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Veterinary Board Exam - Volume 2 > Diagnostics > Flashcards

Diagnostics Flashcards

1
Q

What is the diagnostic test of choice for confirming chlamydophilosis in a pet bird?

A

Histologic or cytologic demonstration of the organism (elementary bodies) in smears, fluids, or tissue.
Polymerase chain reaction demonstration of DNA, or specialized culture isolation, are also possible but less practical.

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2
Q

On radiographs of the equine tarsus, where are the 2 most common locations of osteochondrosis?

A

1) Cranial aspect of the intermediate ridge of the distal tibia
2) Lateral trochlear ridge of the talus

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3
Q

Which endocrine test should be performed on an animal with gastrointestinal signs, lethargy, and the lack of a stress leukogram on its complete blood count?

A

Adrenocorticotropic hormone stimulation test (rule in or out hypoadrenocorticism)

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4
Q

On a patient’s electrocardiogram, ST segment depression becomes apparent. What does this usually indicate?

A

Myocardial hypoxia

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5
Q

What is the purpose of using a Schiotz tonometer?

A

Measuring intraocular pressure (glaucoma, uveitis)

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6
Q

Name a circulating cardiac biomarker that indicates elevated intraventricular pressures (as seen with congestive heart failure) and another cardiac biomarker that indicates myocardial damage (as seen with myocarditis).

A

Elevated intraventricular pressure: The natriuretic peptides (notably NT-proBNP, or B-type natriuretic peptide)

Myocardial damage: The cardiac troponins, cTn-I ans cTn-T.

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7
Q

Laminar cerebrocortical necrosis and eosinophils in the meninges and Virchow-Robin spaces are characteristic histopathological findings of which disease of swine?

A

Salt toxicity (Sodium poisoning and water intoxication)

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8
Q

Feline asthma is characterized by which radiographic findings?

A

Bronchial pattern, hyperinflation of lungs, increased radiolucency of lung, flattened diaphragm; normal radiographs do not rule out asthma.

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9
Q

A right lateral radiograph of a dog’s abdomen shows a gas distended stomach. There is a reverse C sign appearance on the stomach. What is the diagnosis?

A

Gastric dilation volvulus

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10
Q

When performing pericardiocentesis, which intercostal space should be entered, and at which landmark?

A

5th intercostal space, at the costochondral junction (typically from the right side to minimize the risk of catheter-induced coronary artery laceration).

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11
Q

Where would you expect to find the point of maximal intensity (PMI) of a murmur associated with tricuspid insufficiency?

A

Right side of the thorax, over the cardiac apex (approximately 4th ICS)

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12
Q

What is the most common serum biochemical abnormality in dogs with primary hypothyroidism?

A

Fasting hypercholesterolemia

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13
Q

Which of the following does polymerase chain reaction (PCR) detect?

A) Antibody
B) Protein
C) Nucleic acid
D) Antigen

A

C) Nucleic acid
The chain reaction (CR in PCR) refers to exponential expansion of nucleic acid chains.

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14
Q

On ECG, P waves occur at regular intervals, and wide, bizarre QRS complexes occur at a much slower rate, unrelated to the P waves. What is the diagnosis?

A

Third degree (complete) AV block. The wide, bizarre QRS complexes are ventricular escape beats.

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15
Q

Which test is currently the most widely used and preferred method of diagnosing rabies infection in animals?

A

Direct fluorescent antibody testing of brain tissue

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16
Q

What is the most sensitive and specific blood test for the diagnosis of canine and feline pancreatitis?

A

Species-specific (canine or feline) serum pancreatic lipase (pLI) concentration.

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17
Q

Anal sac adenocarcinoma is commonly associated with which serum biochemical abnormality?

A

Hypercalcemia. Previous reports of overrepresentation of females in dogs with anal sac adenocarcinoma are no longer supported.

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18
Q

Which bacterium is most commonly isolated in uncomplicated canine infectious tracheobrionchitis?

A

Bordetella bronchiseptica. Mycoplasma spp. is also acceptable (though rarely cultured). Several other bacterial species may be involved later as secondary opportunists.

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19
Q

Which cytologic changes in nuclear morphology are characteristic of neoplastic cells and are criteria for malignancy?

A

Presence of nucleoli, anisokaryosis, clumped chromatin, and high nuclear to cytoplasmic ratio

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20
Q

On an echocardiogram, an anechoic (black) space is apparent adjacent to the epicardium. What is the diagnosis?

