December Timed Tests Flashcards
You are interning and on the cardiology rotation you are presented with a 4-month-old female Westie. She was diagnosed with a suspected PDA by her referring vet and is here for further cardiac workup and treatment plan. Which of the following clinical findings is consistent with a left-to-right shunting patent ductus arteriosus?
- Decreased QRS amplitudes on electrocardiography
- A grade I-ll/6 heart murmur heard best at the left heart base
- Right ventricular enlargement
- Bounding arterial pulses
Answer: Bounding arterial pulses
Explanation
The correct answer is bounding arterial pulses. Bounding or “waterhammer” arterial pulses are common due to the increased systolic pressure and decreased diastolic blood pressure (widened pulse pressure).
Left chamber enlargement occurs with left-to-right shunting PDAs which can often be detected as increased amplitude of the QRS complex on ECG (not decreased). Right ventricular enlargement would be consistent with a right-to-left shunting PDA (not left-to-right). A continuous, or “machinery” murmur of a higher grade is characteristic of a PDA.
A large swine herd has recently been experiencing coughing in the feeder pigs and a few sows. A few have fevers and inappetence but most remain normal in appearance, however the weight gains in the feeder pigs have slowed and the owner is concerned. A post-mortem reveals purple to gray areas of consolidation in the cranio-ventral lungs, with a catarrhal exudate in the airways and enlarged regional lymph nodes. You identify Mycoplasma hypneumoniae in the lungs. What is the most cost effective approach to controlling this agent?
- Vaccination against M. hypneumoniae
- Improve biosecurity, as this agent is brought in by rodents
- Eliminate carriers by test and slaughter
- Treat all pigs with procaine penicillin for 3 days
- Cull all pigs and start over with specific pathogen free pigs
Answer: Vaccination against M. hypneumoniae
Explanation
Vaccines are effective and widely used in the US to control this disease. Air quality, ambient temperature, and ventilation must also be addressed. Because mycoplasmas do not have cell walls, treatment with penicillin is not effective.
What is the most common signalment for a dog with a perianal adenoma?
- Young intact female
- Older intact female
- Older neutered male
- Older intact male
- Young neutered male
Answer: Older intact male
Explanation
The correct answer is older intact male. Perianal adenomas, sometimes referred to as hepatoid tumors, are driven by testosterone and are seen almost exclusively in older, intact males. The tumor is considered benign and will often resolve on its own after castration.
A 5-month-old intact male Terrier/mixed breed puppy presents as a recheck exam. He was last seen two weeks ago for evaluation of non-seasonal pruritic skin disease. At that visit, you noted marked pruritus and patchy alopecia with occasional papules affecting the pinnae, face, and ventrum. Despite a 10-day course of prednisone, there has been no significant change in the patient’s lesions. He continues to be very pruritic and is constantly rubbing his face. Which of the following is the most likely primary etiology?
- Dermatophytosis
- Cutaneous adverse food reaction
- Demodicosis
- Atopic dermatitis
Answer: Cutaneous adverse food reaction
Explanation
The correct answer is cutaneous adverse food reaction (CAFR). While atopic dermatitis is pruritic, it tends to respond to steroids. It presents initially as a seasonal phenomenon, usually with involvement of the feet and often with pustules, crusts, and other secondary lesions consistent with bacterial or yeast infection. Otitis is also commonly seen (rather than just pinnal lesions). Moreover, pruritus caused by CAFR is more common than atopic dermatitis in dogs <6 months of age.
While non-seasonal in presentation, demodicosis is not pruritic, and a course of steroids would likely have resulted in a worsening of clinical signs. If the trunk is affected, the lateral and dorsal aspects are more likely to be affected than the ventrum.
Dermatophytosis is not pruritic and would also have likely worsened in the face of steroid administration.
The gold standard for diagnosis of a cutaneous adverse food reaction is the abatement of clinical signs with a food trial involving a restricted or novel diet, followed by recurrence of clinical signs when the patient is challenged with the previous food.
You have diagnosed proliferative enteritis in a swine herd and the owners wish to undertake a control program. Which of the following is most effective at controlling the disease?
- Vaccination against Brachyspira pilosicoli
- Vaccination against Lawsonia intracellularis
- Identify and cull carriers of Lawsonia intracellularis
- Cull entire herd and start over with specific pathogen-free pigs
- Vaccination against Salmonella choleraesuis
Answer: Vaccination against Lawsonia intracellularis
Explanation
Proliferative enteritis, also called proliferative ileitis, is caused by L intracellularis. A modified live Lawsonia intracellularis vaccine is marketed in the US and has proven to be effective. Treatment with tiamulin or tylosin for 14 days in the water or feed is also helpful.
