Equine End Sem 1 Exam Flashcards
Diagnosis of equine coronavirus is best made using which diagnostic test?
a) Faecal PCR
b) Faecal ELISA
c) Serum ELISA
a) Faecal PCR
What is the main risk factor for Clostridium difficile diarrhoea?
a) Antimicrobial administration
b) NSAID administration
c) Anthelmintic administration
a) Antimicrobial administration
3rd gen Cephalosporins (e.g. Ceftiofur) antimicrobial linked to Clostridium difficile
Serial faecal samples are recommended when testing for which infectious agent?
a) Clostridium perfringens
b) Salmonella species
b) Salmonella species
A 5-month old foal is presented with severe respiratory distress, bilateral purulent nasal discharge and marked swelling in the thoratlatch area. The foal has a markedly increased inspiratory effort with a loud inspiratory noise which is becoming progressively louder. The foal is agitated and becomes very distressed while examining. The most appropriate course of action at this time is to:
a) Place a rebreathing bag over the foal’s nose and auscultate the thorax
b) Perform an emergency tracheostomy to relieve airway obstruction
c) Sedate the foal and obtain lateral radiographs of the thorax
d) Obtain swabs of the exudate and submit for culture and sensitivity testing
e) Administer gentamicin and penicillin and monitor the foal’s response
b) Perform an emergency tracheostomy to relieve airway obstruction
A horse is presented with trauma due to collision with a fence during training. On physical examination the horse has severe respiratory distress and there is a dorsally located wound over the 6th and 7th ribs of the left hemithorax. The primary aims of emergency management in this case are to:
a) Prevent air moving into the chest via the wound, and early re-expansion of the lungs
b) Control haemorrhage with pressure and achieve rapid primary closure of the wound
c) Control pain with analgesics and administer high doses of antibiotics intravenously
d) Administer general anaesthesia and surgically explore and debride the thoracic wound
e) Administer a balanced electrolyte solution IV and bronchodilator therapy
a) Prevent air moving into the chest via the wound, and early re-expansion of the lungs
A 3 year old Standardbred horse is presented with a history of excessive respiratory noise during exercise. Following examination determined that the noise is due to excessive nasal flutter. This noise is best described as:
a) Low pitched whistling or snoring that is continuous, but loudest during expiration
b) Low pitched whistling or snoring that is continuous but loudest during inspiration
c) High pitched whistling or snoring that is intermittend and loudest during inspiration
d) A choking or gagging sound that is loudest during inspiration when the horse is at rest
e) A intermittent roaring sound that is loudest during inspiration, when the horse is exercising
a) Low pitched whistling or snoring that is continuous, but loudest during expiration
A 2 year old Thoroughbred horse is presented with history of exercise intolerance and abnormal respiratory noise during exercise. During physical examination it is noted that airflow from the left nostril is markedly decreased compared to airflow from the right nostril. The most appropriate approach to this case is to:
a) Collect and submit blood and serum for routine haematology and biochemical evaluation
b) Obtain a tracheal aspirate and submit for cytology, bacterial culture and sensitivity testing
c) Perform both endoscopic and radiographic examinations of the upper respiratory tract
d) Perform a thoracocentesis and a radiographic examination of the lower respiratory tract
e) Perform centesis of the frontal and maxillary sinuses and submit aspirates for cytology
c) Perform both endoscopic and radiographic examinations of the upper respiratory tract
A 40kg dysmature foal was born approx. 10h ago. The feeding plan for this foal is based on a 6% body weight per day and feedings every 2 hours via NG tube.
How much milk would you administer to this foal per feed?
a) 2.4L
b) 2400mL
c) 2000mL
d) 240mL
e) 200mL
e) 200mL
0.06 (6%) x 40 (BW in kg) = 2.4
2.4 / 12 feedings per day if every 2 hours = 0.2L = 200mL
A 5 year old horse presents with bilateral epistaxis, approx 2 weeks after having pyrexia, nasal discharge and a cough for 3 days duration. Physical exam reveals: HR 44bpm, RR 16bpm, rectal temp 37.8, CRT 2 sec and petechiation of the oral mucosa. Prolonged bleeding after venepuncture is noticed. CBC reveals: PCV 30%, TS 56g/L, total leukocyte count 5.4 x 10^9/L and thrombocyte count 26 x 10^9/L. There were no platelet clumps seen on blood smear and clotting times (PT and aPTT) were within normal reference ranges. Which of the following diagnoses is most likely?
a) Myeloproliferative disease
b) Immune-mediated thrombocytopenia
c) Disseminated intravascular coagulopathy (DIC)
d) Chronic haemorrhage
c) Disseminated intravascular coagulopathy (DIC)
Which of the following options is an unacceptable method of euthanasia when used on its own, because it will induce loss of muscle tone prior to loss of conciousness?
a) Intracardiac barbiturate injection
b) Succinylcholine IM injection
c) Intrathecal lignocaine
d) Exsanguination
e) Barbiturate IV injection
d) Exsanguination
Which of the following statements regarding enteroliths in horses is correct?
