Neurology SBAs Flashcards
Scenario: A 3-year-old French Bulldog presents with a 2-week history of progressive paraparesis. Neurological examination reveals increased tone in the hindlimbs, with conscious proprioception and withdrawal reflexes present. Spinal reflexes are normal in the forelimbs. Where is the lesion most likely to be?
Options:
a) C1-C5
b) C6-T2
c) T3-L3
d) L4-S3
e) Sciatic nerve
Answer: c) T3-L3
Scenario: A 7-year-old Border Collie presents with a 1-week history of progressive hindlimb ataxia. The owners have noticed that the dog has become increasingly weak and struggles to jump onto furniture. Neurological examination reveals decreased conscious proprioception in both hindlimbs, with absent patellar reflexes. What is the most likely differential?
Options:
a) Atlantoaxial subluxation
b) Cauda equina syndrome
c) Cervical spondylomyelopathy
d) Degenerative myelopathy
e) Intervertebral disc disease
Answer: e) Intervertebral disc disease
Scenario: A 5-year-old Dachshund presents with acute onset paraparesis. The owners report that the dog was running in the garden when she suddenly yelped and collapsed. Neurological examination reveals absent voluntary motion, absent withdrawal reflexes, and absent deep pain in both hindlimbs. What is the most likely diagnosis?
Options:
a) Intervertebral disc disease with spinal cord transection
b) Fibrocartilaginous embolism
c) Spinal cord neoplasia
d) Meningomyelitis of unknown origin
e) Degenerative myelopathy
Answer: a) Intervertebral disc disease with spinal cord transection
Scenario: A 9-year-old German Shepherd Dog presents with a 3-month history of progressive hindlimb ataxia. The owners report that the dog has difficulty walking and often stumbles. Neurological examination reveals decreased conscious proprioception in both hindlimbs, with increased tone and hyperreflexia. What is the most appropriate diagnostic test to perform next?
Options:
a) MRI
b) Radiography
c) CSF analysis
d) Myelography
e) CT scan
Answer: a) MRI
Scenario: A 4-year-old Staffordshire Bull Terrier presents with a 2-week history of progressive tetraparesis. The owners report that the dog is weak and stumbles frequently. Neurological examination reveals decreased conscious proprioception in all four limbs, with increased tone and hyperreflexia. What is the most likely diagnosis?
Options:
a) Cervical spondylomyelopathy
b) Degenerative myelopathy
c) Intervertebral disc disease
d) Meningomyelitis of unknown origin
e) Fibrocartilaginous embolism
Answer: a) Cervical spondylomyelopathy
Scenario: A 6-month-old Chihuahua presents with acute onset tetraparesis. The owners report that the dog was playing with a child when it suddenly yelped and collapsed. Neurological examination reveals decreased conscious proprioception in all four limbs, with absent withdrawal reflexes and decreased tone. What is the most likely diagnosis?
Options:
a) Atlantoaxial subluxation
b) Cervical spondylomyelopathy
c) Intervertebral disc disease
d) Meningomyelitis of unknown origin
e) Fibrocartilaginous embolism
Answer: a) Atlantoaxial subluxation
Scenario: A 2-year-old cat presents with acute onset non-ambulatory paraparesis. The owners report that the cat was fine yesterday but is now unable to use its hind legs. Neurological examination reveals increased tone in the hindlimbs, with intact withdrawal reflexes and pain sensation. What is the most likely diagnosis?
Options:
a) Aortic thromboembolism
b) Fibrocartilaginous embolism
c) Spinal cord neoplasia
d) Trauma
e) Meningomyelitis
Answer: a) Aortic thromboembolism
Scenario: A 10-year-old Labrador Retriever presents with a 2-day history of progressive tetraparesis. The owners report that the dog is weak and stumbles frequently. Neurological examination reveals decreased conscious proprioception in all four limbs, with increased tone and hyperreflexia. What is the most appropriate diagnostic test to perform next?
Options:
a) MRI
b) Radiography
c) CSF analysis
d) Myelography
e) CT scan
Answer: a) MRI
Scenario: A 6-year-old French Bulldog presents with a 2-month history of progressive generalized seizures. The seizures are now occurring 3 times per day and last for approximately 3 minutes each. The dog is dull and ataxic between seizures. Neurological examination reveals a left-sided head tilt, spontaneous nystagmus, and reduced mentation. What is the most likely cause of the seizures?
