Incorrect MCQ - Week of 10/21 Flashcards
All-encompassing questions on topics you got wrong + info from questions you got right that you did not remember!
A range cow from south Texas near the Mexican border is presented for a two-day history of high fever, anorexia, depression, and “redwater” (hemoglobinuria).
What is your top differential?
Babesiosis (Babesia)
You believe your patient has babesia. What is the next step?
Report !!!
The most likely cause of a large uterine mass in an intact female pot-bellied pig is a ?
Uterine leiomyoma.
What is the treatment for a uterine leiomyoma in a potbellied pig?
These tumors do not typically metastasize so you can cure the patient via surgical removal of the uterus.
Do vaccines and maternal antibodies interfere with FeLV testing?
NO! They do NOT
FeLV ELISA and FeLV PCR test for?
Circulating antigen, which is why vaccination does not interfere with testing
What are the major clinical signa of nephrosplenic entrapment in a horse?
Mild to moderate recurrent abdominal pain
Rectal palpation reveals the large colon is displaced to the left lateral abdominal wall & the spleen is displaced medio-ventrally
What is the difference between succussion & ballottement?
Succussion is when you use your fist and push into the abdomen to feel/elicit splashing sounds in the gut.
Ballottement is when you push to feel for an organ or baby’s head or hips in the uterus
Equine botflies are called?
Gasterophilus spp.
Describe the life cycle of a horse botfly
Horse botflies lay eggs on a horse’s shoulders or forelimbs and hatch when the horse licks them. They become embedded in a horse’s mouth and then hatch in the stomach. These bots are either asymptomatic or cause mild gastritis.
What is the tx of choice for a case of acute pancreatitis in which the patient is intermittently vomiting?
Enteral nutrition (aka feeding via the stomach). You only choose nothing per os for cats & dogs when the patient is uncontrollably vomiting.
Other tx add-ons: IVF, antiemetics, analgesia, GI prokinetics. NO ab unless there is pancreatic abscessation.
Feline pancreatitis is commonly _______, although it has been associated with?
Idiopathic, diabetes mellitus, IBD, cholangitis, pancreatic hypoperfusion, trauma, and some medications and drugs.
What is the most sensitive and specific test currently available for Feline Pancreatitis?
Serum fPLI to measure pancreatic lipase immunoreactivity.
What is pictured here? What are the C/S? Dx? Tx? Prognosis?
Hemivertebrae
C/S can either be asymptomatic or kyphosis, ataxia, paresis, scoliosis.
Dx: Xrays
Tx: If asymptomatic, no tx. If symptomatic, would need to surgically decompress.
Prognosis: Good for asymptomatic.
Hemivertebra is inherited in what dog breed?
German shorthaired pointer
Describe what premature placental separation looks like. What does it mean? How is it treated?
A bright red, velvety membrane.
This means the chorioallantois has separated from the endometrium before the foal is able to breathe on its own. You must tear open the “Bag” to assist in foal delivery immediately.
What should you normally see during stage 2 of labor in a horse?
A translucent white amniotic sac. This occurs after the water breaks.
What is ma huang? What happens if it is ingested by a dog?
Ma huang is Ephedra sinica, a herb containing ephedrine and pseudoephedrine that is used for weight loss and athletic performance. If ingested by a dog, it causes hyperthermia, tachycardia, and tremors.
The FDA banned the used of supplements containing ephedrine alkaloids.
What electrolyte deficits can predispose a horse to develop a-fib?
K and Mg
How can you convert a-fib to a sinus rhythm?
Quinidine sulfate
OR transvenous electrical cardioversion (gold standard at some hospitals)
How do you successfully eliminate classical swine fever in a population?
Depopulation of infected herds.
Typically vaccinate in endemic areas and cull in nonendemic areas.
How is classical swine fever transmitted?
Between live animals, pork products, mechanically via fomimtes.
Classical swine fever is often endemic in?
Wild boar
What is grossly seen on necropsy of a pig that died of classical swine fever?
Petechiae, hemorrhage, “button” ulcers at the ileocecal junction.
What is a characteristic microscopic lesion seen in patients that died from classical swine fever?
Nonsuppurative encephalitis with a characteristic vascular cuffing
T/F: Narrow surgical removal is always appropriate when diagnosing an injection site sarcoma.