a) Most commonly found in the right dorsal colon, Lucerne hay is a predisposing factor and horses often present with intermittent colic
b) Most commonly found in the right dorsal colon, grass hay is a predisposing factor and horses often present with intermittent colic
c) Most commonly found in the left dorsal colon, grass hay is a predisposing factor and horses often present with intermittent colic
d) Most commonly found in the left dorsal colon, Lucerne hay is a predisposing factor and horses often present with intermittent colic
a) Most commonly found in the right dorsal colon, Lucerne hay is a predisposing factor and horses often present with intermittent colic
A 2 day old foal is straining, tail flagging and occasionally in dorsal recumbency. The foal is not nursing but has passed meconium with yellow faeces present on the perineum. Which of the following is the MOST appropriate immediate plan for this foal?
a) Complete physical examination, blood work including PCV/TP/lactate/glucose, faecal egg count, digital rectal examination
b) Complete physical exam, blood work including PCV/TP/lactate/glucose, replace fluid deficits, enteral mare’s milk
c) Complete physical exam, blood work including PCV/TP/lactate/glucose, faecal egg count, replace fluid deficits, enteral mare’s milk
d) Complete physical exam, blood work including PCV/TP/lactate/glucose, abdominal ultrasound, abdominal fluids, replace fluid deficits
c) Complete physical exam, blood work including PCV/TP/lactate/glucose, faecal egg count, replace fluid deficits, enteral mare’s milk
Fill in the blanks of the following statement: Ideally euthanasia methods should result in rapid loss of (blank), followed by (blank) or (blank) arrest and the subsequent loss of (blank) function
Ideally euthanasia methods should result in rapid loss of CONCIOUSNESS, followed by RESPIRATORY or CARDIAC arrest and the subsequent loss of NEUROLOGICAL function
One of the hallmark radiographic signs of pleural effusion is that the lung is retracted from the thoracic wall and the material outside of the lung is more lucent than the lung itself. True / False?
True
You are scheduled to perform a general anaesthesia on a horse for field castration. Which of the following anaesthesia maintenance techniques would be LEAST appropriate?
a) An IV infusion of midazolam, ketamine & medetomidine for up to 40-60 mins
b) An IV infusion of guaifenesin, ketamine & xylazine for up to 40-60 mins
c) Inhalation anaesthesia with Isoflurane & O2 for up to 40-60 mins
d) Additional doses of ketamine & xylazine (1/2 to 1/4 of original premedication induction doses) given every 10-15 mins for up to 40-60 mins
c) Inhalation anaesthesia with Isoflurane & O2 for up to 40-60 mins
Identify the structures labelled A & B on the ultrasound image.
A = Liver
B = Duodenum
Image of cytology - mixed bacteria & plant material (arrow) surrounded by inflammatory cells (consisting of degenerate neutrophils with phagocytised bacteria).
Which of the following diagnoses is most likely?
a) Intestinal rupture
b) Enterocentesis
c) Infectious peritonitis
d) Small intestinal strangulating lesion
a) Intestinal rupture
A 14 year old Quarter horse gelding presents with lethargy and a 2 day history of decreased appetite. The initial blood work and a picture of the blood sample are shown below.
Total bilirubin massively increased.
a) Likely due to anorexia leading to an increase in unconjugated bilirubin
b) Likely due to anorexia leading to an increase in conjugated bilirubin
c) Likely due to haemolysis leading to an increase in unconjugated bilirubin
d) Likely due to haemolysis leading to an increase in conjugated bilirubin
a) Likely due to anorexia leading to an increase in unconjugated bilirubin
Which of the following dental conditions is most frequently associated with a marked limitation in lateral excursion of the mandible?
a) Chisel mouth
b) Shear mouth
c) Wave mouth
d) Step mouth
b) Shear mouth
Which of the following options describes the chronological order & initial treatment of an acutely burned horse best?
a) Cooling of affected area for 20 min and ice boot application
b) Cooling of affected area for 10 min and IV clenbuterol administration
c) Cooling of affected area for 5 min and IV fluid therapy
d) Cooling of affected area for 15 min and systemic analgesia
a) Cooling of affected area for 20 min and ice boot application
Pleuropneumonia and pleural effusion cases often require thoracic drainage. Which of the following statements regarding pleural effusion and thoracic drainage in horses is CORRECT?
a) The best way to determine if the chest drain can be removed is to observe the amount of fluid flowing through the drain
b) It is important to perform an ultrasound examination in order to estimate continued pleural effusion and accumulation and timing of drain removal
c) In horses it is only necessary to perform thoracic drainage on one side of the thorax
d) Pleural effusion should not be drained as it is often a septic effusion with fibrin build up which can result in draining tract cellulitis
b) It is important to perform an ultrasound examination in order to estimate continued pleural effusion and accumulation and timing of drain removal
Foals should ideally have their serum IgG concentration assessed at (blank) age to allow prompt treatment with (blank) or (blank) if failure of transfer of passive immunity has been detected.
a) 12-24 hours: IV plasma, systemic antimicrobials
b) >36 hours: IV plasma, systemic antimicrobials
c) >36 hours: stored per oral colostrum, IV plasma
d) 12-24 hours: stored per oral colostrum, IV plasma
d) 12-24 hours: stored per oral colostrum, IV plasma
The pleural space always contains fluid to a degree that is visible on a radiograph to reduce lung friction against the body wall during respiration. True / False?
