Final Exam - NAVLE Radiology Review Flashcards
An 8 month old castrated Irish Wolfhound presents with left front limb lameness of several weeks duration. Physical exam reveals a grade 3 left forelimb lameness, pain on extension of the left shoulder, and mild atrophy of the left shoulder musculature. A complete blood count and serum chemistry profile show mild hyperphosphatemia and mildly elevated alkaline phosphatase (ALP). The patient was sedated for radiographs which confirm your diagnosis of:
a. osteochondrosis
b. septic arthritis
c. hypertrophic osteodystrophy
d. humeral fracture
e. juvenile osteosarcoma
a. osteochondrosis
flattened caudal humeral head with increased lucency
young, giant breed dogs with chronic limb lameness - osteochondrosis!!!
A 9 year old spayed female German Shepherd presents with a moist, intermittent cough. On physical exam, the patient is very thin (body condition score 2/9), mildly febrile (103°F) and soft crackles are appreciated on ventral chest auscultation. A complete blood count reveals moderate neutrophilia. Thoracic radiographs are most consistent with pneumonia secondary to:
a. regurgitation
b. vomiting
c. hematogenous infection
d. neoplasia
e. fungal disease
a. regurgitation
A 7 year old female Brittany Spaniel presents with a 3 day history of lethargy, vomiting, polyuria and polydipsia. Physical examination reveals 8% dehydration and tense abdominal palpation. The patient is afebrile. A complete blood count reveals a leukocytosis characterized by a neutrophilia with a left shift and a mild, normocytic, normochromic, non-regenerative anemia (PCV of 35%). Abdominal radiographs confirm your primary suspicion for:
a. closed pyometra
b. hemoabdomen
c. small intestinal foreign body
d. functional small intestinal ileus
e. pancreatitis
a. closed pyometra
An 11 year old spayed female mixed breed canine presents for evaluation of a painful, stiff gait in all four limbs. She has a history of multiple coughing episodes per day with frequent hemoptysis. Radiographs confirm your primary suspicion of:
a. hypertrophic osteopathy
b. metastatic neoplasia
c. pathologic fractures
d. primary joint neoplasia
e. bone infarcts
a. hypertrophic osteopathy
typically will have multiple limbs affected - likely from a thoracic or abdominal mass
metastatic neoplasia is unlikely to go to every single bone!!
A 7 year old castrated male Labrador Retriever presents for lethargy and inappetence. On physical exam, the patient has peripheral lymphadenomegaly and palpable splenomegaly. Thoracic radiographs are performed as part of a complete work up. The primary abnormality noted in these images is:
a. sternal lymphadenomegaly
b. a pulmonary mass
c. pericardial effusion
d. an osteolytic bone lesion
e. pneumomediastinum
a. sternal lymphadenomegaly
A 3 year old castrated male Golden Retriever presents with a 12-hour history of vomiting. His vital parameters were within normal limits. Physical exam revealed 5% dehydration and tense abdominal palpation. Abdominal radiographs are diagnostic for:
a. intestinal foreign body
b. mesenteric lymphadenopathy
c. hemorrhagic gastroenteritis
d. functional ileus
e. pancreatitis
a. intestinal foreign body
A 10 year old Paint gelding presents with a swollen right carpus. The horse is 1/5 lame at a jog straight away and 2/5 lame when circled. Carpal radiographs are obtained for evaluation. The primary radiographic abnormality is:
a. chronic fracture of the second metacarpal bone
b. biarticular slab fracture of the third carpal bone
c. primary bone neoplasia
d. osteochondrosis
e. reactive periostitis of the fourth metacarpal bone
a. chronic fracture of the second metacarpal bone
remember - 2 over 2 (metacarpal 2 only touches carpal bone 2)
if it looks like you can push it back together like a puzzle piece - acute fracture
this is chronic because the bone is trying to make a callus
A 5 month old female Persian kitten presents with a history of progressively increased respiratory rate and effort. On physical exam, the patient is bright, alert, and responsive. Her heart rate is 180 bpm with a regular rhythm and no auscultated murmurs. Her respiratory rate is 100 bpm with increased effort. Upon review of the thoracic radiographs, the most likely diagnosis is:
a. peritoneopericardial diaphragmatic hernia
b. non-cardiogenic pulmonary edema
c. traumatic diaphragmatic hernia
d. pleural effusion
e. Tetralogy of Fallot
a. peritoneopericardial diaphragmatic hernia
The owner of a 10 year old castrated male Brittany Spaniel reports that the dog has been straining to defecate for the past two weeks. The most likely location for the mass observed on abdominal radiographs is:
a. retroperitoneal space
b. dorsolateral body wall
c. descending colon
d. anal gland
e. mesenteric lymph node
a. retroperitoneal space
mass likely originates from the medial iliac lymph nodes - can be concerning for cancer of the prostate and/or perianal tumors, back legs, or lymphoma
A 6 month old Great Dane presents with a chief complaint of anorexia. On physical exam, the patient is mildly febrile (103.6°F) and subjectively depressed with moderate swelling at the distal radius and ulna. Radiographs of the carpus confirm your suspicion for:
a. hypertrophic osteodystrophy
b. osteochondritis dissecans
c. nutritional secondary hyperparathyroidism
d. septic physitis
e. osteoarthritis of the radiocarpal joint
a. hypertrophic osteodystrophy
look for the double physis sign!!
