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Veterinary Board Exam - Volume 3 > Diagnostics > Flashcards

Diagnostics Flashcards

1
Q

The P-R interval on an ECG tracing represents which event(s) of the cardiac cycle?

A

Atrial depolarization and conduction through the AV node (P wave is included in the P-R interval)

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2
Q

The canine parvovirus ELISA test will detect which feline virus?

A

Feline panleukopenia virus

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3
Q

In small animals with disease of the tricuspid valve or right ventricle, manual compression of the cranial abdomen may distend the jugular vein due to excessive venous return to the right heart. What is the name of this maneuver?

A

The hepatojugular reflux test

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4
Q

What are expected serum biochemical changes in dogs with xylitol toxicosis (sugar-free gum/mint ingestion)?

A

Hypoglycemia, markedly increased liver enzymes, hyperphosphatemia

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5
Q

With respiratory alkalosis, which organ is responsible for the primary disturbance, and which organ is responsible for the compensatory response?

A

Primary disturbance: Lungs
Compensatory response: Kidneys

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6
Q

What is the purpose of an anti-scatter grid in radiography?

A

Prevent degradation of image quality due to scatter radiation

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7
Q

In reference to direction of blood flow on standard color Doppler, which color shows flow toward the probe, and which shows flow away from the probe?

A

Blue = Away
Red = Towards
(aka the BART rule)

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8
Q

In the presence of anti-thyroxine (T4) antibodies, will the measures total T4 be higher or lower than the actual total T4?

A

Higher.
Anti-T4 antibodies bind reagent in vitro and trigger a falsely elevated reading.

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9
Q

Animals that have prolonged activated partial thromboplastin and activated clotting times, but do not have a bleeding disorder, may have a deficiency of which coagulation factor?

A

XII
Consequently, it is generally accepted that the factor XII is not involved in normal hemostasis

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10
Q

Name a major contraindication for the administration of intravenous contrast medium.

A

Dehydration or hypersensitivity

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11
Q

Why is CSF tap contraindicated in a patient with clinical signs of increased intracranial pressure?

A

Increased risk of brain herniation

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12
Q

A radiograph of a 6 month-old dog’s elbow indicates a radiolucent defect in the humeral condyle above the medial ulnar coronoid process. What are the radiographic diagnosis and treatment of choice?

A

Osteochondrosis. This is a component of elbow dysplasia, which can lead to degenerative joint disease. Surgical removal of the cartilage flap is the treatment of choice.

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13
Q

In diagnostic ultrasound, which property of materials allows for an echo to be formed at the boundary of two different tissues?

A

Acoustic impedance

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14
Q

A prolonged prothrombin time (PT), normal activated partial thromboplastin time (aPTT), and a normal thrombin time (TT) fit with an abnormality in which part of the coagulation cascade - common, extrinsic, or intrinsic?

A

Extrinsic

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15
Q

An electrocardiogram shows QRS complexes without P waves. Name 3 of the 5 differential diagnoses.

A

1) Atrial standstill (hyperkalemia or primary atrial myopathy)
2) Atrial fibrillation
3) Atrial flutter
4) Premature ventricular complexes/Ventricular tachycardia
5) Isoelectric P waves

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16
Q

In ethylene glycol toxicosis, there may be a large difference between osmole concentration measured directly in the blood, versus calculated. Name the 4 major blood osmoles. What is the name of the difference between measured and calculated values?

A

Sodium, potassium, glucose and blood urea nitrogen.
Osmole gap (abnormally high in ethylene glycol toxicosis because serum ethylene glycol registers during direct measurement of osmolality but is not part of the calculated value)

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17
Q

For ophthalmoscopy, which gives a more complete view of the whole fundus: Direct of indirect?

A

Indirect ophthalmoscopy (lens held in hand) provides a more complete view of the fundus, It also allows visualization through both eyes using a headset, and distances the observer from a patient that chooses to bite or head-butt without warning.

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18
Q

Hyphema makes it impossible to see a patient’s posterior chamber. Ultrasound reveals an undulating membrane tracing a wavelike course through the posterior chamber. What is the diagnosis?

