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ACVIM General Boards 2024 > Practice > Flashcards

Practice Flashcards

1
Q

Splintered QRS in what congenital heart disease?

A

Tricuspid valve dysplasia

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2
Q

Dog with jugular pulses, ascites (signs of R CHF), no murmur?

A

Pulmonary hypertension

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3
Q

Consensus statement on CHF for dogs (Stage A-D): CKCS with III/VI no clinical signs, cardiomegaly on thoracic radiographs.

A

CVD B2

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4
Q

ECG from dog treated with doxorubicin. Wide QRS complex with deep S wave. P present for every QRS. What is the diagnosis?

A

Right bundle branch block

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5
Q

Which of the following would be expected to be decreased in a patient with pulmonary hypertension? (this question is straight from CVT)

a) endothelin
b) angiotensin II
c) Nitric oxide

A

C. Nitric oxide

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6
Q

Which of the following is inactivated in the lungs?

a) bradykinin
b) leukotrienes
c) angiotensin
d) prostaglandins

A

A. Bradykinins by ACE

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7
Q

What electrolyte abnormality can cause increased Digoxin toxicity?

a) hyperkalemia
b) hypokalemia
c) hypernatremia
d) hyponatremia

A

B. Hypokalemia

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8
Q

Which of the following tests is more sensitive for heartworm in the cat than the dog?

a) antigen test
b) antibody test
c) Echocardiogram
b) thoracic radiographs

A

B. Antibody test

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9
Q

What heart rhythm is this?

A

A fib

Note: atrial flutter has a sawtooth appearance

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10
Q

Which of the following would cause a hyperdynamic pulse?

a) aortic stenosis
b) aortic insufficiency
c) pulmonic stenosis

A

B. aortic insufficiency

Note: a PDA would also cause hyperdynamic pulses

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11
Q

Be able to ID isovolumetric contraction on a pressure volume tracing.

A
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12
Q

What predisposes to endocarditis?

A

Subaortic stenosis

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13
Q

Describe the baroreceptor reflex.

A

Increased blood pressure/volume–>increased baroreceptor stretch–>increased vagal output–
>decreased CO

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14
Q

What congential heart problem does a 5 month old cat with right sided heart murmur have?

A

Ventricular septal defect

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15
Q

What is responsible for the S4 heart sound?

A

Atrial systole

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16
Q

In a patient with a suspected drug reaction, which of the following would be the best to biopsy?

a) ulcer
b) pustule
c) erythematous skin
d) crust

A

B. Pustule

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17
Q

Older dog with the following thyroid panel: TT4 – high, TSH – high. What is the diagnosis?

A

Immune mediated thyroiditis

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18
Q

Older Saint Bernard with the following bloodwork: Baseline cortisol – low (1), ACTH – low, Cortisol following ACTH stimulation – low (1). What is the likely diagnosis?

A

Secondary hypoadrenocorticism

Note: With primary hypoadrenocorticism, ACTH should be high

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19
Q

ACTH stim test: Baseline cortisol – high (92), 4 hr post stim – 25 (normal < 30), 8 hour post stim – 88 (normal < 30). What is the most likely diagnosis?

A

PDH - 8 hour consistent with HAC, and there was suppression indicating PDH

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20
Q

Which of the following electrolyte abnormalities could result in hemolysis following treatment of a DKA patient?

a) hyperphosphatemia
b) hypophosphatemia
c) hyperkalemia
d) hypokalemia

A

B. Hypophosphatemia

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21
Q

Given the following bloodwork: Ionized calcium of 1.8 - high, PTH – normal. What is the diagnosis?

A

Primary hyperparathyroidism

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22
Q

Nutritional hyperparathyroidism would be associated with which of the following?

A. Diet high in calcium
B. Diet high in vitamin D
C. Increased renal excretion of phosphorus
D. High serum calcium levels

A

C. Increased renal excretion of phosphorus

Note: nutritional hyperparathyroidism results from a nutritional deficiency in calcium and vitamin D

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23
Q

This thyroid hormone has shortest latency period and is quickest to reach maximum cellular activity?

A

T3

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24
Q

Syndrome of inappropriate ADH secretion would cause which of the following?

A. Hypernatremia
B. Volume depletion
C. Normal GFR

A

C. Normal GFR - Renal blood flow increases, but the percent filtered is the same.

A. - would cause dilutional hyponatremia
B. - would cause volume retension

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25
Q

Bloodwork: pH: 7.2, HCO3: 10, PCO2: 50 – what is the acid base status?

A

Mixed respiratory and metabolic acidosis

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26
Q

Bloodwork showing low chloride (92), HCO3 (8), K (5.4) and Na (140) – what does this indicate?

A. Elevation in unmeasured anions
B. Hypoventilation
C. Metabolic acidosis
D. Anion gap of 20

A

A. Elevation in unmeasured anions

Note:
B. Hypoventilation - normal anion gap
C. Maybe true? don’t have pH
D. AG = (Na + K) - (HCO3 + Cl) = (140+5.4) - (8+92) = 145-100 = 45 = high gap acidosis (addition of
unmeasured anions)

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27
Q

What are three causes of a normal anion gap acidosis?

A

Renal tubular acidosis, hypoventilation, and diarrhea (all of these are from loss of bicarb and typically are hyperchloremic).

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28
Q

What hormone is responsible for stimulating appetite and what counteracts that?

A

Ghrelin and leptin

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29
Q

You are testing goats for a disease. You test 100 goats and 60 are positive. On necropsy (gold standard), 50 of the positive goats have the disease, but the other 10 that tested positive do not. In addition, an additional 10 goats were found to have the disease that were not identified by the test. What is the sensitivity and specificity of this test?

A

Sensitivity = true positives/(true positives+false negatives) = a/(a+c) = 50/(50+10) = 85%

Specificity = true negative/(true negative+false positives) = d/(d+b) = 30/30+10 = 75%

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30
Q

If an animal was going to be euthanized if it tests positive for a disease, you want what type of test?

