MSK SBAs Flashcards
Scenario: A 6-month-old Labrador Retriever presents with a chronic, progressive hindlimb lameness. On physical examination, there is pain on hip extension and abduction.
Lead-in: According to the information, which of the following is the most likely underlying condition?
Options:
a) Panosteitis
b) Elbow dysplasia
c) Hip dysplasia
d) Osteochondrosis dissecans of the stifle
e) Metaphyseal osteopathy
Answer: c) Hip dysplasia
Explanation: Hip dysplasia is a common cause of chronic, progressive hindlimb lameness in young, large-breed dogs like Labrador Retrievers, with pain often elicited on hip extension and abduction [cite: 3. Investigation and management of juvenile lame dog .pdf].
Scenario: A 7-month-old Rottweiler presents with a shifting lameness affecting different limbs over the past few weeks. On physical examination, there is pain on palpation of the diaphysis of the long bones.
Lead-in: What is the most likely diagnosis?
Options:
a) Hip dysplasia
b) Elbow dysplasia
c) Panosteitis
d) Osteochondrosis dissecans
e) Septic arthritis
Answer: c) Panosteitis
Explanation: Panosteitis is a common cause of shifting leg lameness in young, rapidly growing large and giant breed dogs like Rottweilers, characterised by pain on palpation of the long bone diaphysis [cite: 3. Investigation and management of juvenile lame dog .pdf].
Scenario: A mature Springer Spaniel presents with a chronic, intermittent forelimb lameness that is exacerbated by exercise.
Lead-in: According to the information, which of the following conditions is a common cause of forelimb lameness in this breed?
Options:
a) Hip dysplasia
b) Elbow dysplasia
c) Humeral intracondylar fissure
d) Osteosarcoma
e) Carpal hyperextension
Answer: c) Humeral intracondylar fissure
Explanation: Humeral intracondylar fissure is a condition that can cause chronic, intermittent forelimb lameness in mature Spaniels, often exacerbated by exercise [cite: 4. Mature Lame Animals Part 1.pdf].
Scenario: A mature German Shepherd Dog presents with a chronic hindlimb lameness and a history of progressive weakness and incoordination.
Lead-in: Which of the following conditions is a common cause of hindlimb lameness and neurological signs in this breed?
Options:
a) Hip dysplasia
b) Elbow dysplasia
c) Lumbosacral disease
d) Osteosarcoma
e) Degenerative myelopathy
Answer: c) Lumbosacral disease
Explanation: Lumbosacral disease, affecting the nerves in the lower back, is a common cause of chronic hindlimb lameness, pain, and neurological deficits in German Shepherd Dogs [cite: 4. Mature Lame Animals Part 1.pdf].
Scenario: Radiographs of a dog’s tibia show a fracture line that runs perpendicular to the long axis of the bone.
Lead-in: According to the classification of fractures, what type of fracture is this?
Options:
a) Oblique
b) Spiral
c) Transverse
d) Comminuted
e) Avulsion
Answer: c) Transverse
Explanation: A transverse fracture is characterised by a fracture line that runs at a right angle (perpendicular) to the long axis of the bone [cite: 5. SDL - Fracture Descriptions.pdf].
Scenario: Radiographs of a dog’s femur show a fracture line that curves around the bone.
Lead-in: What type of fracture is this?
Options:
a) Transverse
b) Oblique
c) Spiral
d) Comminuted
e) Greenstick
Answer: c) Spiral
Explanation: A spiral fracture is characterised by a fracture line that encircles the bone in a spiral pattern, often resulting from rotational forces [cite: 5. SDL - Fracture Descriptions.pdf].
Scenario: Radiographs of a dog’s humerus show the bone broken into multiple fragments.
Lead-in: What term describes this type of fracture?
Options:
a) Simple
b) Compound
c) Greenstick
d) Comminuted
e) Impacted
Answer: d) Comminuted
Explanation: A comminuted fracture is one in which the bone is broken into more than two fragments [cite: 5. SDL - Fracture Descriptions.pdf].
Scenario: Radiographs of a young dog’s tibia show a fracture involving the growth plate and extending through the metaphysis.
Lead-in: According to the Salter-Harris classification, what type of physeal fracture is this?
Options:
a) Type I
b) Type II
c) Type III
d) Type IV
e) Type V
Answer: b) Type II
Explanation: A Salter-Harris Type II fracture involves a fracture through the physis (growth plate) and extending into the metaphysis [cite: 5. SDL - Fracture Descriptions.pdf].
Scenario: Radiographs of a dog’s fracture taken several weeks after surgical repair show a cloud of new bone forming around the fracture site.
Lead-in: What is this new bone formation called?
Options:
a) Sequestrum
b) Involucrum
c) Callus
d) Osteophyte
e) Sclerosis
Answer: c) Callus
Explanation: Callus is the woven bone that forms around a fracture site during the secondary bone healing process [cite: 5. SDL - Fracture description and radiographic assessment of fracture healing.pdf].
Scenario: Radiographs of a fracture show that the fracture line is no longer visible, and the bone has returned to its normal shape and size.
Lead-in: According to the stages of fracture healing, what stage is this?
Options:
a) Inflammatory phase
b) Soft callus formation
c) Hard callus formation
d) Remodelling
e) Repair
Answer: d) Remodelling
Explanation: Remodelling is the final stage of secondary bone healing where the callus is reshaped into mature lamellar bone, and the medullary canal is restored [cite: 5. SDL - Fracture description and radiographic assessment of fracture healing.pdf].
Scenario: A juvenile dog presents with lameness and pain in the stifle joint. Radiographs reveal a defect in the articular cartilage of the femoral condyle.
Lead-in: What is the most likely diagnosis?
Options:
a) Septic arthritis
b) Osteoarthritis
c) Osteochondrosis dissecans (OCD)
d) Panosteitis
e) Patellar luxation
Answer: c) Osteochondrosis dissecans (OCD)
Explanation: Osteochondrosis dissecans (OCD) is a common cause of lameness in juvenile dogs, particularly affecting the stifle joint and characterised by defects in the articular cartilage [cite: 3. Investigation and management of juvenile lame dog .pdf].