A

Retinal detachment

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19
Q

In a majority of cases, cytologic analysis of pericardial effusion in dogs is diagnostic for the underlying cause: true or false?

A

False. 74% of malignancies are not detected, and 13% of benign disorders are misdiagnosed as malignant, when cytology alone is used.

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20
Q

What is the normal size of the feline kidney as compared to the length of the body of L2 in abdominal radiographs?

A

2-3 times the length of the second lumbar vertebra

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21
Q

What is the radiographic hallmark of feline bronchial disease?

A

Peribronchial cuffing, caused by infiltration of inflammatory cells around the airways

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22
Q

Which changes from normal are expected in a dog with psychogenic polydipsia for: Urine osmolality, plasma osmolality, urine osmolality after water deprivation, and plasma vasopressin after water deprivation?

A

1) Urine osmolality: Decreased
2) Plasma osmolality: Normal or decreased
3) Urine osmolality after water deprivation: Increased
4) Plasma vasopressin after water deprivation: Normal or high

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23
Q

Why is lidocaine ineffective when administered orally?

A

High first-pass effect (hepatic metabolism of drug immediately when absorbed from the GI tract and transported through the portal circulation).

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24
Q

Cytology of swab samples from the oral cavity and liver of a pigeon carcass reveals flagellate protozoa with an undulating membrane and axostyle. What is the most likely diagnosis?

A

Trichomoniasis (Trichomonas columbae)