A

Highly specific

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31
Q

What is the source of Cryptosporidium hominis?

A

Humans

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32
Q

What approaches zero as prevalence of a disease declines?

A

Positive predictive value

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33
Q

What can bring about a hemolytic crisis in dogs with PFK deficiency?

A

Exercise

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34
Q

A 6 month old Irish setter with history of recurrent infections and elevated WBC count (I believe very high, 200,000?). What is the likely cause?

A

Canine leukocyte adhesion deficiency (CD18)

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35
Q

What percentage of equine and canine patients that are hospitalized in the ICU develop nosocomial infections?

A

16% (cats are 12%) - In general remember 15%, which is about right for all species

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36
Q

What is the most specific way to diagnose feline pancreatitis?

A. Abdo rads
B. Abdo AUS
C. Serum lipase
D. Serum amylase

A

Abdominal ultrasound (Bx even more specific)

Most specific BLOOD test for feline pancreatitis is fPLI

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37
Q

What is the diagnostic test for protein losing enteropathy?

A

Alpha 1 protease inhibitor

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38
Q

What would be the best treatment for acute exacerbation of hepatic encephalopathy?

A

Cleansing enema

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39
Q

Why is alkp more specific in cats?

A

Because they don’t have a steroid induced isoenzyme.

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40
Q

How is alkp cleaved from the biliary membrane?

A

Bile salts

Note: ALP is anchored to cell membranes by glycophosphatidylinositol (GPI) proteins. Cleavage of these proteins by bile acids, phospholipase D, and proteases releases ALP from membranes, resulting in increased ALP levels in serum/plasma

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41
Q

In which scenario would post prandial bile acids be useful?

A. To differentiate intraheptatic from extrahepatic shunts
B. To determine the cause of hypoalbuminemia – liver disease versus PLE
C. To determine intrahepatic versus extrahepatic cholestasis (or bile duct obstruction)

A

B. To determine the cause of hypoalbuminemia, specifically liver disease vs PLE

Note: You would not run bile acids in a patient with cholestasis because you know they will be high

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42
Q

What are the mechanisms of neutrophil killing?

A

Respiratory burst using NADPH (oxidant generation)

Also release of lytic enzymes and antimicrobial peptides from granules - Lytic enzyme release: lysosomes fuse with phagosome –> phagolysosome

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43
Q

Where are NK cells formed?

A

In the bone marrow

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44
Q

Neutrophils bind to antibody coated organisms via what receptor?

A

CD 32

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45
Q

What do NK cells secrete large amounts of?

A

Interferon Gamma

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46
Q

What is the main clinical sign of systemic lupus erythematous?

A

Non-erosive polyarthritis

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47
Q

CpG and LPS are example of:

A

PAMPs

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48
Q

Which white blood cell has the shortest half-life in circulation?

A. neutrophil
B. eosinophil
C. platelet
D. lymphocyte

A

B. eosinophil

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49
Q

There are more BP substitutions in the coding versus non-coding region of MHC Class II receptor. This means that MHC II diversity is:

A

Selected for ie an advantage

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50
Q

What is the function of microRNA?

A

Decreased gene expression

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51
Q

What part of the cell does lupus attack?

A

The nucleus

  • can diagnose by detection of anti-nuclear antibodies
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52
Q

IL-4, 10 and 13 cause macrophages to become:

A. M1
B. M2
C. NK cells

A

B. M2

M1 phenotype is stimulated by microbial products or pro-inflammatory cytokines [IFN-γ, TNF, or Toll-like receptor (TLR) ligands], and the typical characteristics of M1 macrophages include high antigen presentation, high production of IL-12 and IL-23, and high production of nitric oxide (NO) and reactive oxygen intermediates. In contrast, M2-type responses are the “resting” phenotype and are observed in healing-type circumstances without
infections. Such responses can also be further amplified by IL-4, IL-10, or IL-13

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53
Q

Vesiculobullous lesions of the mucus membranes in the mouth?

A

Pemphigus

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54
Q

Mutations in TLR-4 will _______ the risk of sepsis and _______ the risk of gram negative infections (know TLRs)

A

Increase, increase

TL3 - ds DNA (virus)
TL4 - LPS (bacteria)
TL5 - flagellin (bacteria)
TL 7, 8 - ss RNA (virus)
TL 9 - ds DNA, cpG DNA (virus)

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55
Q

Which immunoglobulin is present in the highest concentration in the blood?

A

IgG

Note:
IgM - Largest Ig, first produced in with antigenic stimulation
IgA - Found at mucosal surfaces (GI, lungs, etc)
IgE - smallest concentration

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56
Q

Something about kallikrein and what receptor it binds to.

A

The plasma kallikrein-kinin system counterbalances the renin-angiotensin system

When HK (high molecular weight kininogen)*PK (prekallikrein) binds to endothelial cells, PK is rapidly converted to kallikrein (K) by the enzyme prolylcarboxypeptidase (PRCP), which is constitutively active on endothelial cell membranes.Kallikrein autodigests its receptor, HK, to liberate bradykinin (BK), which can liberate tissue plasminogen activator (tPA), nitric oxide (NO), and prostacyclin (PGI2) from endothelial cells. Kallikrein also activates FXII, which binds to the same multiprotein receptor complex as HK in its absence

Kallikreins (tissue and plasma kallikrein) are serine proteases that liberate kinins (Bradykinin and Kallidin) from the kininogens, which are plasma proteins that are converted into vasoactive peptides. Prekallikrein is the precursor of plasma kallikrein. It can only activate kinins after being activated itself by factor XIIa or other stimuli. Bradykinin is released from high molecular weight kininogen. Kallidin is released from low molecular weight kininogen.

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57
Q

What is the major protein involved in breakdown of clots?

A

Plasmin

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58
Q

In addition to doxycycline, what drug do you need to treat a patient with Neorickettsia helminthoeca?

