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
