Most Difficult Questions Category Flashcards
How soon after administration of a dose of dexamethasone for induction of parturition in a cow do you expect parturition?
A. 24 hours
B. 48 hours
C. 8 days
D. 12 hours
B. 48 hrs
Parturition may occur anytime between 2 and 7 days but on average it occurs on the second day. A dose of
25-30 mg IM is sufficient.
A 8-year old Siamese cat presents to you with a single 2 cm skin mass on top of his head that is well circumscribed, hairless, dome-shaped and fixed to the overlying skin but freely movable from underlying fascia. The mass has been present for months and has been slowly growing. What is the most likely diagnosis?
A. Basal cell tumor
B. Squamous cell carcinoma
C. Cutaneous lymphosarcoma
D. Mast cell tumor
A. Basal cell tumor
The correct answer is basal cell tumor. This is the most common skin tumor in the cat (about 20% of all feline skin tumors). These tumors are usually hairless, dome-shaped, raised masses as described. They are most frequently found on the head, neck, and shoulders. They are almost always benign although histologically, they may have aggressive characteristics.
Which of these parameters tells you that an animal is hyperventilating?
A. PaCO2 < 30 mmHg
B. RR >60 bpm
C. PaO2 >120 mmHg
D. Pa02 < 80 mmHg
E. PaCO2 >50 mmHg
Answer: A PaCO2 < 30 mmHg
The correct answer is PaCO2 < 30 mm Hg. Ventilation is defined by the PaCO2. Normal is 35-45 mmg. A hypoventilated patient has a high PaCO2, and a hyperventilated patient has a low PaCO2.
Topic: Cytauxzoon Felis
Cytauxzoon felis is a protozoal organism and transmission to cats is through tick bites. Cats usually show clinical signs 1-3 weeks after infection. Signs can be non specific and include anorexia, lethargy, dyspnea, and icterus. Cats will also commonly have a marked pyrexia.
The organism invades the reticuloendothelial cells of the lungs, spleen, liver, lymph nodes, and other organs so cranial organomegaly can often be present. The bone marrow can be affected causing pancytopenias. Thrombocytopenia is likely related to the development of disseminated intravascular coagulation, which can cause spontaneous bleeding. There is no effective therapy and prognosis is poor to grave. Current treatment recommendations include the antimalarial drug atovaquone combined with the antimicrobial azithromycin as well as fluids, heparin and supportive care.
Anti-protozoal medications such as imidocarb have been used with varying success. Corticosteroids and antibiotics such as doxycycline, enrofloxacin, and marbofloxacin are commonly used to treat Mycoplasma haemofelis, but they are ineffective against Cytauxzoon.
Immune mediated hemolytic anemia, cholangiohepatitis, and FIP should also be considered as differentials.
Intravenous fluids, heparin therapy, blood transfusion; grave
Topic: Eosinophillic Granuloma Complex
Feline eosinophilic granuloma complex consists of 3 separate clinical syndromes.
A. The collagenolytic granuloma (also known as eosinophilic granuloma or linear granuloma) usually occurs on the (4) ? The lesions are typically ________ and ___________ or ____________.
B. The eosinophilic plaque occurs most frequently on the _____________ and ____________ ___________ but can appear other places. They appear as ? They frequently have a ___________ appearance and unlike eosinophilic ulcers, these are often ________. This condition is histopathologically similar to miliary dermatitis and is usually associated with underlying allergy.
C. The eosinophilic ulcer (also known as indolent ulcer) typically occurs on the ? and may be _________ or _________. They often have a characteristic central area of _______ to _______ tissue with a slightly raised circumferential edge
The underlying cause of eosinophilic ulcers and collagenolytic granulomas are _________, although an underlying allergic cause such as arthropod bites and/or cutaneous hypersensitivity have been suggested.
Treatment of collagenolytic granulomas is also controversial so it is unlikely that you would be asked about treatment of this disorder on a board exam aside from knowing that you should attempt to identify and remove/treat underlying allergy or biting arthropod problems.
Some cases respond to antibiotic therapy but most require glucocorticoid therapy.
A. The collagenolytic granuloma (also known as eosinophilic granuloma or linear granuloma) usually occurs on the nose, chin, oral cavity, or caudal thighs. The lesions are typically raised and ulcerative or nodular.