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25
On abdominal ultrasound, a transverse image of bowel with a transverse image of bowel with a multilayered series of concentric rings is evident, with a centrally located hyperechogenicity. What is you diagnosis?
Intussusception (target pattern); the central hyperechoic material is mesenteric fat
26
Normal adult mammalian plasma protein concentrations vary slightly by species, but are generally in which range?
6-8 g/dL (60-80 g/L)
27
A modified water deprivation test, and response to vasopressin, are diagnostic tools meant to rule in or rule out which disorder? A) Diabetes insipidus B) Diabetes mellitus C) Diabetic ketoacidosis
A) Diabetes insipidus
28
Name 2 differences that may be seen in the radiographic appearance of left heart failure in cats as opposed to dogs.
There may be a more patchy distribution to pulmonary edema in cats, cats can have pulmonary atrial and venous enlargement, and cats may develop pleural effusion with left heart failure.
29
What are the expected serum vitamin B12 and folate abnormalities in a dog with small intestinal bacterial overgrowth/''antibiotic-responsive diarrhea''/intestinal dysbiosis?
Low serum B12; High folate (because bacteria bind B12, furnish folate)
30
25-40% of dogs with multiple myeloma will excrete which substance that is normally absent in the urine of healthy dogs?
Bence-Jones proteins
31
What is the main advantage of somatic cell counts (SCC) over the California mastitis test (CMT) in terms of interpreting results?
SCC provides quantitative results: you receive a cell count (cells/mL), whereas the results of the CMT are interpreted subjectively. With CMT, discrepancies may arise between evaluators, and estimates of SCC that correlate with CMT score vary greatly.
32
In dogs, at which approximate absolute reticulocyte count would you say regeneration is occuring?
More than 80 000 reticulocytes/microliter indicates a regenerative response
33
Which of the following results is LEAST likely with end-stage fibrosing/cirrhotic liver disease in small animals? Elevated prothrombin time, hypoalbuminemia, hypoglycemia, increased alanine aminotransferase (ALT), or low serum urea level
Increased ALT is least likely. The other changes are consistent with poor hepatic synthetic functions; with end-stage disease, markedly reduced hepatocyte mass means ALT and AST often are NOT high.
34
Name 2 ways to differentiate mechanical ileus and functional ileus radiographically.
1) Mechanically obstructed bowel is usually of larger diameter than dysfunctional unobstructed bowel 2) The lumen of mechanically obstructed bowel usually contains gas and fluid, but dysfunctional unobturated bowel is more gas-filled 3) Mechanical obstruction usually creates some dilated and some normal-appearing loops of bowel, but patients with functional ileus may have generalized involvement of bowel
35
When measuring the following parameters in the same patient, which can be expected to be significantly different (e.g. more than 25%) in venous blood samples compared to arterial samples? PCO2, PO2, HCO3, pH
Only PO2 is appreciably different - Typically 50% lower in venous samples compared to arterial.
36
When performing a myelogram, why is cervical myelography rarely of value when severe thoracolumbar cord swelling is present?
With cervical injection, only the cranial margin of the compressive lesion may be imaged since the contrast medium flows rostrally into the intracranial ventricular system when resistance to caudal flow is encountered.
37
What is the effect of alkalosis on circulating ionized and protein-bound calcium concentrations?
Alkalosis reduces ionized calcium by increasing calcium binding to protein
38
How should the technique differ in terms of kVp and mAs between thoracic and abdominal radiographs?
Abdomen: High mAs, low kVp Thorax: High kVp, low mAs
39
On a lateral thoracic radiograph of a dog, how do you objectively determine if the cranial lobar pulmonary vessels are enlarged?
They should be the same size as each other and no larger than the proximal portion of the 4th rib.
40
Which radiographic views constitute a complete series for imaging the tympanic bullae in a dog or cat?
Lateral, ventrodorsal or dorsoventral, open mouth rostrocaudal, left rostral-right caudal oblique, and right rostral-left caudal oblique
41
What is a simple, rapid, in-hospital test that can detect clinically significant levels of methemoglobin?
Spot test - Place 1 drop of the patient's blood on absorbent white paper next to a drop of control blood. If the methemoglobin content is 10% or greater, the patient's blood will have a noticeably brown coloration compared with the bright red color of the control blood.
42
What is the most common infectious cause of pulmonary arterial enlargement in the dog?
Heartworm disease
43
An 8 month-old puppy receiving a raw meat-based diet shows multi-limb lameness and overall weakness. Bloodwork reveals hypocalcemia and increased alkaline phosphatase. Radiographs show widened physes, particularly at the distal ulnae. What is your diagnosis?
