December Timed Tests

Question 1

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 1

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.

Question 2

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 2

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.

Question 3

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 3

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.

Question 4

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 4

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.

Question 5

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 5

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.

Question 6

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 6

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

Question 7

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 7

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.

Question 8

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 8

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.

Question 9

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 9

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.

Question 10

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 10

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.

Question 11

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 11

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.

Question 12

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 12

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.

Question 13

What dog breed has a familial syndrome of hypertriglyceridemia?

• Golden Retrievers
• Cocker Spaniels
• Cairn Terriers
• Greyhounds
• Miniature Schnauzers

Answer 13

Answer: Miniature Schnauzers

Explanation
The correct answer is Miniature Schnauzers. There is a well described familial basis for hypertriglyceridemia in Mini Schnauzers.

Question 14

What is the duration of a mare’s estrus?

• 20 days
• 14 days
• 6 days
• 12 hours
• 1 day

Answer 14

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.

Question 15

Quittor defines a chronic infection of what part of a horse?

• Suspensory ligament
• Cartilage of P1
• Carpus
• Cartilage of P3

Answer 15

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.

Question 16

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 16

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.

Question 17

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 17

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.

Question 18

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 18

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.

Question 19

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 19

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.

Question 20

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 20

Answer: State Veterinary Board

Explanation
To prescribe drugs to a veterinary patient, the clinician must be licensed by the state veterinary board.

Question 21

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 21

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.

Question 22

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 22

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.

Question 23

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 23

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.

Question 24

A 1.5-year old Quarter Horse gelding is presented to you for symmetric ataxia, weakness, and spasticity of all limbs, but worse in the hind limbs. When walking, the horse frequently drags his toes and the hind limbs frequently interfere with one another. Based on the signalment, history and physical examination findings, which of the following is the most likely cause of these clinical signs?

• Cauda Equina Syndrome
• Equine Protozoal Myeloencephalitis (EPM)
• Equine Degenerative Myeloencephalopathy (EDM)
• Botulism
• Equine Motor Neuron Disease (EMND)

Answer 24

Answer: Equine Degenerative Myeloencephalopathy (EDM)

Explanation
The horse in this question has clinical signs most consistent with EDM; cervical vertebral malformation (wobblers) is also a possibility, but was not provided as an answer. The cause of EDM is unknown, but this disease typically affects young horses (< 2-3 years of age; but older horses can develop disease). Clinical signs are a result of diffuse neuronal fiber degeneration of various portions of the central nervous system. This disease has been associated with low serum vitamin E concentrations, suggesting that oxidative damage may play a role in the development of disease.

EMND is typically associated with muscle tremors, shifting of weight while standing, muscle atrophy and recumbency. Botulism is associated with generalized muscle weakness. Cauda equina syndrome causes analgesia of the perineum. EPM can cause a range of clinical signs, but is typically with asymmetric neurologic deficits.

Question 25

You are called out to a horse farm to look into a disease outbreak. Multiple horses are showing signs of fever, colic, and subcutaneous edema. You find 2 dead horses that do not show rigor mortis with unclotted blood exuding from their noses. Which of these is the LEAST appropriate diagnostic or therapeutic step to take next?

• Perform a CBC and Chemistry panel on one of the sick horses
• Administer penicillin to all the febrile horses
• Look at a blood smear from one of the sick horses
• Perform a field necropsy on one of the dead horses

Answer 25

Answer: Perform a field necropsy on one of the dead horses

Explanation
The answer is perform a field necropsy on one of the dead horses. While many of the signs are non-specific, the unclotted blood and lack of rigor mortis should raise your suspicion that you may be dealing with an anthrax outbreak. Performing a field necropsy would be dangerous to you and to the other horses and people in the area.

Question 26

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 26

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.

Question 27

An intact adult female Domestic Shorthair, recently found as a stray, is presented for a wellness exam. The new owners report that the cat is eating well, using the litter box normally, and otherwise doing well at home. The owners have two other cats in the home and are looking forward to introducing the cats and allowing them to interact. On physical exam, you note a BCS of 5/9, pink mucous membranes, mild dental calculus/gingivitis, no abnormalities on thoracic auscultation, and no abnormalities on abdominal palpation. You recommend a FeLV/FIV test and fecal parasite exam. The cat is negative for fecal parasites and FIV, but tests positive for FeLV. What do you recommend?

• Euthanize the cat to prevent viral spread
• Perform a FeLV IFA test to confirm the diagnosis
• Vaccinate with FeLV to minimize the severity of disease
• Treat with azidothymidine (AZT) to minimize the severity of disease

Answer 27

Answer: Perform a FeLV IFA test to confirm the diagnosis

Explanation
You recommend an IFA test to determine whether the cat is truly infected with FeLV, in accordance with the AAFP Retroviral Testing Guidelines. You also educate the owners about the disease and transmission, cautioning them to keep this cat away from their other cats until her FeLV status is known.

There is no reason to euthanize at this time, because false positives may occur on in-house FeLV testing.

Azidothymidine is a potential treatment for FIV, but not for FeLV.

Vaccinating a FeLV positive cat would not offer any benefits.

Question 28

A 3-year old German Shepherd presents for multiple subcutaneous nodules on the right front limb that have been present for about one week. The dog is otherwise healthy. The owner states that the dog lives mostly outdoors in a wooded area with ponds in Florida. You are highly suspicious of pythium; what is the best therapeutic option for this disease?

• Prednisone
• Ivermectin
• Antifungal therapy
• Amputation and treatment with an antifungal
• Amputation and treatment with doxycycline
• Lufenuron

Answer 28

Answer: Amputation and treatment with an antifungal

Explanation
Pythium is an aquatic organism that inhabits ponds of the Southeast United States. These organisms have different cell walls than regular fungi, which makes them difficult to treat since most antifungal treatments target fungal cell wall synthesis. Prognosis is extremely poor with this disease and amputation (if the lesions are localized to an affected limb) is currently the best option. Amputation should always be followed with multiple long-term antifungal therapies. Owners should be warned that local postoperative recurrence is common. Dogs are most commonly affected, but this disease can also occur in cats. It has also been reported in humans and horses.

Doxycyline is an antibiotic and would not be effective for this disease. Prednisone would be contraindicated for pythium. Lufenuron is a chitin synthesis inhibitor used for flea control and would not be effective.

Ivermectin is an anti-parasite drug and would not be effective.

Question 29

In cattle, pododermatitis circumscripta involves a lesion at the______

• Coronary band-hoof wall junction
• Interdigital region-coronary band junction
• Sole/bulb junction
• Hoof wall-white line junction

Answer 29

Answer: Sole/bulb junction

Explanation
The correct answer is sole/bulb junction. Usually the weight-bearing claws are affected first (lateral digits in the hind and medial digits in the front).