FALSE it is never appropriate. Remove the entire tumor with wide margins (incisional biopsy).
Name several inverting suture patterns.
Connell
Cushing
Halsted
Lembert
Parker-Kerr
Purse string
Name several examples of appositional patterns.
Simple continuous
Simple interrupted
Cruciate
Gambee
Intradermal/subcuticular
Ford interlocking
What forms of lymphoma are commonly seen with FeLV infection?
GI lymphoma was commonly seen but has decreased significantly due to vaccination.
Other: Spinal, multicentric, mediastinal lymphoma
What are the two types of GI lymphoma? What are the clinical signs? Tx? Prognosis?
Small cell lymphoma - T cell in origin; slowly progressing. Low grade lymphoma. Stays confined to mucosa. Tx = pred and chlorambucil Prognosis is good.
Large cell lymphoma - B cell in origin; Found in intestinal wall, lymphadenopathy, hepatic involvement. High grade lymphoma. Tx - surgical removal only if no disease at other sites. Tx = CHOP; prognosis is guarded to poor with mean survival with tx 45-100 days.
Strangles is caused by? C/S? Dx? Tx? Transmission?
Caused by: Streptococcus equi subsp equi
C/S: submandibular lymphadenopathy, mucopurulent nasal discharge, fever, difficulty swallowing
Dx: PCR or culture on nasopharyngeal or guttoral pouch wash OR abscess lymph node exudate.
Tx: Procaine penicillin, supportive care
Transmission: Direct contact, fomites; HIGHLY CONTAGIOUS
How do you dx and tx a sinus infection in a horse?
Dx: radiographs
Tx: Trephination and lavage sinus cavity and systemic AB; if secondary sinusitis, tx underlying disease
You see pigs with intense pruritus, headshaking, and tiny red pimples + crusty deposits in their ears. What is your top differential? Tx?
Sarcoptic mange
Topical permethrin + injectable ivermectin
When do clinical signs associated with sarcoptic mange in pigs develop?
Several few weeks following exposure. At this point, most of the herd is affected.
What are your top two differentials for caseous exudate with necrotic foci in the mouth and esophagus of a bird?
Candidiasis (thrush) or trichomonosis
How do birds develop candidiasis? C/S? Dx? Tx?
Candida spp. are apart of normal GI flora. Birds succumb to disease if administered ab or unsanitary drinking facilities.
C/S: See caseous exudate in mouth and esophagus.
Dx: Epithelial hyperplasia, ballooning degeneration, visualization of pseudohyphae and blastospores.
Tx: No approved tx in U.S. Possibly nystatin?
How do birds develop trichomonosis? C/S? Dx? Tx?
Apart of normal flora
Contaminated water is most important source of infection.
Lesions start off as small, yellowish areas on oral mucosa then rapidly coalesce to form large masses.
Dx: histo
Tx: Possibly AB (metronidazole, other azoles)
Control: separate infected birds from breeding birds
Porcine stress syndrome is caused by?
An autosommal recessive mutation of a Ca release channel in the sarcoplasmic reticulum
What are some triggers of porcine stress syndrome?
Stress, inhalant anesthesia, depolarizing neuromuscular blocking drugs. Use preanesthetic sedatives, use total IV anesthesia when possible
How can you treat porcine stress syndrome?
Prophylactically treat with dantrolene.
- NOTE: relatively ineffective if signs are severe. Discontinue anesthesia, ice baths, alcohol baths, Tx any arrhythmias
Loss of patellar reflex and an inability to bear weight on hind limbs = lesion @?
L4-L6 aka where the femoral nerve is
An intact withdrawal reflex means what nerve is not damaged?
The sciatic nerve is ok!
If there was a lesion at L4-S3, what neuro signs would you see?
LMN signs in hind limbs
If there was a lesion at T3-L3, what neuro signs would you see?
UMN - hind limbs
If there was a lesion at C6-T2, what neuro signs would you see?
UMN - pelvic limbs
LMN - forelimbs
If there was a lesion at C1-C5, what neuro signs would you see?
UMN - all limbs
A lesion at C1-C5 can result in?
Death by respiratory failure
What clinical signs may you see in a patient with a lesion at C6-T2?
absent cutaneous trunci, two different gaits being expressed by forelimbs and hindlimbs
Horner syndrome occurs if there is a lesion at?