Rickets, most likely a dietary deficiency in vitamin D. Therapy should consist of a regular diet with adequate and not excessive amounts of calcium, phosphorus and vitamin D.
44
What is the normal orientation of the stomach on the lateral radiograph of a dog or cat?
Parallel to the ribs (craniodorsal to caudoventral), perpendicular to the vertebral column, or in between
45
In which order should the following ophthalmic diagnostic tests be conducted on a patient? A) Bacterial culture swab B) Fluorescein stain C) Schirmer tear test
A, C, B. Bacterial samples first, to reduce contamination; Schirmer second, to avoid interference by artificial tears used with fluorescein stain (last)
46
What causes reverberation artifact in diagnostic ultrasound?
Sound bouncing back and forth between tissue boundaries and then returning to the receiver.
47
An electrocardiogram shows unusually wide P waves. Which structural change in the heart is suspected, and what is the Latin term that describes wide P waves associated with such a change?
Left atrial enlargement, ''P mitrale''
48
EPSS is an effective and reproducible measurement based on which heart valve?
Mitral valve. E-point to septal separation (EPSS) identifies early opening of the valve, which reflects diastolic function.
49
Between coherent scattering, the photoelectric effect, and Compton scattering, which process of x-ray photon interaction with matter is the one that ultimately results in an image being formed?
Photoelectric effect
50
What are 3 radiographic signs consistent with intervertebral disc protrusion?
1) Narrowing of the disc space 2) Narrowing of the dorsal intervertebral articular process joint space 3) A small intervertebral foramen 4) Increased opacity in the intervertebral foramen 5) Extruded, mineralized disc material within the vertebral canal
51
In ultrasonography, what are the definition and the appearance of ''acoustic enhancement''?
An artifact consisting of localized increase in echogenicity distal to a structure of low attenuation. A common example is the increased echogenicity of the liver immediately beyond the gallbladder.
52
If performing an upper gastrointestinal positive contrast study on a patient that you suspect to have a gastrointestinal perforation, which contrast medium is NOT recommended?
Barium sulfate. If leaked outside the GI tract, barium can cause granuloma and adhesion formation.
53
Name 2 radiographic signs of hypertrophic cardiomyopathy in a cat.
1) Marked left atrial enlargement, ''valentine'' heart shape (dorsoventral; ventrodorsal) 2) Enlarged pulmonary veins - not a common finding 3) Interstitial or alveolar opacification (pulmonary edema) 4) Pleural effusion. Left ventricular enlargement not generally seen - hypertrophy of the ventricular wall is concentric at the expense of chamber volume rather than changing the external shape of the heart.
54
What are 3 of the 4 radiographic signs of an aggressive bone lesion?
Cortical destruction, bony lysis, irregular periosteal reaction, and indistinct zone of transition from diseased to healthy bone
55
A patient with metabolic alkalosis has serum (HCO3-) = 34 mEq/L (normal = 17-24 mEq/L). Is the expected compensatory response an increase or decrease in PCO2?
Increase in PCO2 (by 7mmHg, since compensation for metabolic alkalosis = 0.7 mmHg increase in PCO2 for every 1 mEq/L decrease in (HCO3-))
56
What is the pinnal-pedal reflex and which disorder does it suggest?
It is the vigorous scratching motion performed with the hindlimb, typically in dogs, in response to gentle rubbing of the ipsilateral pinna. It is a sign of intense pruritis, and is most commonly associated with scabies/sarcoptic mange.
57
You notice that a small clot is present in a whole blood sample. Name 2 complete blood count abnormalities that you might expect as a result.
Typically, platelet counts are markedly reduced, and significant reduction can sometimes occur in hematocrit and leukocyte counts.
58
Which view is preferable for imaging a horse's left fourth metacarpal bone? A) Dorsomedial-to-palmarolateral oblique (DMPLO) B) Dorsolateral-to-Palmaromedial oblique (DLPMO)
B) Dorsolateral-to-Palmaromedial oblique (DLPMO) The source of the beam is ahead of the horse (cranial) and to its left (lateral), which exteriorizes the left fourth metacarpal on the radiograph (but hides the second left metacarpal).
59
Patients with multiple myeloma typically have an immunoglobulinemia characterized as monoclonal, biclonal or polyclonal?
Monoclonal
60
Is the major cross-match used for detecting serum antibodies in the recipient's blood directed against the donor's erythrocytes, or to detect antibodies in the donor's serum directed against the recipient's erythrocytes?
The major cross-match is used for detecting antibodies in the recipient's serum that are directed against the donor's erythrocytes.
61