Question 30

The fused lumbosacral region in birds is known as the ______

• Conectosacrum
• Synsacrum
• Fusacrum
• Disacrum

Answer 30

Answer: Synsacrum

Explanation
The correct answer is the Synsacrum. The other answers are ‘made up’ terms.

Question 31

What is the most common cause for the formation of eosinophilic plaques in the skin of cats?

• Tapeworm infection
• Flea allergy dermatitis
• Inflammatory bowel disease
• Herpesvirus infection

Answer 31

Answer: Flea allergy dermatitis

Explanation
The correct answer is flea allergy dermatitis. Eosinophilic plaques are areas of alopecia, ulceration, erythema, and pruritus seen in the inguinal, caudal thigh, and perianal regions of cats. It occurs commonly in association with flea allergy dermatitis, but can also occur with atopy or food allergies. Treatment includes treatment for the underlying allergy, steroids, antihistamines, antibiotics, and essential fatty acids.

Question 32

An adult chicken in a small, back-yard flock has lost weight and is thin and sluggish. The chicken is euthanized and on necropsy, you find multiple solid-to-soft crumbly, gray nodules that range in size from less than 1 millimeter to several centimeters in size deeply embedded and throughout several organs and tissues including the liver, spleen, and intestines. Which of the following would you expect to find on the rest of your necropsy or on a diagnostic test?

• An unstained organism with a large capsule when India ink is applied to a smear
• Isolation of a hemagglutinating virus
• Intranuclear inclusion bodies in cells from the liver, kidneys, heart, and spleen
• Acid-fast bacteria in smears from the lesions
• An enlarged sciatic nerve
• Fungal spores in smears from the lesions

Answer 32

Answer: Acid-fast bacteria in smears from the lesions

Explanation
This case describes the typical appearance of avian tuberculosis. The disease is rarely seen in commercial chickens because of their short life span and the husbandry practices utilized. Signs develop late in infection with weight loss, lethargy and lameness as common signs. Granulomatous nodules of varying sizes are commonly found in the liver, spleen, bone marrow, and intestine. Other tissues may also be involved.

Avian tuberculosis is caused by Mycobacterium avium var avium. There are several strains or serovars that can cause disease. Large numbers of acid-fast bacteria provide a tentative diagnosis.

Enlarged sciatic nerve is seen in chickens with Marek’s disease. Intranuclear inclusions are seen with certain viral infections in poultry. An organism with a large capsule seen with India Ink is Cryptococcus. A hemaggluintating virus is the cause of Newcastle disease.

Question 33

What is the morbidity rate and mortality rate of a 3 week old piglet with coccidiosis?

• Moderate to high morbidity and low mortality
• Low morbidity and low to moderate mortality
• High morbidity and low to moderate mortality
• Low morbidity and high mortality

Answer 33

Answer: High morbidity and low to moderate mortality

Explanation
The correct answer is high morbidity and low to moderate mortality. Coccidiosis in piglets is usually caused by Isospora suis, and less often by Eimeria spp. The disease usually affects confinement raised, 1-3 week old, nursing piglets. Diagnosis can be made by identification of oocysts in feces or more reliably, identification of coccidia in mucosal smears or histologic sections. Clinical signs include watery diarrhea, ill thrift, failure to gain weight, and dehydration. The disease is sometimes confused with colibacillosis (diarrhea caused by E. coli), but affected animals do not respond to antibiotics.

Question 34

You receive a call from a small family farmer who would like to blood test 5 pigs for the upcoming county fair. The county fair is in just 10 days. They bred their 2 sows to 2 high value boars. They purchased the semen from a national boar stud. All pigs have been growing quite well, to the point they were concerned the pigs will be too heavy for the fair. As the second pig is snared and you start to collect your blood sample, it starts shaking uncontrollably. It turns blotchy and goes into respiratory distress. As the pig is released, you try some chest compressions but are not successful. The pig dies. The owner grants permission to necropsy the pig. You perform the necropsy immediately. It is difficult to position the pig for necropsy as it is still stiff. Necropsy reveals pulmonary edema and pale soft musculature often containing hemorrhages. Which of the following should be your recommendation to the owner?

• Add 10 mg/lb of chlortetracycline to the feed
• Change genetics for his next matings
• Treat all remaining pigs with injectable procaine penicillin
• Check feed for mycotoxins
• Water supply should be checked for adequate flow

Answer 34

Answer: Change genetics for his next matings

Explanation
The correct answer is to talk to the owner about changing his genetics for his next mating. The sudden rigor mortis of the pig as well as the soft pale muscle on a pig that just died is very suggestive of porcine stress syndrome (PSS). PSS is a simple recessive genetic myopathy. Pigs with heavy muscling and fast growth (desired characteristics in show pigs) can many times carry this gene. This condition can be eliminated from a herd through the selection of genetics. In this case at least one of the sows must be a carrier that was bred to a carrier boar. Antibiotics, water, and mycotoxins have no effect on the clinical presentation of the condition. This genetic condition often results in death of the pig when triggered by excitement, stress or placed under some anesthetics (especially halothane).

Question 35

What is the underlying cause of postparturient hemoglobinuria?

• Hypomagnesemia
• Hypocalcemia
• Hypokalemia
• Hypophosphatemia

Answer 35

Answer: Hypophosphatemia

Explanation
The correct answer is hypophosphatemia; one observes decreased erythrocyte ATP which is not compatible with maintenance of ATP-dependant membrane pumps, and cells lyse.

Question 36

Which of the following is true about demodectic mange (Demodex caballi and Demodex equi) infections in horses?

• This species of external parasite rarely causes disease in horses
• The Morgan breed has a higher incidence of infection Your Answer
• Skin scrapings are usually unrewarding
• The disease is one of a common causes of pruritus and alopecia in horses
• The treatment of choice is oral fenbendazole

Answer 36

Answer: This species of external parasite rarely causes disease in horses

Explanation
The correct answer is that Demodex rarely causes disease in horses. If clinical disease is observed, Demodicosis in horses is not typically pruritic in nature. A skin scraping is the diagnostic test of choice, but keep in mind that Demodex are commonly found in healthy horses. Therefore, the presence of large numbers of mites is suggestive of clinical disease whereas a single mite may not be significant. If clinical signs are present, patchy alopecia with scaling and papules may be observed. There is no breed predisposition and the condition is typically asymptomatic and may regress or resolve spontaneously.

However, oral ivermectin may be helpful in confirmed cases. Keep in mind that Chorioptic mange (Chorioptes equi) is more common and causes intense pruritus and irritation of infested areas which typically include the distal limbs. Skin scrapings will reveal the mites under microscopic examination and in the case of Chorioptic mange, the hair of involved areas must be shaved and the area must be scrubbed with insecticidal shampoos such as organophosphates. Oral ivermectin should also be given several times to kill the mites.