False
Tube with red (sanguinous) fluid. Which of the following diagnoses is most likely?
a) Strangulating pedunculated lipoma
b) Small intestinal volvulus
c) Ascarid impaction
d) Ileal impaction
e) Small intestinal inguinal herniation
a) Strangulating pedunculated lipoma
(Strangulating > damaged RBCs > red / sanguinous fluid)
Which statement concerning small colon impactions is CORRECT?
a) If treated surgically there is a low risk of postoperative salmonella shedding
b) The aim of medical management is to soften the impaction, but diarrhoea may be a presenting sign
c) Can be localised to small colon based on the lack of a antimesenteric band
d) NSAID coverage and pain control are the most important aspects of treatment
e) Affected patients typically present with nasogastric reflux
b) The aim of medical management is to soften the impaction, but diarrhoea may be a presenting sign
Which of the following lists best describes the initial assessment of the cardiovascular system of a horse with colic in the field?
a. Palpate peripheral pulse; auscultate the heart; evaluate the mucous membranes and skin tent; assess the temperature of the extremities
b. Auscultate the heart and lungs; rectal temperature; evaluate the mucous membranes and skin tend; assess temperature pf the extremities
c. Palpate peripheral pulse; auscultate the heart; evaluate MMs; rectal temperature and auscultate the abdomen
d. Auscultate the heart and lungs; auscultate the abdomen; evaluate the MMS; check PCV, TS and lactate.
a. Palpate peripheral pulse; auscultate the heart; evaluate the mucous membranes and skin tent; assess the temperature of the extremities
A 4-year-old horse presents with a poor body condition (score 2/9) is dull and lethargic with watery diarrhoea. Blood analysis reveals albumin 16g?L (ref range 28-39g/L) globulin 44g/L (ref range 20-38g/L), urea 16mmol/L (ref range 3.2-8.1mmol/L), creatinine 0.22,,p;/L (ref range 0.08-0.16 mmol/L) and neutrophils 12.9g/L (ref range 2/8-8g/L).
Faecal analysis revealed no specific pathogens on culture and no helminth eggs.
Which of the following is the first and most important treatment for this horse?
a. IV fluid therapy
b. Antimicrobial treatment with trimethoprim sulphonamide
c. Withdraw food but offer fresh drink water with electrolytes
d. Supplement food with psyllium and Biosponge.
a. IV fluid therapy
Which of the following statements regarding air bronchograms is CORRECT?
a. An air bronchogram is a normal finding that has developed due to the increased contrast resolution that occurred when we shifted to digital imaging detectors
b. Air bronchograms are a sign of bronchial wall thickening and are indicative of bronchitis
c. Air bronchograms are the hallmark sigh of pleural effusion
d. Air bronchograms are air filled airways that become more visible in the lung periphery due to increased contrast when surrounded by the soft tissue opacity of alveolar pulmonary infiltrates.
d. Air bronchograms are air filled airways that become more visible in the lung periphery due to increased contrast when surrounded by the soft tissue opacity of alveolar pulmonary infiltrates.
Soft palate cautery is performed on the oro-pharyngeal surface of the soft palate rather than on the nasopharyngeal side Which of the following justifications is correct to support that statement?
a. It is less likely to damage the musculature of the soft palate
b. It is cheaper as it doesn’t require sophisticated equipment
c. it is safer as it doesn’t require general anaesthesia
d. it is creating much better sclerosis of the soft palate
a. It is less likely to damage the musculature of the soft palate
Image of endoscope of airway with white frothy mucous / liquid. Which of the following options describes the best sample to collect and the best diagnostic test (based on the most likely disease affecting this horse?)
a) Nasal swab for PCR
b) Needle aspirate of the retro-pharyngeal lymph node abscess for PCR
c) Nasopharyngeal lavage for bacterial culture
d) Needle aspirate of the retro-pharyngeal lymph node abscess for culture
a) Nasal swab for PCR
Which of the following upper respiratory tract obstructive disorders can be diagnosed on a resting endoscope examination?
a. Epiglottal retroversion
b. Lateral pharyngeal wall collapse
c. Dorsal displacement of the soft palate
d. Recurrent laryngeal neuropathy
b. Lateral pharyngeal wall collapse
Which of the following options include the most common clinical signs of Equine Gastric Ulcer Syndrome (EGUS)?
a. Colic, poor performance and poor haircoat
b. Diarrhoea, poor performance and weight loss
c. Partial anorexia, bruxism and colic
d. Partial anorexia, colic and changed behaviour
d. Partial anorexia, colic and changed behaviour
Diagram of inguinal hernia (looks like a testicle hanging down).
Most important muscle of an inguinal hernia?