When a thoracic radiograph of a standing horse is taken, which ling is most clearly seen - the lung that is closer to the plate or the lung that is farther from the plate?
The lung that is closer to the plate. This is the opposite to a recumbent animal, where the nondependent lung remains better aerated and therefore is better visualized.
62
Which age group normally has high levels of serum alkaline phosphatase (ALP)?
Young, growing animals (bone isoenzyme)
63
Why is it that the protein concentration in plasma is usually about 0.2 to 0.5 g/dL (2 to 5 mg/L) higher than that in serum?
Due to the presence of fibrinogen in plasma, which is consumed during coagulation.
64
Adequate renal concentrating ability is presumed to exist if the urine specific gravity is greater than which value in cats?
1.035
65
What is the expected change in appearance of a plate containing a specimen of hair on dermatophyte test medium if a positive result occurs?
The medium turns from clear yellow to deep red in color in approximately 1 week; after 10 days, false positive results are possible (saprophytes).
66
Name 2 differences in the appearance of normal canine anatomic structures in a dorsoventral thoracic radiograph compared to the appearance of the same structures in a ventrodorsal thoracic radiograph.
1) The heart is more ovoid in appearance in a DV (more elongated in a VD) 2) The accessory lung lobe is less aerated in a DV 3) The caudal pulmonary vessels and bronchi are more conspicuous in a DV 4) The diaphragmatic crura are more convex in appearance in a VD
67
On a dog's abdominal radiographs, you note fluid-filled gastric dilation, with granular mineral-opacity material in the pyloric antrum (the gravel sign). Which disorder do you suspect?
Chronic partial obstruction of gastric outflow
68
A 10 year-old domestic shorthaired cat presents with acute blindness, severe generalized weakness, and ventroflexion of the neck, On ultrasound examination, you identify a right adrenal mass. What is the most likely diagnosis?
Primary hyperaldosteronism, a disorder caused by an aldosterone-secreting adrenal mass that causes systemic hypertension which caused the blindness, and hypokalemia which resulted in weakness and neck ventroflexion.
69
Corrected reticulocyte percentages superior to _____% in the dog indicate bone marrow response to anemia.
1%
70
When assessing the vertebral heart size of a cat from a lateral thoracic radiograph, after measuring the long and short axes of the heart, from the cranial aspect of which vertebra do you begin counting?
Fourth thoracic (T4)
71
With acidosis, what are the expected changes in serum pH and (H+)?
Decreased pH, increased serum (H+)
72
On radiographs of the pes of a dog, you see near-complete lysis of the distal phalanx of the third digit, with associated soft tissue swelling. What is the differential diagnosis?
Neoplasia (squamous cell carcinoma, melanoma) or pododermatitis. Biopsy is needed to differentiate neoplasia from infection.
73
Why is barium powder (as opposed to commercially prepared barium sulfate suspension) not recommended for use in upper GI contrast studies?
The powder does not stay in suspension as well with multiple factors (e.g. pH of tap water, mucous, blood) that can lead to flocculation, thus making interpretation of the study more difficult.
74
A creatinine level that is higher in the abdominal fluid than the creatinine level in the serum is usually a sequela of which condition?
Ruptured urinary bladder or ureter
75
Which 3 ultrasound characteristics would help you suspect that an abdominal mass was simply an intra-abdominal lipoma?
Uniformly coarse echogenicity, hypovascularity, absence of metastases.
76
On an unlabled lateral thoracic radiograph of a dog, how can you determine if its a right or left lateral projection?
On a right lateral, the caudal vena caval border blends with the more cranially located right crus of the diaphragm.
77
Name 3 radiographic signs of left-to-right shunting patent ductus arteriosus.
1) Segmental enlargement of the proximal descending aorta 2) Enlargement of the main pulmonary artery 3) Enlargement of the left atrium, and possibly the left auricle 4) Enlarged left ventricle 5) Enlarged pulmonary arteries and veins 6) Diffuse interstitial opacification of the lungs due to pulmonary overcirculation 7) interstitial infiltration due to pulmonary edema
78
What is the typical range of ultrasound frequencies used for clinical diagnostic imaging? A) 2 GHz- 17 GHz B) 2 kHz - 17 kHz C) 2 MHz - 17 MHz
C) 2 MHz - 17 MHz
79
Why is a heartworm antigen test less reliable as a screening test in cats compared to dogs?
Because cats have a lower worm burden, and therefore, lower antigenemia (more false negative results)
80
You measure activated partial thromboplastin time (aPTT) to assess the efficacy of anticoagulation. Which drug did you administer? A) Aspirin B) Clopisogrel C) Heparin D) Warfarin
C) Heparin Warfarin is monitored using prothrombin time (PT), and the other two are antiplatelet (no effect on PT, PTT)