Question 37

An 8-year-old male castrated mixed breed dog presents for lethargy and depression. The dog is thin, depressed, and appears dehydrated. The owner reports he has been drinking a lot of water recently. A chemistry panel reveals a serum calcium of 13.8 mg/dl (9.1-11.7 mg/dl). An ionized calcium level is also performed, confirming a true elevation. Which condition could potentially cause these symptoms and calcium results?

• Hypoparathyroidism
• Diabetes mellitus
• Nutritional hyperparathyroidism
• Anal sac adenocarcinoma

Answer 37

Answer: Anal sac adenocarcinoma

Explanation
Lymphoma, anal sac adenocarcinomas, chronic renal failure, and primary hyperparathyroidism can all cause hypercalcemia in the dog. Nutritional secondary hyperparathyroidism does not result in hypercalcemia.

Diabetes mellitus can cause weight loss and increased drinking but does not typically cause elevated calcium.

Hypoparathyroidism causes low calcium.

Don’t forget the rectal exam to check the anal sacs for any masses or enlargement.

Question 38

Red maple toxicity causes which of the following?

• Colic
• Opisthotonos
• Hypersalivation
• Liver Failure
• Anemia

Answer 38

Answer: Anemia

Explanation
The correct answer is anemia. Red maple toxicity leads to Heinz body anemia due to oxidative damage to red blood cells.

Question 39

What phase of the estrus cycle does pyometra usually occur in the dog?

• Diestrus
• Proestrus
• Anestrus
• Estrus

Answer 39

Answer: Diestrus

Explanation
The correct answer is diestrus. In diestrus, progesterone is the predominant hormone, and it promotes endometrial growth, suppresses myometrial activity, and inhibits leukocyte response to infection. This all predisposes the dog to development of pyometra.

Question 40

The owner of a small hobby farm is seeing an outbreak of respiratory disease in his herd of cattle. You arrive at his farm and perform examinations on several ill cows, which are off feed and isolating themselves from the rest of the herd. Some, but not all, of the cows have high fevers, ranging from 104°F-106°F. Other signs include coughing. abnormal lung sounds, and nasal discharge. You discuss the benefits of performing diagnostic testing, but the producer elects to proceed with symptomatic treatment. What antibiotic would you recommend for these animals?

• Ampicillin as a one-time injection
• Gentamicin once daily for 10 days
• Ceftiofur as a one-time injection
• Ciprofloxacin once daily for 10 days

Answer 40

Answer: Ceftiofur as a one-time injection

Explanation
Although undifferentiated respiratory disease in cattle may have a wide variety of causes, antibiotic therapy is often attempted before proceeding with diagnostics. A lack of response to appropriate antibiotic therapy indicates a need for further diagnostics. Ceftiofur is a USDA approved treatment for bovine respiratory disease and is often effective when given as a one-time injection.

Ampicillin is also an approved treatment, but must be administered once daily.

Gentamicin and ciprofloxacin are not approved for the treatment of bovine respiratory disease.

Question 41

A horse presents for ingestion of Jimsonweed which contains scopolamine. Which of the following is the treatment of choice against such an intoxicant?

• Acetazolamide
• Atropine
• Physostigmine
• Diphenhydramine
• Epinephrine

Answer 41

Answer: Physostigmine

Explanation
The correct answer is physostigmine. Scopolamine is an atropine-like alkaloid and causes depression and is parasympatholytic to the autonomic nervous system. It can cause convulsions, respiratory failure, incoordination, mydriasis, and constipation. Treatment consists of activated charcoal, laxatives, diazepam to control convulsions and physostigmine (a parasympathomimetic).

Question 42

A necropsy of an aborted bovine fetus shows enlarged lymph nodes and spleen, destructive lesions to the thymus, and evidence of chronic granulomatous infection. What is the most likely cause of this abortion?

• Epizootic bovine abortion
• Tritrichomonas foetus
• Brucellosis
• Infectious bovine rhinotracheitis

Answer 42

Answer: Epizootic Bovine Abortion

Explanation
The correct answer is epizootic bovine abortion (EBA), also called foothill abortion. EBA is an important disease for beef producers in the foothill and mountainous regions of California, Northern Nevada and Southern Oregon. The lesions described in the question are consistent with this diagnosis. The etiologic agent of EBA is a bacteria, Pajaroellobacter abortibovis and the vector is a tick, Ornithodoros coriaceus.
Tritrichomona foetus is involved with early embryonic death.

Brucellosis abortions are rare since it has been almost completely eradicated from the U.S. Lesions include autolysis, placentitis, and bronchopneumonia.

Infectious Bovine Rhinotracheitis (IBR) causes rapid fetal death; therefore, there is very little time for fetal response. Lesions you are likely to see include autolysis and focal necrosis of the organs.

Question 43

How is equine influenza transmitted?

• Blood-sucking arthropods
• Through bite wounds
• Venereally
• Aerosol

Answer 43

Answer: Aerosol

Explanation
The correct answer is aerosol. Equine influenza is an orthomyxovirus and is spread in respiratory secretions of infected animals. It can be endemic in areas or spread as an epidemic because it is highly contagious.

Question 44

Which of the following tests used to test a population of cats will yield the most false negatives?

• Sensitivity 95%, Specificity 65%
• Sensitivity 100%, Specificity 50%
• Sensitivity 80%, Specificity 80%
• Sensitivity 65%, Specificity 95%

Answer 44

Answer: Sensitivity 65%, Specificity 95%

Explanation
The correct answer is sensitivity 65%, specificity 95%. The sensitivity determines the number of false negatives because sensitivity looks at the animals that do have the disease of interest and is the percentage of them that will test positive. If 65% test positive, that means 65% are true positive and 35% are false negative. Specificity defines the number of true negatives and false positives.

Question 45

White muscle disease is a caused by ______

• Iron deficiency
• Selenium deficiency
• Copper deficiency
• Vitamin D deficiency

Answer 45

Answer: Selenium deficiency

Explanation
The correct answer is selenium deficiency. Vitamin E deficiency may also cause WMD, but selenium is the key player. Selenium is essential for glutathione peroxidase, deiodinase, and selenoprotein-P to work.

Glutathione peroxidase breaks hydrogen peroxide and lipoperoxide to water or harmless alcohols. White muscle disease occurs as a result of having excessive free radicals which cause intracellular membrane damage due to lack of functional glutathione peroxidase. This results in excessive calcium entry into the cell, which then results in too much calcium uptake by the mitochondria. This will lead to mitochondrial damage and impaired energy metabolism. At the same time, the elevated cytoplasmic calcium results in hypercontraction of muscles and eventual necrosis and hyalinization. Diets high in polyunsaturated fatty acids are more likely to cause free radical damage. The good thing is that the rumen is capable of saturating these fatty acids, but the rumen can be overwhelmed, leading to trouble.