Scenario: A mature cat presents with a non-weight bearing lameness of the hindlimb. Radiographs reveal a transverse fracture of the femoral diaphysis. The fracture is visible through an open wound.
Lead-in: What type of fracture is this?
Options:
a) Closed, simple
b) Open, simple
c) Closed, comminuted
d) Open, comminuted
e) Greenstick
Answer: b) Open, simple
Explanation: The fracture is open because it communicates with the external environment via a wound, and it is simple because there are only two main fracture fragments [cite: 5. SDL - Fracture Descriptions.pdf].
Scenario: A mature dog presents with a chronic forelimb lameness. Radiographs of the elbow show sclerosis of the subchondral bone and osteophyte formation.
Lead-in: What is the most likely diagnosis?
Options:
a) Septic arthritis
b) Osteoarthritis (elbow dysplasia)
c) Tendonitis
d) Nerve root compression
e) Fracture non-union
Answer: b) Osteoarthritis (elbow dysplasia)
Explanation: The radiographic findings of subchondral bone sclerosis and osteophyte formation in the elbow joint of a mature dog with chronic lameness are consistent with osteoarthritis, which can be a sequela to elbow dysplasia [cite: 4. Mature Lame Animals Part
Scenario: A young, small-breed dog presents with intermittent hindlimb lameness. On physical examination, the patella can be easily displaced medially.
Lead-in: What is the most likely diagnosis?
Options:
a) Hip dysplasia
b) Elbow dysplasia
c) Medial patellar luxation
d) Lateral patellar luxation
e) Cruciate ligament rupture
Answer: c) Medial patellar luxation
Explanation: Medial patellar luxation is a common cause of intermittent hindlimb lameness in young, small-breed dogs, characterised by the patella being easily displaced medially [cite: 4. Mature Lame Animals Part 1.pdf].
Scenario: A mature, large-breed dog presents with acute, non-weight bearing hindlimb lameness. On physical examination, there is a positive cranial drawer sign.
Lead-in: What is the most likely diagnosis?
Options:
a) Hip dysplasia
b) Elbow dysplasia
c) Cranial cruciate ligament rupture
d) Osteosarcoma
e) Lumbosacral disease
Answer: c) Cranial cruciate ligament rupture
Explanation: A positive cranial drawer sign is a classic finding indicative of a rupture of the cranial cruciate ligament in the stifle joint, a common cause of acute hindlimb lameness in mature, large-breed dogs [cite: 4. Mature Lame Animals Part 1.pdf].
Scenario: A juvenile dog presents with lameness and pain in the hip joint. Radiographs reveal flattening of the femoral head and widening of the joint space.
Lead-in: What is the most likely diagnosis?
Options:
a) Hip dysplasia
b) Elbow dysplasia
c) Legg-Calve-Perthes disease
d) Panosteitis
e) Osteochondrosis dissecans
Answer: c) Legg-Calve-Perthes disease
Explanation: Legg-Calve-Perthes disease is characterised by avascular necrosis of the femoral head, leading to flattening and pain in the hip joint of juvenile, small-breed dogs [cite: 3. Investigation and management of juvenile lame dog .pdf].
Scenario: A mature cat presents with a sudden onset of severe hindlimb lameness. On physical examination, the limb is cold and painful, with absent pulses.
Lead-in: What is the most likely diagnosis?
Options:
a) Fracture
b) Osteoarthritis
c) Arterial thromboembolism
d) Nerve root compression
e) Tendon rupture
Answer: c) Arterial thromboembolism
Explanation: Sudden onset of severe hindlimb lameness with coldness, pain, and absent pulses is highly suggestive of arterial thromboembolism, a common cause of acute lameness in cats [cite: 4. Mature Lame Animals Part 1.pdf].
Scenario: A mature dog presents with a firm, painful swelling on a long bone. Radiographs reveal a lytic lesion with periosteal reaction.
Lead-in: What is the most likely diagnosis?
Options:
a) Fracture non-union
b) Osteomyelitis
c) Osteosarcoma
d) Panosteitis
e) Soft tissue sarcoma
Answer: c) Osteosarcoma
Explanation: A firm, painful swelling on a long bone with a lytic lesion and periosteal reaction on radiographs is highly suspicious for osteosarcoma, a common primary bone tumour in mature, large-breed dogs [cite: 4. Mature Lame Animals Part 1.pdf].
Scenario: Radiographs of a dog’s ulna show a fracture involving the distal epiphysis. The fracture line runs through the growth plate and extends into the metaphysis.
Lead-in: According to the Salter-Harris classification, what type of physeal fracture is this?
Options:
a) Type I
b) Type II
c) Type III
d) Type IV
e) Type V
Answer: b) Type II
Explanation: A Salter-Harris Type II fracture involves a fracture through the physis and extending into the metaphysis, which matches the description [cite: 5. SDL - Fracture Descriptions.pdf].
Scenario: A mature dog presents with a chronic, progressive lameness of the forelimb. Radiographs reveal new bone formation around the shoulder joint.
Lead-in: What is the most likely diagnosis?
Options:
a) Elbow dysplasia
b) Shoulder osteoarthritis
c) Bicipital tendonitis
d) Fracture non-union
e) Nerve root compression
Answer: b) Shoulder osteoarthritis
Explanation: Chronic progressive lameness with new bone formation around a joint is indicative of osteoarthritis. In this case, the location is the shoulder joint
Scenario: A 6-month-old Labrador Retriever presents with a chronic, progressive hindlimb lameness. On physical examination, there is pain on hip extension and abduction.
Lead-in: What is the most likely underlying condition?
Options:
a) Cruciate disease
b) Hip dysplasia
c) Patella luxation
d) Ligament injury
e) Osteoarthritis
Answer: b) Hip dysplasia
Explanation: Hip dysplasia is a common developmental condition in large-breed dogs like Labrador Retrievers that causes hindlimb lameness and pain on hip manipulation [cite: 7. Hip dysplasia.pdf].