81
What is the bony structure within the eyes of birds that is easily seen radiographically?
The scleral ring
82
Above which measurement (cm) for body thickness should you use an anti-scatter grid in abdominal radiography?
10 cm
83
If you decide to take a horizontal beam ventrodorsal projection of a dog's abdomen, because you are trying to rule out free peritoneal gas, should the patient be placed in left or right lateral recumbency?
Left lateral recumbency, so that the pylorus is on the non-dependent side. If the patient is in right lateral recumbency for this procedure, gas may fill the fundus and obscure a small amount of free peritoneal gas.
84
One week after receiving a new batch of grain, a farmer reports his cattle are experiencing redness and swelling from the coronary band to the fetlock - particularly in the hind limbs. Some cows have similar lesions on the tips of the ears and teats. What is the suspected diagnosis, and how would you confirm your suspicion?
Ergot poisoning is the likely cause, and the grain should be tested for the fungus Claviceps purpurea. These lesions are identical to those caused by fungus-infested tall fescue grass.
85
In the adult horse, normally concentrated urine should have a specific gravity greater than which value?
1.025
86
Name 2 conditions that lead to abnormally high concentrations of Howell-Jolly bodies on blood smears.
Accelerated erythropoiesis or post-splenectomy
87
An anemic Dalmatian dog is lacking the Dal gene. Which clinical pathologic test should you perform to assess the risk associated with this genetic defect?
You should perform a cross-match before any blood transfusion, because lack of the Dal gene is associated with spontaneous adverse transfusion reactions.
88
Which type of anemia tends to have the most pronounced regenerative response - hemorrhagic or hemolytic?
Hemolytic (iron from hemolyzed erythrocytes is more readily available for erythropoiesis than is storage iron or hemosiderin)
89
What is the purpose of the sulfosalicylic acid test component of a urinalysis?
It assesses proteinuria. Sulfosalicylic acid testing helps to differentiate between bona fide proteinuria and a false-positive dipstick protein reading from alkaline urine.
90
Other than hemorrhage, what is the major consideration, in terms of patient management, if you are contemplating percutaneous fine needle aspiration or biopsy of an adrenal mass?
If the mass is a pheochromocytoma, catecholamine release may lead to a hypertensive or paradoxical hypotensive crisis.
91
Free abdominal fluid with a protein concentration of less than 2.5 g/dL (less than 25 mg/L) would be classified as which type of effusion?
Transudate (ure)
92
In radiographs of the cervical spine in the horse, which vertebrae are distinct in appearance and must be included in the views in order to verify location?
C1, C2 or C6
93
On radiographic evaluation of the tympanic bullae, you note increased opacity or thickening of the osseous bulla. Is this consistent with otitis externa, media, or interna?
Otitis media
94
In domestic animals, which bony landmarks do you use when performing a cervical spinal puncture for either injecting contrast medium for myelography or obtaining a cerebrospinal fluid sample?
The wings of the atlas and the external occipital protuberance
95
Which type of test is the Coggings test? A) Agar-gel immunodiffusion B) Enzyme-linked immunosorbent assay C) Immunofluorescence assay D) Polymerase chain reaction
A) Agar-gel immunodiffusion test (AGID) It screens for equine infectious anemia
96
In small animals, which of these 3 tests best reflects liver function? A) Bilirubin B) Aspartate Aminotransferase (AST) C) Alanine Aminotransferase (ALT)
A) Bilirubin It is synthesized by the liver and thus reflects liver function. The other two are intracellular enzymes, and elevations in serum levels merely reflect hepatocyte leakage.
97
In dogs with primary hypothyroidism, serum thyroid-stimulating hormone (TSH) levels are not elevated in which proportion of cases? A) 0% B) 20-40% C) More than 60%
B) 20-40%
98
Name a disease that is characterized by proliferation of immature lymphoblasts in the bone marrow.
Lymphoblastic leukemia, Stage V lymphoma
99
What is the most widely used indicator of mastitis in individual cows and dairy herds?
Somatic cell count; mastitis increases the relative proportion of neutrophils in mammary secretions.
100
What are 2 reasons the volume of contrast medium administered for a positive contrast gastrointestinal study is a critical factor in interpretation?
1) Potentially not adequately highlighting the mucosal margins of the stomach 2) You need an adequate volume bolus contrast medium in order to stimulate normal gastric emptying and intestinal motility; i.e. a small volume of barium administered may not stimulate gastric emptying, leading to a misdiagnosis of delayed gastric emptying

Veterinary Board Exam - Volume 3 (6 decks)

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