Question 46

A 7-year old Arabian gelding is presented to you for clinical signs of fever and lethargy of 2 days duration along with signs of hind-limb ataxia and muscle fasciculations of the face and neck. The CBC and biochemistry profile are relatively normal and you decide to collect cerebrospinal fluid (CSF) from the lumbosacral space. Results of CSF analysis yields the following:

Color Clear
Total Protein 156 mg/dL (reference interval 50-80 mg/dL)
Total Nucleated Cell Count 40 cells/mcL (ref interval less than 5 cells/mcL)
Cytology Lymphocytic pleocytosis
Based on the clinical signs and CSF analysis, which of the following is the most likely diagnosis and the most appropriate diagnostic test listed to confirm your diagnosis?

• Cervical Vertebral Malformation (CVM); Myelography of the cervical spine
• Equine Herpes Virus (EHV) Myeloencephalitis; Virus isolation of buffy coat, nasal swab and/or CSF
• Verminous encephalitis (Micronema deletrix); Culture of CSF
• West Nile Encephalitis (WNV); Serum Immunoglobulin M (IgM) capture ELISA
• Equine Protozoal Myelitis (EPM); Western Blot of CSF

Answer 46

Answer: West Nile Encephalitis (WNV); Serum Immunoglobulin M (IgM) capture ELISA

Explanation
The correct answer is WNV. This is a mosquito born flavivirus that affects horses in multiple areas of the United States. Clinical signs are variable and can be mild (muscle fasiculations, slight ataxia) to severe (recumbency). Of note, muscle fasiculations is somewhat characteristic of WNV but fever may be detected in all patients. A readily available diagnostic test is the serum IgM capture ELISA which will detect infection, even in the face of vaccination. There is a vaccine available for WNV, making the clinical presentation less common.

Question 47

Which of the following avian diseases is considered to be zoonotic?

• Lymphoid leukosis
• Avian encephalomyelitis
• Chlamydophila psittaci
• Infectious bursal disease

Answer 47

Answer: Chlamydophila psittaci

Explanation
The correct answer is Chlamydophila psittaci. This is the causative organism of avian chlamydiosis, a disease of pet birds, poultry, and wild avian species. It is also the cause of parrot fever or psittacosis in humans.

Question 48

You are called to a horse ranch that has an ongoing problem controlling Streptococcal infections (Streptococcus equi subsp. equi) among its horses. You attempt to identify carriers by collecting wash samples from the guttural pouch, since this is the most common place that horses harbor the organism. On endoscopy, you detect several hard, smooth, stone-like structures within the guttural pouch. What are these and what is their clinical significance?

• These are chondroids and are a source of persistent bacterial shedding
• These are inhaled foreign bodies and should be removed
• These are fungal granulomas and are an indicator of guttural pouch mycosis
• These are calcium carbonate gutturoliths and are an insignificant finding
• These are osteoids which are bony proliferations due to chronic osteomyelitis

Answer 48

Answer: There are chondroids and are a source of. Persistent bacterial shedding

Explanation
These objects are chondroids, which are concretions of pus and bacteria. They most commonly occur when horses develop guttural pouch empyema, an accumulation of purulent exudate in the guttural pouch due to mucosal infection or drainage from the retropharyngeal lymph nodes with Streptococcus equi subsp. equi (Strangles). This inspissated guttural pouch exudate provides a refuge for the bacteria and allows for continued bacterial shedding. When exudate persists, it can become increasingly dense (inspissated), forming solidified concretions that are difficult to extract and serve as a nidus for prolonged shedding of the organism.

To reduce shedding and transmission, these chondroids should be removed and the guttural pouch should be flushed and infused with 5 million units of penicillin G in 3% gelatin.

In addition, these horses should be treated with penicillin G intramuscularly for 7 days, isolated for 30 days, and then retested with 3 consecutive series of nasopharyngeal swabs and culture. Animals that remain positive should go through a repeat treatment and culture cycle.

Question 49

Which of these urine specific gravities would you most likely find in a horse with chronic renal insufficiency and moderate azotemia?

• 1.004
• 1.012
• 1.042
• 1.024
• 1.001

Answer 49

Answer: 1.012

Explanation
The correct answer is 1.012. Isosthenuria would be expected in any horse with chronic renal insufficiency that is causing azotemia. Isosthenuria is typically defined by a urine specific gravity of about 1.008-1.015.

Question 50

A number of young growing pigs on a commercial hog farm are experiencing head tilt, incoordination, reduced weight gains, and weak rear limbs. Most have normal vital signs, and you suspect a nutritional deficiency. Which of the following deficiencies might cause such clinical signs?

• Vitamin D
• Sodium
• Folic acid
• Vitamin A
• Thiamine (vitamin B1)

Answer 50

Answer: Vitamin A

Explanation
A shortage of vitamin A in the diet can lead to these signs in young pigs, especially an increase in middle ear infections, as also seen in turtles. In sows it can cause embryonic mortality and congenital defects in their offspring.

Question 51

A broiler flock has increased mortality and you conduct a necropsy to find three lesions: fibrinous pericarditis, perihepatitis and airsacculitis. What infectious agent is usually the cause of this classic triad of lesions?

• Bordetella avium
• Staphylococcus aureus
• Clostridium perfringens
• Mycoplasma synoviae
• Escherichia coli

Answer 51

Answer: Escherichia coli

Explanation
E.coli is typically the cause of disease when this triad of lesions is seen. Large numbers of E.coli are often found in poultry houses due to fecal contamination. Poultry routinely exposed to large numbers of pathogenic E. coli become systemically infected when the bacteria gain access to the bloodstream via the respiratory tract or intestine. If the bird survives septicemia, they often develop subacute fibrinopurulent airsacculitis, pericarditis and perihepatitis as well as lymphocytic destruction of the bursa and thymus.

Question 52

A 23-year old male Blue Front Amazon parrot presents for lethargy and poor feather quality. The bird is fed a diet of sunflower seeds and peanuts. The bird is kept in a 2x3 foot iron cage lined with newspaper. On physical exam the bird is obese, the feathers are dull and contain many stress bars, and there are white plaques located on the oral mucosa. Complete blood count and chemistry results are within normal limits. What is the most likely diagnosis?

• Candidiasis
• Psittacosis
• Trichomoniasis
• Mycobacteriosis
• Hypovitaminosis A

Answer 52

Answer: Hypovitaminosis A

Explanation
Hypovitaminosis A is seen most commonly in birds that are on poor quality diets, such as all seed diets or diets high in nuts. Amazon parrots appear to be more sensitive to this condition. Clinical signs are related to squamous metaplasia and include white plaques in the oral cavity, poor feather quality, respiratory distress and renal disease.

Trichomoniasis can cause white plaques but is more common in wild birds such as raptors and pigeons.

Candidiasis may cause white plaques in the mouth but is seen more commonly in young birds or birds that are immunosuppressed.

Psittacosis is the common name for Chlamydophila psittaci, a bacterial infection that causes respiratory and liver disease.