You are managing a poultry flock that has had problems with coccidiosis. In choosing an appropriate prevention plan, you need to consider drug withdrawal times. Which of the following agents has the shortest withdrawal time?
- Sulfadimethoxine
- Sulfaquinoxoline
- Robenidine
- Amprolium
- Nicarbazin
Answer: Amprolium
Explanation
Amprolium has zero withdrawal time
Sulfaquinoxoline has a 10 day withdrawal time
Sulfadimethoxine has a 5 day withdrawal period
Nicarbazin has a 4 day withdrawal
Robenidine has a 5 day withdrawal period
Which of the following is not typically a clinical sign of hog cholera?
- Coughing and sneezing
- Vomiting and diarrhea
- Oral petechiation
- Oral ulceration
- Paresis or paralysis
Answer: Coughing and sneezing
Explanation
The correct answer is coughing and sneezing. Hog cholera is caused by a virus from the same family (Flaviviridae)as Bovine Viral Diarrhea virus (BVD), Border Disease virus (BD), Japanese Encephalitis virus, and West Nile virus. The USA is currently free of this reportable disease. The virus affects stem cells in bone marrow causing neutropenia and thrombocytopenia. Infected pigs become immune-suppressed and are more susceptible to many enteric bacterial infections. The virus can cross the placenta causing reproductive failure.
Clinical signs include fever, anorexia, diarrhea, vomiting, shivering, paresis, paralysis, conjunctivitis, oral ulcers, and petechiation. Diagnosis is by fluorescent antibody, serum neutralization, or virus isolation.
You are working with a dairy producer that has observed decreased fertility and frequent abortions in their herd. In addition to reproductive issues, the producer has also noticed intermittent diarrhea and an increased incidence of pneumonia. Based on these findings, you elect to test a stillborn calf for bovine viral diarrhea virus using virus isolation. The calf tests positive. Now that a diagnosis has been obtained, the producer would like to eliminate this virus from his herd. What would be your approach to identify and eliminate persistently infected animals?
- Perform individual ELISA testing on all cows and calves
- Perform pooled RT-PCR testing, then perform individual testing on groups that screen positive
- Perform pooled ELISA testing, then perform individual testing on groups that screen positive
- Perform individual RT-PCR testing on all cows and calves
Answer: Perform pooled RT-PCR testing, then perform individual testing on groups that screen positive
Explanation
Identification and removal of persistently infected (PI) animals should occur in breeding herds. Identifying BVDV in sick or dead animals or aborted fetuses provides the justification for further whole-herd screening for BVDV Pl animals. Because of high sensitivity, RT-PCR assays using pooled samples have been developed and tested to screen populations of animals for BVDV Pl. Sample types that have been used in RT-PCR assays of pooled samples include serum, whole blood, bulk tank milk, and skin biopsy samples. With pooled whole blood samples, a single Pl animal can be detectable in pools of up to 250 negative samples. This makes pooled sample testing a rapid and cost effective method for screening populations of cattle for BVDV Pl animals.
Subsequent testing of individuals within the positive pools may be performed by using immunohistochemistry, virus isolation, or RT-PCR.
A week after a visit to the farrier, the horse becomes acutely lame. There is increased heat and pain in the right thoracic foot. There is edema and swelling over the pastern and fetlock. What is the most likely diagnosis?
- Subsolar abscess
- Laminitis
- Navicular syndrome
- Pedal osteitis
Answer: Subsolar abscess
Explanation
The correct answer is subsolar abscess. Subsolar abscesses result from a puncture wound in the hoof from a penetrating foreign body or poor farrier work. Lameness is usually severe. Clinical signs may include pointing of the affected foot and increased heat and pain, which progresses to the coronary band.
Edematous swelling of the pastern and fetlock may occur. In neglected cases, draining at the coronary band may occur in 2-3 weeks.
Treatment consists of disinfectants and poultices. Ensuring adequate drainage is the mainstay of therapy. If a foreign body is present, it should be found and removed, and adequate drainage should be established.
An 8 year-old, 1223 lb, Quarter Horse gelding is presented to you with a 4-day history of lethargy, inappetance, intermittent fever (ranging from 101.2-104.5F, 38.4-40.3 C), and peripheral limb edema. Upon physical examination, you note the following abnormalities: lethargy, tachycardia (60 beats/min), limb edema and fever (103.2F, 39.6 C).
