Infectious Disease

Question 1

Bivalent leptospirosis vaccine

Tetravalent contains

Answer 1

Canicola and icterohaemorrhagiae

Grippotyphosa and Bratislava

Question 2

Best way to diagnose leptospirosis

Answer 2

Rising MAT >1:1600 (likely to be positive at this level if not vaccinated)

Positive PCR urine or blood (can get false negatives)

ELISA positive - needs confirmed with rising MAT

Question 3

Best test for FeLV infection

Answer 3

IFA for p27 antigen

ELISA good screening test but can be negative in early infection and needs to be confirmed with IFA

If both negative and highly suspicious can do PCR

Question 4

Toxoplasma serology

Answer 4

IgG positive titre indicates exposure

IgM indicates active infection and reduces when the IgG rises

Question 5

Toxoplasmosis treatment

Answer 5

Clindamycin 12.5-25mg/kg PO BID 4 weeks

TMS 15mg/kg PO BID

Azithromycin 5mg/kg PO BID

Question 6

Best test for crenosoma vulpis

Answer 6

Zinc flotation

Question 7

DDx skin fragility syndrome

Answer 7

Diabetes mellitus
HAC
Progesterone
FIP
Cholangiocarcinoma

Question 8

Definitive diagnosis of FIP

Answer 8

Immunohistochemistry for coronavirus antigen in tissue samples (good if there are skin lesions)

Effusion analysis has good predictive value (immunoflourescence of coronavirus antigen within macrophages in effusion is diagnostic of FIP)

Question 9

Ddx for hypergammaglobulinaemia

In a cat

Answer 9

Lymphoma
Multiple myeloma/plasma cell neoplasm
Chronic infection
FIV
FIP

Question 10

Indicators of FIP on haem/biochem

Answer 10

A:g ratio <0.4
Glob > 35 g/l
Alpha1-acid-glycoprotein >1500
(Especially in effusions)

Anaemia non-regen
Lymphopaenia
Left shift neutrophilia

Question 11

How to perform rivaltas test

Answer 11

One drop of fluid to 98% acetic acid solution - positive if a precipitate is formed

PPV 86%
NPV 96%

Question 12

False positive rivalta test can occur with what diseases

Answer 12

Lymphoma

Bacterial peritonitis

Question 13

Best test on CSF in cats for FIP

Answer 13

RT-PCR if having neurological signs (100% specificity and PPV for FIP)

Ab titre useless and CSF immunocytochemistry is sensitive/specific but too low to confirm FIP

Question 14

Two main causes of tuberculosis in cats and dogs

Answer 14

M. Microti

M. Bovis

Question 15

Is FeLV or fiv infection a consistent feature in cats with leprosy

Answer 15

No

Question 16

Treatment of ehrlichia Canis

Answer 16

Doxycycline for at least 21 days for acute disease or 6-8weeks for chronic/subclinical disease

Imidocarb diproprionate if resistant to tetracyclines

Supportive: blood transfusions, glucocorticoids for immune-mediated disease

Human granulocyte colony stimulating factor, vincristine?

Question 17

What is considered gold standard test for e.canis

Answer 17

Indirect immunoflourescent antibody titre (IFA)

Use PCR for monitoring response to tx

Should do serology and PCR to confirm

PCR is actually the most sensitive and specific test for ehrlichia

Question 18

Cause of canine granulocytic ehrlichiosis

Answer 18

Anaplasma phagocytophilum

Question 19

Transmission of anaplasma

Answer 19

Ixodes ricinus

Question 20

Clinical signs of anaplasma phagocytophilum (canine granulocytic ehrlichiosis)

Answer 20

Lethargy
Anorexia
Seizures
Reluctance to move
Weakness 
Fever
Lymphadenopathy
Diarrhoea

Neck pain
Splenomegaly
Lymphadenopathy
Lameness
Subcutaneous oedema
Multiorgan failure / shock

Question 21

Diagnosis of anaplasma

Answer 21

Intracytoplasmic inclusions in neutrophils

Fourfold increase in IFA titre over 2-4 weeks

Positive PCR

Question 22

Cause of canine cyclic thrombocytopaenia

Answer 22

Anaplasma platys

Question 23

Diagnosis of A.platys

Answer 23

PCR
Intra-platelet inclusions (morulae)

(Serology not possible)

Question 24

Feline ehrlichiosis clinical signs

Answer 24

Polyarthropathy
Fever
Uveitis

Question 25

Best way to diagnosis feline ehrlichiosis

Answer 25

PCR | And intracytoplasmic monocytic inclusions

Question 26

Acute manifestations of canine monocytic ehrlichiosis

Answer 26

``` Fever Anorexia Weight loss Haemorrhages Purulent Ocular/nasal discharges Dyspnoea/cough Lymphadenopathy CNS signs ```

Question 27

Chronic manifestations of monocytic ehrlichiosis

Answer 27

``` Lymphadenopathy Weight loss Anaemia Bleeding Glomerulonephritis and renal failure Depression Weight loss ```

Question 28

Clinicopathologic abnormalities with canine ehrlichiosis

Answer 28

``` Thrombocytopaenia Non regen anaemia Leucopaenia Pancytopaenia Monocytosis Lymphocytosis Hypoalbuminaemia Hypergammaglobulinaemia Low albumin:globulin ratio Abnormal electrophoretic pattern ```

Question 29

Prognosis of acute ehrlichiosis And chronic

Answer 29

Acute - Good Chronic - guarded

Question 30

Infectious causes of glomerulonephritis

Answer 30