A

Pericardial effusion

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21
Q

Describe the expected serum ionized calcium, parathyroid hormone (PTH) and parathyroid hormone related protein (PTHrP) concentrations in primary hyperparathyroidism.

A

Elevated ionized calcium with normal to elevated PTH, or normal ionized calcium with elevated PTH; undetectable PTHrP in either case.

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22
Q

Hyperglycemia, glucosuria, ketonuria, and metabolic acidosis are the hallmark findings of which endocrine disorder?

A

Diabetic ketoacidosis

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23
Q

Name two ways to confirm a suspected diagnosis of retinal detachment in a blind animal.

A

Fundic examination and ocular ultrasound examination. Only ultrasound is effective if there is severe hyphema, obscuring the anterior an posterior chambers.

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24
Q

During echocardiography, the left atrium is usually compared to which structure for deciding whether left atrial enlargement is present? (a ratio of about 1:1 is expected in most animals)

A

Aorta. The proximal aorta is anchored to the fibrous cardiac skeleton and therefore almost never changes in size with any heart disease, making it an excellent reference point.

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25
Q

Which type of urinary crystal is observed in normal Dalmatian dogs or dogs with liver disease?

A

Ammonium biurate crystals

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26
Q

When a standing lateral thoracic radiograph of a horse is taken, which lung is most clearly seen - the lung field closest to the cassette, or the opposite lung field?

A

Lung field closest to the cassette. The opposite lung field gets distorted due to the great width of the equine chest.

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27
Q

At which sites in the canine stifle does osteochondritis dissecans (OCD) occur most commonly?

A

Lateral and medial femoral condyles

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28
Q

Which form of Blastomyces dermatidis is most commonly found on cytological or histopathological preparations of infected tissues?

A

Yeasts (classically broad-based budding). Never cultured in-house (risk of aerosol transmission causing zoonosis)

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29
Q

In dogs and cats, what is the most reliable blood test for detecting liver disease such as a portosystemic shunt?

A

Serum bile acids (elevated postprandial bile acid level)

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30
Q

Which form of Coccidioides immitis may be found on cytological or histopathological preparations of infected tissues?

A

Spherules (containing endospores). Never cultured in-house because aerosolization causes zoonosis.

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31
Q

With a primary glomerular disease, would you expect a mild, moderate, or severe proteinuria?

A

Severe proteinuria with urine protein to urine creatinine ratios often more than 3 and usually more than 5.

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32
Q

Besides the liver, elevations in aspartate aminotransferase (AST) may originate from which other tissue?

A

Muscle, and minuscule quantities from kidney, red blood cells, brain, and placenta.

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33
Q

What is the simplest test for confirming the patency of the nasolacrimal duct (also called the Jones test)?

A

Application of fluorescein stain on the eye, and observation for its emergence at the nasolacrimal puncta

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34
Q

Adequate renal concentrating ability is presumed to exist if the urine specific gravity is greater than which value in dogs?

A

1.030

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35
Q

Decreased production of which substance causes non-regenerative anemia in animals with chronic kidney disease?

A

Erythropoietin, which is synthesized by the peritubular capillary cells of the kidney

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36
Q

What does an elevated serum l-lactate value indicate? How would this affect the anion gap?

A

Poor tissue perfusion, decreased oxygenation, anaerobic respiration. It would result in an increased anion gap.

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37
Q

Which common fungal organism has a distinguishing polysaccharide capsule?

A

Cryptococcus spp.

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38
Q

Arrhythmogenic right ventricular cardiomyopathy (formerly called Boxer cardiomyopathy) is characterized by which type of cardiac arrhythmia?

A

Premature ventricular complexes (right sided) and ventricular tachycardia

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39
Q

What is the most reliable diagnostic test for feline hypertrophic cardiomyopathy?

A

An echocardiogram. Genetic testing of a blood sample for the beta-myosin heavy chain mutation is simpler but less reliable (many false negatives).

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40
Q

Is the ELISA test for Johne’s disease more sensitive when used in clinically diseased animals or in subclinically infected animals?

A

More sensitive for detecting Johne’s disease (paratuberculosis) in clinically diseased animals

41
Q

An electrocardiogram shows unusually tall P waves. What structural change in the heart is suspected, and what is the Latin term that describes tall P waves associated with such a change?

A

Right atrial enlargement; ‘‘P pulmonale’’

42
Q

Which avian blood cell (granulocyte) is analogous to the mammalian neutrophil?