septic physitis is very rare in dogs - seen more commonly in large animals
The owner of a newly adopted 7 year old blue tongued skink brings the pet to you for evaluation of reluctance to move and dragging its hindlimbs. Based on the radiograph, the patient’s clinical signs can be explained by:
a. metabolic bone disease
b. lower respiratory infection
c. vertebral fracture
d. congenital malformation of long bones
e. gastrointestinal foreign body
a. metabolic bone disease
A 12 year old spayed female Maltese presents with a chronic, progressive expiratory cough and gagging. She has a grade I/VI systolic heart murmur. Thoracic radiographs demonstrate:
a. dynamic tracheal collapse
b. cardiogenic pulmonary edema
c. aspiration pneumonia
d. chronic bronchitis
e. mediastinal mass
a. dynamic tracheal collapse
The predominant pulmonary pattern demonstrated in these radiographs is:
a. miliary interstitial
b. unstructured interstitial
c. alveolar
d. bronchial
e. vascular
a. miliary interstitial
miliary means very tiny sized nodules vs. unstructured which is no tiny nodules!!
fungal disease & metastatic neoplasia are concerns for this pattern!
A 6 year old Percheron gelding presents for lameness after stumbling into a fence post 5 days ago. The patient is grade 4/5 lame in the right front foot. Radiographs of the right fore foot are obtained. The primary cause of lameness in this patient is:
a. articular third phalanx fracture
b. a subsolar abscess
c. laminitis
d. septic arthritis
e. osteomyelitis
a. articular third phalanx fracture
An 11 year old spayed female Miniature Schnauzer presents for evaluation of coughing. The owner also reports fainting episodes and abdominal distension. Physical examination reveals jugular pulsation, grade V/VI systolic heart murmur, and soft crackles in all lung fields. After evaluating thoracic radiographs, what is the most likely diagnosis?
a. right sided heart failure
b. aortic endocarditis
c. cardiogenic pulmonary edema
d. peritoneal-pericardial diaphragmatic hernia
e. mediastinal lymphoma
a. right sided heart failure
giant heart on films!!!!! very rounded on the vd view
pay attention to clinical signs - jugular pulses & ascites are key for diagnosing right sided heart failure
An energetic 2 year old castrated male Labrador Retriever presents for evaluation of vomiting. On physical examination, he is mildly tachycardic, approximately 8% dehydrated, and painful on abdominal palpation. There is frank blood in his rectum. Preliminary blood work reveals mild azotemia and mildly elevated lactate. The most likely diagnosis is:
a. linear foreign body
b. intestinal lymphoma
c. splenic hematoma
d. colonic torsion
e. obstipation
a. linear foreign body
A 6 year old castrated male Dachshund presents with acute, lumbar pain and bilateral hind limb paresis. Patellar reflexes are absent and perineal reflex, anal tone and withdrawal in the hind limbs are decreased. Superficial pain, deep pain, and minimal motor function remain. The major abnormality in these radiographs that explains the clinical signs is located at:
a. T13-L1
b. L2-L3
c. L5-L6
d. L6-L7
e. L7-S1
c. L5-L6
look for the mineralized chunk of disk that is within the spinal canal
T13-L1 disk is abnormal but it is not extruded into the canal!!!