B. The eosinophilic plaque occurs most frequently on the abdomen and medial thighs but can appear other places. They appear as single or multiple, raised, red, often ulcerated lesions of varying size (0.5-7 cm). They frequently have a cobblestone appearance and unlike eosinophilic ulcers, these are often pruritic. This condition is histopathologically similar to miliary dermatitis and is usually associated with underlying allergy.
C. The eosinophilic ulcer (also known as indolent ulcer) typically occurs on the upper lip and may be unilateral or bilateral. They often have a characteristic central area of yellow to pink tissue with a slightly raised circumferential edge
The underlying cause of eosinophilic ulcers and collagenolytic granulomas are unknown, although an underlying allergic cause such as arthropod bites and/or cutaneous hypersensitivity have been suggested.
Treatment of collagenolytic granulomas is also controversial so it is unlikely that you would be asked about treatment of this disorder on a board exam aside from knowing that you should attempt to identify and remove/treat underlying allergy or biting arthropod problems.
Some cases respond to antibiotic therapy but most require glucocorticoid therapy.
What is pictured below?
Eosinophillic granuloma - chin
What is pictured below?
Eosinophillic ulcer - top lip
What is pictured below>
Eosinophillic granuloma - mouth
What is pictured below?
Eosinophillic plaque
Which of these is the most important treatment for salmon poisoning?
A. Oxytetracycline
B. Ivermectin
C. Praziquantel
D. Fenbendazole
The correct answer is oxytetracycline.
Salmon poisoning commonly occurs in the ?
Dogs contract the disease by ingesting _____ _______ containing the fluke ____________ _________ which carries the rickettsial organism _____________ __________________.
The most common vector is _____ _________, hence the name. Other cases have occurred from the ingestion of (2)?
Clinical signs include ?
Rare cases can develop neurrological signs such as _________ and ?
Because the signs are caused by a rickettsial organism, treatment is with a __________-type of drug. Left untreated, _____% of dogs will die.
________________ is usually given to eliminate the fluke in order to prevent contamination of other waterways.
Salmon poisoning commonly occurs in the Pacific Northwest (Washington, Oregon, Northern California, and southern Vancouver Island in Canada). Dogs contract the disease by ingesting raw fish containing the fluke Nanophyetus salmincola which carries the rickettsial organism Neorickettsia helminthoeca.
The most common vector is raw salmon, hence the name. Other cases have occurred from the ingestion of freshwater trout and salamanders. Clinical signs include fever, vomiting, diarrhea, enlarged lymph nodes, and depression. Rare cases can develop neurologic signs such as seizures and muscle twitching.
Because the signs are caused by a rickettsial organism, treatment is with a tetracycline-type of drug. Left untreated, 90% of dogs will die.
Praziquantel is usually given to eliminate the fluke in order to prevent contamination of other waterways.
A 2-year old MN DSH has recently been treated for a urethral obstruction. He went home last week from the hospital on an acidifying canned diet for this condition. The owner reports he is passing urine in moderate amounts, but he is still straining frequently. You re-examine the cat and find that the bladder is empty on palpation and the wall feels a little thickened. You are confident that the cat has not re-blocked and the cat’s bloodwork shows normal electrolytes and renal values. Which of the following medications may help the cat with this problem?
A. Prednisolone
B. Amitriptyline
C. Phenylpropanolamine
D. Phenexybenzamine
E. Methocarbamol
Explain your answer choice!!
This cat is likely suffering from hypertonicity of urethral muscle, which was incited from the recent obstruction and urinary catheter. This can cause spasms, which makes urinating painful and not easily controlled. Phenoxybenzamine can be used in this case to reduce internal urethral sphincter tone such that the cat may urinate more easily.
Methocarbamol is a muscle relaxant but would not directly help spasms of the urethra.
Prednisolone is not used to help reduce inflammation or spasms in the urethra and may predispose the cat to contracting a urinary infection, especially while his bladder and urethra are compromised.
Phenylpropanolamine is used to treat urinary incontinence from urethral hypotonicity most often in dogs and would be contraindicated in this case.
Amitriptyline is an anti-depressant medication that has been implicated as part of a treatment plan for cats with cystitis, although benefit has never been proven. Because cats with cystitis can flare up during times of stress, the amitriyptyline has been thought to helo prevent this. This medication would not work to stop spasms in the urethra.
Which of these tests is used to diagnose a Corynebacterium pseudotuberculosis infection with internal abscesses in horses?
