Quiz 1 - Neurology & Respiratory Medicine Flashcards
You are rechecking a 3-year-old spayed cat who has been diagnosed with chylothorax and for the past 16 weeks has been managed with intermittent thoracocentesis, rutin, and a low fat diet. On auscultation, lung sounds are decreased ventrally. You perform thoracocentesis and remove 60 ml of milky fluid from each side of the thorax. The cat is breathing comfortably. You obtain radiographs and note that despite removal of most of the pleural fluid, the lung lobes are retracted from the chest wall and have rounded margins.
Based on these findings, you diagnose the cat with which of the following?
a. fibrosing pleuritis
b. underlying lymphoma
c. iatrogenic pyothorax
d. traumatic pneumothorax
a. fibrosing pleuritis
Your patient is a 6-year-old castrated male mixed breed dog with suspected aspiration pneumonia after surgical removal of a gastric foreign body. You have performed an endotracheal wash and submitted the sample for culture and sensitivity.
Which of the following strategies will you employ while that is pending?
a. admit the dog for oxygen therapy until the preliminary culture report confirms the presence of infection.
b. submit a bacterial PCR of the endotracheal wash fluid so you don’t have to wait for culture and sensitivity results.
c. administer empiric antibiotics that are usually effective against the likely pathogens.
d. wait to start antibiotics until the culture results are reported to avoid promoting antimicrobial resistance.
c. administer empiric antibiotics that are usually effective against the likely pathogens.
Which of the following is the most common nasal tumor in cats?
a. b-cell lymphoma
b. carcinoma
c. fibrosarcoma
d. t-cell lymphoma
a. b-cell lymphoma
A 3-year-old castrated male mixed-breed dog presents to your east Texas clinic with a progressive history of weight loss and diarrhea. Other than thin body condition, physical exam is unremarkable. Abdominal ultrasound reveals one large mass near the ileocolic junction, another mass in the jejunum, and lymphadenomegaly. Which of the following is the most appropriate prioritized differential diagnosis list?
a. pythiosis, histoplasmosis, protothecosis
b. coccidioidomycosis, histoplasmosis, cryptococcosis
c. cryptococcosis, coccidioidomycosis, blastomycosis
d. blastomycosis, protothecosis, pythiosis
a. pythiosis, histoplasmosis, protothecosis
In small animal medicine, infection caused by which fungal organism preferentially causes nasal signs, and can often be diagnosed on cytology (“snotology”) of nasal discharge as a yeast with a thick, refractile capsule?
a. blastomyces dermatiditis
b. cryptococcus neoformans
c. coccidioides species
d. histoplasma capsulatum
b. cryptococcus neoformans
Your patient is a 7-year-old castrated male Labrador Retriever with megaesophagus and suspected aspiration pneumonia. For financial reasons your client declines culture and susceptibility testing and you make an empiric decision about antimicrobial therapy for the suspected bacterial infection
Which bacterial organisms would you expect to find if culture were performed?
a. gram-positive aerobes
b. gram-negative aerobes
c. gram-positive anaerobes
d. gram-negative anaerobes
e. all of the above
e. all of the above
Frank, a 10-year-old mixed breed dog, is a long-standing patient of yours. You recently diagnosed a nasal adenocarcinoma in Frank and referred him to the Texas A&M Oncology group. Frank completed his definitive-intent radiation therapy for his nasal tumor at Texas A&M approximately 1 week ago. The client calls your hospital on a Friday afternoon that Frank is not doing well, and your technician leaves a message with a list of clinical signs the client is describing. In regards to acute radiation side effects, which of the following is a correct statement in an expected radiation side effect for Frank and recommended treatment of that side effect?
a. clinical Signs: Ptyalism, inappetence (dropping food, prefers canned food) Suspect Diagnosis: Oral Mucositis Recommended Treatment: increase pain control medications and/or frequency
b. clinical Signs: Patient has been licking at previous IV catheter site. The area is now sore and raw. Client thinks TAMU inadvertently irradiated the limb. Suspect Diagnosis: Moist desquamation of the limb Recommended Treatment: Bandage care
c. clinical Signs: Ptyalism, Inappetence (dropping food, prefers canned food) Suspect Diagnosis: Pancreatitis Recommended Treatment: Cerenia, IV fluid supportive care
d. clinical Signs: Diarrhea, Lethargy Suspect Diagnosis: Gastroenteritis Recommended Treatment: Metronidazole
a. clinical Signs: Ptyalism, inappetence (dropping food, prefers canned food) Suspect Diagnosis: Oral Mucositis Recommended Treatment: increase pain control medications and/or frequency
A 4-year-old Boxer presents with a 10 day history of dropped jaw. He is otherwise healthy, fully vaccinated and indoor unless out on a leash with his owner. His neurologic examination is unremarkable other than being unable to close his jaw…you can close it but it drops open immediately. There is no decrease in range or motion or pain. Which of the following differential BEST fits this clinical picture?