A grade I/VI sternal systolic heart murmur is discovered during a routine physical exam in a 7 year old domestic shorthair cat. Based on the primary radiographic abnormality seen here, which is the most appropriate diagnostic test to recommend next?
a. echocardiography
b. thoracic CT scan
c. fungal antigen titer
d. thoracocentesis
e. bronchoalveolar lavage
a. echocardiography
A 9 year old castrated male Weimaraner presents for examination due to 5 hours of retching that began after he ate an entire bag of dog food. On physical exam, the patient is tachycardic and lethargic. Which of the following is the most appropriate next diagnostic or therapeutic step for the patient?
a. orogastric intubation
b. exploratory laparotomy
c. abdominal ultrasound
d. thoracic radiographs
e. gastric biopsy
a. orogastric intubation
A 9 month old castrated male Pug presents limping on the hind limbs. On physical exam, the patient is painful during hip extension with moderate atrophy of bilateral thigh muscles. Pelvic radiographs are obtained to confirm your suspicion for bilateral…
a. aseptic necrosis of the femoral head
b. hip dysplasia
c. septic arthritis
d. osteochondrosis
e. femoral capital physeal fracture
a. aseptic necrosis of the femoral head
top two differentials - avascular necrosis of the femoral head & hip dysplasia
due to the age & size - not hip dysplasia (usually doesn’t result in changes to femoral head in dogs this young!)
underlying cause of avascular necrosis - trauma (blood vessels are crushed)
An 8 year old female spayed domestic short hair cat is presented for evaluation of tachypnea (respiratory rate 85 breaths per minute). Routine blood work is unremarkable. What is the most appropriate next diagnostic or therapeutic step for the patient?
a. thoracocentesis
b. lung biopsy
c. abdominal ultrasound
d. barium esophagram
e. echocardiography
a. thoracocentesis
A 5 year old castrated male Yorkshire Terrier presents with a 2.5 month history of hematuria. Abdominal radiographs are performed to confirm diagnosis of:
a. cystolithiasis
b. transitional cell carcinoma
c. diabetes mellitus
d. ectopic ureter
e. urethral obstruction
a. cystolithiasis
A 6 year old castrated male German Shepherd presents for chronic, bilateral forelimb lameness. On physical exam, the dog is painful during manipulation of bilateral elbows, bilateral hips, and the lumbar spine. Radiographs of the right elbow are made to confirm:
a. ununited anconeal process
b. osteosarcoma
c. septic arthritis
d. ischemic necrosis of the interosseous ligament
e. fracture of the medial humeral epicondyle
a. ununited anconeal process
if not addressed when they are young - dog will develop elbow arthritis
nasty elbows can look like cancer/septic arthritis, but!!! remember that elbow arthritis is extremely common compared to other differentials!!
always radiograph the other elbow!!! it is unlikely that you will have an aggressive process in both elbows, but it is extremely likely to have arthritis in both elbows!!!
A 20 year old castrated male Arabian presents with a progressive forelimb lameness. On physical exam, the horse is 3/5 lame on the left fore foot and 1/5 lame on the right fore foot with increased digital pulses bilaterally. A palmar digital block does not resolve the lameness in either limb. The most likely diagnosis is:
a. chronic laminitis
b. severe navicular degeneration
c. fracture of the third phalanx
d. deep digital flexor tendonitis
e. low ring bone
a. chronic laminitis
A 5 month old female English Bulldog presents for noisy breathing and progressive exercise intolerance over the past two months. On physical exam, the patient has stenotic nares and referred upper airway noises are noted upon thoracic auscultation. Which one of the following related abnormalities is identified on thoracic radiographs?
a. hypoplastic trachea
b. cranial mediastinal mass
c. aspiration pneumonia
d. esophageal foreign body
e. cardiogenic pulmonary edema
a. hypoplastic trachea
A 6 year old male Belgian Shepherd presents with a two month history of tenesmus and intermittent hematuria. He is otherwise normal at home. On rectal exam, the patient has a firm, approximately 5 cm diameter, bilaterally symmetrical mass palpated ventrally. Blood work and urinalysis are normal today. Considering the most likely radiographic diagnosis, which of the following is most likely to improve the patient’s clinical signs?