The serum biochemistry analysis is within relatively normal reference intervals but the CBC yields the following abnormalities:
WBC: 1.50 x 10,000/mcL (reference 5.0-11 × 10,000/mcL)
HCT: 32% (reference 34-45%)
Platelet: 71 x 10,000/mcL (reference 130-300 × 10,000/mcL)
Neutrophil: 1.20 × 10,000/mcL (reference 2.2-6.5 × 10,000/mcL)
Lymphocyte: 0.23 x 10,000/mcL (reference 1.3-4.5 x 10,000/mcL)
Fibrinogen: 500 mg/dL (reference 100-400 mg/dL)
In addition, the following was observed on microscopic examination of the blood smear (see image). The most likely diagnosis, based on the history, clinical findings, and CBC results in this case, is which of the following?
- Endotoxemia/septicemia (toxic changes within cell)
- Streptococcus equi infection
- Heinz body anemia
- Anaplasma phagocytophilum infection
- Equine infectious anemia (EIA) infection
Answer: Anaplasma phagocytophilum infection
Answer
Explanation
Based on the clinical signs (fever, lethargy, tachycardia and limb edema), CBC results (leukopenia, neutropenia, thrombocytopenia) and microscopic observation of a morula within the neutrophil, the correct answer and diagnosis is Anaplasma phagocytophilum infection. Diagnosis can be supported via PCR assays.
Anaplasmosis (formerly Ehrlichi equi) infects primarily neutrophils and form inclusion bodies which consists of one or more coccobacillary organisms within these cells, known as morula. The complete pathogenesis of this disease is not fully elucidated but the organism is spread via tick bites. Other clinical signs that may be associated with this disease include petechiation, icterus and ataxia. The drug of choice for this disease is…(think about it for a second) …you got it…oxytetracycline.
The dairy cow in the picture presents to you with mild signs of ataxia, a right eye droop, and right ear droop. Physical examination also reveals that she is also febrile and does not have a palpebral response on the right side. You are suspicious of Listeriosis and perform a CS tap; you expect to find ______ on the cytology.
- A neutrophilic pleocytosis
- A normal CSF
- A mononuclear pleocytosis
- A lymphocytic pleocytosis
Answer: A mononuclear pleocytosis
Explanation
The correct answer is a mononuclear pleocytosis. CSF tap is most important for distinguishing Listeriosis from thromboembolic meningoencephalitis (TEME), in which you will see a neutrophilic pleocytosis on CSF cytologic examination. Remember with Listeria, you will often observe CNS signs, an increased number of monocytes and macrophages. Also remember that Listeria is usually contracted from ingesting silage that has been stored at a pH > 5.0.
A new horse owner calls you and wants to know how to prevent calcium carbonate urolith formation in a horse. Which of the following promotes calcium carbonate urolith formation?
- Maintaining an acidic urine pH
- Low urine specific gravity
- Maintaining an alkaline urine pH
- Low amounts of mucoproteins
Answer: Maintaining an alkaline urine pH
Explanation
The correct answer is maintaining an alkaline urine. Calcium carbonate stones in horses have a higher likelihood of forming in alkaline urine. Mucoproteins in urine may serve as a nidus for stone formation but is not specific for calcium carbonate stones.
What dog breed has a familial syndrome of hypertriglyceridemia?
- Golden Retrievers
- Cocker Spaniels
- Cairn Terriers
- Greyhounds
- Miniature Schnauzers
Answer: Miniature Schnauzers
Explanation
The correct answer is Miniature Schnauzers. There is a well described familial basis for hypertriglyceridemia in Mini Schnauzers.
What is the duration of a mare’s estrus?
- 20 days
- 14 days
- 6 days
- 12 hours
- 1 day
Answer: 6 days
Explanation
The correct answer is 6 days. Estrus in a mare can last 2-10 days but, on average, is 6 days long. The mare is a polyestrous animal from the beginning of spring through summer. The estrous cycle’s duration lasts 19-26 days.
Quittor defines a chronic infection of what part of a horse?
- Suspensory ligament
- Cartilage of P1
- Carpus
- Cartilage of P3
Answer: Cartilage of P3
Explanation
The correct answer is the cartilage of P3. Quittor can result in a draining tract from the coronary band due to infection and inflammation of the affected cartilage. Surgery is the treatment of choice.
A horse presents to you with signs of fistulous withers. From where is this condition most likely contracted?