A

Praziquantel (for Nanophyetus salmincola trematode)

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59
Q

Which of the following tests would be most specific for diagnosis of T. gondii in a cat with clinical signs? (check CVT)

A. Oocysts in feces
B. IgM >1:64 in CSF
C. IgG > 1:64 in blood
D. Blood culture

A

B. IgM>1:64 in CSF

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60
Q

Young cat with acute, hemolytic anemia with epicellular RBC parasites? How would you treat this cat?

A

Doxycycline.
This is likely mycoplasma haemophelis. Remember that mycoplasma doesn’t have a cell wall so can’t cell wall inhibitors like penicillins or cephalosporins.

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61
Q

Dog with pleural effusion, elevated temperature (104.5). On cytology of pleural fluid, you see non-acid fast filamentous organism. Aerobic culture is negative. What is the most likely cause?

A

Actinomyces

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62
Q

Most common cause of pyothorax in a cat?

A

Pasteurella

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62
Q

What is the most common infectious causes of discospondylitis?

A

Staph aureus

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63
Q

3 year old dog with large bowel diarrhea. On rectal scrapings you see small (2-4 um) organisms inside macrophages. What is the diagnosis?

A

Histoplasmosis

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64
Q

You have a cat that has tested positive for FIV. Four weeks ago, she gave birth to kittens, who subsequently tested positive for FIV. What would you do?

A

Isolate kittens and retest in 6 months*
- Tests for Ab, have to wait for maternal Ab to leave (FeLV tests for Ag rather than Ab)

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65
Q

Horses and dogs are a reservoir for humans for which of the following?

A. Pythium
B. Blasto
C. Staph aureus
D. Staph pseudintermedius

A

C. Staph aureus

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66
Q

What tick carries Anaplasma phagocytophilum?

A

Ixodes (co-transmitted with Borrelia)

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67
Q

Which of the following cause myocarditis in dogs, cerebellar hypoplasia in cats and diarrhea in pigs?

A

Parvovirus

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68
Q

How do you diagnose rabies?

A

IFA on brainstem, cerebellum

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69
Q

What is the ideal test for cryptococcus diagnosis

A

Latax agglutination test

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70
Q

How to diagnosis Hepatozoon americanum?

A

Muscle biopsy

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71
Q

Where is CSF reabsorbed?

A

Arachnoid villi

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72
Q

What is the long term treatment of myasthenia gravis?

A. Pyridostigmine bromide
B. Steroids
C. Mycophenolate
D. Edrophonium bromide

A

A. Pyridostigmine bromide - long acting Acetylcholinesterase inhibitor

Note: Edrophonium bromide - Short acting acetylcholinesterase inhibitor (too short acting for Tx; tensilon test)

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73
Q

Dog that is circling to the left and has the following cranial nerve abnormalities:

Menace: L normal R decreased
PLR: L Normal R normal
Nasal sensation: L Normal R absent
Thoracic limb CP: L normal R decreased
Pelvic limb CP: L normal R decreased

A

Left cortex or thalamus (circle to the side of the lesion, deficits on contralateral side)

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74
Q

What nerve innervates the external urethral sphincter?

A

Pudendal

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75
Q

What % of animals that have cerebral-vascular events are hypertensive?

A

30%

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76
Q

What are signs of an UMN lesion?

A. Hyperreflexia
B. Flaccid paralysis
C. Muscle atrophy

A

A. Hyperreflexia

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77
Q

You have a boxer with signs consistent with steroid responsive meningitis. How could you definitively diagnosis this?

A

IgA levels in serum and CSF

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78
Q

You have a patient with a dropped jaw and otherwise normal neurologic examination. Which will be affected?

A

Trigeminal nerve – mandibular branch

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79
Q

Which of the following drugs could you use for a dog with urinary incontinence?

A. Oxybutynin
B. Ephedrine
C. Pseudephedrine

A

B. Ephedrine - nonselective sympathomimetic, similar to PPA but less effective

Note: Oxybutynin - parasympatholytic, decreases detrusor overactivity (opposite bethanechol)

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80
Q

Alpaca with dilated left pupil. Menace is intact but the left pupil does not constrict when light is shone in left or right eye. Right eye is normal. Where is the lesion?

A

Left oculomotor

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81
Q

Bulldog that has head horizontal head tremors that last about 30 seconds. The tremors can be stopped by giving him a treat. What is the diagnosis?

A

Idiopathic

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82
Q

9 year old dog with coombs negative hemolytic anemia, hypoalbuminemia, hypocholesterolemia, mildly elevated bilirubin. What is the most likely diagnosis?

A. Primary IMHA
B. Histiocytic neoplasia
C. Erythroblastic anemia

A

B. Histiocytic neoplasia

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83
Q

What are 4 chemotherapy drugs that cross the blood-brain barrier?

A

Cytosar, procarbazine, hydroxyurea, CCNU

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84
Q

You are treating a Collie with chemotherapy while awaiting MDR mutation testing. Which of the drugs would be the safest to use while you await the results?

A. vincristine
B. doxorubicin
C. cytoxan
d. mitoxantrone

A

C. Cytoxan

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85
Q

What would be your first line treatment for dog with splenic mass, Hct: 35%, Plt: 95,000, mildly elevated PT/PTT?

A. Heparin
B. Packed RBC transfusion to increase oxygen carrying capacity.
C. Fluid therapy/ volume expansion
D. Plasma transfusion

A

C

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86
Q

What is the mechanism of action of mitoxantrone?

A

Inhibits topoisomerase II and also causes intercalation of DNA

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87
Q

What is the most common skin tumor in cats?

A

Basal cell tumor

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88
Q

You have a patient with a suspected mast cell tumor that does not stain with aqueous quick stains. What would be the next stain to use?

A

Wright-Geimsa

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89
Q

Feline blood typing. Type A is:

A. Rare in siamese
B. Dominant to B
C. Recessive to AB

A

B. Dominant to B

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90
Q

What is the most antigenic blood type in dogs?