Mycobacteriosis is caused by the Mycobacterium avium complex and most commonly causes lesions in the Gl tract or skin in birds.

Question 53

Cytauxzoon felis is transmitted by ______

• Fleas
• Ticks
• Cats
• Mosquitoes
• Lice

Answer 53

Answer: Ticks

Explanation
The correct answer is ticks. Dermacentor variabilis or Amblyomma americanum are the most likely vectors.

The disease in cats is rapidly progressive and almost 100% fatal. A recent study shows 32 of 34 cats dying or being euthanized as a result of infection. Clinical signs include anorexia, lethargy, dyspnea, dark urine, dehydration, icterus, fever, prolonged capillary refill time, and death (essentially disseminated intravascular coagulation).

Ring-shaped organisms can be seen in erythrocytes or schizonts in spleen, liver, blood, bone marrow aspirates, or lymph nodes.

Question 54

Which of the following is most consistent with a parvovirus infection in a gilt?

• Abortions
• Bloody diarrhea
• Bred gilts return to heat
• Vomiting
• Severe, chronic leukopenia

Answer 54

Answer: Bred gilts return to heat

Explanation
The correct answer is bred gilts return to heat. Parvovirus infections in gilts usually result in an inapparent infection. A transient leukopenia may occur, but the first noticed sign is usually the return to heat of a bred gilt.

This is likely due to embryo resorption. Other signs may include mummified fetuses, weak piglets, small litters, or still births. Abortions are rare because the endometrium is not affected, so there is no PGF2-alpha released.

Question 55

What is the most common dermatophyte infecting the cat?

• Microsporum canis
• Microsporum felis
• Trichophyton mentagrophytes
• Microsporum nanum
• Microsporum gypseum

Answer 55

Answer: Microsporum canis

Explanation
The correct answer is Microsporum canis. 98% of dermatophyte infections in cats are M. canis. M. felis does not exist.

Question 56

Which of the following tests used to test a population of cats will yield the most false negatives?

• Sensitivity 80%, Specificity 80%
• Sensitivity 65%, Specificity 95%
• Sensitivity 100%, Specificity 50%
• Sensitivity 95%, Specificity 65%

Answer 56

Answer: Sensitivity 65%, Specificity 95%

Explanation
The correct answer is sensitivity 65%, specificity 95%. The sensitivity determines the number of false negatives because sensitivity looks at the animals that do have the disease of interest and is the percentage of them that will test positive. If 65% test positive, that means 65% are true positive and 35% are false negative. Specificity defines the number of true negatives and false positives.

Question 57

What is the correct post-exposure prophylaxis protocol after being exposed to rabies for a vaccinated human?

• Five injections of approved rabies vaccine
• Injection of human rabies immune globulin followed by 5 injections of approved rabies vaccine
• Two injections of approved rabies vaccine
• Three injections of human rabies immune globulin followed by 2 injections of approved rabies vaccine
• No treatment is required if the person is vaccinated

Answer 57

Answer: Two injections of approved rabies vaccine

Explanation
The correct answer is two injections of an approved rabies vaccine at Day O and Day 3. If you are not vaccinated, then you will need an injection of human rabies immunoglobulin immediately after exposure followed by 4-5 injections of an approved rabies vaccine IM over the course of 2-4 weeks. PEP is not required for accidental injection of animal rabies vaccine into a human.

Question 58

A 12-year old mare presents for a sudden onset of ptyalism and an inability to prehend food. Where is the lesion?

• Caudal cerebellar peduncle and medial longitudinal fasciculus
• Lateral lemniscus and rostral olivary nucleus
• Corpus callosum and amygdala
• Substantia nigra and globus pallidus

Answer 58

Answer: Substantia nigra and globus pallidus

Explanation
The correct answer is substantia nigra and globus pallidus. A lesion to these basal ganglia will result in movement disorders. Particularly, yellow star thistle poisoning will lead to an inability to prehend food in horses. The corpus callosum connects the two cerebral hemispheres together, and the amygdala is involved with fear and memory. The caudal cerebellar peduncle connects the medulla to the cerebellum and is involved in transmission of signals pertaining to movement. The medial longitudinal fasciculus is involved in conjugate gaze. The rostral olivary nucleus and lateral lemniscus are both involved in auditory pathways.

Question 59

Copper deficiency in ruminants is most often secondary and mainly associated with marginal copper levels and high levels of______

• Iron
• Molybdenum
• Zinc
• Cadmium

Answer 59

Answer: Molybdenum

Explanation
The correct answer is molybdenum. This question is sort of tricky because the other answer choices also interfere with copper absorption but to a lesser degree.

Sulfates are another contributing factor.

Question 60

You are investigating a case of high mortality in 14 week old pigs. You are suspicious of Porcine circovirus associated disease (PCVAD). What sample do you need to submit to a laboratory to confirm your diagnosis?

• Lymphoid tissue for histology
• Serum sample for PCR testing
• Serum sample for ELISA antibody testing
• Whole blood for complete blood count (CBC)
• Serum sample for virus isolation

Answer 60

Answer: Lymphoid tissue for histology

Explanation
The correct answer is lymphoid tissue for histology. A diagnosis of PCVAD requires 3 parts:
1) at least a doubling of mortality (clinical history)
2) demonstration of lymphoid depletion (histopathology)
3) high number of PCV2 antigen in the lesion (immunohistochemistry on tissue)

Question 61

A 72-lb, 4-year-old spayed female Rhodesian Ridgeback named Maggie presents at approximately 3pm for ingestion of chocolate. To raise money for an extracurricular activity, Maggie’s human brother has been selling World’s Finest Chocolate Bars. Today he came home sick from school but left the chocolate bars where Maggie had access. Sometime between 9am and 1pm, Maggie ate 28 of the 1.3 oz. milk chocolate bars (36.4 oz total, or approximately 1020 grams). On presentation, Maggie is her usual self, very bright, alert, and responsive. All vital signs are normal, and no significant abnormalities are found on physical examination. Based on the information provided by the owner, which of the following clinical signs might be expected from this chocolate ingestion?

• Vomiting, diarrhea, hyperactivity, seizures, cardiac arrhythmias, death
• None. The amount of chocolate ingested is below toxic levels.
• Mild vomiting, diarrhea, hyperactivity
• Pancreatitis

Answer 61

Answer: Vomiting, diarrhea, hyperactivity, seizures, cardiac arrhythmias, death

Explanation
This is a severe case of chocolate toxicity, so the correct answer is Vomiting, diarrhea, hyperactivity, seizures, cardiac arrhythmias, and death.

Although milk chocolate is not as toxic as dark, semisweet, or baking chocolate, it averages 60 mg of methylxanthines (MX) per ounce (28 g) of chocolate. Approximately 80-85% of the methylxanthines in chocolate are theobromine while the other 15-20% are caffeine.