A

Heterophil

43
Q

Name 2 erythrocyte features that are normal in Akitas but are not found in most other dog breeds.

A

Microcytosis (or low mean corpuscular volume) and very high intracellular potassium. Thus, in this breed and other Japanese breeds (Shiba Inu, Tosa Inu), in vitro hemolysis can cause marked (but artifactual) hyperkalemia.

44
Q

Which 2 abnormal erythrocyte morphologies are associated with canine splenic hemangiosarcoma?

A

Schistocytes and acanthocytes

45
Q

Which form of canine hyperadrenocorticism is most likely if a 4-hour serum cortisol concentration is inferior to 50% of baseline is reported on a low-dose dexamethasone suppression test?

A

Pituitary dependent hyperadrenocorticism, because this result indicates suppression. A primary adrenocortical tumor would be associated with a cortisol concentration above 50% (i.e. failure to suppress)

46
Q

In the canine hemogram, which changes constitute a stress leukogram?

A

Neutrophilia (without a left-shift), lymphopenia, eosinopenia, and monocytosis.

47
Q

Acid-fast, intranuclear inclusions in the proximal convoluting tubular epithelium are diagnostic for what?

A

Lead poisoning

48
Q

Which fecal diagnostic test is optimal for identifying Cryptosporidium oocysts?

A

Flotation with saturated sugar (centrifugation will improve recovery of oocysts)

49
Q

Which percentage of dogs with appendicular osteosarcoma have pulmonary metastasis visible on thoracic radiographs at the time of diagnosis?

A) Less than 10%
B) 15-30%
C) 40-60%
D) More than 75%

A

A) Less than 10%

50
Q

After approximately how many days would you expect to see signs of regeneration following acute blood loss in a dog?

A

2-3 days, and reach maximum regeneration approximately 7 days post onset of hemorrhage.

51
Q

When sampling the lower respiratory tract of a horse with suspected bacterial pneumonia, which diagnostic procedure is preferred for obtaining a bacterial culture sample?

A

Tracheal aspiration (Bronchoalveolar lavage is for cytology only)

52
Q

Which cardiac arrhythmia is most commonly noted in dogs with gastric dilation and volvulus?

A

Premature ventricular complexes. Some patients also develop transient atrial fibrillation, often if fluid resuscitated rapidly and treated with opioid drugs.

53
Q

Patients with acute hemorrhagic diarrhea can rapidly lose large amounts of fluid from the GI tract. What is a common abnormality noted initially on a CBC in such patients?

A

Elevated PCV (relative polycythemia from hemoconcentration)

54
Q

Central diabetes insipidus can be differentiated from nephrogenic diabetes insipidus using which test?

A

Vasopressin/antidiuretic hormone (ADH) response test. Note that a water deprivation test does NOT distinguish between central and nephrogenic forms.

55
Q

Which serum liver enzyme may be elevated due to normal bone growth or exposure to corticosteroids in dogs?

A

Alkaline phosphatase (ALP)

56
Q

What are typical radiographic features of advanced but compensated (‘‘asymptomatic’’, or ‘‘murmur only’’) chronic mitral valve insufficiency in dogs?

A

Left atrial enlargement, left-sided cardiomegaly, possibly pulmonary venous enlargement; absence of an interstitial pattern (no pulmonary edema).

57
Q

In a case of septic peritonitis, is the blood glucose concentration higher or lower than the glucose level in the free abdominal fluid?

A

Higher, generally more than 20 mg/dL (More than 1.1 mmol/L) difference. This is attributed to anaerobic glycolysis by leukocytes in the abdominal exudate.

58
Q

Which structure, producing the ‘‘sail sign’’, might be seen cranial to the heart on a ventrodorsal thoracic radiograph of a young dog?

A

The thymus

59
Q

What is the difference between an osteophyte and an enthesiophyte?

A

Osteophytes: Bony outgrowths caused by abnormal joint wear in osteoarthritis, seen at articular cartilage margins.

Enthesiophytes: Bony outgrowths at an enthesis (where soft tissue inserts on a bone, aka tendon, ligament, or fascia).

60
Q

What is the purpose of gonioscopy?

A

To assess the iridocorneal angle for signs that could indicate predisposition to glaucoma (narrow/closed/obstructed iridocorneal angle)

61
Q

Name 3 radiographic signs of osteoarthritis.