A

DEA 1.1+

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91
Q

Where is most of the body’s iron?

A

Bound to hemoglobin

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92
Q

If a patient has hemolysis of RBCs following a transfusion, which type of HS reaction is involved?

A

Type II hypersensitivity- Ab mediated destruction

Note:
Type 1 IgE mediated
Type 2: Ab mediated cytoxic
Type 3: Immune complex
Type 4: delayed

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93
Q

Which of the following conditions would result in a high serum iron?

A. Hemolysis
B. Iron deficiency anemia
C. Anemia of chronic disease

A

A. Hemolysis

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94
Q

In which of the following conditions would you see microcytosis before hypochromia?

A. B12 deficiency
B. folate deficiency
C. iron deficiency anemia

A

C. iron deficiency anemia

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95
Q

Gompertzian growth; smaller tumors grow _____ as compared to larger tumors and are _____ susceptible to chemotherapy.

A

Faster, more

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96
Q

What is the most consistent finding for patients with a stress leukogram?

A

Lymphopenia

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97
Q

What is a target for mTOR

A

Sirolimus/Rapamycin

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98
Q

Question about PARR – multiple bands present in dog with lymphadenopathy. What is the diagnosis?

A

Inflammatory disease

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99
Q

What determines the specificity of PCR?

A

Primers

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100
Q

Where does oxygen bind on RBC?

A

Fe2+ (iron atom on the heme group)

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101
Q

What is the most common secondary brain tumor?

A

Hemangiosarcoma

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102
Q

Adult beagle with 1 month history of vomiting and inappetance. Physical exam is unremarkable. Bloodwork shows hypoglycemia with no other abnormalities. Staging shows mass in stomach. What is the diagnosis?

A

Leiomyosarcoma

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103
Q

What is the mechanism of action of Doxycycline?

A

bind to 30s ribosomal subunit of bacteria

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104
Q

What is the mechanism of action of cisipride?

A

5HT-4 agonist

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105
Q

What is the mechanism of action of gabapentin

A

inhibits voltage gated calcium channels

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106
Q

What is the mechanism of action of ondansetron?

A

5HT-3 antagonist

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107
Q

What is the mechanism of action of cyclosporine?

A

Binds and forms complex with cyclophilin which inhibits calcineurin/NFAT (nuclear factor of activated T
cells), which decreases T-cell inflammatory cytokine production (IL-2)

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108
Q

What is the mechanism of action of enrofloxacin?

A

DNA gyrase inhibitor

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109
Q

What is the mechanism of action of derlapitide?

A

Slentrol - accumulation of lipids in enterocytes

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110
Q

What is the location for nephrotoxicity for gentamycin?

A

PCT

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111
Q

What is the mechanism of action of aspirin?

A

Irreversible COX inhibition

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112
Q

What drug decreases CSF production?

A

Omeprazole

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113
Q

What is the mechanism of action of the following drugs and where do they work?

  1. Furosemide
  2. Thiazide diuretics
  3. Spironolactone
A

Furosemide - loop diuretic, it works by inhibiting electrolyte reabsorption from the kidneys and enhancing the excretion of water from the body

Thiazide diuretics - distal convoluted tubule, decrease sodium reabsorption and therefore decreased fluid reabsorption

Spironolactone - distal convoluted tubule and collecting ducts, interfere with sodium reabsorption in distal renal tubules by competitively inhibiting the action of aldosterone

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114
Q

What is a side effect of misoprostal

A

Abortion in humans

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115
Q

You give a boxer Diazepam and it starts having neurologic signs. What drug do you give it?

A

flumazenil (reversible)

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116
Q

Name three antibiotics that penetrate the prostate

A

TMPS, enrofloxacin, chloramphenicol

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117
Q

What do you need to determine drug dose in an animal?

A

Volume of distribution

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118
Q

What drug can cause clinical signs of hypothyroidism?

A

TMPS

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119
Q

If given concurrently with theophylline, what drug has to be dose reduced?

A

Enrofloxacin

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120
Q

Essential amino acids for cats only

A

Argenine and taurine

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121
Q

What is the mechanism of uptake of peptides in the GI tract?

A

Small peptides are absorbed into the small intestinal epithelial cell by cotransport with H+ ions via a transporter called PepT1. Once inside the enterocyte, the vast bulk of absorbed di- and tripeptides are digested into amino acids by cytoplasmic peptidases and exported from the cell into blood

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122
Q

What is the mechanism of uptake of sodium in the GI tract?

A

Electrical and chemical gradients

123
Q

What percentage of sodium is absorbed in the proximal convoluted tubule?

A

65%

124
Q

Which of the following is most important for protecting the gastric mucosa?

PGE2 or PGI2

A

PGE2

125
Q

Resting membrane potential is determined by:
A. Passive diffusion of K
B. Active transport of K
C. Passive diffusion of Na
D. Active transport of Na

A

A. Passive diffusion of K

126
Q

Which cell in the lung produces surfactant?

A

Type 2 pneumocytes

127
Q

Which of the following is present in the gastric fluid of a fasting dog or horse?

A. Calcium
B. Phosphorus
C. Gastrin
D. Intrinsic factor

A

D. Intrinsic factor

128
Q

Where are J receptors located?

A

In the alveoli in the lungs

129
Q

What increases cardiac contractility?

A

Increased extracellular calcium

130
Q

In excitation contraction coupling, which of the following is responsible for spread of the action potential?

A

T tubules

131
Q

Where are bile acids conjugated?

A

In the hepatocytes

132
Q

A patient is still lipemic after a 24 hour fast. This is due to elevation of which of the following?

A. HDL
B. LDL
C. VLDL
D. Cholesterol

A

C. VLDL

133
Q

What causes release of ach?

A. Influx of Na
B. Efflux of Na
C. Influx of Ca
D. Efflux of Ca

A

C. Influx of calcium

134
Q

What inhibits glucagon secretion?