- Contaminated feed
- Infected cattle
- Contaminated soil
- Infected sheep
Answer: Infected cattle
Explanation
The correct answer is infected cattle. The causative agent of fistulous withers is Brucella abortus, and it usually is transmitted to horses by infected cattle.
A 5-month-old mixed breed puppy is presented for a new pet exam. On exam, you note generalized erythema, a thin coat, and localized skin excoriations. You perform a deep skin scraping, a superficial skin scraping, and a skin cytology; all of these diagnostic tests are negative. You perform a Wood’s lamp examination, which is also negative. After collecting samples for a DTM culture, you administer vaccines and send the owner home with heartworm and flea prevention. Nearly three weeks later, a small amount of growth is noted on the DTM culture. You perform acetate tape cytology using New Methylene Blue stain and observe the following. What is your next step?
- Prescribe miconazole/chlorhexidine shampoo and oral terbinafine
- Prescribe chlorhexidine shampoo and oral lufenuron
- No action is necessary; this fungus is a contaminant
- Prescribe miconazole shampoo and oral fluconazole
Answer: Prescribe miconazole/chlorhexidine shampoo and oral terbinafine
Explanation
This puppy has Trichophyton mentagrophytes. Microscopically, T. mentagrophytes microconidia are numerous, round to pyriform in shape, and found in grapelike clusters. Spiral hyphae are often present.
Macroconidia are multi-septate and club-shaped but often absent. The optimal treatment for dermatophytosis is a combination of a topical treatment and systemic therapy. According to the 2017 Clinical Consensus Guidelines of the World Association for Veterinary Dermatology, recommended topical treatments include lime sulfur, enilconazole or miconazole/chlorhexidine shampoo. These options are regarded as more effective than miconazole or chlorhexidine alone. The guidelines also recommend the use of itraconazole or terbinafine for systemic therapy.
Fluconazole is less effective and lufenuron is not recommended for use in the treatment of dermatophytosis.
A 5-month-old mixed breed puppy is presented for a new pet exam. On exam, you note generalized erythema, a thin coat, and localized skin excoriations. You perform a deep skin scraping, a superficial skin scraping, and a skin cytology; all of these diagnostic tests are negative. You perform a Wood’s lamp examination, which is also negative. After collecting samples for a DTM culture, you administer vaccines and send the owner home with heartworm and flea prevention. Nearly three weeks later, a small amount of growth is noted on the DTM culture. You perform acetate tape cytology using New Methylene Blue stain and observe the following. What is your next step?
- Prescribe miconazole/chlorhexidine shampoo and oral terbinafine
- Prescribe chlorhexidine shampoo and oral lufenuron
- No action is necessary; this fungus is a contaminant
- Prescribe miconazole shampoo and oral fluconazole
Answer: Prescribe miconazole/chlorhexidine shampoo and oral terbinafine
Explanation
This puppy has Trichophyton mentagrophytes. Microscopically, T. mentagrophytes microconidia are numerous, round to pyriform in shape, and found in grapelike clusters. Spiral hyphae are often present.
Macroconidia are multi-septate and club-shaped but often absent. The optimal treatment for dermatophytosis is a combination of a topical treatment and systemic therapy. According to the 2017 Clinical Consensus Guidelines of the World Association for Veterinary Dermatology, recommended topical treatments include lime sulfur, enilconazole or miconazole/chlorhexidine shampoo. These options are regarded as more effective than miconazole or chlorhexidine alone. The guidelines also recommend the use of itraconazole or terbinafine for systemic therapy.
Fluconazole is less effective and lufenuron is not recommended for use in the treatment of dermatophytosis.
A 5-year old female intact New Zealand White rabbit presents for hematuria, anorexia, and weight loss. What is the most likely differential?
- Uterine adenocarcinoma
- Rabbit syphilis
- Pregnancy
- Porphyrinuria
- Normal estrous
Answer: Uterine adenocarcinoma
Explanation
Uterine adenocarcinoma is the most common neoplasia of female rabbits, with up to 80% incidence among intact females of certain species. Because of this, all female rabbits that are not breeders should be spayed. The most common signs of uterine ACA are hematuria, anorexia, depression, dysuria, and milk production.
Pregnancy would be unlikely to cause hematuria. Rabbits are induced ovulators and do not exhibit estrous.