Vaginal ring
The lung will naturally look more opaque in expiration as compared to inspiration.
a. True
b. False
True
Which of the following statements regarding “epidermal inclusions cysts (atheromas) is CORRECT?
a. Typically diagnosed using upper airway endoscopy
b. Can be treated using minimal invasive techniques in the field
c. Requires surgical intervention and is typically malignant
d. Typically affects older horses
e. Affects the dorsal conchal meatus
b. Can be treated using minimal invasive techniques in the field
Which of the following options best describe the ECG findings shown in the trace below? Looks like a normal rhythm (P:QRS ratio of 1:1) but some closer together & some further apart.
a. Supraventricular (atrial) premature complexes
b. Sinus arrhythmia
c. Second degree AV block
d. Ventricular premature complexes
b. Sinus arrhythmia
Which of the following are the most common pathogens associated with acute watery diarrhoea in horses?
a. Salmonella spp, Clostridium difficile and Rotavirus
b. Clostridium perfrinagens (Types A and C) Clostridium difficile and Corona virus
c. Clostridium difficile, Clostridium perfringens (A and C) and Clostridium septicum
d. Salmonella spp, clostridium difficile and clostridium perfingens (A and C)
d. Salmonella spp, clostridium difficile and clostridium perfingens (A and C)
A horse with colic has the following in-house lab results:
PCV 50%, TS 55g/L, serum lactate 5mmol/L.
Which of the following options is the MOST LIKELY interpretation of the results?
a) These laboratory results are mostly normal
b) Dehydration & splenic contraction
c) 10% dehydration & hypoproteinaemia
d) Splenic contraction & organ hypoperfusion
c) 10% dehydration & hypoproteinaemia
Which of the following options provides the cause of “high blowing” in the horse, the phase of respiration it occurs in and its clinical significance correctly?
a. Vibration of the nares during expiration, a normal finding
b. Vibration of the alar folds during inspiration, a normal finding
c. Vibration of the nares during inspiration, an abnormal finding causing airway obstruction
d. Vibration of the alar folds during expiration, an abnormal finding causing airway obstruction
d. Vibration of the alar folds during expiration, an abnormal finding causing airway obstruction
If a mass is seen in a location you have to consider what anatomic structure normally occupies that space & can become diseases. In regards to structures located within the thoracic mediastinum which of the following options is CORRECT?
- Cranial vena cava
- Heart
- None of these structures are in the mediastinum
- All of these structures are in the mediastinum
- Sternal lymph node
- Hilar lymph nodes
- Trachea
- Esophagus
- Caudal vena cava
- Thymus
- All of these structures are in the mediastinum
Which of the following treatments is most effective for exercise induced pulmonary haemorrhage (EIPH)?
a. Oral administration of non-steroid anti-inflammatories to reduce airway inflammation
b. Application of nasal dilator strip during exercise
c. IV administration of a pro-coagulant such as aminocaproic acid to strenuous exercise
d. Intravenous administration of furosemide before strenuous exercise
d. Intravenous administration of furosemide before strenuous exercise
Pneumo-peritoneum (free air in the abdomen) has multiple findings on radiographs. Which of the following statements does NOT describe a typical finding of pneumo-peritoneum?
a. There is increased visibility of the intestinal walls
b. Severe segmental dilation of the small intestine develops (two populations of bowel).
c. Odd, angular gas bubbles are noted amongst the abdominal contents
d. A diaphragmatic stripe sign is present
b. Severe segmental dilation of the small intestine develops (two populations of bowel).
Which of the following statements is NOT correct with respect to development of ‘sharp points’ in the molar/premolar region of the equine mouth?
a. Are exacerbated by reduced grazing of coarse roughage
b. Occur on the lingual aspect of the maxillary arcade and the buccal aspect of mandibular arcade
c. Are the main reason regular routine dentistry is required
d. Can cause buccal ulceration
e. Occur on the buccal aspect of the maxillary arcade and the lingual aspect of the mandibular arcade
e. Occur on the buccal aspect of the maxillary arcade and the lingual aspect of the mandibular arcade
Which of the following options best describes the ECG findings shown in the image below from a horse identified with a cardiac arrhythmia at rest.
Several normal complexes followed by a complex that occurs early with wide & bizarre QRS.
a. Sinus arrhythmia
b. Ventricular premature complex
c. Second degree AV block
d. Supraventricular atrial premature complex
b. Ventricular premature complex
Myopathy and neuropathy are well-recognised potential complications of anaesthesia in horses. Which of the following is LEAST likely to prevent this complication from occurring?
a. Monitoring arterial blood pressure and maintain mean arterial blood pressure >70 mmHg
b. Use of appropriate padding and positioning of the limbs (e.g. down leg forward if in lateral recumbency).
c. Use of appropriate padding and positioning of the limbs (e.g. down leg forward if in lateral recumbency).
d. Removal of halters once the horse is recumbent
d. Removal of halters once the horse is recumbent
A horse presents with an extended head and neck carriage, intermittent nasal discharge, parotid region swelling and enlargement of the parotid and submandibular lymph nodes. Which of the following is the MOST likely diagnosis and most appropriate diagnostic testing respectively?