``` Lymes Leishmania Ehrlichia Leptospirosis Babesia Hepatozoon canis ```

Question 31

Diagnosis of babesiosis

Answer 31

Examination of a blood smear (inclusions) Elisa IFA PCR - most sensitive Dogs from endemic areas may be seropositive so should do PCR (if always been in the UK a positive antibody titre would likely be diagnostic)

Question 32

Treatment of babesiosis

Answer 32

Imidocarb diproprionate once then repeated in 14days Dimenazene Once Phenamidine Once and repeat in 24hrs Trypan blue once Steroids?? May reduce response of immune system if IMHA is involved but could worsen signs

Question 33

Prognosis of acute and chronic babesiosis

Answer 33

Acute - good Chronic - guarded

Question 34

Acute manifestation of babesiosis

Answer 34

``` Fever Anorexia Lymphadenopathy Splenomegaly Weakness Pallor Haemolytic anaemia (may be immune mediated) Splenomegaly Thrombocytopaenia Disproportionately high urea Mixed acid base disorders ```

Question 35

Chronic manifestations of babesia

Answer 35

Intermittent fever Variable appetite Marked loss of weight Regenerative anaemia Can process to multi organ failure : Acute renal failure, hepatopathy and icterus, cerebral pathology, acute respiratory distress syndrome

Question 36

Clinical signs of acute lymes disease

Answer 36

``` Fever Inappetance Lethargy Lymphadenomegaly Polyarthropathy (lanes, stiffness) ```

Question 37

Clinical signs of chronic lymes

Answer 37

``` Recurrent intermittent non erosive arthritis 2 or more joints involved Erythema Glomerulonephritis Myocarditis Neurological signs ```

Question 38

Treatment of lymes

Answer 38

``` Doxycycline Penicillin like antibiotics Tetracycline NSAID Ceftriaxone IV if chronic ```

Question 39

Lymes prognosis

Answer 39

Acute - good usually improves in two weeks Chronic - guarded

Question 40

Hepatozoon canis clinical signs

Answer 40

``` Fever Lethargy Pallor Mucopurulent ocular discharge Anorexia Vomiting Bloody diarrhoea Myalgia (temporal muscle atrophy) Myosotis Myocarditis Posterior paresis Tetraparesis SC oedema Hind limb oedema Lumbar pain Pneumonia Hepatitis Splenitis Glomerulonephritis ```

Question 41

Clinicopathologic abnormalities with hepatozoon canis

Answer 41

``` Neutrophilia Increased ALP Hypoalbuminaemia Hypoproteinaemia Hypoglycaemia Mild non regen anaemia ```

Question 42

Diagnosis of h.canis

Answer 42

Inclusions within neutrophils on blood smear Serology - Elisa (most sensitive method) Muscle biopsy

Question 43

Treatment of hepatozoon canis

Answer 43

TMPS +/- Clindamycin Pyrimethamine Decoquinate (anti coccidial) use for years Imidocarb (unsure about this one not enough studies)

Question 44

How long for bone marrow to react to haemolysis

Answer 44

3-5 days

Question 45

Vaccinations against infectious disease for dogs

Answer 45

Babesiosis vaccine Lymes vaccine Leishmania vaccine

Question 46

Prevention of leishmaniasis in endemic areas

Answer 46

Keep dogs in at dawn and dusk | Deltamethrin impregnated collars

Question 47

Treatment of leishmaniasis

Answer 47

Megline antiomoniate daily s/c for 3-6 weeks Allopurinol twice weekly orally (can be continued) Miltefosine

Question 48

Clinical signs of leishmaniasis

Answer 48

``` Pyrexia Lymphadenopathy Cutaneous crusting/alopecia Renal disease Onychogryphosis Conjunctivitis/uveitis secondary glaucoma Vasculitis (poly arthritis) Thrombocytopaenia and bleeding Non-regen anaemia DIC ``` See hyperglogulinaemia and hyperalbuminaemia on bloods

Question 49

What is caval syndrome

Answer 49

The concomitant presence of right sided congestive heart failure and intravascular haemolysis

Question 50

Diagnosis of dirofilaria immitis

Answer 50

Visualisation of larvae in blood smear or using modified knots test Antigen Elisa (may get false neg if low worn burdens) Serology (only really useful for ruling out infection as may have been previously exposed and treated) PCR - good but not widely available May see worms in pulmonary artery/ r ventricle on echo Eosinophilia +/- worms on BAL

Question 51

Treatment of dirofilaria immitis

Answer 51

Melarsomine dihydrochloride Physical removal of worms via jugular Eliminate microfilariae 4-6 weeks after adulticide therapy (using ivermectin or milbemycin oxime) can give prednisolone alongside this In cats only supportive tx as usually clear infection themselves and high risk of thromboembolism with adulticide tx (steroids, oxygen etc)

Question 52

What test should be used to confirm a positive FIV in house Elisa

Answer 52

IFA (PCR not great given low levels of circulating antigen) Could do western blot but time consuming and expensive Virus isolation is the gold standard but not commonly available

Question 53

Diagnosis of leishmania

Answer 53

Presence of amastigotes in tissue samples or LN aspirates Serology May be negative early in course of disease when PCR is positive and then the titre will rise and PCR May be negative so best to use both tests together