Scenario: A 7-year-old Rottweiler presents with acute, non-weight bearing hindlimb lameness. On examination, a positive cranial drawer sign is elicited in the stifle joint.
Lead-in: What is the most likely diagnosis?
Options:
a) Hip dysplasia
b) Cruciate disease
c) Patella luxation
d) Ligament injury
e) Osteoarthritis
Answer: b) Cruciate disease
Explanation: A positive cranial drawer sign is a classic indicator of cranial cruciate ligament rupture, a common cause of acute hindlimb lameness in dogs [cite: 8. Cruciate disease.pdf].
Scenario: A small-breed dog presents with an intermittent skipping lameness of the hindlimb. On physical examination, the patella can be easily displaced medially.
Lead-in: What is the most likely diagnosis?
Options:
a) Hip dysplasia
b) Cruciate disease
c) Patella luxation
d) Ligament injury
e) Osteoarthritis
Answer: c) Patella luxation
Explanation: Medial patella luxation is common in small-breed dogs and can cause an intermittent, skipping lameness when the patella moves out of its groove
Scenario: A dog sustains a traumatic injury to the stifle joint, resulting in instability and pain.
Lead-in: Which of the following structures is most likely to be injured?
Options:
a) Hip ligament
b) Cruciate ligament
c) Patellar ligament
d) Collateral ligament of the elbow
e) Tarsal ligament
Answer: b) Cruciate ligament
Explanation: The cruciate ligaments are major stabilisers of the stifle joint and are commonly injured due to trauma [cite: 8. Cruciate disease.pdf, 9. Ligament injuries, joint luxations and salvage techniques.pdf].
Scenario: Radiographs are taken of a dog’s hips for hip scoring.
Lead-in: Which of the following is a key radiographic feature assessed during hip scoring?
Options:
a) Elbow incongruity
b) Subluxation of the femoral head
c) Osteophyte formation in the stifle
d) Carpal joint effusion
e) Tarsal bone sclerosis
Answer: b) Subluxation of the femoral head
Explanation: Hip scoring involves assessing various radiographic features of the hip joint, including the degree of subluxation (displacement) of the femoral head from the acetabulum [cite: 7. Hip dysplasia.pdf].
Scenario: A dog with cruciate ligament rupture undergoes surgical repair using a tibial plateau levelling osteotomy (TPLO).
Lead-in: What is the primary aim of a TPLO procedure?
Options:
a) To directly repair the torn cruciate ligament
b) To replace the damaged cartilage in the stifle joint
c) To neutralise tibial thrust during weight-bearing
d) To fuse the stifle joint
e) To remove any meniscal damage
Answer: c) To neutralise tibial thrust during weight-bearing
Explanation: TPLO is a surgical technique used to treat cruciate ligament rupture by changing the angle of the tibial plateau to eliminate the cranial tibial thrust that occurs during weight-bearing [cite: 8. Cruciate disease.pdf].
Scenario: A dog with patella luxation is being considered for surgical correction.
Lead-in: Which of the following surgical techniques is commonly used to address patella luxation?
Options:
a) Femoral head ostectomy
b) Tibial plateau levelling osteotomy
c) Trochleoplasty
d) Arthrodesis
e) Tenotomy
Answer: c) Trochleoplasty
Explanation: Trochleoplasty involves deepening the trochlear groove in the femur to provide better stability for the patella and prevent luxation [cite: 10. SDL - Patella Luxation.pdf].
Scenario: A dog sustains a traumatic hip luxation.
Lead-in: What is the primary goal of initial management?
Options:
a) Immediate surgical repair with ligament reconstruction
b) Closed reduction of the luxation as soon as possible
c) Strict cage rest for several weeks to allow spontaneous reduction
d) Administration of high doses of corticosteroids to reduce inflammation
e) Application of a Robert Jones bandage to stabilise the limb
Answer: b) Closed reduction of the luxation as soon as possible
Explanation: Prompt closed reduction (manipulation to return the joint to its normal position) is the primary goal in managing traumatic joint luxations, including hip luxations, to improve the chances of a successful outcome [cite: 9. Ligament injuries, joint luxations and salvage techniques.pdf].
Scenario: A dog with severe, chronic hip dysplasia is experiencing persistent pain despite medical management.
Lead-in: Which salvage surgical procedure might be considered to alleviate pain and improve function?
Options:
a) Triple pelvic osteotomy (TPO)
b) Total hip replacement (THR)
c) Arthroscopy
d) Arthrodesis
e) Tenotomy
Answer: b) Total hip replacement (THR)
Explanation: Total hip replacement is a salvage procedure that involves replacing the entire hip joint with prosthetic components and can provide excellent pain relief and function in dogs with severe hip dysplasia [cite: 7. Hip dysplasia.pdf, 9. Ligament injuries, joint luxations and salvage techniques.pdf].
Scenario: A dog with a torn cranial cruciate ligament also has a meniscal tear.
Lead-in: What is the recommended approach to manage the meniscal tear during surgical repair of the cruciate ligament?
Options:
a) Leave the torn meniscus in place as it may still provide some support
b) Perform a partial or complete meniscectomy to remove the damaged portion
c) Attempt to suture the torn meniscus
d) Inject corticosteroids into the meniscus to reduce inflammation
e) Apply a compression bandage to the stifle joint post-operatively
Answer: b) Perform a partial or complete meniscectomy to remove the damaged portion
Explanation: Damaged portions of the meniscus are typically removed during surgery for cruciate ligament rupture to prevent ongoing pain and inflammation [cite: 8. Cruciate disease.pdf].
Scenario: A cat presents with a lateral patella luxation.
Lead-in: According to the information, which breeds are more commonly affected by lateral patella luxation?
Options:
a) Toy breeds like Yorkshire Terriers
b) Large breeds like Labrador Retrievers
c) Brachycephalic breeds like Bulldogs
d) Flat-coated Retrievers
e) Persian cats
Answer: d) Flat-coated Retrievers
Explanation: Lateral patella luxation is less common than medial luxation and is more often seen in larger breeds, with Flat-coated Retrievers being specifically mentioned [cite: 10. SDL - Patella Luxation.pdf].