Therefore, this dog ingested approximately:
36.4 oz x 60 mg MX/oz = 2184 mg MX
or
2184 mg /32.7 kg = 66.7 mg/kg MX

(Dark or semisweet chocolate averages 150 mg MX per ounce, and baking chocolate averages 450 mg MX per ounce.)

Mild reactions may be seen at 20 mg/kg.

Moderate to severe reactions occur at doses exceeding 40 mg/kg.

Any dose that exceeds 40 to 45 mg/kg should be considered potentially life-threatening.

Cardiotoxicity begins at 50 mg/kg, and seizures are possible at doses greater than 60 mg/kg.

Question 62

What is NOT a likely outcome of a fetus infected at 100 days of gestation with bovine viral diarrhea?

• Cerebellar hypoplasia
• Persistently infected calf
• Abortion
• No significant disease

Answer 62

Answer: No significant disease

Explanation
A fetus infected at less than 125 days gestation can have early embryonic death, fetal death, abortion, congenital defects, mummification, or be persistently infected. After 170 days of gestation the outcomes are usually abortion, weak calf, and abnormal calf.

Question 63

You are examining a group of 20 yearling beef heifers in a late summer in Alberta, Canada that has been cooler and wetter than normal. The heifers have been experiencing poor growth and diarrhea. The farmer reports that the cows have developed a frequent, non-productive cough after exertion in the past week. You examine the cows and find their vital parameters to be within normal limits with the exception of several mildly tachypneic cows. There is no ocular or nasal discharge seen. You auscult occasional crackles in many of the cows. Fecal examination reveals Dictyocaulus viviparus L3 in three of six samples. You treat the cows with ivermectin and see cessation of coughing and diarrhea within a few days. Which of the following would be the best way to prevent this problem next year now that there is a known risk?

• Control of earthworms
• Injectable vaccine administered 4 weeks before the grazing season
• Control of snails
• Persistent use of anthelmintics 2 to 3 times during the grazing season
• Control of ticks

Answer 63

Answer: Persistent use of anthelmintics 2 to 3 times during the grazing season

Explanation
Based on the presentation and diagnostic findings, this is a case of Dictyocaulus viviparus, the bovine lungworm and cause of verminous bronchitis. Although the worm is more common in Europe, cases can be seen worldwide including in North America, particularly when weather conditions permit (cooler, moist summers).

Dictyocaulus often affects younger cattle more severely. Signs include cough and frequently tachypnea. The diagnosis is frequently suggested by the seasonal incidence although confirmation with fecal examination (Baermann) is important to achieve a definitive diagnosis. Treatment with an anthelmintic of clinically affected animals is usually effective.

Dictyocaulus has a direct life cycle and does not require a snail, earthworm, or tick for transmission. There are 2 main methods of prevention. A strategic anthelmintic program entails administration of an anthelmintic such as ivermectin at 3, 8, and 13 weeks post-turnout. There are approximately 28 days of residual activity against lungworm. Vaccination is used in some areas (mainly Europe) and involves an attenuated oral vaccine of 1,000 irradiated L3 Dictyocaulus viviparous at 6 and 2 weeks pre-turnout.

Question 64

When conducting a necropsy, the two key organs that are examined to make a diagnosis of histomoniasis (Blackhead) are:

• Spleen and pancreas
• Lung and kidney
• Cecum and kidney
• Liver and cecum
• Brain and liver

Answer 64

Answer: Liver and cecum

Explanation
Histomoniasis causes marked inflammation and ulcerations, leading to a thickening of the cecal wall. The liver is also often affected and may appear green or tan. Cecal and liver lesions together are considered pathognomonic for this disease.

Question 65

Which of these clinical findings would you expect in a case of lymphangiectasia in a Belgian Sheepdog as depicted in the photo?

• Hypercholesterolemia
• Lymphocytosis
• Panhypoproteinemia
• Hypercalcemia

Answer 65

Answer: Panhypoproteinemia

Explanation
The correct answer is panhypoproteinemia. Lymphangiectasia is a classic example of a protein-losing enteropathy. It is characterized by dilation and dysfunction of intestinal lymphatics and leakage of protein-rich lymph into the intestinal lumen. As a result, protein, cholesterol, and lymphocytes are all lost. Calcium is also frequently low due to either low albumin or vitamin D and calcium malabsorption.

Question 66

You are looking at Diff-quick stained slides of joint fluid from a 7-year old Labrador with shifting-leg lameness and fever. You see a moderate to large number of nondegenerate neutrophils, accounting for 95% of the cell population, and scattered small mononuclear cells (accounting for 5% of the cell population). How would you describe this joint fluid?

• Granulomatous inflammation
• This is a normal cell population for joint fluid
• Pyogranulomatous inflammation
• Suppurative, nonseptic inflammation
• Suggestive of osteoarthritis
• Suggestive of neoplasia

Answer 66

Answer: Suppurative, nonseptic inflammation

Explanation
The marked predominance of nondegenerate neutrophils without apparent intracellular organisms makes this suppurative, nonseptic inflammation. Primary differentials include immune-mediated polyarthritis and polyarthritis due to rickettsial disease.

A small mononuclear cell population is normally present in joint fluid, but neutrophils are not.

“Granulomatous” describes a predominantly mononuclear cell population (lymphocytes, macrophages, plasma cells), and “pyogranulomatous” describes a mixed population of neutrophils and mononuclear cells.

Osteoarthritis may result in a mild increase in mononuclear cells with a few neutrophils, but should not produce markedly inflammatory joint fluid.

Question 67

A 3 year old indoor/outdoor MN feline named Dudley presents to your clinic because the owner saw “some white rice-looking things” around his anus. They were small and flat and seemed to be moving. Some of them were dried up. Which of the following treatments would be best?

• Fipronil (Frontline)
• Pyrantel (Strongid)
• Selamectin (Revolution)
• Praziquantel (Droncit)
• Fenbendazole (Panacur)

Answer 67

Answer: Praziquantel (Droncit)

Explanation
This cat likely has a tapeworm infection. Tapeworm segments are typically flat and white and small, resembling a grain of rice. The most common tapeworms in cats are Taenia taeniaeformis and Dipylidium caninum. The only medication that will treat both types is praziquantel.

Praziquantel is in the products Drontal Plus and Profender, approved for the use in cats. Drontal Plus also contains pyrantel. Profender also contains emodepside. Both are also effective against roundworm and hookworm.

Pyrantel is not effective against tapeworms and treats hookworm and roundworm infection. Fenbendazole (or Panacur), treats Taenia but not Dipylidium, and also treats hookworm, roundworm, and whipworm infection.

Revolution treats and prevents hookworm, roundworm, heartworm, fleas, and ear mites in cats. Frontline treats and prevents fleas and ticks. A flea control should be recommended since Dipylidium is transmitted by ingestion of an infected flea. Taenia is transmitted through eating an infected prey.