A

Somatostatin

135
Q

What is the primary constituent of chylomicrons?

A

Triglycerides

136
Q

What amino acid stimulates insulin release?

A

Alanine

Actual question was which of the following stimulates insulin release

137
Q

An increase in which of the following would result in an decrease in GFR?

A. Glomerular capillary hydrostatic pressure
B. Glomerular capillary oncotic pressure

A

A. Glomerular capillary oncotic pressure

Glomerular capillary Hydrostatic pressure favours filtration, while glomerular oncotic pressure opposes filtration. So an increase in hydrostatic pressure would increase GFR while an increase in oncotic pressure would decrease GFR.

138
Q

Does growth hormone increase or decrease the utilization of carbohydrates?

A

Decrease (so it can be stored and used for growth)

139
Q

What is the main stimulus for GI motility?

A

Myenteric plexus

140
Q

An abnormality of the ornithine cycle would result in an elevation of what?

A

AKA urea cycle which converts highly toxic ammonia to urea for excretion.
Elevation in ammonia

141
Q

What is the most potent stimulus for H+ secretion by the kidney?

A

Histamine (and Ach)

142
Q

What is responsible for the automaticity of cardiac pacemaker cells?

A

Slow Na and Ca channels

143
Q

Osmosis due to protein is related to which of the following properties?

A. Charge
B. Number
C. Mass
D. Shape

A

B. Number

144
Q

What activates pepsin in the stomach?

A

HCl

145
Q

What percentage of total body water is extracellular fluid?

What is the 60-40-20 rule?

A

1/3

60% of body weight is water, 40% of body weight is ICF, and 20% of body weight is ECF

146
Q

Which of the following would increase cerebral blood flow?

A. Increased CO2
B. Decreased CO2
C. Increased pH

A

A. Increased CO2

147
Q

Know what shifts O2-hemoglobin dissociation curve to the right and left.

A

Right is at offloading O2 at tissues, Left is onloading O2 at Lung

Right - increased temperature, increased CO2, increased H+(decreased pH), 2,3-DPG

Left - opposite

148
Q

Bicarbonate secretion into the pancreatic duct results in which of the following?

A

Diffusion of water into the duct.

149
Q

What is the treatment for oselerus osleri?

A

Fendbendazole

150
Q

You have a puppy with respiratory signs and nodules seen in trachea on radiographs. Most likely diagnosis?

A

Oselerus osleri

151
Q

What is an example of something that will not respond to oxygen supplementation?

A

Cyanide toxicity
Shunt

152
Q

What is the treatment for acetominephin toxicity?

A

SamE

153
Q

MOA of strichnine toxicity

A

Inhibits glycine, which makes it easier for neurons to fire action potentials leading to tetanus

154
Q

Poodle with 24 history of vomiting, anorexia, lethargy. Bloodwork shows elevated ALT, ALP, GGT, Tbil, low albumin, NORMAL BG and BUN. What is the most likely diagnosis?

A

Afalotoxin

155
Q

MofA of Cyanide toxicity

A

Inhibits ATP production in the mitochondria - not responsive to O2 supplementation

156
Q

MofA carbon monoxide toxicity

A

Binds Hb with high affinity, preventing O2 from binding

157
Q

Which of the following would increase osmolarity?

A

a. Ethylene glycol
i. Osmolar gap = calculated - measured
1. difference indicated unmeasured osmoles

158
Q

MofA of botulinin toxin

A

inhibits ACh from axon terminal causing flaccid paralysis

159
Q

Dog with lower urinary signs is diagnosed with a UTI based on culture and susceptibility (susceptible to many antibiotics). Dog is treated with appropriate antibiotics and infection resolves. Two weeks following completion of antibiotics, lower urinary signs return. Urine is culture and has same organism and susceptibility profile as first culture. This is an example of what? (This from CVT)

a. Reinfection
b. Relapse
c. Resistant infection
d. Superinfection

A

B. Relapse

160
Q

Adult female spayed dog with a 2 week history of blood vulvar discharge. Vaginal cytology shows degenerative and non-generative neutrophils with extracellular bacteria and non-cornified epithelial cells. What is the diagnosis?

A

Stump pyometra
Note: I think absence of cornified epithelial cells is important for ruling out ovarian remnant syndrome,
which would secrete estrogen and result in cornification of epithelial cells.

161
Q

You have a cat with a creatinine of 3.0 and a UPC of 0.3. What IRIS stage is this cat?

A

Stage 3, borderline proteinuric

162
Q

Urinary sodium excretion of <1% is most consistent with?

A

Severe volume depletion

163
Q

What is the mechanism of action for PUPD for dogs with pyometra?

A

E Coli toxin interferes with ADH on the distal tubule/collecting ducts - causes a nephrogenic DI

164
Q

What is the mechanism of action for PUPD with CKD?

a. Increased blood flow to existing nephrons due to decreased renal function
b. Select damage to distal tubule and collecting ducts
c. Increased solute load resulting in osmotic diuresis

A

C. Increased solute load resulting in osmotic diuresis

165
Q

Dog with a USG of 1.005. Dog fails to respond to water deprivation or vasopressin. What is the diagnosis?

a. Nephrogenic diabetes insipidus
b. Central diabetes insipidus
c. Chronic kidney disease

A

A. Nephrogenic diabetes insipidus

Note: Central (neurogenic, pituitary, or neurohypophyseal) DI, characterized by decreased secretion of antidiuretic hormone (ADH); Nephrogenic DI, characterized by decreased ability to concentrate urine because of resistance to ADH action in the kidney. So nephrogenic will not respond to vasopressin.

166
Q

Eosinophils are associated with what type of response?

A

TH2

Produce IL-5 which increases eosinophil release from BM and activates them at site of interest

167
Q

What stage of Cytauxzoon felis is associated with vascular obstruction?

A

Schizont

Note: Stage that causes clinical signs

168
Q

Most common reported side effect of oclacitinib?