Scenario: A dog has sustained a complete rupture of the common calcaneal tendon (Achilles tendon).
Lead-in: What is the characteristic clinical sign associated with this injury?
Options:
a) Hyperextension of the stifle joint
b) Plantigrade stance (hock on the ground)
c) Inability to flex the hock joint
d) Severe pain on palpation of the tarsal joint
e) Swelling of the distal limb only
Answer: b) Plantigrade stance (hock on the ground)
Explanation: Rupture of the common calcaneal tendon results in a characteristic plantigrade stance, where the hock is dropped towards the ground due to loss of support from the gastrocnemius, superficial digital flexor, and biceps femoris muscles [cite: 9. Ligament injuries, joint luxations and salvage techniques.pdf].
Scenario: A dog with hip dysplasia is being managed conservatively.
Lead-in: Which of the following is a key aspect of conservative management for hip dysplasia?
Options:
a) Strict exercise restriction
b) Weight management and controlled exercise
c) High-impact exercise to strengthen the muscles
d) Surgical fusion of the hip joint
e) Prolonged courses of high-dose corticosteroids
Answer: b) Weight management and controlled exercise
Explanation: Conservative management of hip dysplasia focuses on maintaining a healthy weight to reduce stress on the joints and engaging in controlled, low-impact exercise to build muscle strength and support [cite: 7. Hip dysplasia.pdf].
Scenario: A dog has a medial patella luxation that only occurs with manual palpation but the dog is not lame.
Lead-in: According to the classification of patella luxation, what grade is this?
Options:
a) Grade 1
b) Grade 2
c) Grade 3
d) Grade 4
e) Grade 0
Answer: a) Grade 1
Explanation: Grade 1 patella luxation is characterised by the patella being manually luxated but returning to the trochlear groove spontaneously when pressure is released [cite: 10. SDL - Patella Luxation.pdf].
Scenario: A dog with a ruptured cranial cruciate ligament is being considered for surgical stabilisation.
Lead-in: Which of the following is a common complication associated with cruciate ligament rupture?
Options:
a) Elbow dysplasia
b) Hip dysplasia
c) Meniscal tear
d) Patella luxation
e) Shoulder osteoarthritis
Answer: c) Meniscal tear
Explanation: Tears of the medial meniscus are a common concurrent finding in dogs with cranial cruciate ligament rupture due to the altered biomechanics of the stifle joint [cite: 8. Cruciate disease.pdf].
Scenario: A dog with severe osteoarthritis secondary to hip dysplasia is being considered for a femoral head ostectomy (FHO).
Lead-in: What is the primary goal of an FHO procedure?
Options:
a) To restore normal joint anatomy
b) To eliminate bone-on-bone contact and alleviate pain
c) To fuse the hip joint
d) To replace the damaged cartilage
e) To tighten the hip joint capsule
Answer: b) To eliminate bone-on-bone contact and alleviate pain
Explanation: A femoral head ostectomy involves removing the femoral head and neck, eliminating the painful bone-on-bone contact in the dysplastic hip joint [cite: 9. Ligament injuries, joint luxations and salvage techniques.pdf].
Scenario: A dog with a joint luxation is presented several days after the injury.
Lead-in: What is a potential complication associated with delayed reduction of a joint luxation?
Options:
a) Increased risk of infection
b) Easier reduction due to muscle relaxation
c) Development of contractures and increased difficulty in reduction
d) Decreased pain due to nerve damage
e) Reduced risk of ligament damage
Answer: c) Development of contractures and increased difficulty in reduction
Explanation: Delayed reduction of a joint luxation can lead to the development of muscle contractures and fibrosis around the joint, making reduction more difficult and potentially requiring surgical intervention [cite: 9. Ligament injuries, joint luxations and salvage techniques.pdf].
Scenario: A dog with a torn cruciate ligament is being managed conservatively.
Lead-in: What is a key aspect of conservative management for this condition?
Options:
a) Aggressive exercise to promote ligament healing
b) Strict exercise restriction and weight management
c) Surgical repair as soon as possible
d) Application of a tight stifle bandage for support
e) Prolonged use of high-dose corticosteroids
Answer: b) Strict exercise restriction and weight management
Explanation: Conservative management of cruciate ligament rupture involves strict exercise restriction to allow inflammation to subside and weight management to reduce stress on the joint [cite: 8. Cruciate disease.pdf].
Scenario: A dog with patella luxation has a very shallow trochlear groove.
Lead-in: Which surgical technique might be used to address this specific anatomical abnormality?
Options:
a) Tibial tuberosity transposition
b) Lateral imbrication
c) Trochlear wedge resection
d) Medial release
e) Capsulotomy
Answer: c) Trochlear wedge resection
Explanation: A trochlear wedge resection is a surgical technique used to deepen the trochlear groove, providing better stability for the patella [cite: 10. SDL - Patella Luxation.pdf].
Scenario: A dog with a chronic ligament injury is being considered for arthrodesis.
Lead-in: What is the primary goal of arthrodesis as a salvage procedure?
Options:
a) To restore normal joint function
b) To eliminate pain by fusing the joint
c) To repair the damaged ligament
d) To replace the joint with a prosthesis
e) To improve the range of motion of the joint
Answer: b) To eliminate pain by fusing the joint
Explanation: Arthrodesis is a salvage procedure that involves surgically fusing a joint to eliminate painful movement in cases of severe, chronic joint disease or irreparable ligament injuries [cite: 9. Ligament injuries, joint luxations and salvage techniques.pdf].
Sources and related content
Scenario: A 14-month-old Labrador Retriever presents with a history of lethargy, inappetence, and reluctance to get out of its basket for the past few days. On physical examination, all four limbs are stiff and painful on manipulation of multiple joints.
Lead-in: According to the information, what is the most likely underlying condition?