Options:
a) Idiopathic epilepsy
b) Hepatic encephalopathy
c) Meningoencephalitis of unknown origin
d) Intracranial neoplasia
e) Trauma
Answer: b) Hepatic encephalopathy
SBA 65
Scenario: A 2-year-old Golden Retriever presents with a sudden onset of seizures. The dog has had 1 seizure per week for the past 3 weeks. The dog is reported to be normal between seizures. Neurological examination is unremarkable. What is the most appropriate treatment?
Options:
a) Phenobarbital IV
b) Imepitoin PO
c) Potassium bromide PO
d) Levetiracetam PO
e) Zonisamide PO
Answer: b) Imepitoin
Scenario: A 10-year-old Domestic Shorthair cat presents with a 3-month history of progressive seizures. The seizures are now occurring every 2 weeks. The cat is normal between seizures. Neurological examination reveals reduced conscious proprioception in the right forelimb and hindlimb, reduced vision in the right eye, and circling to the left. What is the most likely cause of the seizures?
Options:
a) Idiopathic epilepsy
b) Hepatic encephalopathy
c) Meningoencephalitis of unknown origin
d) Intracranial neoplasia
e) Trauma
Answer: d) Intracranial neoplasia
SBA 67
Scenario: An 8-year-old Jack Russell Terrier presents with sudden onset seizures. The dog has had 5 generalized tonic-clonic seizures in the past 2 hours, each lasting approximately 3 minutes. The seizures started 1 hour after strenuous exercise. On examination, the dog is laterally recumbent with episodes of opisthotonos. What is the most appropriate immediate treatment?
Options:
a) Diazepam 0.5 mg/kg intravenously
b) Phenobarbital 4 mg/kg intravenously
c) Levetiracetam 60 mg/kg intravenously
d) Imepitoin 30 mg/kg orally
e) Potassium bromide 40 mg/kg orally
Answer: a) Diazepam 0.5 mg/kg intravenously
Explanation: This dog is experiencing cluster seizures, which are a medical emergency. Diazepam administered intravenously is the most appropriate treatment for rapid seizure control. It has a fast onset of action and is effective in terminating seizures.
Scenario: A 5-year-old male neutered Border Collie presents with a 1-week history of progressive ataxia and weakness. The owners report that the dog is stumbling and has difficulty climbing stairs. Neurological examination reveals decreased conscious proprioception in all four limbs, with increased tone and hyperreflexia in the hindlimbs. What is the most likely diagnosis?
Options:
a) Cervical spondylomyelopathy
b) Degenerative myelopathy
c) Intervertebral disc disease
d) Meningomyelitis of unknown origin
e) Fibrocartilaginous embolism
Answer: a) Cervical spondylomyelopathy
Scenario: A 4-year-old Border Collie is presented to you with ongoing status epilepticus. The dog has received 3 rounds of 1mg/kg diazepam intravenously 10 minutes apart with no improvement. The seizures consist of tonic-clonic activity with paddling of all four limbs, hypersalivation, and loss of bladder and bowel continence. What is the most appropriate treatment to administer now?
Options:
a) Levetiracetam 60mg/kg intravenously
b) Midazolam 0.2mg/kg intravenously, followed by a constant rate infusion of 1mg/kg/hour
c) Phenobarbital 15mg/kg PO
d) Propofol 4mg/kg intravenously as a bolus, followed by a constant rate infusion at 0.4mg/kg/min
e) Atipamezole 50mcg/kg intramuscularly
Answer: D
Scenario: A 9-year-old male neutered West Highland White Terrier presents with a 1-month history of circling to the right, a left head tilt, and nystagmus with the fast phase to the right. Neurological examination reveals no other abnormalities. Which of the following is the most likely diagnosis?
Options:
a) Otitis media/interna
b) Idiopathic vestibular syndrome
c) Cerebellar neoplasia
d) Brainstem neoplasia
e) Thalamic infarct
Answer: a) Otitis media/interna
Answer: a) Otitis media/interna.
Explanation: While idiopathic vestibular syndrome is common in older dogs, this dog has a chronic history (1 month) which makes otitis media/interna more likely.