a. Guttural pouch mycosis; radiography of skull and cranial neck and ultrasonographic evaluation of the swollen regions
b. Guttural pouch empyema; radiography of skull and cranial neck and ultrasonographic evaluation of the swollen regions
c. Guttural pouch empyema; upper respiratory tract endoscopy and guttural pouch lavage for culture and sensitivity
d. Guttural pouch mycosis; upper respiratory tract endoscopy and guttural pouch lavage for culture and sensitivity testing
c. Guttural pouch empyema; upper respiratory tract endoscopy and guttural pouch lavage for culture and sensitivity
Which of the following is the most important in the after care of an emergency tracheotomy?
a. providing broad spectrum antimicrobials to prevent surgical site infection
b. daily cleaning and replacement of the tracheostomy tube and providing incisional care
c. providing broad spectrum antimicrobials to prevent lower airway infection
d. nebulizing the horse with bronchodilators to prevent further lower airway collapse
b. daily cleaning and replacement of the tracheostomy tube and providing incisional care
Which of the following findings on blood work would be present in a horse with a severe acute bacterial colitis?
a. leukopenia
b. hyperfibrinogenemia
c. Anaemia
d. Leucocytosis
d. Leucocytosis
(Increased WBCs due to bacterial infection)
A grade 3 holo-diastolic, decrescendo murmur with the point of maximal intensity over the left heart base is auscultated in a 16-year old eventer. Which of the following options is the most likely origin of this murmur?
a. tricuspid regurgitation
b. aortic regurgitation
c. physiological pulmonary ejection murmur
d. mitral regurgitation
b. aortic regurgitation
What volume and rate of isotonic crystalloid fluids would be most appropriate for initial resuscitation of a 50kg foal with signs of hypovolaemic shock?
a. 2-3 litres IV, given as 1 litre boluses, with frequent reassessment of hydration status.
b. 3 litres of Hetastarch© given over 20-40mins
c. 2.5 litres given over 6h, followed by 2.5 v
d. 0.5-1.5 litres orally per nasogastric tube given over 6 hrs
?
Fill in the blanks… Radiographic signs of broncho-pneumonia are usually a(an) (blank) pattern distributed (blank). Which of the following answer combinations is most CORRECT?
a. Interstitial, dorsally
b. Alveolar, ventrally
c. Alveolar, diffusely
d. Alveolar, dorsally
e. Bronchial, diffusely
f. Bronchial, cranio-dorsally
g. Interstitial, diffusely
h. Bronchial, cranio-ventrally
c. Alveolar, diffusely
Thoracic radiographs performed after trauma can be confusing because multiple common lesions can occur simultaneously. I taught you to consider a list of five traumatically induced lesions that occur with thoracic blunt trauma to assist your interpretation. Which of the following lesions is NOT included in this list because it does not commonly occur with trauma?
a. Rib fracture
b. Pericardial effusion
c. Diaphragmatic hernia
d. All of the above
e. Pulmonary contusions
f. Pneumothorax
g. None of the above
h. Pleural effusion
b. Pericardial effusion
During total intravenous anaesthesia, assessing anaesthesia depth can be difficult in horses. Which of the following variables provide you with the LEAST valuable information regarding depth of anaesthesia?
a. Muscle tone
b. Arterial blood pressure
c. Heart rate
d. Presence of nystagmus
a. Muscle tone
In a horse with acute, severe colic (photo on left), 200mg of xylazine is administered to allow a brief clinical examination (mucous membranes are shown on the right) but the horse remains uncomfortable. What is the first thing you should do next?
Has toxic line - hyperaemic around gums > endotoxaemic
Early aggressive treatment - IV fluids, AB treatment (broad spectrum approach). Antitoxin (if toxic event). Surgery if stable.
Which combination of clinical and laboratory findings would be MOST supportive of the need for fluid therapy, in a horse you suspect is hypovolaemic?
a. Increased Heart Rate, Decreased PCV, Increased respiratory rate, Increased creatinine
b. Increased Heart Rate, Increased PCV, Decreased anion gap, Decreased capillary refill time
c. Increased Heart Rate, Increased PCV, Increased blood lactate, Increased capillary refill time
d. Normal heart rate, Increased PCV, normal blood lactate, Increased rectal temperature
c. Increased Heart Rate, Increased PCV, Increased blood lactate, Increased capillary refill time
Which of the following are the morphological and possible physiological characteristics of a premature/dysmature foal?
a. Morphological: overgrown foal, floppy ears, domed forehead and short and fine hair coat. Physiological: immature lungs, normal GI tract, poor thermoregulation, wear or normal suckle reflex, entropion.
b. Morphological: thin, floppy ears, cleft palate and short fine hair coat. Physiological: immature lungs, immature Gi tract, poor thermoregulation, weak or normal suckle reflex, normal eyes.
c. Morphological: thin, floppy ears, domed head and short and fine hair coat. Physiological: immature lungs, immature GI tract, poor thermoregulation, weak or normal suckle reflex, entropion.
d. Morphological: thin, floppy ears, cleft palate and short and fine hair coat. Physiological: immature lungs, immature Gi tract, poor thermoregulation, weak or normal suckle reflex, normal eyes.
c. Morphological: thin, floppy ears, domed head and short and fine hair coat. Physiological: immature lungs, immature GI tract, poor thermoregulation, weak or normal suckle reflex, entropion.