Options:
a) Panosteitis
b) Osteosarcoma
c) Polyarthritis
d) Myasthenia gravis
e) Fibrocartilaginous embolism
Answer: c) Polyarthritis
Explanation: The clinical signs of lethargy, inappetence, and pain and stiffness affecting multiple joints in all four limbs are highly suggestive of polyarthritis [cite: 11. Multi-limb lameness.pdf, 12. SDL - investigation of polyarthritis .pdf].
Scenario: A dog is diagnosed with immune-mediated polyarthritis.
Lead-in: According to the information, which is the most common type of immune-mediated polyarthritis in dogs?
Options:
a) Type II (erosive)
b) Type III (associated with systemic lupus erythematosus)
c) Type IV (associated with neoplasia)
d) Type I (idiopathic)
e) Type V (associated with chronic infection)
Answer: d) Type I (idiopathic)
Explanation: Type I, or idiopathic immune-mediated polyarthritis, is the most common form in dogs, where no underlying cause can be identified [cite: 12. SDL - investigation of polyarthritis .pdf].
Scenario: A dog with suspected polyarthritis undergoes joint fluid analysis (arthrocentesis).
Lead-in: What is a typical finding in the synovial fluid of a dog with inflammatory polyarthritis?
Options:
a) Low white blood cell count with predominantly mononuclear cells
b) High white blood cell count with predominantly neutrophils
c) Presence of bacteria on cytology
d) Low protein concentration
e) High red blood cell count
Answer: b) High white blood cell count with predominantly neutrophils
Explanation: Inflammatory conditions like polyarthritis typically result in synovial fluid with an increased white blood cell count, with neutrophils being the predominant cell type [cite: 12. SDL - investigation of polyarthritis .pdf].
Scenario: A dog is diagnosed with immune-mediated polyarthritis and is being treated with corticosteroids.
Lead-in: According to the information, what is a key aspect of monitoring the response to therapy in these cases?
Options:
a) Monitoring heart rate and respiratory rate
b) Regular assessment of joint pain and swelling
c) Daily measurement of body temperature
d) Weekly complete blood counts
e) Monthly urine analysis
Answer: b) Regular assessment of joint pain and swelling
Explanation: Monitoring the degree of joint pain and swelling on physical examination is crucial for assessing the response to treatment and adjusting medication dosages in dogs with polyarthritis [cite: 12. SDL - investigation of polyarthritis .pdf].
Scenario: A young German Shepherd Dog presents with a shifting lameness affecting multiple limbs.
Lead-in: Which of the following conditions is a common cause of this presentation in this breed?
Options:
a) Hip dysplasia
b) Elbow dysplasia
c) Panosteitis
d) Osteochondrosis dissecans
e) Lumbosacral disease
Answer: c) Panosteitis
Explanation: Panosteitis is an inflammatory condition of multiple long bones that commonly causes a shifting lameness in young, large-breed dogs like German Shepherds [cite: 11. Multi-limb lameness.pdf].
Scenario: A dog presents with a history of tick exposure and now has a fever and lameness affecting multiple joints.
Lead-in: Which of the following infectious diseases is a potential cause of polyarthritis in dogs following a tick bite?
Options:
a) Canine parvovirus
b) Canine distemper
c) Lyme disease (Borrelia burgdorferi)
d) Leptospirosis
e) Babesiosis
Answer: c) Lyme disease (Borrelia burgdorferi)
Explanation: Lyme disease, transmitted by ticks, is a known cause of polyarthritis and fever in dogs [cite: 11. Multi-limb lameness.pdf].
Scenario: A dog with suspected polyarthritis has undergone joint fluid analysis, which is inconclusive.
Lead-in: According to the information, which further diagnostic test might be helpful in investigating the underlying cause?
Options:
a) Electrocardiogram (ECG)
b) Abdominal ultrasound
c) Thoracic radiographs
d) Antinuclear antibody (ANA) test
e) Faecal examination
Answer: d) Antinuclear antibody (ANA) test
Explanation: An ANA test is a serological test used to screen for autoimmune diseases, including some forms of immune-mediated polyarthritis [cite: 12. SDL - investigation of polyarthritis .pdf].
Scenario: A dog with immune-mediated polyarthritis is not responding adequately to corticosteroid therapy.
Lead-in: Which of the following steroid-sparing immunosuppressant drugs might be considered?
Options:
a) Phenylbutazone
b) Meloxicam
c) Azathioprine
d) Tramadol
e) Gabapentin
Answer: c) Azathioprine
Explanation: Azathioprine is an immunosuppressant drug that can be used in conjunction with or as an alternative to corticosteroids in the treatment of immune-mediated polyarthritis [cite: 12. SDL - investigation of polyarthritis .pdf].
Scenario: A dog presents with progressive muscle weakness affecting all four limbs, along with a change in bark and difficulty swallowing.
Lead-in: Which of the following conditions is a potential cause of this presentation, although listed under non-inflammatory myopathies?
Options:
a) Immune-mediated myositis
b) Masticatory myositis
c) Polymyositis
d) Myasthenia gravis
e) Dermatomyositis
Answer: d) Myasthenia gravis
Explanation: Myasthenia gravis is a neuromuscular disorder that can cause progressive muscle weakness affecting all four limbs, as well as the muscles involved in swallowing and vocalisation [cite: 11. Multi-limb lameness.pdf].
Scenario: A dog with suspected polyarthritis has joint fluid cytology that reveals the presence of bacteria.
Lead-in: What is the most likely diagnosis?
Options:
a) Idiopathic immune-mediated polyarthritis
b) Erosive immune-mediated polyarthritis
c) Septic arthritis
d) Reactive polyarthritis
e) Systemic lupus erythematosus
Answer: c) Septic arthritis
Explanation: The presence of bacteria in the synovial fluid is indicative of septic arthritis, a bacterial infection within the joint [cite: 11. Multi-limb lameness.pdf].
Scenario: A dog with polyarthritis has a history of recent vaccination.
Lead-in: According to the information, what type of immune-mediated polyarthritis has been suggested to have a possible association with recent vaccination, although the evidence is not strong?