a. polyradiculoneuritis
b. focal myositis
c. trigeminal neuritis
d. malignant nerve sheath neoplasm
c. trigeminal neuritis
You are presented with a 2-year-old, intact male unvaccinated mixed breed ranch dog. His owners witnessed him fighting with a Texas grey fox a few days ago, and he suffered bite wounds to his right forelimb. He seemed to be using the leg well within 48 hours of the event, but now he is dragging that limb and on your exam he has a poor withdrawal on that limb. Which of the following differential diagnoses is MOST likely for this dog?
a. masticatory myitis
b. myasthenia gravis
c. rabies
d. botulism
c. rabies
You are evaluating an 8-year-old spayed domestic medium haired cat with a 2-week history of eating less than normal and hiding in the closet. A CBC, chemistry panel, urinalysis, and FeLV/FIV test results are normal. Thoracic radiographs show a large volume of pleural effusion, and you remove 90 ml of a slightly milky fluid by thoracocentesis. On fluid analysis the protein is elevated (3.0 g/dL) and the nucleated cell count is mild to moderately elevated (3500/uL) and the cells are predominantly small lymphocytes.
Which of the following diagnostics is the LEAST important to perform at this time?
a. measurement of triglycerides on the pleural effusion and serum
b. echocardiogram
c. ultrasound of the mediastinum
d. aerobic and anaerobic culture of the effusion
d. aerobic and anaerobic culture of the effusion
A 12-year-old castrated Akita dog presents with a 3-week history of progressive exercise intolerance. In the past week, his appetite has also decreased. He has lost 2 kg in the past 2 months. He has no prior history of medical problems. He is an indoor dog who goes outside in a fenced yard with supervision. There are no other pets in the home. He is up-to-date on vaccines and preventatives. T=101°F, P=80/minute, R=44/minute, mm pink, CRT 1-2 seconds. On thoracic auscultation lung sounds are decreased ventrally on both sides. Thoracic radiographs show a moderate volume of pleural effusion. You perform thoracocentesis and remove 300 ml of red-colored fluid. PCV of effusion is 20% and PCV of peripheral blood is 38%. CBC is otherwise normal. Chemistry panel shows mild hyperglobulinemia. Prothrombin time (PT) and partial thromboplastin time (PTT) are normal.
Which of the following is the most likely differential diagnosis for this dog’s pleural effusion?
a. early vitamin K antagonist rodenticide toxicity
b. intrathoracic neoplasia
c. systemic inflammatory response syndrome (SIRS)
d. right-sided congestive heart failure
b. intrathoracic neoplasia
A dog from west Texas has low-grade fever and vague systemic signs (decreased appetite, lethargy). Serology for Coccidioides is positive. Which of the following is the most reasonable interpretation?
a. serology for this pathogen is subject to a large number of cross-reactions with Histoplasma and the test cannot be used to distinguish between the two.
b. the dog has coccidioidomycosis and you should begin long-term azole therapy.
c. in the US, this disease is regionally restricted to Eastern river valleys, and so it is important to ask the owner if the dog has traveled to an endemic area.
d. the dog may have either exposure or true infection, and further diagnostics are needed to provide evidence for coccidioidomycosis.
d. the dog may have either exposure or true infection, and further diagnostics are needed to provide evidence for coccidioidomycosis.
Select the best description of the landmarks for thoracocentesis in a cat with pleural effusion.
a. caudal edge of the 3rd-4th intercostal space one third of the way up from the sternum
b. caudal edge of the 8-9th intercostal space, half way between the sternum and vertebrae
c. cranial edge of the 4-5th intercostal space at the highest point of the thorax
d. cranial edge of rib at 7-8th intercostal space at the level of the costochondral junction
d. cranial edge of rib at 7-8th intercostal space at the level of the costochondral junction
Which of the following is TRUE regarding diagnostic imaging for respiratory neoplasia?
a. computed tomography (CT) is a helpful diagnostic for canine sinonasal tumors because it allows us to determine tumor stage which dictates treatment recommendations.
b. CT staging for pulmonary neoplasia is beneficial for screening for pulmonary metastatic disease, evaluating intra-thoracic lymph nodes, and determining which lung lobe a primary mass is located in prior to surgery.
c. pulmonary lesions must be 3mm or larger to be visible on chest radiographs.
d. CT scans for canine sinonasal tumors are used for radiation therapy planning. Any CT scan can be used for radiation planning.
a. computed tomography (CT) is a helpful diagnostic for canine sinonasal tumors because it allows us to determine tumor stage which dictates treatment recommendations.
b. CT staging for pulmonary neoplasia is beneficial for screening for pulmonary metastatic disease, evaluating intra-thoracic lymph nodes, and determining which lung lobe a primary mass is located in prior to surgery.
All of the following can be used to diagnose tracheal collapse in a toy breed dog except for:
a. thoracic radiographs
b. fluoroscopy
c. endotracheal wash
d. tracheoscopy
c. endotracheal wash