A

Diarrhea

Note: Apoquel, JAK inhibitor for atopic dermatitis

169
Q

Stage of life cycle of toxoplasma associated with transplacental or transmammary transmission

A

Tachyzoites

170
Q

Test that requires live organisms for diagnosis within first 1-2 weeks

A

Lepto - MAT

171
Q

Most potent stimulator for aldosterone secretion?

A

Hyperkalemia

172
Q

Stimulator for ADH secretion

A

Osmoreceptors in the supraoptic nuclei

173
Q

Goat with neurological signs: circline to the right, left sided CP deficits

A

Right forebrain

174
Q

Question about sensitive diagnosis of masticatory myositis 6 weeks after dog had swollen head

A

2M antibody

175
Q

Question about dropped jaw – which nerve?

A

Mandibular branch of trigeminal nerve

176
Q

Dog with 2nd degree AV block that responds to atropine response test, how to treat?

A

Propantheline

177
Q

Dog with decreased menace and nasal sensation on the left, circling to the right, left CP deficits

A

Right forebrain/thalamus

178
Q

MofA for cyclosporine

A

Inhibits pathway that ends up activating NFAT

Note: affinity for calcineurin, causing an inhibition of calcium-stimulated phosphatase in calcineurin. This inhibited dephosphorylation step does not allow for activation of NFAT (nuclear factor of activated T-cells) which is needed for the nuclear transcription of genes coding for several important cytokines.

179
Q

Dog with HCT 75%, which chemo to treat?

A

Hydroxyurea

(for polycythemia vera)

180
Q

How much sodium is reabsorbed in the PCT?

A

65%

181
Q

How much more potent is dexamethasone compared to prednisone?

A

7 times

182
Q

Most sensitive test for Bartonella in dogs?

A

PCR

183
Q

Most sensitive diagnosis of toxoplasma in cats with clinical signs?

A

IgM in CSF

184
Q

Dog with really high TT4, high TSH?

A

Idiopathic thyroiditis

B/C Antibodies against T4 cause TT4 to be elevated

185
Q

Dog with chronic weight loss/diarrhea, low cobalamin, normal TLI/folate/PLI?

A

Inflammatory bowel disease

186
Q

Dog with acute vomiting, nervous tremoring, abdominal pain. CBC: mild anemia with 50 nRBCs

A

Lead toxicity

187
Q

Drugs to treat lead/mercury toxicity?

A

CaEDTA

188
Q

Most common secondary malignancy to brain?

A

Hemangiosarcoma

189
Q

Mechanism of action of diazoxide?

A

Inhibition of closure of ATP-dependent K+ channels in beta cell (inhibits depolarization, inhibiting insulin)

190
Q

Most common cause for migrating necrotizing dermatitis?

A

Glucagonoma

191
Q

Old beagle with mild abdominal pain, history of inappetence, hypoglycemic on bloodwork and stomach mass?

A

Leiomyosarcoma

192
Q

Acid base: low pH, low HCO3-, high pCO2

A

Mixed respiratory/metabolic acidosis

193
Q

Cause of S3 heart sound

A

Ventricular filling

194
Q

English bulldog with intermittent horizontal head tremors that can be distracted out of them by a treat

A

Idiopathic head tremors

195
Q

Mechanism of action of phenylpropanolamine?

A

Alpha agonist at the urethral sphincters

196
Q

Which nerve innervates skeletal muscle at the external urethral sphincter?

A

Pudendal

197
Q

Young boxer with neck pain and suspect SRMA. What is needed to support your diagnosis?

A

Elevated IgA on CSF

198
Q

What is a cause for low ionized calcium?

A

Metabolic alkalosis

Note: because a portion of both hydrogen ions and calcium are bound to serum albumin,
when blood becomes alkalotic, the bound hydrogen ions dissociate from albumin, freeing up the albumin to bind with more calcium and thereby decreasing the freely ionized portion of total serum calcium

199
Q

Collie with lymphoma pending ABCB1 mutation test; which chemo should you start with?

A

Cyclophosphamide

200
Q

ECG with rapid complexes that are narrow and tall, irregular rhythm, no obvious P waves (flat baseline)

A

Afib

Atrial standstill would have a regular bradycardic rhythm with no obvious P waves, while Atrial flutter has a typical sawtooth appearance.

201
Q

Which of the following is least likely to respond to oxygen therapy?

A. Cyanide toxicity
B. V/Q mismatch
C. Hypoventilation

A

A. Cyanide toxicity

202
Q

Dog that is mydriatic, bradycardic, ataxic and dribbling urine

A

THC toxicity

203
Q

Most common clin path abnormality with Hepatozoon americanum?

A

Neutrophilia

204
Q

Mechanism of orlistat?

A

Decreased absorption of lipids from intestinal tract and increased satiety.

205
Q

Zoonotic disease from both dogs and horses

A

Staph aureus

206
Q

Most common community acquired cause of pneumonia in cats

A

Mycoplasma

207
Q

Most common cause of discospondylitis in dogs

A

Staphylococcus

208
Q

Drug that can cause clinically significant hypothyroidism AND cross blood prostate barrier

A

TMPS

209
Q

Carrier for copper in the blood

A

Cerruloplasmin

210
Q

What would support an iron deficiency anemia?

A

Decreased saturation of serum transferrin levels

211
Q

Cavalier King Charles Spaniel comes in for dietary indiscretion and acute vomiting and estimated to be 10% dehydrated. On CBC has 25,000 platelets. How to treat first?

A

Fluid therapy

Note: Congenital macrothrombocytopenia is normal in this breed

212
Q

Old cat with DKA. Give bloodwork showing severe acidosis, mild hypokalemia, severe hypochloridemia, severe hyperglycemia, ketonuria and glucosuria. How to treat first?

A

Fluid therapy

If there is a choice choose plasmalyte or norm R over saline

213
Q

Inappetant cat for 10 days. Bloodwork showing ALT 200s, ALP 600s, GGT 7, Tbili 4. Most likely diagnosis?