Options:
a) Type I (idiopathic)
b) Type II (erosive)
c) Type III (associated with SLE)
d) Type IV (associated with neoplasia)
e) Type V (associated with chronic infection)
Answer: a) Type I (idiopathic)
Explanation: Type I idiopathic immune-mediated polyarthritis has been suggested to have a possible association with recent vaccination in some cases, although the evidence is not definitive [cite: 12. SDL - investigation of polyarthritis .pdf].
Scenario: A dog presents with lameness and stiffness that is worse in the morning and improves with exercise. Multiple joints are affected.
Lead-in: This pattern of clinical signs is most consistent with which condition?
Options:
a) Septic arthritis
b) Trauma
c) Osteoarthritis
d) Panosteitis
e) Myositis
Answer: c) Osteoarthritis
Explanation: Morning stiffness that improves with exercise is a common characteristic of osteoarthritis, which can affect multiple joints [cite: 11. Multi-limb lameness.pdf].
Scenario: A dog with polyarthritis has erosive lesions visible on radiographs of the affected joints.
Lead-in: According to the classification, what type of immune-mediated polyarthritis is this?
Options:
a) Type I
b) Type II
c) Type III
d) Type IV
e) Type V
Answer: b) Type II
Explanation: Type II immune-mediated polyarthritis is characterised by erosive lesions in the joints that can be seen on radiographs [cite: 12. SDL - investigation of polyarthritis .pdf].
Scenario: A dog with multi-limb lameness is suspected of having a paraneoplastic syndrome.
Lead-in: Which of the following is a potential underlying cause of paraneoplastic polyarthritis?
Options:
a) Osteosarcoma
b) Lymphoma
c) Hip dysplasia
d) Cruciate ligament rupture
e) Elbow dysplasia
Answer: b) Lymphoma
Explanation: Lymphoma and other types of neoplasia can sometimes be associated with paraneoplastic polyarthritis, where the arthritis is a consequence of the cancer elsewhere in the body [cite: 11. Multi-limb lameness.pdf].
Scenario: A dog with polyarthritis has a joint tap that reveals a very high white blood cell count (>50,000 cells/µL).
Lead-in: This finding is most suggestive of which condition?
Options:
a) Mild inflammatory polyarthritis
b) Moderate immune-mediated polyarthritis
c) Septic arthritis
d) Chronic osteoarthritis
e) Early-stage Lyme disease
Answer: c) Septic arthritis
Explanation: A very high white blood cell count in the synovial fluid is highly suggestive of a septic arthritis, indicating a bacterial infection within the joint.
Scenario: A dog with multi-limb lameness is being investigated for a potential endocrine cause.
Lead-in: Which endocrine disorder is listed as a potential cause of associated polyarthritis or myopathy?
Options:
a) Diabetes mellitus
b) Hyperthyroidism
c) Hypothyroidism
d) Hyperadrenocorticism
e) Hypoadrenocorticism
Answer: c) Hypothyroidism
Explanation: Hypothyroidism is listed as a potential endocrine disorder that can be associated with polyarthritis or myopathy, leading to multi-limb lameness [cite: 11. Multi-limb lameness.pdf].
Scenario: A dog with polyarthritis has a poor response to initial corticosteroid therapy.
Lead-in: Which of the following further immunosuppressive medications might be considered?
Options:
a) Intra-articular methylprednisolone
b) Amoxicillin
c) Cyclosporine
d) Furosemide
e) Enalapril
Answer: c) Cyclosporine
Explanation: Cyclosporine is another immunosuppressant drug that may be used in cases of immune-mediated polyarthritis that do not respond well to corticosteroids alone [cite: 12. SDL - investigation of polyarthritis .pdf].
Scenario: A dog presents with acute onset of non-weight bearing lameness in all four limbs.
Lead-in: Which of the following conditions is a rare but possible cause of acute, severe multi-limb lameness?
Options:
a) Osteoarthritis
b) Panosteitis
c) Fibrocartilaginous embolism (FCE)
d) Hip dysplasia
e) Elbow dysplasia
Answer: c) Fibrocartilaginous embolism (FCE)
Explanation: Fibrocartilaginous embolism, a vascular event affecting the spinal cord, can sometimes cause acute, severe non-weight bearing lameness in multiple limbs, although it is more commonly seen as a non-painful condition [cite: 11. Multi-limb lameness.pdf].
Scenario: A dog with polyarthritis has a joint tap that reveals a low white blood cell count but an elevated protein level.
Lead-in: This finding might be suggestive of which type of polyarthritis?
Options:
a) Septic arthritis
b) Immune-mediated polyarthritis
c) Non-inflammatory arthropathy
d) Reactive polyarthritis
e) Lyme disease
Answer: c) Non-inflammatory arthropathy
Explanation: A low white blood cell count with elevated protein in the synovial fluid might suggest a non-inflammatory arthropathy, although inflammatory conditions usually have higher cell counts.
Scenario: A dog with multi-limb lameness is being investigated for a potential cardiac cause.
Lead-in: Which cardiac condition is listed as being associated with polyarthritis?
Options:
a) Dilated cardiomyopathy
b) Hypertrophic cardiomyopathy
c) Endocarditis
d) Mitral valve disease
e) Pericardial effusion
Answer: c) Endocarditis
Explanation: Endocarditis, an infection of the heart valves, can sometimes be associated with polyarthritis due to immune complex deposition [cite: 11. Multi-limb lameness.pdf].
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Scenario: A rabbit presents with sudden onset hindlimb paralysis after a struggle.
Lead-in: According to the information, what is the most likely musculoskeletal injury in this scenario?
Options:
a) Tibial fracture
b) Femoral fracture
c) Spinal fracture (lumbar)
d) Hip luxation
e) Muscle rupture
Answer: c) Spinal fracture (lumbar)
Explanation: Rabbits are prone to spinal fractures, particularly in the lumbar region, due to their powerful hindlimbs and relatively fragile skeleton, often occurring after sudden movements or struggles [cite: 14. Musculoskeletal Disease in Small Mammals and Exotic Species.pdf].