Question 68

A 3-week-old Holstein calf presents for diarrhea, fever, and anorexia. On physical exam, the calf appears to have a very stiff neck and hyperesthesia. Blood work shows an increased WBC and neutrophilia. A CSF tap is performed, which shows a turbid fluid, protein of 120 mg/dl, and 420 WBCs/uL which are mainly neutrophils. What is the most likely diagnosis?

• Meningitis
• Salt poisoning
• Polioencephalomalacia
• Listeriosis

Answer 68

Answer: Meningitis

Explanation
The correct answer is meningitis. This conclusion can be made by examining the CSF. An elevated CS protein and CS neutrophilia indicates a bacterial infection. Listeriosis tends to be associated with monocytosis of the CSF. The clinical signs and blood work are non-specific, and only the CSF results allow good differentiation between the other answer choices. With polioencephalomalacia the CSF changes in WBC count and protein will be much lower (5-50 WBCs/uL and protein slightly greater than 50mg/dl). Salt poisoning will not change the CSF protein and WBC count by much either.

Question 69

A 4-year-old Guernsey cow presents for a suspected urinary tract infection. In the last several days, her owner noticed that her appetite has decreased and she is showing signs of abdominal discomfort. On closer observation, he also noted that she is straining to urinate and there appears to be blood staining around her perineum. You collect a urine sample via catheter. When should you perform a microscopic sediment exam on the sample, in order to obtain the best cytologic detail on the collected sample?

• Observe sediment within 4-6 hours of collection
• Observe sediment within 24 hours of collection
• Observe sediment within 12 hours of collection
• Observe sediment within one hour of collection

Answer 69

Answer: Observe sediment within one hour of collection

Explanation
Pyuria is confirmed by obtaining a midstream or catheterized urine sample (or both) and quantitating the number of bacteria in the urine sediment. Evaluation of the urine sediment within 30 to 60 minutes of collection enables preservation of the greatest cytologic detail.

Question 70

On a chilly fall day, Mr. Jones, the local mechanic from down the street, brings in his shop cat on emergency. Sprocket is a 4-year-old, scrappy neutered male Domestic Shorthair. He presents with a 45-minute history of vomiting and “acting drunk.” Just as you enter the exam room, Sprocket vomits a large amount. In a stroke of brilliance, you decide to pull out the Wood’s lamp, and sure enough, it fluoresces! You quickly realize time is of the essence to start treatment for this patient. Based on the toxicity described in this case, at what point after ingestion would you expect to see signs of acute renal failure?

• 12-24 hours
• 24-36 hours
• 2-4 hours
• 6-12 hours

Answer 70

Answer: 12-24 hours

Explanation
The correct answer is 12-24 hours. Based on the history, clinical signs, and fluorescence of the vomitus, Sprocket most likely is suffering from antifreeze toxicity. Ethylene glycol toxicity causes oliguric acute renal failure at 12-24 hours in the feline patient and 36-72 hours in the dog. Feline patients with EG toxicity succumb to the negative effects much more quickly than dogs. It is critical to get these patients admitted to the hospital as soon as possible to begin diuresis and other treatment.

Question 71

Several does in a large goat herd, all of which are in late gestation, have not been able to rise to the standing position.
They are being fed good quality grass and alfalfa hay. It is December and the weather is cold. They have reduced feed intake and the most severely affected individuals appear blind and depressed, and two have died. On post-mortem examination, your only finding is that they have fatty livers and 4 fetuses each. The physical exam is otherwise not very revealing except that all have significant ketonuria. What steps should be taken to prevent more does from developing this disorder?

• Add magnesium oxide to feed
• IM dexamethasone
• Feed anionic diet
• Calcium gluconate IV
• Increase energy intake

Answer 71

Answer: Increase energy intake

Explanation
About one lb/head/day of good quality grain should be introduced by mid gestation for sheep and goats carrying multiple fetuses. The prognosis for animals already showing clinical signs is poor and treatment is expensive. A C-section can be done, IV glucose administered slowly by drip. This should be followed by rumen transfaunations and feeding 15 to 30 ml propylene glycol every 12 hours, as well as feeding high quality feed.

Question 72

On examination of a dog with a history of scant bloody diarrhea, abdominal pain, a palpable doughy sausage in the abdomen, and vomiting, you suspect an intestinal intussusception. What is the most common type of intussusception in small animals?

• Jejuno-jenunal intussusception
• Jejuno-ileal intussusception
• Duodeno-jejunal intussusception
• Ileocolic intussusception

Answer 72

Answer: Ileocolic intussusception

Explanation
The correct answer is ileocolic intussusception. The second most common is jejuno-jenunal intussusception.

Question 73

Calves that are fed milk replacers containing linseed oil, soybean oil, fish oil, or corn oil are predisposed to what deficiency?

• Vitamin B12
• Vitamin K
• Vitamin D
• Vitamin A
• Vitamin E

Answer 73

Answer: Vitamin E

Explanation
The correct answer is vitamin E. Because these oils are high in polyunsaturated fatty acids, it is necessary to increase the amount of vitamin E provided so that it can scavenge all the additional free radicals that result.

Question 74

What is the oldest tooth in the horse?

• Incisor 1
• Premolar 1
• Molar 1
• Canine

Answer 74

Answer: Premolar 1

Explanation
The correct answer is premolar 1. This is also known as the wolf tooth and is commonly removed so that bits can be easily fitted to the horse’s mouth. This tooth erupts at 5-6 months of age. Molar 1 does not erupt until about one year of age. The canine does not come in until 4-5 years of age. The first permanent incisor is seen at approximately 2.5 years of age.

Question 75

Which of the following zoonotic pathogens is most likely to be acquired via raw goat milk?

• Brucella melitensis
• Bacillus anthracis
• Brucella abortus
• Clostridium difficile
• Brucella suis

Answer 75

Answer: Brucella melitensis

Explanation
B. melitensis is a severe pathogen in humans, as are B. abortus from cattle, B. suis from pigs and B. canis from dogs.

Question 76

A 2-year old rabbit presents for scratching its ears. On physical exam you observe crusts and excoriations in its ears. Microscopic exam of the crusts reveals numerous mites. You prescribe ivermectin to treat which parasite in this rabbit?

• Encephalitozoon cuniculi
• Treponema paraluis cuniculi
• Otodectes cynotis
• Psoroptes cuniculi Correct Answer
• Chevletiella parasitovorax

Answer 76

Answer: Psoroptes cuniculi

Explanation
Psoroptes cuniculi, the rabbit ear mite, causes severe crusting and inflammation in the external ear canals.

Treatment is ivermectin or selamectin. Encephalitozoon cuniculi is a microsporidian parasite of rabbits that causes neurologic and renal disease. Cheyletiella parasitovorax is the rabbit fur mite and causes white flakes that resemble dandruff. Otodectes cynotis is the ear mite of dogs and cats. Treponema paraluis cuniculi is the causative agent of rabbit syphilis.

