pp. 846-47, and Plumb’s Veterinary Drug Handbook, online edition; Pilocarpine. Image courtesy of Fedor Leuhkin. Link: Treatment of Glaucoma in Animals https://www.merckvetmanual.com/pharmacology/systemic-pharmacotherapeutics-of-the-eye/treatment-of-glaucoma-in-animals Link: Systemic Treatment of Inflammatory Airway Disease in Animals https://www.merckvetmanual.com/pharmacology/systemic-pharmacotherapeutics-of-the-respiratory-system/systemic-treatment-of-inflammatory-airway-disease-in-animals?autoredirectid=17111#v12763244

Answer 72

Answer: when the blood glucose level exceeds the kidney’s ability to reabsorb it. Glucosuria is excess glucose in the urine. It occurs when the blood glucose level exceeds the kidney's ability to reabsorb it in the tubules (called the renal threshold). The renal threshold for glucose is 180 mg/dl (9.99 mmol/L) in the dog and 280 mg/di (15.54 mmol/L) in the cat. Glucosuria seen in conjunction with hyperglycemia is suggestive of diabetes mellitus. Patients with glucosuria should be checked for concurrent hyperglycemia. Refs: Bassert, Beal and Samples, McCurnin's Clinical Textbook for Veterinary Technicians, 9thed. p. 400. Link: Treatment of Diabetes Mellitus https://www.merckvetmanual.com/endocrine-system/the-pancreas/diabetes-mellitus-in-dogs-and-cats#v3271694

Answer 73

Answer: Rat. Plague, caused by Yersinia pestis, is a zoonotic, reportable disease that is carried by fleas and found in wild rodents (e.g. ground squirrels, wood rats) and rabbits. It is enzootic in the western U.S. and Hawaii. Pets develop infection secondary to contact with infected rodents. Cats are the most commonly infected domestic species. Cats typically present with systemic illness and enlarged/abscessed lymph nodes. About ten cases of human plague are reported each year, most often infected via a flea bite. Link: Plague in Animals https://www.merckvetmanual.com/generalized-conditions/plague/plague-in-animals?autoredirectid=21104 Plague in Animals - Comprehensive Veterinary Information Definitions and Terminology: • Plague: A serious, life-threatening disease caused by Yersinia pestis, a gram-negative, facultative coccobacillus. Causative Agents: • Pathogen: Yersinia pestis. Epidemiology and Transmission: • Hosts: Maintained between rodent species and their fleas. • Transmission: Flea bites, ingestion of infected rodents, contact with infected fluids/tissues, aerosol droplets. • Risk Factors: Roaming in enzootic areas, hunting rodents, exposure to infected fleas. Clinical Findings: • Cats: • Bubonic Plague: High fever, lethargy, anorexia, lymphadenopathy (buboes). • Septicemic Plague: High fever, lethargy, anorexia, vomiting, diarrhea, sepsis signs. • Pneumonic Plague: Fever, dyspnea, oral/nasal discharge, coughing/sneezing. • Dogs: Transient fever, anorexia, rarely severe disease. Diagnosis: • Tests: PCR, direct fluorescent antibody (DFA), culture (gold standard). • Sample Collection: Lymph node aspirates, whole blood, fresh tissue. Treatment: • Antibiotics: Fluoroquinolones, doxycycline, trimethoprim-sulfonamide, gentamicin, chloramphenicol. • Supportive Care: Hospitalization, isolation, appropriate PPE for handlers. Control and Public Health: • Prevention: Flea control, avoiding exposure to rodents, maintaining pets indoors. • Public Health Response: Notify health officials, implement isolation and disinfection procedures, prophylactic antibiotics for exposed humans. Physiopathology: • Infection Route: Flea bite introduces bacteria, which spread through the lymphatics to lymph nodes, causing buboes, and potentially disseminating via the bloodstream (septicemic) or to the lungs (pneumonic).

Answer 74

Answer: Right . In right lateral recumbency, the right lungs are on the down side and the left lungs are on the upper side. The down side will have reduced lung volume which causes ventilation/perfusion (V/Q) mismatch and impaired gas exchange in the lungs on the bottom. Horses in dorsal recumbency will have decreased lung volume in the dorsal lung fields, and if they have abdominal enlargement (i.e., gas-distended bowel or pregnant uterus) the Gl compartment/diaphragm exerts even more pressure on the thorax, worsening ventilation of the dorsal lung fields. Horses undergoing anesthetic procedures over 90 minutes, or any horse under gas anesthesia, are typically maintained on controlled mechanical ventilation to increase alveolar ventilation and mitigate V/Q mismatch. Furthermore, it is recommended to place an arterial catheter for monitoring arterial blood gas in these patients. This allows the anesthetist to stay on top of hypoxemia or pH disturbances. Refs: Bassert, Beal and Samples, McCurnin's Clinical Textbook for Veterinary Technicians, 9th ed. pp. 1049-53, Hornof, et al, "Effects of lateral recumbency on regional lung function in anesthetized horses" in American Journal of Vet Research and Mosing and Senior, "Maintenance of equine anaesthesia over the last 50 years: Controlled inhalation of volatile anaesthetics and pulmonary ventilation" in Equine Vet Journal. Link: Effect of lateral recumbency on regional lung function in anesthetized horses https://pubmed.ncbi.nlm.nih.gov/3954203/ Link: Maintenance of equine anaesthesia over the last 50 years https://beva.onlinelibrary.wiley.com/doi/10.1111/evj.12793