A. Zinc sulfate turbidity test
B. Coggin’s test
C. KOH test
D. Synergistic hemolysis inhibition test
The correct answer is the synergistic hemolysis inhibition test. Other clinicopathologic data that would support an internal abscess would include leukocytosis, hyperfibrinogenemia and hyperglobulinemia. A KOH test is used to diagnose dermatophytes. The zinc sulfate turbidity test evaluates for failure of passive transfer. The Coggin’s test is for equine infectious anemia. Remember, goats get C.
pseudotuberculosis as well.
You are in charge of a slaughter house and are asked about why so many of the culled dairy cattle in a recent shipment have liver abscesses (see photo) and what can be done about it. The abscesses result in a significant financial loss for the owner because the liver is condemned, and he is concerned. What is the cause?
A. Foot abscesses showering bacteria to the liver
B. Rumen acidosis
C. Liver fluke migration
D. Black disease
E. Traumatic reticuloperitonitis with hepatic involvement
Explain your answer choice!
Dairy cattle which are fed a high concentrate diet should be gradually introduced to it. Even so, an additional dietary buffer may be needed. The herd veterinarian should check rumen pH on about 5 high-producing cows by needle stick of the rumen 2 to 3 hours after they are fed. If some fall below pH 5.5, additional sodium bicarbonate should be added to the ration.
The low rumen pH causes rumenitis allowing bacteria to translocate through the mucosa and be filtered from the hepatic portal circulation by the liver, resulting in one or more hepatic abscesses.
The key to picking rumenitis is that there are many culled dairy cattle coming in with this problem of hepatic abscess. If it were feet or hardware it would only occasionally lead to a liver abscess.
A horse is referred to your practice for further evaluation and treatment of glomerulonephritis. Which of the following is not a treatment option?
A. Long term furosemide administration
B. Low protein diet
C. Corticosteroids
D. Plasma transfusion
The correct answer is long term furosemide administration.
Horses with glomerulonephritis are usually polyuric. Furosemide is only indicated for oliguric renal failure.
The other choices are commonly used in the treatment and management of glomerulonephritis. A low protein diet will help decrease the amount of proteinuria and blood urea nitrogen circulating at any given time, therefore helping reduce the degree of azotemia.
What is the most appropriate medical treatment for transitional cell carcinoma at the trigone of the bladder, as depicted in the photo?`
Transitional cell carcinoma of the bladder in dogs can be palliatively managed with non-steroidal anti-inflammatory drugs such as piroxicam. Progression-free interval and survival can be extended with the addition of chemotherapy. The most commonly used agents are carboplatin, cisplatin, and mitoxantrone. Although cisplatin is effective against TCC, it has increased nephrotoxicity with piroxicam and is less commonly used these days in the author’s experience. Secondary infections can be treated with appropriate antibiotics.
You are investigating a case of high mortality in 14 week old pigs. You are suspicious of Porcine circovirus associated disease (PCVAD). What sample do you need to submit to a laboratory to confirm your diagnosis?
A. Serum sample for virus isolation
B. Whole blood for complete blood count (CBC)
C. Serum sample for PCR testing
D. Lymphoid tissue for histology
E. Serum sample for ELISA antibody testing
The correct answer is lymphoid tissue for histology. A diagnosis of PCVAD requires 3 parts:
1) at least a doubling of mortality (clinical history)
2) demonstration of lymphoid depletion (histopathology)
3) high number of PCV2 antigen in the lesion (immunohistochemistry on tissue)
In a dog, Cushing’s response is characterized by a?
A. Compensatory hyperadrenocorticism to maintain cerebral perfusion
B. Compensatory increase in mean arterial pressure to maintain cerebral perfusion pressure
C. Compensatory decrease in systolic blood pressure to maintain peripheral perfusion
D. Compensatory elevation in blood glucose to enhance cerebral function
The correct answer is a compensatory increase in mean arterial pressure to maintain cerebral perfusion pressure.
Cerebral perfusion pressure= Mean arterial pressure - intracranial pressure or (CPP=MAP-ICP).
This response is seen in situations where intracranial pressure increases such as in brain trauma. In this case, you need to think before you intervene to decrease your patient’s mean arterial pressure as this might eliminate cerebral blood flow and kill your patient.