A

Hepatic lipidosis

214
Q

Poodle with elevated ALT 600s, ALP 200s, mild hypoalbuminemia, elevated Tbili, normal BUN/Creat. Most likely diagnosis?

A

Afaloxtoxicosis

215
Q

Old Labrador with moderate anemia that is NOT Coombs positive, hyperbilirubinemia, hypoalbuminemia,
hypocholesterolemia. What is the most likely diagnosis?

A

Hemophagocytic histiocytic sarcoma

216
Q

Cat with thoracic effusion. Effusion is light gold and has non-degenerative neutrophils, protein 8 g/dL, WBC 5000/uL. What’s the most likely diagnosis?

A

FIP

217
Q

Mechanism of action of ascites with FIP?

A

Virus triggering VEGF leading to leakage of fluid.

Note: Production of vascular endothelial growth factor by infected monocytes may be lead to increased vascular permeability and contribute to cavitary effusion

218
Q

2 YO dog with hemothorax – PT more elevated than PTT with 80,000 platelets. Most likely diagnosis?

A

Vitamin K antagonist toxicity

219
Q

What cell type is lost causing lymphopenia in cats with FeLV/FIV?

A

CD4+

220
Q

What is the mechanism of PU/PD in hypercalcemia of malignancy?

A

Inhibition of effect of ADH

221
Q

Primary hyperparathyroidism

A

Give an elevated ionized calcium and normal PTH, what’s the diagnosis?

222
Q

Mechanism of PU/PD in chronic renal disease?

A

Solute overload due to loss of nephrons which leads to osmotic diuresis

223
Q

Cat with IRIS Stage 3 CKD, UPC 0.5 repeated 3 times, with a negative urine culture. How to treat?

A

Enalapril

224
Q

What electrolyte abnormality worsens digoxin toxicity?

A

Hypokalemia – Digoxin competitively binds at K binding site on Na/K ATPase, so with less K, more
digoxin binds which worsens toxicity

225
Q

Vaginal cytology of an intact female dog: no blood, no neutrophils, but angular epithelial cells with small nuclei

A

Estrus

226
Q

What effect does stimulation of the baroreceptors have?

A

Activation of the vagal center

227
Q

Mechanism for neutrophil killing?

A

Respiratory burst via NADPH oxidase

228
Q

What would IV lipid emulsion therapy be useful in treating?

A

Ivermectin toxicity

229
Q

What should one of the goals be within 6 hours when following the goal of directed sepsis therapy?

A

Attain MAP of at least 65 mmHg

230
Q

What is the most common action by the liver in phase II drug metabolism?

A

Glucoronidation

231
Q

Calculate an odds ratio given a table of numbers.
Calculate sensitivity and specificity (kind of tricky; given % sensitivity and supposed to calculate how many do NOT have the disease in that study, so you need to be able to fill out the table.

A
232
Q

Calculate anion gap and try to predict what more is going on given a blood gas

A

This patient has REALLY high bicarbonate; answer might have been paradoxical aciduria

233
Q

What is one mechanism of Pimobendan?

A

Enhanced sensitivity to calcium

234
Q

What drug is MESNA used for?

A

Ifosfamide – Mesna used to decrease risk of hemorrhagic cystitis with cyclophosphamide or ifosfamide

235
Q

Interpret a low dose dexamethasone suppression test that shows no suppression at 4 or 8 hours.

A

Consistent with hyperadrenocorticism but can’t identify which type

236
Q

What is the ideal diet for a cat with diabetes?

A

High protein, low carb

237
Q

Dog with lipemic sample 12 hours after a meal. What causes it?

A

VLDL

238
Q

What enzyme in the adrenal cortex is stimulated by ACTH?

A

Cholesterol desmolase

239
Q

Markers that could be found on B cells?

A

CD21, CD45, CD79

240
Q

What is HCO3- secretion in the pancreas associated with?

A

Osmotically draws water into secretion

241
Q

What is responsible for automaticity in the SA node?

A

Slow Na and Ca channels

242
Q

What is the most important in regulating intestinal motility?

A

Myenteric plexus

243
Q

What has the greatest effect on resistance?

A

Vessel radius

244
Q

If you have alveoli that are getting low oxygen, what happens in the tissues immediately adjacent to them?

A

Constriction of capillaries, moving blood to parts of the lung that are better aerated

245
Q

What is the mechanism of action of botulinum toxin?

A

Inhibition of acetylcholine release from the presynaptic membrane

246
Q

When should you treat Salmonella?

A

When clinically necessary due to clinical signs

247
Q

What does cisplatin do to cats?

A

Pulmonary edema

248
Q

Most specific test for feline asthma?

A

> 25% eosinophils in bronchoalveolar lavage

249
Q

What is the definition of functional residual capacity?

A

The volume of air left in the lungs at the end of a normal expiration

250
Q

Immune molecule most commonly associated with IMHA?

A

IgG

251
Q

Treatment of choice for Boxer histiocytic ulcerative colitis?

A

Enrofloxacin

252
Q

What is contra-indicated in head trauma?

A

Methylprednisolone

253
Q

What first line treatment has the highest initial response rate for perianal fistulas?

A

Cyclosporine

254
Q

What does TLR-4 recognize?

A

LPS

255
Q

What is stimulated with acid in the duodenum, fatty acids/amino acids and something else?

A

Acetylcholine – released in response to H+, FAs, AAs in duodenum

256
Q

What causes increased contractility?

A

Increased extracellular calcium

257
Q

What is typical of presentation of hypoadrenocorticism?

A

Chronic vague GI signs due to low cortisol

258
Q

What does RDW represent on a CBC

A

Anisocytosis

259
Q

Cause of hyperkinetic pulse?

A

Aortic insufficiency and PDA

260
Q

Most common clinical signs of hepatic encephalopathy in cats?

A

Aggression, hypersalivation, seizures

261
Q

What disease process could worsen hepatic encephalopathy?