Question 77

Voiding of the bladder involves

• Parasympathetic inhibition and sympathetic stimulation
• Sympathetic inhibition and parasympathetic inhibition
• Parasympathetic stimulation and sympathetic inhibition
• Somatic stimulation

Answer 77

Answer: Parasympathetic stimulation and sympathetic inhibition

Explanation
The correct answer is parasympathetic stimulation and sympathetic inhibition.

The hypogastric nerve is a part of the sympathetic nervous system. This nerve provides innervation primarily to beta receptors in the detrusor muscle and alpha receptors in the internal urethral sphincter.

The pelvic nerve is a part of the parasympathetic nervous system. The nerve primarily innervates the detrusor muscle of the bladder wall.

The pudendal nerve is a somatic nerve. It provides innervation to the external urethral sphincter.
During the voiding phase of micturition, the parasympathetic nervous system is active. The pelvic nerve stimulates cholinergic receptors in the detrusor muscle that result in contraction of the bladder and expulsion of urine.

During the storage phase, the sympathetic and somatic nervous systems are active. The hypogastric nerve stimulates beta receptors in the detrusor muscle which causes the muscle to relax. It also stimulates alpha receptors in the internal urethral sphincter, which causes the sphincter to contract. While this is going on, the external urethral sphincter is contracting as a result of stimulation from the pudendal nerve.

Question 78

You are called to examine a pregnant ewe. The ewe is due to give birth in two weeks per the owner’s records. Two days ago, the ewe started to show signs of depression and anorexia. The owner separated her from the rest of the herd for supplemental feeding and careful monitoring. This morning, she developed mild muscle tremors and began to act uncoordinated, prompting the owner to contact you. By the time you arrive at the farm, the ewe is ataxic and reluctant to rise. You perform a serum B-hydroxybutyrate (BHB) assay. The ewe’s BHB is 2 mmol/L (reference range: <1 mmol/L). This is a valuable breeding ewe and the owner wants the best possible outcome for her. What treatment do you recommend?

• Administer dexamethasone
• Administer prostaglandin F2a
• Administer oral calcium supplementation
• Administer intravenous propylene glycol

Answer 78

Answer: Administer dexamethasone

Explanation
The ewe’s clinical signs and elevated BHB level are consistent with a diagnosis of pregnancy toxemia. This condition typically occurs in ewes and goats during the last 2-4 weeks of gestation, especially those that are pregnant with twins or triplets. The fetus needs more nourishment than the ewe or doe is taking in, resulting in hypoglycemia and ketosis of the ewe and potential death of the fetus. Given the ewe’s rapid decline and the owner’s desire to save her as a breeding animal, the best option is to induce parturition immediately. In ewes, this is achieved through the administration of dexamethasone.

In does, dexamethasone or prostaglandin F2a can be utilized to induce parturition.

Propylene glycol can be administered as an energy source, but it is given orally and not intravenously.

Oral calcium supplementation may also play a role in treatment, but it will not work quickly enough to benefit this ewe.

Question 79

Imaging options for a young, intact urinary-incontinent bitch with unremarkable plain abdominal radiographs include all but which of the following?

• Abdominal fluoroscopy
• Vaginocystourethrography
• Excretory urography
• Abdominal ultrasound exam
• Abdominal contrast computed tomography
• Cystoscopy

Answer 79

Answer: Abdominal fluoroscopy

Explanation
Top differential rule-outs for this patient include congenital defects such as ectopic ureter, pelvic bladder or vestibulovaginal stricture with urine pooling and recurrent urinary tract infections. Abdominal fluoroscopy, in the absence of any positive or negative contrast material, will likely offer no further information in the diagnosis.

Question 80

Tag 10169, a 2.5-year old Guernsey, presents for clinical signs of colic. There is a history of very little feces being passed over the last 24 hours. On rectal exam, a distended structure can be palpated just cranial to the pelvis. The structure feels like a loaf of bread. Additionally, there is a right sided ping heard from the last rib to the pelvis, high up. The rest of the physical was unremarkable. What is your top differential?

• Intussusception
• Right displaced abomasum
• Cecal tear
• Cecal displacement or torsion
• Torsion of the omasum and abomasum

Answer 80

Answer: Cecal displacement or torsion

Explanation
The 3 most common causes of colic are intussusception, cecal dilation with or without torsion, and abomasal volvulus. You can quickly rule out the torsion of the omasum and abomasum and the RDA, as the ping would be lower on the right and in front of the last rib, plus you would not have palpated the “loaf of bread” rectally.

Cattle with intussusception usually have scant dark blackberry jam-colored feces and on rectal exam, sometimes have a palpable hard and painful mass on the right.

Question 81

A 6-year old indoor/outdoor female spayed Siamese presents to you for a 2 day history of anorexia, lethargy, and dyspnea. On presentation the cat has icteric mucous membranes, a grade Il/VI left parasternal heart murmur, and a temperature of 104.4F (40.2 C). Initial bloodwork showed a normochromic, normocytic non-regenerative anemia with concurrent thrombocytopenia. A blood smear revealed the following organisms (seen in the picture). The owner has 3 other cats at home. What is your diagnosis and what would your recommendation be for the owner?

• Cytauzoon felis; diligent tick preventative application and restrict access to the outdoors
• Cytauxzoon felis; have the other cats tested
  since they have been around the sick one
• Mycoplasma haemofelis; diligent tick
  preventative application and restrict access to the outdoors
• Mycoplasma haemofelis; have the other cats
  tested since they have been around the sick one

Answer 81

Answer: Cytauzoon felis; diligent tick preventative application and restrict access to the outdoors

Explanation
Cytauxzoon felis is a tick borne disease prevalent in the southern states. Cats typically present with a marked pyrexia, icterus or pallor, anemia associated heart murmur, and thrombocytopenia.

This disease should be differentiated from Mycoplasma haemotelis as treatment and prognosis vary greatly. Both organisms infect erythrocytes and it can sometimes be difficult to distinguish between the two.

Cytauxzoon is a protozoal organism that characteristically has a signet ring shape with a prominent nuclear area as seen in the image.
Mycoplasma haemofelis is a bacterial parasite that can appear as cocci, rings, or rods.

Treatment of a Cytauxzoon infection is challenging and costly, so prevention should be the goal. Current treatment recommendations include the antimalarial drug atovaquone combined with the antimicrobial azithromycin as well as fluids, heparin and supportive care.

Without treatment, mortality is close to 100%, but even with treatment mortality can be upwards of 40%. Cats should be kept indoors to limit exposure to ticks and tick preventative should be applied consistently.

ChGPT: Cytauxzoonosis is a life-threatening infectious disease in domestic cat…

https://www.merckvetmanual.com/circulatory-system/blood-parasites/cytauxzoonosis-in-cats?query=cytauxzoonosis%20in%20cats