Scenario: A rabbit presents with a swollen, painful hock joint. Radiographs reveal periosteal reaction and lysis of the underlying bone.
Lead-in: What is the most likely diagnosis?
Options:
a) Osteoarthritis
b) Septic arthritis/osteomyelitis
c) Sprain
d) Luxation
e) Tendonitis
Answer: b) Septic arthritis/osteomyelitis
Explanation: Swelling, pain, and radiographic findings of periosteal reaction and bone lysis are consistent with a bone infection, such as septic arthritis and/or osteomyelitis [cite: 14. Musculoskeletal Disease in Small Mammals and Exotic Species.pdf].
Scenario: A young rabbit is unable to use its hindlimbs, which are splayed laterally.
Lead-in: What is the common term for this congenital musculoskeletal condition?
Options:
a) Hip dysplasia
b) Spinal dysraphism
c) Splay leg
d) Osteogenesis imperfecta
e) Arthrogryposis
Answer: c) Splay leg
Explanation: Splay leg is a congenital condition in rabbits characterised by the inability to adduct the hindlimbs, resulting in a splayed appearance [cite: 14. Musculoskeletal Disease in Small Mammals and Exotic Species.pdf].
Scenario: A guinea pig presents with a swollen, painful foot with ulcerated lesions on the plantar surface.
Lead-in: What is the most likely diagnosis?
Options:
a) Pododermatitis (bumblefoot)
b) Gout
c) Septic arthritis
d) Fracture
e) Dermatophytosis
Answer: a) Pododermatitis (bumblefoot)
Explanation: Pododermatitis, also known as bumblefoot, is a common condition in guinea pigs characterised by inflammation and ulceration of the plantar surface of the feet, often due to inappropriate flooring or obesity [cite: 14. Musculoskeletal Disease in Small Mammals and Exotic Species.pdf].
Scenario: A parrot presents with a non-weight bearing lameness of one leg. On physical examination, the leg is swollen and painful.
Lead-in: What is the most likely initial differential diagnosis?
Options:
a) Metabolic bone disease
b) Gout
c) Fracture
d) Bumblefoot
e) Arthritis
Answer: c) Fracture
Explanation: Acute onset non-weight bearing lameness with swelling and pain in a bird is highly suggestive of a fracture, often due to trauma [cite: 15. Workshop - Musculoskeletal Disease in Avian Species .pdf].
Scenario: A raptor presents with a swollen foot and reluctance to perch. Examination reveals ulcerated lesions on the plantar surface of the foot.
Lead-in: What is the most likely diagnosis?
Options:
a) Gout
b) Bumblefoot
c) Arthritis
d) Fracture
e) Tendonitis
Answer: b) Bumblefoot
Explanation: Bumblefoot (pododermatitis) is a common condition in birds, especially raptors, characterised by swelling and ulceration of the plantar surface of the feet, often linked to inappropriate perching or husbandry [cite: 15. Workshop - Musculoskeletal Disease in Avian Species .pdf].
Scenario: A young parrot is presented with a history of weakness, reluctance to perch, and a pliable beak.
Lead-in: What is the most likely underlying cause of these signs?
Options:
a) Fracture
b) Infection
c) Metabolic bone disease
d) Toxin ingestion
e) Neoplasia
Answer: c) Metabolic bone disease
Explanation: Pliable beak, weakness, and reluctance to perch are classic signs of metabolic bone disease in young birds, often due to calcium and vitamin D3 deficiency from an inappropriate diet and lack of UV-B light [cite: 14. Musculoskeletal Disease in Small Mammals and Exotic Species.pdf].
Scenario: A rabbit is being prepared for radiography to assess a suspected tibial fracture.
Lead-in: What is a key consideration for positioning a rabbit for radiographs?
Options:
a) Rabbits do not require sedation for radiography.
b) Manual restraint is sufficient for all radiographic views.
c) Sedation or general anaesthesia is often required to obtain good quality, correctly positioned radiographs.
d) Only one view is usually necessary to diagnose a fracture.
e) Rabbits should be placed in lateral recumbency for all limb radiographs.
Answer: c) Sedation or general anaesthesia is often required to obtain good quality, correctly positioned radiographs.
Explanation: Due to their easily stressed nature and potential for sudden movements, sedation or general anaesthesia is often necessary for rabbits to obtain diagnostic quality radiographs [cite: 14. Musculoskeletal Disease in Small Mammals and Exotic Species.pdf].
Scenario: A bird with a suspected fracture is being managed with a bandage.
Lead-in: What is a critical aspect of bandage application in birds?
Options:
a) The bandage should be applied very tightly to provide maximum support.
b) Birds tolerate tight bandages well.
c) Bandages should be applied loosely to avoid restricting circulation or respiration.
d) Only adhesive bandages should be used.
e) Feathers do not need to be considered when applying bandages.
Answer: c) Bandages should be applied loosely to avoid restricting circulation or respiration.
Explanation: Birds have delicate respiratory systems and are prone to stress. Bandages should be applied loosely to avoid impairing circulation or affecting their ability to breathe [cite: 15. Workshop - Musculoskeletal Disease in Avian Species 2.pdf].
Scenario: A guinea pig with bumblefoot is being treated.
Lead-in: Besides antibiotics and pain relief, what is a crucial aspect of managing this condition in guinea pigs?
Options:
a) Increasing exercise to improve circulation.
b) Providing soft, appropriate bedding and addressing any underlying husbandry issues.
c) Applying heat packs to the feet.
d) Restricting water intake to reduce swelling.
e) Surgical removal of the affected foot.
Answer: b) Providing soft, appropriate bedding and addressing any underlying husbandry issues.
Explanation: Addressing the underlying causes, such as inappropriate flooring, obesity, and poor hygiene, and providing soft bedding are essential for the successful management of bumblefoot in guinea pigs [cite: 14. Musculoskeletal Disease in Small Mammals and Exotic Species.pdf].
Scenario: A reptile presents with lameness and swelling of a joint.