Hematuria must be distinguished from porphyrinuria, which is a normal red or orange pigment in the urine of some rabbits. However, porphyrinuria does not cause anorexia and weight loss. Rabbit syphilis is a sexually transmitted disease caused by Treponema paraluis cuniculi. It causes perineal lesions but does not cause hematuria.
Which of the following bodies licenses veterinarians to prescribe a drug to a patient in the United States?
- State veterinary board
- United States Department of Agriculture
- Food and Drug Administration
- American Veterinary Medical Association
- State veterinary medical associations
Answer: State Veterinary Board
Explanation
To prescribe drugs to a veterinary patient, the clinician must be licensed by the state veterinary board.
Which one of the following anatomic features is not found in old world primates such as the colobus monkey, proboscis monkey, or langur?
- Ischial callosities for sitting
- Opposable thumbs
- Prehensile tail
- Sex skin
Answer: Prehensile tail
Explanation
The correct answer is prehensile tail. Old world primates are found in Asia and Africa, whereas new world primates are found in South and Central America. Some old world primates such as the colobus, proboscis and langur may have a long tail, but it lacks the ability to grasp; therefore, old world primate tails are never prehensile. Prehensile tails are only found in some species of new world primates.
Goiter in budgerigars is treated with which of the following?
- lodine supplementation
- Irradiating the thyroid gland
- Surgical excision of the thyroid
- Vitamin A supplementation
- There is no effective treatment
Answer: lodine supplementation
Explanation
The correct answer is iodine supplementation. Goiter is usually a result of dietary deficiency of iodine in budgies. Surgery and irradiation are not necessary, and vitamin A deficiency does not cause goiter.
After severe weather conditions of driving wind and snow, a shepherd complains that a large number of heavily pregnant ewes on the hill have suddenly become blind. The ewes are markedly photophobic with blepharospasm and epiphora with tear staining of the cheeks (see image). Clinical examination reveals pronounced conjunctivitis and keratitis. In some eyes there is also corneal ulceration more clearly observed after fluorescein dye strips have been placed in contact with the eye. Which of the following is the most appropriate recommendation?
- Topical or systemic antibiotic (i.e. oxytetracycline)
- Topical or systemic antifungal (i.e. natamycin)
- Cull affected animals
- Systemic atropine
Answer: Topical or systemic antibiotic (i.e. oxytetracycline)
Explanation
This case describes sheep with classic signs of infectious keratoconjunctivitis (IKC). The two common causal organisms of IKC in sheep are Mycoplasma and Chlamydia. Each are susceptible to a wide range of antibiotics including oxytetracycline. Topical oxytetracycline ophthalmic ointment or powder can be applied twice daily. Ewes with bilateral corneal lesions should be injected with long-acting oxytetracycline. Ewes with impaired vision in both eyes must be housed, thereby ensuring adequate feeding.
Confinement also prevents deaths from misadventure. Ewes should be taken off exposed hill ground when storms are forecast but this is not always possible.
Topical 1% atropine may be beneficial in severe cases with painful ciliary body spasms but systemic atropine is not recommended.
A 12 year-old female spayed mixed breed dog presents for further evaluation of intermittent vomiting of 2 weeks duration. A general physical exam was performed and found to be unremarkable. Blood work was performed and the following abnormalities were observed: CK 1019 IU/L (52-368 IU/L), AST 106 U/L (13-15 IU/L), ALK Phos 864 U/L (1- 114 IU/L), ALT 340 U/L (10-109 IU/L). An abdominal ultrasound was performed and revealed a massive, multilobular, heterogenous mass associated with the right medial liver lobe. The remaining liver lobes appeared to be unaffected. Based on the history, blood work, and findings what is the likely long-term survival of this patient if surgery is pursued and a hepatocellular carcinoma is diagnosed?
- Approximately 28 days
- Approximately 700 days
- Approximately 300 days
- Approximately 1400 days
Answer: Approximately 1400 days
Explanation
Single solitary liver masses are generally considered a surgical disease as long there is no overt evidence of metastasis or concern that the mass is a metastatic lesion as opposed to a primary tumor arising from the liver.
Primary liver masses include hepatomas, hepatocellular carcinomas, bile duct adenomas, bile duct carcinomas, and rarely, neuroendocrine tumors. Hepatocellular carcinomas are the most common liver tumor of dogs and second most common in cats. Adenomas will have a better prognosis, however hepatocellular carcinomas generally carry a good prognosis after surgical excision as well.
Bile duct carcinomas have a much more guarded prognosis with an average survival time of approximately 6 months. The prognosis for neuroendocrine tumors of the liver is poor.