A

1) Joint effusion
2) Widening and/or thinning of radiolucent joint space
3) Enthesiophyte formation on non-weight bearing surfaces
4) Remodeling of subchondral bone
5) Mineralization of intra-articular and peri-articular soft tissues
6) Formation of subchondral cysts
7) Subluxation (coxofemoral)

62
Q

A puppy with respiratory signs, conjunctivitis, and vomiting and bloody diarrhea is suspected to have distemper. What is the diagnostic test of choice?

A

Indirect fluorescent antibody testing of conjunctival swabs or white blood cells from circulating blood, or blood smears for virus isolation.

63
Q

You suspect an outbreak of Marek’s disease in chickens. Name 2 diagnostic tests that can be useful for confirming the diagnosis.

A

Histopathologic examination of nerves and tumors; Polymerase chain reaction; Virus isolation; Bird challenge experiments; Serologic titers only in specific pathogen-free flocks.

64
Q

An audible S4 gallop on auscultation is usually associated with what type of lesion of the ventricles?

A

Hypertrophy and stiffness. It occurs due to resonance/vibration of ventricular walls during end-diastole (atrial contribution to ventricular filling).

65
Q

In a biopsy specimen from a patient with hepatic amyloidosis, in which anatomic region does the amyloid accumulate?

A

Space of Disse

66
Q

Approximately which percentage of the functional hepatocytes must be lost before alterations of hepatic function are detectable by serum biochemical testing?

A

70%. It is worth remembering here that indicators of hepatic function (e.g. Bilirubin, albumin, cholesterol) are distinct from indicators of hepatic damage (ALT, AST, etc.) - a common oversight.

67
Q

Does the feline leukemia (FeLV) ELISA test detect antigen, antibody or both?

A

Antigen only. This is why the result is unaffected by previous vaccination, unlike other vaccines.

68
Q

What is the most common cause of macrocytosis?

A

Reticulocytosis, typically as part of a regenerative anemia

69
Q

With hepatic lipidosis in cats, on ultrasound examination is the liver hyperechoic or hypoechoic?

A

Hyperechoic (fatty infiltration). Hepatic lipidosis livers are generally ‘‘big and bright’’.

70
Q

Name 3 screening tests for hyperadrenocorticism in the dog.

A

1) Low dose dexamethasone suppression test
2) Urine cortisol : creatinine ratio
3) Adrenocorticotropic hormone stimulation test

71
Q

Wood’s lamp examination, direct microscopic hair examination, and culture with microscopic identification are tests used for diagnosing which zoonotic, cutaneous disease of dogs and cats?

A

Dermatophytosis

72
Q

In a dog, what are parameters that allow you to determine whether the diameter of the small intestine is enlarged on a radiograph?

A

The normal diameter of the jejunum should not exceed twice the width of a rib and not exceed the height of the central part of the vertebral body of the second lumbar vertebra, L2.

73
Q

Which diagnostic test is most likely to help determine whether the patient is truly hypothyroid or is affected by the euthyroid sick syndrome?

A

Free T4 equilibrium dialysis; Total T4 and concurrent thyroid stimulating hormone (TSH) measurements are also acceptable.

74
Q

The minimum inhibitory concentration (MIC) breakpoint for ampicillin is lesser or equal to 8 ug/mL. Your patient’s infection has a bacterial isolate that has an MIC value of 2. Is the isolate sensitive or resistant to ampicillin?

A

Sensitive. Bacterial growth was inhibited at an in vitro concentration of only 2 ug/mL, indicating that the microbe should perish when standard drug dosages are used (assuming normal distribution to affected tissue).

75
Q

Which characteristic finding is seen in a fresh saline preparation of whole blood from a dog with immune-mediated hemolytic anemia, and what is its major differential diagnosis (microscopically)?

A

In-saline autoagglutination (= aggregates of erythrocytes); not to be confused with rouleaux formation (roll-of-coins appearance).

76
Q

Which species normally has the least prominent vessels in funduscopic visualization of the optic disk: Ovine, bovine, equine, canine or feline?

A

Equine

77
Q

Why does a very deep corneal ulcer show no central uptake of fluorescein?

A

Because Desmet’s membrane does not retain fluorescein stain (descemetocele). Beware of perforation at this stage – No jugular pressure, and use caution when handling the eye/administering ocular medications.

78
Q

Tortuous pulmonary arteries, right ventricular enlargement and a main pulmonary artery bulge are radiographically suggestive of which infectious disease of dogs?