a. castration
b. laparotomy for colonic foreign body
c. prednisone therapy
d. antibiotic treatment
e. decompressive cystocentesis
a. castration
likely benign prostatic hypertrophy!!!!
castration will involute the prostate
A 5 month old castrated male Labrador Retriever presents with a “bunny-hopping” gait that the owner notices most commonly after exercise. On physical exam, an Ortolani sign is palpable bilaterally and the patient is painful with full extension of the hips. The underlying etiopathogenesis of this patient’s primary diagnosis is most likely…
a. developmental
b. degenerative
c. metabolic
d. toxic
e. ischemic
a. developmental
A 12 year old female mixed breed canine presents for evaluation of recent onset weight loss and muscle atrophy. The patient has an intermittent cough and the owner mentions that sometimes the dog coughs up blood. Mild pulmonary crackles are auscultated in the right caudal thorax. The top differential for the thoracic abnormalities is:
a. metastatic neoplasia
b. non-cardiogenic pulmonary edema
c. hiatal hernia
d. aspiration pneumonia
e. acquired megaesophagus
a. metastatic neoplasia
A 12 year old castrated male Domestic Long Hair cat presents for a 7 day history of lethargy, decreased appetite, and intermittent vomiting. On physical exam, the patient is approximately 8% dehydrated and shows signs of abdominal discomfort with palpation. A firm, tubular structure is palpated in the caudal abdomen. The primary radiographic abnormality on abdominal radiographs is:
a. megacolon
b. linear foreign body
c. intestinal foreign body
d. mesenteric lymphadenomegaly
e. abdominal effusion
a. megacolon
A 1 year old Quarter Horse colt presents with grade 3/5 lameness of the right hind limb. The lameness does not resolve with distal limb analgesia. Radiographs confirm your suspicion for…
a. osseous cyst like lesion
b. proximal tibial physitis
c. condylar fracture
d. medial meniscal injury
e. septic arthritis with osteomyelitis
a. osseous cyst like lesion
A 5 year old spayed female Labrador Retriever presents with clinical signs of exercise intolerance and a soft cough that are both progressive over the past several months. On physical exam, there are mildly increased bronchovesicular sounds bilaterally. The primary differential is:
a. heartworm disease
b. metastatic neoplasia
c. hematogenous pneumonia
d. pulmonary hypertension
e. patent ductus arteriosus
a. heartworm disease
A 7 year old male Bull Mastiff presents for evaluation of vomiting green liquid for one week. On physical exam, the patient is dehydrated with abdominal pain. Blood work reveals hypernatremia, hypokalemia, mild neutrophilia, and elevated total protein. Abdominal radiographs are consistent with:
a. a jejunal foreign body
b. septic peritonitis
c. pyloric outflow obstruction
d. functional ileus
e. a focal hepatic mass
a. a jejunal foreign body
2 populations of intestines are visible, foreign body can be seen in the ventral & caudal abdomen (corn cob)
A 9 year old female Peach Faced Lovebird presents for a 1 week history of respiratory distress and general malaise. She has had several bowel movements containing runny, dark yellow-brown material. This patient is suffering from:
a. an impacted oviduct
b. aspergillosis
c. synsacral fracture
d. salpingitis
e. cystic right oviduct
a. an impacted oviduct
folded/crushed egg is visible
A 12 year old castrated male domestic shorthair cat presents with a history of straining in the litter box for the past two weeks. He is mildly anemic and mildly azotemic. Based on the radiographic findings, what is the most likely diagnosis?
a. renal lymphoma
b. cystitis
c. radiolucent cystolithiasis
d. ureteral obstruction
e. transitional cell carcinoma
a. renal lymphoma
major finding is abnormal kidneys on radiographs - lumpy/heart-shaped
A 2 year old castrated male Great Dane presents on emergency for acute onset of hypersalivation, restlessness and visibly distended abdomen. In addition to gastric derotation, what secondary surgical procedure is indicated in this patient?