Which of the following cell types are most likely to be elevated in the respiratory secretions of a horse with moderate equine asthma?
a. eosinophils
b. macrophages
c. lymphocytes
d. neutrophils
d. neutrophils
Which of the following statements regarding Biosponge® (di-trioctahedral smectite) is CORRECT?
a. It binds to bacterial toxins within the gastrointestinal lumen and reduces bacterial translocation into circulation.
b. Several cases of Di-trioctahedral smectite associated with toxicosis in horses have been reported.
c. No studies support Di-trioctahedral smectite use in equine medicine
d. It has a prokinetic mechanism of action thereby increasing gastrointestinal transit time and reducing the frequency diarrhoea.
a. It binds to bacterial toxins within the gastrointestinal lumen and reduces bacterial translocation into circulation.
Diagram of anus with rectal tear in submucosa / mucosa. What is the most appropriate treatment?
a) Antimicrobials, laxatives, daily inspection and evacuation of rectum
b) Immediate euthanasia due to grave prognosis
c) Antimicrobials, NSAIDs, rectal enema and referral
d) Antimicrobials, NSAIDs, suture of tear and rectal packing
e) Antimicrobials, laxatives, rectal liner, daily inspection and evacuation of rectum
c) Antimicrobials, NSAIDs, rectal enema and referral
Photo of very obvious V-shaped epiglottis. Which of the following is the most likely diagnosis?
a) Epiglottal entrapment
b) Subepiglottal cyst
a) Epiglottal entrapment
Fill in the blanks: A 48 hour old colt is dull and not nursing well. Haematology reveal a moderate leukopenia with a left shift neutropenia, moderate toxic change and an IgG concentration of 5g/L.
a) What is the most likely differential diagnosis?
b) What diagnostic test would help you confirm your suspicion?
a) Failure of passive transfer
b) Antibody Test (IgG)
Which of the following lists best describes the initial assessment of the cardiovascular system of a horse with colic, in the field?
a. auscultates the heart and lungs; rectal temperature; elevate the mucous membranes and skin tent; assess the temperature of the extremities.
b. Palpate peripheral pulse; auscultate the heart; evaluate the mucous membranes and skin tent; assess the temperature of the extremities
c. Auscultate the heart and lungs; auscultate the abdomen; evaluate the mucous membranes; check PCV, TS and lactate.
d. Palpate peripheral pulse; auscultate the heart; evaluate mucous membranes; rectal temperature and auscultate the abdomen.
a. auscultates the heart and lungs; rectal temperature; elevate the mucous membranes and skin tent; assess the temperature of the extremities.
A neonatal foal hasn’t been observed to urinate since foaling (approximately 24 hours ago) and a ruptured bladder is suspected. Which of the following diagnostic findings confirms the diagnosis of a uroperitoneum?
a. Transabdominal ultrasonography and with evidence of an increase in free peritoneal fluid
b. Urine analysis and culture
c. Systemic creatinine two times higher than peritoneal fluid creatinine
d. Peritoneal fluid creatinine two times higher than systemic creatinine.
d. Peritoneal fluid creatinine two times higher than systemic creatinine.
List two differential diagnoses for the following trans-cutaneous ultrasonographic finding(s) of a mare with acute, moderate to severe signs of colic with injected and tacky mucous membranes and a CRT of 3-4 sec. (0.5 marks each)
- Intussusception
- Peritonitis
Which combination of clinical and laboratory findings from a horse suspected to be hypovolemic would be MOST supportive for the need for fluid therapy?
Increased heart rate, increased PCV, increased blood lactate
A 500kg thoroughbred mare has had profuse water diarrhoea for 2 days and is now estimated to be 6% dehydrated. What volume of fluid is needed to correct this fluid deficit?
a) 10L
b) 100L
c) 15L
3) 30L
?
How can hypovolemia be best distinguished from dehydration when performing a clinical examination?
a) The horse is mildly depressed, skin turgor 2 sec and heart rate 52 beats per minute
b) The horse is depressed, tacky mucous membranes and skin turgor 1 sec
c) The horse is depressed, mucous membranes are tacky and CRT 2 sec
d) The horse is depressed, CRT 2-3s and cold extremities
d) The horse is depressed, CRT 2-3s and cold extremities
(Horses with hypovolemia show signs of loss of circulating IV fluid including depression, cold extremities, increased capillary refill time)
You have decided to administer IV fluids to a horse for management of dehydration. Which ONE of the following findings would indicate that your fluid replacement plan had been successful?
a) The horse’s rectal temperature returns to normal
b) The horse starts drinking from its water bucket
c) The horse’s appetite returns
d) The horse starts urinating
d) The horse starts urinating
(Urination is a good indicator of adequate circulating fluid volume in response to fluid therapy. Monitoring the specific gravity of the urine can also indicate adequate hydration (USG will normalise, having been increased in the dehydrated state)
Which is the most appropriate type and route of fluid administration to an adult horse with profuse, watery diarrhoea and signs of hypovolemia?
a) Synthetic colloid given orally
b) Isotonic bicarbonate fluid given IV
c) Isotonic crystalloid fluid given IV
d) Water with 5% dextrose given orally
c) Isotonic crystalloid fluid given IV
What is the most appropriate fluid therapy regimen for a cardiovascularly stable 500kg horse with an uncomplicated impaction of the left ventral colon?