A

Heartworm disease

79
Q

On a cat’s radiograph, the normal diameter of the jejunum should not exceed…….

A

12 mm, or twice the height of the central portion of L4

80
Q

In patients that suffer from Addison’s disease (hypoadrenocorticism), what are the two most common electrolyte disturbances?

A

Hyperkalemia and hyponatremia. Azotemia (especially BUN elevation), hypoalbuminemia, hypoglycemia, and hypercalcemia also can occur.

81
Q

What is the typical acid/base abnormality found with ethylene glycol toxicosis?

A

Metabolic acidosis

82
Q

Unlike dogs, which serum liver enzyme in cats is not easily affected by corticosteroid exposure?

A

Alkaline phosphatase (ALP)

83
Q

Which group of dog breeds has higher hematocrit values than the established reference ranges for other breeds?

A

Sight hounds (Greyhounds, Afghan hounds, etc.)

84
Q

In cats, at which approximate absolute reticulocyte count would you say regeneration is occuring?

A

More than 60 000/microliter indicates a regenerative response, though 50000/microliter could still be classified as a ‘‘slight’’ degree of regeneration.

85
Q

Which diagnostic procedure differentiates hematuria from hemoglobinuria and myoglobinuria?

A

Analysis of urine sediment. In hematuria, there will be red blood cells in the sediment. RBCs are absent in cases of pure hemoglobinuria or myoglobinuria.

86
Q

What is the name of the ultrasound principle that provides information on velocity and direction of blood flow?

A

Doppler (color or spectral (pulsed or continuous wave))

87
Q

When would you expect to see reticulocytes in the blood of horses?

A

Never - Reticulocytes are absent in the blood of horses, both in health and regenerative anemias.

88
Q

Which is more echogenic in the dog and cat: The liver or the spleen?

A

The spleen is usually slightly more echogenic (and has a finer/less coarse echotexture)

89
Q

Which ultrasound mode is most useful for precisely measuring the dimensions and relative movements of the left ventricle over several heartbeats?

A) A-mode
B) B-mode
C) M-mode

A

C) M-mode.
The name is a contraction of ‘‘Motion-mode’’, to distinguish it from A-mode, which is an obsolete, 1-dimensional modality from the early days of ultrasonograohy.

90
Q

During which season is blastomycosis most commonly diagnosed in North America?

A

Autumn, likely due to increased moisture content of soil (allowing release of fungal spores)

91
Q

A normal prothrombin time (PT), prolonged partial thromboplastin time (PTT) and a normal thrombin time (TT) fits with an abnormality in which part of the coagulation cascade?

A) Common
B) Extrinsic
C) Intrinsic

A

C) Intrinsic

92
Q

What is the most likely source of high serum gamma glutamyltransferase (GGT) levels in a 1 week-old calf?

A

Passive transfer through colostrum

93
Q

Would severe hemophilia A be expected to result in a prolonged prothrombin time (PT), a prolonged partial thromboplastin time (PTT) or both?

A

Prolonged partial thromboplastin time (PTT) - Factor VIII deficiency

94
Q

Which event in the heart is represented by the T wave in an electrocardiogram?

A

Ventricular repolarization

95
Q

What are the radiographic signs of left-sided congestive heart failure?

A

1) Pulmonary venous enlargement
2) Unstructured interstitial pattern (Right caudal lung lobe often affected first in the dog)
3) Possibly pleural effusion (cats)

96
Q

Which urinary stones are radiopaque, and which are not?

A

Most radiopaque: Calcium phosphate, Calcium oxalate, Struvite
Least radiopaque: Cystine and urate
(Memory aid for cystine and urate as least radiopaque: ‘‘I can’t C U’’)

97
Q

Cats with acetaminophen toxicosis can present with which hemoglobin abnormality?

A

Methemoglobinemia

98
Q

When performing a thoracocentesis, should you advance the needle into the thorax off the cranial or caudal aspect of the rib? Why?

A

Off the CRANIAL aspect of the rib, to avoid the intercostal vessels and nerves located (protected) caudal to each rib.

99
Q

A normal cat’s abdominal ultrasound image shows 2 gallbladders within 2 livers, one of each on each side of the diaphragm. How is this observation explained?

A

Mirror-image artifact, a result of reflection of ultrasound waves on the concave surface of the diaphragm.

Veterinary Board Exam - Volume 2 (6 decks)

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