T1-T3
“Bowed tendon” in horses is typical of?
Acute superficial digital flexor tendinitis
Name the two causes of equine piroplasmosis. C/S? Dx? Tx?
Etiologies: Babesia caballi, Theileria equi
C/S: Fever, petechiae, hemolytic anemia, lethargy, pale/icteric mm, hemoglobinuria, etc.
Dx: Intra-erythrocytic organisms on blood smear and/or serology.
Tx: Imidocarb dipropionate
What is the characteristic appearance of mycotic rhinitis?
White and dark spots on the surface of a nasal mass
How can you treat mycotic rhinitis?
Tx success if poor but you can do sodium iodide or repeated cryotherapy
What is pictured in this radiograph?
Patellar tendon rupture
What medication is used to treat Chlamydia felis?
Oral doxycycline; treat all cats in the household at the same time!
How do you confirm Chlamydia felis infection?
PCR testing
Methicillin resistant staph pseudointermedius is resistant to what AB?
all beta lactam AB including penicillins, cephalosporins, and carbapenams; often also resistant to tetracycline and streptomycin
If you are presented with a cow that has lymphadenopathy, nasal and oral ulceration, and is also aggressive with CNS signs, what is your top differential?
Malignant catarrhal fever
(not BVD b/c no neuro signs with BVD)
List the etiology, pathogenesis, clinical signs, dx, tx and prevention for Bovine Viral Diarrhea Virus
Etiology: BVDV, a pestivirus
Pathogenesis: If become infected between day 40-120, can become persistently infected.
C/S: Lethargy, diarrhea, anorexia, oral ulcers, etc. Cerebellar hypoplasia or death.
Dx: viral isolation or PCR on milk, serum, whole blood, tissues, or semen; paired serology to determine if recent infection or exposure or vaccination
Tx: supportive care
Prevention: test and remove PI calves; vaccinate
How do you treat a patient with Cuterebra aka grubs, warbles?
Gently open the breathing hole and extract the grub WITHOUT rupturing it.
Pilocarpine is a what kind of drug? Used to diagnose?
Topical miotic agent aka a pupil constrictor
Use to diagnose cranial nerve 3 lesions
Tropicamide is a?
Topical mydriatic agent
What are the clinical signs associated with HCM in cats? How is it Dx? Tx? Prognosis?
C/S: Often asymptomatic. If symptomatic, will present with respiratory distress, hind in paralysis due to aortic thromboembolism or sudden death.
Dx: Radiographs (dilated pulmonary vessels, alveolar pattern, cardiomegaly), echocardiogram
Tx: Acute = furosemide. Chronic = furosemide, clopidogrel (reduce risk of thromboembolism), enalapril (for hypertension), and pimobendan.
Prognosis: Guarded. Median survival time for severe cases is 3 months but varies.
What is the most common cause of splenomegaly in cats?
Mast Cell Tumor
A well-circumscribed, raised, pale pink, hairless mass is noted in a 10 yr old Siamese cat. Mandibular LN palpate normally. Bloodwork and labs all come back normal. FNA shows this below. What is your top differential? Tx? What is the prognosis?
Cutaneous MCT
Tx: Complete surgical excision is usually curative.
Prognosis: Unlike in dogs, cat MCT are not as aggressive. Extent of excision does not affect prognosis as recurrence is unlikely.
What is the median survival time of a mammary tumor that is < 2 cm? What about if it is > 2 cm?
< 2 cm = 3 yr median survival time post-op
> 2 cm = 4-6 mo median survival time post-op
Which cat breeds have a higher risk of developing mammary tumors?
Siamese and domestic shorthair cats. Siamese have 2x the risk of other breeds.
A systolic BP of > 160 mmHg in a patient with clinical signs if indicative of ? While a systolic BP of > 180 without clinical signs is indicative of?
Target organ damage, Hypertension
What two drugs can successfully manage hypertension in cats?
Amlodipine, a calcium channel blocker, and Telmisartan, an angiotensin-II receptor block (only FDA approved treatment for feline hypertension)
Describe clinical signs, diagnostics, tx, and prevention for goats suffering from Caprine Arthritis Encephalitis (CAE):
C/S - Adults: Progressive polysynovitis, arthritis. Hard udder!!!