a) Encourage access to free water containing salt solution
b) Repeat fluid boluses of 8-10 litres isotonic fluid given via nasogastric tube
c) Continuous rate enteric fluid therapy with hypotonic fluids at a rate of 5L/hr via an indwelling nasogastric tube
d) Repeat administration of 20 litre fluid bolus of IV crystalloid solution
b) Repeat fluid boluses of 8-10 litres isotonic fluid given via nasogastric tube
(Aggressive enteric fluid therapy with frequent doses of isotonic fluids via NGT has been shown to be the most effective (& economic) method of clearing colonic impactions in horses)
What is the most appropriate fluid therapy / regime for a 500kg horse with hypovolemia (8-10% dehydration)?
a) IV administration of 5 litres Hetastarch (synthetic colloid solution) and crystalloid fluids at maintenance rates
b) Oral fluids by nasogastric tube 8-10L/hour
c) IV fluids at 4-6L/hr
d) Drinking water with electrolytes (salts 4.9g/L)
c) IV fluids at 4-6L/hr
(This degree of hypovolemia reflects a marked loss of circulating fluid volume and requires at least 4-6L per hour (4-6 x maintenance fluid rates) during the first 12 hours to restore the fluid deficit. Alternatively, a bolus of 80ml/kg (40L) could be given followed by a fluid rate of 2-3L per hour)
What volume and rate of isotonic crystalloid fluid would be most appropriate for initial fluid replacement for a 50kg foal with signs of hypovolemic shock?
a) 500-1500ml orally per nasogastric tube given once
b) 2-5L IV given as increments of 1L boluses with frequent reassessment of hydration status
c) 5L IV given over 20-40 mins
d) 2.5L given over 6h followed by 2.5L over the next 12hr
b) 2-5L IV given as increments of 1L boluses with frequent reassessment of hydration status??
Calculate the approximate maintenance fluid requirement rate (over 12 hours) for a 500kg horse that has ongoing losses of 6L every 2 hours due to gastric reflux.
a) 24L (2L/hr)
b) 36L (3L/hr)
c) 12-18L (1-1.5L/hr)
d) 49-54L (4-5L/hr)
?
Which is the most appropriate clinical indication for the administration of hypertonic (7.2%) saline?
a) An adult horse showing signs of hypovolemic shock
b) A mildly dehydrated horse
c) A neonatal foal showing signs of hypovolemic shock
d) An endurance horse with signs of significant dehydration
?
Which of the following is most consistent with biopsy report for a horse suffering clinical signs of liver disease from Senecio spp. ingestion?
a) Biliary hyperplasia, periportal fibrosis, megalocytosis
b) Centrilobar necrosis
c) Periportal hepatocellular necrosis and bridging fibrosis
d) Bile duct stasis, suppurative cholangitis
a) Biliary hyperplasia, periportal fibrosis, megalocytosis
Which of the following biochemical abnormalities would you expect from a horse suffering choledocholelithiasis?
a) Elevated GGT, elevated total bilirubin
b) Elevated GGT, elevated SDH
c) Elevated AST, elevated SDH
d) Elevated AST, normal GGT
a) Elevated GGT, elevated total bilirubin
Which of the following is correct for a pony suffering hepatic lipidosis?
a) Insulin resistance promotes peripheral lipolysis which potentiates hyperlipaemia
b) Ketones are typically elevated in urine
c) The liver is typically small and cirrhotic at necropsy
d) The failure of hormone sensitive lipase to clear VLDL from circulation leads to lipaemia
a) Insulin resistance promotes peripheral lipolysis which potentiates hyperlipaemia
What is the most common cause of photodermatitis in Australia (direct or indirect)?
a) Salvation Jane plant causing liver disease
b) Blue Heliotrope plant causing liver disease
c) Direct photodermatitis unrelated to liver disease
d) Oleander plant causing liver disease
a) Salvation Jane plant causing liver disease
What are the classical histopathology findings of a liver biopsy of horses with pyrrolizidine alkaloid toxicity?
a) Megalocytosis, periportal fibrosis and bile duct hyperplasoa
b) Megalocytosis, bile duct fibrosis and hyperplasia
c) Periportal fibrosis, bile stone and bile duct hyperplasia
d) Lymphocytes and neutrophils, periportal fibrosis and bile duct hyperplasia
a) Megalocytosis, periportal fibrosis and bile duct hyperplasoa
Describe your initial diagnostic plan for a horse with suspected liver disease (no neurlogic signs noted).
a) Specific and non-specific liver enzyme activities, liver ultrasound and liver biopsy
b) Specific liver enzyme activities, liver palpation and liver biopsy
c) Specific and non-specific liver enzyme activities, liver ultrasound and blood anaemia concentration
d) Liver function tests, liver ultrasound and liver biopsy
a) Specific and non-specific liver enzyme activities, liver ultrasound and liver biopsy
Which of the following tests do you consider important during your diagnostic testing in a horse suspected of liver disease:
a) AST, GGT, bile acids and bilirubin
b) AST, GLDH, bile acids and ammonia
c) AST, CK, bilirubin and ammonia
d) CK, GGT, bile acids and bilirubin
a) AST, GGT, bile acids and bilirubin
Which IV fluid would not be appropriate to administer to a hypovolaemic horse?