You examine a 4-year old Holstein dairy cow which freshened 2 weeks ago. She has a history of abrupt cessation of lactation and loss of interest in feed. T=105F, HR=90 and RR=30. The cow has an arched back and is treading and swishing her tail frequently. On rectal exam you find an enlarged and painful left kidney. You catch urine in a cup after stimulating her to urinate. Which description of the urine best fits what you would expect to find in this cow?
Amytoid casts
Hemoglobinuria
Cloudy and bloody
Correct Answer
-Crystats present
Ketonuria
Explanation
This cow is likely to have acute pyelonephritis. It is most commonly ascending and associated with E. coli, other coliforms, or Corynebacterium renale. You could also use ultrasound to confirm the diagnosis, but finding neutrophils, RBCs and bacteria with these signs is indicative of acute pyelonephritis.
A farmer complains to you that many of his sheep have been doing poorly. You visit his flock and find many listless, emaciated adult sheep that are dyspneic and tachypneic. The sheep have normal temperatures, appetites, and no adventitious lung sounds. What is your top differential?
Pasteurella pneumonia
-Oestrus ovis infestation
Ovine Progressive Pneumonia
Correct Answer
Chlamydia psittaci pneumonia
Explanation
Ovine Progressive Pneumonia is caused by a lentivirus, also known as Maedi-Visna virus. This generally causes a chronic, progressive condition, and affected sheep tend to be afebrile and maintain their appetites as long as they do not develop secondary bacterial pneumonia. This is in contrast to Pasteurella pneumonia, which tends to be much more acute. Clinical signs of Oestrus ovis tend to be more confined to the nares. Chlamydial pneumonia is rare in sheep.
A 6-month old male German Shepherd Dog presents for castration. A 4/6 left systolic murmur is heard best over the apex of the heart. Thoracic radiographs reveal a moderately enlarged left atrium. What is the most likely diagnosis?
Aortic stenosis
Tricuspid valve dysplasia
Mitral valve dysplasia
Correct Answer
Myxomatous degeneration of the mitral valve
Your Answer
Explanation
The correct answer is mitral valve dysplasia. This abnormality is a congenital anomaly of the mitral valve. The valve leaflets may be thickened, fused, fibrosed, etc. The chordae tendinae or the papillary muscles attaching to the mitral valve may be irregular as well.
German Shepherd Dogs, Great Danes, and other large breed dogs are predisposed to this disease. Myxomatous mitral valve degeneration occurs in older dogs, but would otherwise result in similar physical exam and radiographic findings as those described. Tricuspid dysplasia results in an enlarged right heart, and the murmur would be heard best on the right side of the dog. Aortic stenosis results in concentric hypertrophy of the left heart, which may or may not be detectable on radiographs. Also, the murmur is heard best at the left heart base with aortic stenosis.
Which of these compounds is effective at inducing emesis in the cat?
Ketamine
Acepromazine
Diazepam
Xylazine
Your Answer
Correct Answer
Explanation
The correct answer is xylazine. Xylazine can cause emesis fairly reliably in cats. The other drugs listed do not.
A 3-year old Golden Retriever presents for acute onset of a non-painful myelopathy localized to the spinal segments from T3-L3. The dog has superficial and deep pain perception and some motor function present in its pelvic limbs. It also has hyperreflexive patellar and gastrocnemius reflexes. The dog is diagnosed with a fibrocartilagenous embolism (FCE). What do you tell the owners?
The dog should be treated with heparin to prevent further emboli
Your Answer
The dog should have decompressive surgery
♥ Most cogs with FCEtstally get beter on theirown with mersingeare
Correct Answer
The dog will prebably continue to get worse and has a poor prognosis
Explanation
The correct answer is most dogs with FCE usually get better on their own with nursing care. FCE is caused by an embolus of disc material in the spinal vasculature. It is unknown how the disc material gets into the vasculature. The prognosis of dogs with FCE varies. Most dogs get better with supportive and nursing care. The loss of pain perception and lower motor neuron signs are poor prognostic indicators.
A pregnant cow has a uterine torsion. Which of these therapeutic interventions should you attempt if the torsion is clockwise?
Push forward on the vagina while rolling the cow counterclockwise
Perform uterine surgery to relieve the torsion
Administer oxytocin
Push forward on the vagina while rolling the cow clockwise
Correct Answer
Explanation
The correct answer is push forward on the vagina while rolling the cow clockwise, which may seem counter-intuitive. By stabilizing the uterus and rotating the cow around it, you can attempt to relieve the torsion.