C//S - Kids: Encephalomyelitis, placing deficits in pelvic limbs, may progress to para or tetraparesis or paralysis
Etiology: Enveloped Single-stranded RNA lentivirus (Retroviridae family)
Dx: AGID (specific), ELISA(sensitive), Biopsy/necropsy to show lymphoproliferation w/ degenerative mononuclear cells = definitive, virus isolation or PCR
Tx: NONE
Prevent: Isolate kids @ birth & feed heat-treated colostrum, pasteurized milk. CULL seropositive animals
How does Bluetongue present in small ruminants?
Lameness, changes @ the coronary band, crusty/scabby lesions on the nose.
Describe the etiology, clinical signs, diagnostics, tx for Contagious Agalactia in sheep.
Etiology: Mycoplasma agalactiae
C/S: Hot, painful arthritis, pneumonia, keratoconjunctivitis
Dx: Culture, PCR on mammary and lung tissue/milk/joint fluid, ELISA
Tx: Cull infected animals
REPORTABLE DISEASE IN USA
What medication is used to treat exaggerated pain responses following surgery?
Ketamine, a NMDA antagonist. NMDA antagonists prevent or minimize the amplification that causes sensitization.
Name four NMDA receptor antagonists:
Ketamine, methadone (an opioid), amantadine (anti-viral), dextromethorphan (anti-tussive)
These radiographs were taken of a 2-yr old FS mixed breed dog. What is the primary abnormality?
If you see the pulmonary artery is dilated - this is called the pulmonary knob sign and is a classic indicator of heartworm disease.
If you see @ 1 oclock there is a prominent bulge - that is the aorta.
If you look at 2 oclock that bulge is the pulmonary artery.
And then at 2 oclock there is a bulge in the cardiac silhouette.
These three “bulges” are classic for patent ductus arteriosis.
Describe what a patent ductus arteriosus is. C/S? Dx? Tx?
A PDA is a congenital defect in which the connection between the aorta and the pulmonary artery is still open after birth.
On PE, you will hear a consistent murmur at the left heart base and bounding pulses.
Dx: Rads, but mainly echo and angio.
Tx: Place an occluder and tx pulmonary edema (left heart failure) if present.
What is pharmaceutical name for Vitamin K1?
Phytonadione
Define accounts payable.
Accounts payable is how much money the practices owes someone else.
Hemolytic-uremic syndrome is a fatal complication of?
Shiga-toxin producing E.coli infection
What is the shortest effective treatment for ethylene glycol toxicity?
4-methylpyrazole
What rate per hour is considered to be safe for lowering serum sodium levels in a 10 mo old puppy?
0.5-1 meQ/L/hr over 24-48 hrs
Can be increased to 1 if the known cause if hypernatremia
What is the name of the rumen fluke?
Paramphistomum cervi.
Do not typically cause overt disease unless immature flukes attach to duodenum and ileum, then can cause severe enteritis, local damage leading to diarrhea, anorexia, polydipsia, etc.
Specificity = true ?
Sensitivity = true ?
Specificity = true negatives; if a test is highly specific, you can trust a + result.
Sensitivity = true positives
Describe a classic case of hardware disease. What is the best treatment?
Descreased milk production, tachypnea, lethargy, anorexia positive grunt test, arched back
Treat by performing a rumenotomy to remove hardware if rumen magnet does not work (which it does in 50% of cases)
Describe a classic case of neonatal maladjustment syndrome. Tx? Prognosis?
Within first three days of life, foal loses interest in mother and stops suckling for milk.
Tx: AB, supportive care, maldigan squeeze
Prognosis is excellent with supportive care.
Describe the clinical signs and radiographic findings of a canine patient with synovial cell sarcoma. How is it treated?
Limb lameness, progressive swelling, painful and firm on palpation, not warm.
On radiographs you see perarticular soft tissue swelling, poorly defined periosteal reaction, multifocal punctat osteolytic lesions.
Tx: limb amputation as proximal as possible to decrease recurrence +/- adjuvant chemo
List the risk factors of gastric ulcers in pigs.
Episodes in which they had no access to feed, finely ground (usually pelletted) feed which decreases gut transit time.
What is the most common cite for OCD in horses?
Distal Intermediate Ridge of the Tibia AKA DIRT LESION
An upside-down U shaped urinary bladder in a horse is indicative of?
Bladder rupture –> uroperitoneum