a) Plasma
b) Dextrose 50%
c) 0.9% saline
d) Hypertonic saline
b) Dextrose 50%
A 14 year old QH is presented with liver disease, liver biopsy reveals biliary stasis and neutrophilic inflammation. What is your treatment?
a) Antimicrobials and supportive therapy
b) Anti-inflammatory and high protein diet
c) Surgery and supportive therapy
d) Antimicrobials and sedative therapy
a) Antimicrobials and supportive therapy
Which statement regarding acute colitis is false?
a) Prostaglandins such as PGI2 & PGE2 may be cytoprotective to gastrointestinal mucosa
b) Horses with severe colitis may have profound hypoproteinaemia
c) Metronidazole use is indicated in cases of C. difficile infection and neutropenia
d) Flunixin meglumine must be administered at 1.1mg/kg BW IV q12h to decrease production of tumour necrosis factor and other inflammatory cytokines in the GI mucosa
d) Flunixin meglumine must be administered at 1.1mg/kg BW IV q12h to decrease production of tumour necrosis factor and other inflammatory cytokines in the GI mucosa
Which commonly used therapy lacks experimental support as a beneficial treatment of acute colitis caused by salmonellosis?
a) Lactobaccilus pentosus
b) Penicillin
c) Biosponge
d) Probiotic pastes
b) Penicillin
Which statement regarding IV fluid therapy for acute colitis is NOT CORRECT?
a) Potassium should be supplemented carefully
b) Fluids should not be administered until clinicopathologic results are available
c) Potassium supplementation is often required due to reduced feed intake and increased GI loss
d) Ongoing fluid losses must be considered in addition to maintenance requirements and replacement of los fluid (diarrhoea) when determining an appropriate fluid plan
b) Fluids should not be administered until clinicopathologic results are available
Which statement regarding acute colitis is NOT CORRECT?
a) If complications do not occur and diarrhoea resolves, the horse should have no longterm effects
b) Antimicrobial therapy should not be routinely administered in colitis cases
c) Laminitis is an uncommon sequela of acute colitis
d) Many components of treatment are the same regardless of aetiology
c) Laminitis is an uncommon sequela of acute colitis
Which statement regarding treatment of acute colitis is NOT CORRECT?
a) Antimicrobial therapy may prolong bacterial shedding in salmonella cases
b) There is evidence to support the use of transfaunation per nasogastric tube
c) Treatment with NSAIDs should be routine because they limit the chance of developing intestinal ulceration
d) Oxytetracycline is an appropriate therapy for salmonellosis cases
c) Treatment with NSAIDs should be routine because they limit the chance of developing intestinal ulceration
Horses with a ventricular septal defect have a:
a) Systolic murmur on the left side, PMI in the apex area
b) Diastolic murmur on the right side, PMI over the heart base
c) Diastolic murmur on the left side, PMI over the heart base
d) Systolic murmur on the right side, PMI in the apex area
d) Systolic murmur on the right side, PMI in the apex area
Examine the following ECG (normal waves & then a p wave without a QRS complex after it). What is your diagnosis?
- 2nd degree AV block
Which of the following is the most common cause of a systolic murmur on the right side of the thorax in the horse?
a) Ventricular septal defect
b) Aortic regurgitation
c) Tricuspid regurgitation
d) Mitral regurgitation
c) Tricuspid regurgitation
What is the most likely cause of a holosystolic murmur auscultated over the left apex and radiating dorsally?
a) Pulmonic valve insufficiency
b) Aortic valve insufficiency
c) Mitral valve regurgitation
d) Flow murmur
c) Mitral valve regurgitation
Which of the following is most important in the ongoing maintenance of equine asthma?
a) Reduction of respirable dust levels
b) Reduced exercise intensity / retirement from strenuous exercise
c) Daily treatment with inhaled corticosteroids
d) Daily nebulisation with a bronchodilator before exercise
a) Reduction of respirable dust levels
Which diagnostic tool is most useful to confirm a definitive diagnosis of equine asthma?
a) Bronchoalveolar lavage
b) Tracheal wash
c) Endoscopy
d) Nasopharyngeal swab
a) Bronchoalveolar lavage
Review the attached endoscopic image and grade the degree of mucous observed.
Grade 3
Review the following cytology slide from a broncho alveolar lavage and identify the cells labelled A, B and C.
A = macrophage, B = neutrophil, C = eosinophil
Review the tracheal wash cytology slide and identify the pink material in the background.
Mucous
In a horse with recurrent laryngeal neuropathy which muscle is implicated in the failure to abduct the arytenoid cartilage?
Cricoarytenoid dorsalis
Which of the following forms of dynamic airway collapse is most likely to be associated with abnormal respiratory sounds during expiration?
a) Dorsal displacement of the soft palate
b) Vocal fold collapse
c) Pharyngeal wall collapse
d) Axial deviation of the aryepiglottal folds
a) Dorsal displacement of the soft palate