a. gastropexy
b. hepatic biopsy
c. foreign body retrieval
d. splenectomy
e. diaphragmatic hernia repair
a. gastropexy
A 20 day old Aberdeen Angus heifer calf presents with a 5 day history of right hind lameness. The owner believes the heifer was stepped on by the cow. On physical exam, the patient is Grade 4/5 lame on the right hind foot with swelling of the fetlock and purulent material draining from a wound proximal to the coronary band. Radiographs of the foot are most consistent with:
a. septic arthritis with osteomyelitis
b. traumatic metatarsophalangeal subluxation
c. osteochondrosis of the fourth metatarsal bone
d. septic physitis
e. fracture of the first phalanx of the fourth digit
a. septic arthritis with osteomyelitis
crosses a joint space, polyostotic, radiographically aggressive
Appropriate differentials for the pulmonary pattern identified in these thoracic radiographs include which one of the following?
a. fungal bronchopneumonia
b. cardiogenic pulmonary edema
c. aspiration pneumonia
d. pulmonary thromboembolism
e. non-cardiogenic pulmonary edema
a. fungal bronchopneumonia
A 4 year old male Holland Lop rabbit presents with hematuria, pollakiuria and stranguria. The patient cries out when lifted. On physical exam, he is 5% dehydrated and otherwise normal. The most likely location for the mineral feature identified on caudal abdominal radiographs is:
a. urethra
b. urinary bladder
c. rectum
d. retroperitoneal space
e. gluteal musculature
a. urethra
stone is stuck in the urethra, urethra in rabbits drop below the pelvis once it is through the pelvic canal
A 9 month old castrated male German Shepherd presents with shifting hind limb lameness noted over the past week. The owner perceives the left limb to be worse than the right. Physical examination reveals pain on palpation of the left proximal femur. Radiographs confirm your primary suspicion for:
a. panosteitis
b. hypertrophic osteodystrophy
c. osteochondrosis of the medial femoral condyle
d. fungal osteomyelitis
e. hip dysplasia
a. panosteitis
An 8 year old spayed female mixed breed canine presents with acute onset generalized weakness. On physical exam, the patient is tachycardic (195 beats per minute) with muffled heart sounds, and jugular venous distention. Thoracic radiographs are consistent with:
a. pericardial effusion
b. pulmonary hypertension
c. pneumothorax
d. heartworm disease
e. aortic aneurysm
a. pericardial effusion
Your client brought this stray adult female dog in for health evaluation and to check for a microchip. On physical exam, the patient’s abdomen is moderately distended and there is a small amount of clear, yellow vaginal discharge. How many fetuses are present?
a. 5
b. 6
c. 7
d. 8
e. 9
c. 7
This 2 month old female Boxer presents on emergency after being picked up and shaken violently by a larger dog. The patient is non-ambulatory upon arrival. Neurologic exam reveals intact withdrawal reflex in both hind limbs and absent deep pain. Radiographs confirm a diagnosis of:
a. thoracic vertebral fracture
b. spinal cord transection
c. traumatic intervertebral disk extrusion
d. scoliosis
e. vertebral malformation
a. thoracic vertebral fracture
A 9 year old castrated male Maine Coon presents for evaluation of rapid, shallow, labored breathing of one month’s duration. Etiopathologic differentials for the major abnormality observed on thoracic radiographs include which of the following?
a. congestive heart failure
b. aspiration pneumonia
c. tracheobronchial lymphadenomegaly
d. primary bronchoalveolar carcinoma
e. pulmonary thromboembolism
a. congestive heart failure
An adult stray dog is presented for evaluation. She is non-weight bearing on the left hind limb and exhibits pain on palpation of the left hip. Radiographs confirm a diagnosis of:
a. craniodorsal coxofemoral luxation
b. pathologic acetabular fracture
c. femoral head fracture
d. sacroiliac luxation
e. ischial fracture
a. craniodorsal coxofemoral luxation
A 7 year old castrated male Golden Retriever presents with left forelimb lameness of 3 months duration. No previous illness or injury is reported by the owners. The patient is reluctant to put weight on the left forelimb and there is moderate swelling dorsal to the radiocarpal joint. Based on radiographic findings, the most likely differential is:
a. primary bone neoplasia
b. an osseous sequestrum and draining tract
c. metastatic neoplasia
d. an invasive soft tissue tumor
e. polyostotic Cryptococcosis
a. primary bone neoplasia