A

Metabolic alkalosis – More NH4+ is converted to NH3 which can cross BBB making signs worse

262
Q

What is the toxic mechanism behind the glycoside plants (foxglove, kalanchoe, etc)?

A

Inhibition of Na/K/ATPase pump

263
Q

Which of the following could be used as a prokinetic thanks to its acetylcholinesterase inhibitor activity?

A

Neostigmine

264
Q

Mechanism of action of the antiemetic maropitant citrate?

A

NK-1 antagonist

265
Q

Essential fatty acid in dogs and cats?

A

Linoleic or linolenic – also arachidonic acid in cats

266
Q

What makes glargine long-acting?

A

Formation of crystals in the SQ

Note: Slowly reversible binding to albuminàdetemir insulin

267
Q

What would be decreased in pulmonary hypertension?

A

Prostacyclin

268
Q

Which of the following inhibits platelet aggregation?

A

Nitric oxide

269
Q

What is the most potent chemokine produced in the arachidonic acid cascade?

A

Leukotriene B4

270
Q

What detects glycoproteins? Can’t quite remember the question.

A

CD40 – receptor for TNFa

271
Q

Mechanism of action of clopidogrel?

A

Irreversible binding of ADP-receptor on platelets

272
Q

What do microRNAs do?

A

Supress gene expression

273
Q

What inhibits glucagon release?

A

Somatostatin

274
Q

What does hyperthyroidism decrease in order to cause increased glomerular filtration rate?

A

Total peripheral resistance

275
Q

What heartworm test is more sensitive in cats than in dogs?

A

Heartworm antibody – Such small worm burden, antigen levels will likely not be identified

276
Q

Mechanism of action of doxycycline?

A

Inhibition of 30s ribosomal unit

277
Q

Cause of pre-hepatic portal hypertension?

A

Portal vein atresia

278
Q

What are serum bile acids useful in determining?

a. Hepatic versus post-hepatic cholestasis
b. Hypoalbuminemia due to PLE versus liver dysfunction
c. Intrahepatic versus extrahepatic portosystemic shunts

A

B. Hypoalbuminemia due to PLE versus liver dysfunction

279
Q

Which respiratory parasite would you diagnose via Baermann?

A

Aelurostrongylus

280
Q

What does cranial nerve III innervate?

A

Pupillary muscle

281
Q

What is the most common cause of megaesophagus in dogs?

A

Myesthenia gravis

282
Q

Where are apotransferrin and apoferritin located?

A

Apotransferrin is transferrin before it is bound to Fe3+ which moves through circulation to BM or Liver. Apoferritin is before iron binds it and is located in the cell for iron storage.

283
Q

What is the cause of elevated triglycerides in a fasted blood sample

A

VLDL (if ask for a second option then LDL)

284
Q

What infectious disease can cause hypercalcemia?

A

Granulomatous infections ie blasto

285
Q

When does ventricular filling occur?

A

Prior to/at third heart sound after isovolumetric relaxation

286
Q

What CBC change would you see in cats that have diabetes, hyperthyroidism, or lymphoma?

A

Heinz bodies

287
Q

Mechanism of action of omeprazole

A

H/K/ATP pump inhibitor

288
Q

How is cobalamin absorbed?

A

The Cobalamin- intrinsic factor complex is absorbed by receptors in the ileum to mid-jejunum in dogs, and in cats (and humans) only in the ileum. This membrane-bound receptor is called the Cubam receptor

289
Q

Where is CSF made and stored?

A

choroid plexus epithelium and ependymal cells of the ventricles and flows into interconnecting chambers; namely, the cisterns and the subarachnoid spaces.

290
Q

Most common bacteria in canine pyoderma

A

Staph pseudintermedius

291
Q

What does fetal hemoglobin do?
Is O2 affinity greater for fetal hemoglobin or adult hemoglobin? Would fetal hemoglobin shift hemoglobin oxygen curve to left or right?

A

Hb F evolved to potentiate the transfer of oxygen (O2) from maternal blood to fetal tissues, a goal achieved by the higher O2 affinity of Hb F compared with adult Hb A. This is largely due to the insensitivity of Hb F to 2,3 BPG (sometimes called 2,3 DPG), the major modulator of hemoglobin-O2 affinity.J

Shift curve to R

291
Q

How do you prevent the regrowth of a polyp after removal from a cat ear

A

bulla osteotomy

291
Q

On PARR, leukemia vs lymphoma?

A

CD34?

292
Q

What is an early sign of nsaid acute cortical nephrotoxicity

A

urine tubular casts

293
Q

How to diagnose uroabdomen in the dog

A

a diagnosis of uroabdomen can be made if the creatinine ratio is ≥2:1

294
Q

How to diagnose chylous effusion in dog - what lipid molecule do you measure?

A

Chyle is made primarily of chylomicrons, an aggregate of long-chain triglycerides, cholesterol esters, and phospholipids. It is also rich in lymphocytes,

295
Q

How is chlostridium teteni transmitted?

A

by the direct transfer of C. tetani spores from soil and excreta of animals and humans to wounds and cuts

296
Q

6 week old GSD is regurgitating and not gaining weight. It was recently weaned. What is the most likely cause?

A

PRAA causing megaesophagus

297
Q

What organism would you diagnose if you saw morulae in a neutrophil in the southwestern USA?

A

Anaplasma

298
Q

What endothelial derived factor is reduced in pulmonary hypertension?

A

Prostacyclin

299
Q

What hormones acts on the small intestine to inhibit peristalsis?

A

glucagon

300
Q

Is conjugated bilirubin bound to protein in order to travel though body?

A

No, but unconjugated is bound to albumin

301
Q

What are some disease processes that cause hypokalemia?

A

Hyperaldosteronism, metabolic alkylosis (or respiratory?), renal tubular disease, loop diuretics, vomiting/diarrhea, endotoxemia, and due to insulin release

302
Q
A

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