Lead-in: What should be considered as a differential diagnosis, especially if the reptile’s diet and environment are suboptimal?
Options:
a) Fracture
b) Infection
c) Metabolic bone disease
d) Gout
e) Neoplasia
Answer: c) Metabolic bone disease
Explanation: While fractures and infections are possible, metabolic bone disease, often due to calcium and vitamin D3 deficiency from poor diet and lack of UV-B light, can lead to weakened bones and joint swelling in reptiles [cite: 14. Musculoskeletal Disease in Small Mammals and Exotic Species.pdf].
Scenario: A bird with a fracture is being considered for surgical repair.
Lead-in: What is a significant challenge in avian fracture repair compared to mammals?
Options:
a) Birds have a higher pain tolerance.
b) Avian bones are less vascularised.
c) The small size and thin cortices of avian bones can make internal fixation challenging.
d) Birds do not require anaesthesia for fracture repair.
e) External coaptation is always sufficient for avian fractures.
Answer: c) The small size and thin cortices of avian bones can make internal fixation challenging.
Explanation: The small size and thin cortices of avian bones often make the use of traditional internal fixation techniques challenging, requiring specialised equipment and careful surgical technique [cite: 15. Workshop - Musculoskeletal Disease in Avian Species 2.pdf].
which of the following physiological changes contributes to the development of chronic pain?
Options:
a) Decreased sensitivity of peripheral nerves
b) Increased production of endorphins
c) Central sensitisation in the spinal cord
d) Reduced inflammation in affected tissues
e) Increased activity of inhibitory pathways
Answer: c) Central sensitisation in the spinal cord [cite: 13. Workshop - Chronic pain .pdf].
Explanation: Chronic pain can lead to changes in the central nervous system, including increased excitability of neurons in the spinal cord (central sensitisation), making the pain experience more intense and persistent.
Scenario: A dog involved in a road traffic accident (RTA) is being assessed for anaesthesia. The dog is quiet but responsive and has multiple injuries.
Lead-in: According to the ASA physical status classification for emergencies, how would this patient likely be classified?
Options:
a) ASA I
b) ASA II
c) ASA III
d) ASA IV
e) ASA V
Answer: c) ASA III [cite: 16. Anaesthesia and analgesia for RTA and trauma.pdf].
Explanation: A patient with severe systemic disease that is not fully compensated, such as an animal after an RTA with multiple injuries, would likely be classified as ASA III.
Scenario: A trauma patient under general anaesthesia is being monitored.
Lead-in: According to the information, what is a key parameter to monitor closely in these patients?
Options:
a) Blood glucose levels
b) Packed cell volume (PCV) and total solids (TS)
c) Respiratory rate only
d) Body temperature only
e) Pupillary light reflexes
Answer: b) Packed cell volume (PCV) and total solids (TS) [cite: 16. Anaesthesia and analgesia for RTA and trauma.pdf].
Scenario: A dog presents after an RTA with suspected spinal trauma.
Lead-in: According to the information, what is a critical consideration when handling and moving this patient?
Options:
a) Encourage the dog to walk to assess neurological function.
b) Flex the spine to check for pain.
c) Minimise spinal movement to prevent further injury.
d) Apply firm pressure to the spine to assess for fractures.
e) Elevate the hindquarters to reduce spinal cord swelling.
Answer: c) Minimise spinal movement to prevent further injury [cite: 16. Anaesthesia and analgesia for RTA and trauma.pdf].
Explanation: In cases of suspected spinal trauma, it is crucial to handle the patient carefully and minimise spinal movement to avoid exacerbating any existing spinal cord damage.
Scenario: Bonnie, an 11-year-old Labrador with chronic osteoarthritis, is receiving carprofen, gabapentin, and amantadine for pain relief, but her owner reports her pain is worsening.
Lead-in: According to the information, which newer analgesic medication might be considered for managing chronic osteoarthritis pain in dogs?
Options:
a) Tramadol
b) Fentanyl patch
c) Buprenorphine
d) Bendivetmab (Librela)
e) Codeine
Answer: d) Bendivetmab (Librela) [cite: 13. Workshop - Chronic pain .pdf].
Explanation: Bendivetmab (Librela) is a newer monoclonal antibody therapy that targets nerve growth factor (NGF) and can provide effective pain relief for chronic osteoarthritis in dogs.
Scenario: A dog with a suspected pelvic fracture is being assessed.
Lead-in: According to the information, what is a critical aspect of the initial assessment in addition to airway, breathing, and circulation?
Options:
a) Assessing cranial nerve function
b) Determining the integrity of the urinary tract
c) Checking for ocular injuries
d) Evaluating cardiac function with ECG
e) Measuring blood glucose levels
Answer: b) Determining the integrity of the urinary tract
Explanation: Determining the integrity of the urinary tract (bladder and urethra) is crucial in animals with pelvic fractures due to the risk of damage during the traumatic event [cite: 18. Skull mandibular pelvic and spinal fractures and luxations.pdf].
Scenario: A dog presents with a malocclusion and difficulty eating. On examination, there is pain and instability of the mandible.
Lead-in: What is the most likely underlying cause?
Options:
a) Temporomandibular joint luxation
b) Mandibular fracture
c) Dental abscess
d) Trigeminal nerve paralysis
e) Masticatory myositis
Answer: b) Mandibular fracture
Explanation: Pain and instability of the mandible, along with difficulty eating and malocclusion, are indicative of a mandibular fracture [cite: 18. Skull mandibular pelvic and spinal fractures and luxations.pdf].
Scenario: A dog presents with an inability to close its mouth after a traumatic incident.
Lead-in: What is the most likely diagnosis?
Options:
a) Mandibular fracture
b) Temporomandibular joint luxation
c) Trismus due to tetanus
d) Oral foreign body
e) Glossitis
Answer: b) Temporomandibular joint luxation
Explanation: Inability to close the mouth is a common clinical sign of temporomandibular joint (TMJ) luxation, often caused by trauma [cite: 18. Skull mandibular pelvic and spinal fractures and luxations.pdf].
