Reproduction and Preventive Medicine SBAs Flashcards
Scenario: A 3-year-old female Labrador Retriever has failed to conceive after three natural mating attempts with a proven stud dog. Both dogs have a normal reproductive history.
Lead-in: What is the most appropriate next step in investigating this case of apparent infertility?
Options:
a) Advise the owner to try artificial insemination.
b) Perform a full physical examination of both the bitch and the stud dog.
c) Recommend surgical exploration of the bitch’s reproductive tract.
d) Prescribe a course of antibiotics for both dogs.
e) Perform hormonal assays on the bitch to assess her oestrous cycle.
Answer: b) Perform a full physical examination of both the bitch and the stud dog.
Explanation: A thorough physical examination of both animals is crucial to identify any potential underlying anatomical or systemic issues that could be contributing to infertility. This should precede more invasive or specific diagnostic tests.
Scenario: A bitch in the first week of metoestrus is presented for elective neutering.
Lead-in: What is a potential risk associated with performing ovariohysterectomy at this stage of the oestrous cycle?
Options:
a) Increased risk of haemorrhage due to uterine vascularity.
b) Higher chance of developing urinary incontinence post-surgery.
c) Increased likelihood of a prolonged anaesthetic recovery.
d) Reduced surgical time compared to anoestrus.
e) Lower risk of developing a pyometra in the future.
Answer: a) Increased risk of haemorrhage due to uterine vascularity.
Explanation: During metoestrus, the uterus is still under the influence of progesterone and remains more vascular and oedematous than during anoestrus, which can increase the risk of haemorrhage during surgery.
Scenario: A stud dog with a history of successful matings now has a reduced litter size in recently bred bitches. Semen evaluation reveals a decreased sperm count and increased abnormal morphology.
Lead-in: What is the most common underlying cause of haemospermia in stud dogs?
Options:
a) Testicular neoplasia.
b) Epididymitis.
c) Prostatic disease.
d) Cryptorchidism.
e) Scrotal dermatitis.
Answer: c) Prostatic disease.
Explanation: Prostatic disease, such as prostatitis or benign prostatic hyperplasia, is a common cause of haemospermia (blood in the semen) in male dogs and can negatively impact semen quality.
Scenario: A bitch was mated approximately 25 days ago and is presented for pregnancy diagnosis.
Lead-in: Which of the following is the most reliable method for confirming pregnancy at this stage?
Options:
a) Abdominal palpation.
b) Radiography.
c) Serum relaxin assay.
d) Ultrasonography.
e) Observation of mammary gland enlargement.
Answer: d) Ultrasonography.
Explanation: Ultrasonography is highly accurate for pregnancy diagnosis from around day 21-25 post-ovulation, allowing visualization of gestational sacs and foetal heartbeats.
Scenario: A bitch at term is showing signs of stage one labour (restlessness, nesting behaviour) but has not progressed to active straining after 12 hours.
Lead-in: What is the definition of primary uterine inertia?
Options:
a) Failure of the bitch to expel foetuses due to an obstructive cause.
b) Cessation of active straining after the expulsion of one or more foetuses.
c) Failure of the uterus to initiate effective contractions despite no maternal or foetal abnormalities.
d) Weak and infrequent uterine contractions due to maternal exhaustion.
e) Foetal malpresentation preventing progression of labour.
Answer: c) Failure of the uterus to initiate effective contractions despite no maternal or foetal abnormalities.
Explanation: Primary uterine inertia is characterised by the uterus’s inability to start strong, coordinated contractions at the onset of labour, in the absence of any identifiable obstructive cause or foetal distress.
Scenario: During a dystocia, a single foetus is palpated in the birth canal but cannot be delivered with gentle traction. Radiographs reveal the foetus is in a transverse presentation.
Lead-in: What is the most appropriate course of action in this situation?
Options:
a) Administer oxytocin to increase uterine contractions.
b) Apply more forceful traction to deliver the foetus.
c) Attempt to manipulate the foetus into a longitudinal presentation.
d) Perform an episiotomy to widen the birth canal.
e) Proceed with a caesarean section.
Answer: e) Proceed with a caesarean section.
Explanation: A transverse foetal presentation is a malpresentation that typically cannot be corrected manually and will obstruct the birth canal, necessitating surgical delivery via caesarean section.
Scenario: A bitch has just delivered a live puppy but is now exhibiting signs of strong, unproductive straining for over 30 minutes.
Lead-in: What is the most likely cause of this secondary uterine inertia?
Options:
a) Maternal exhaustion.
b) Uterine rupture.
c) Retained foetus.
d) Electrolyte imbalance.
e) Placental abruption.
Answer: c) Retained foetus.
Explanation: Secondary uterine inertia often occurs when the uterus becomes fatigued after delivering one or more puppies, or more commonly, due to the presence of another foetus in the birth canal or uterus preventing effective contractions.
Scenario: A bitch undergoes an emergency caesarean section due to obstructive dystocia.
Lead-in: What is a critical step in the immediate post-operative care of the neonates?
Options:
a) Early administration of antibiotics.
b) Immediate vaccination.
c) Ensuring a warm and clean environment and clearing the airways.
d) Offering food and water immediately.
e) Leaving the puppies with the bitch without intervention.
Answer: c) Ensuring a warm and clean environment and clearing the airways.
Explanation: The immediate priorities for newly delivered puppies are establishing a clear airway by removing any amniotic fluid, ensuring they are warm to prevent hypothermia, and providing a clean environment to reduce the risk of infection.
Scenario: A bitch experienced foetal loss at approximately 5 weeks of gestation.
Lead-in: Which of the following is a common infectious cause of abortion in dogs?
Options:
a) Canine distemper virus.
b) Canine parvovirus.
c) Canine herpesvirus.
d) Canine adenovirus.
e) Canine influenza virus.
Answer: c) Canine herpesvirus.
Explanation: Canine herpesvirus is a significant cause of embryonic loss, abortion, and neonatal death in dogs. Infection in naive pregnant bitches can lead to foetal death at various stages of gestation.
Scenario: A stud dog has a palpable testicular mass.
Lead-in: Which type of testicular tumour is most commonly associated with the production of oestrogens and potential feminisation syndrome?
Options:
a) Seminoma.
b) Leydig cell tumour.
c) Sertoli cell tumour.
d) Teratoma.
e) Interstitial cell tumour.
Answer: c) Sertoli cell tumour.
Explanation: Sertoli cell tumours can produce oestrogens, which in some cases can lead to feminisation syndrome in male dogs, characterised by signs such as gynaecomastia, alopecia, and attraction of male dogs.
Scenario: A bitch is diagnosed with subclinical hypothyroidism.
Lead-in: How might hypothyroidism potentially impact fertility in a bitch?
Options:
a) Increased libido.
b) Prolonged oestrus.
c) Silent heats or failure to cycle.
d) Increased risk of uterine infections.
e) Production of higher quality oocytes.
Answer: c) Silent heats or failure to cycle.
Explanation: Hypothyroidism can disrupt the normal hormonal balance required for regular oestrous cycles, potentially leading to silent heats (where signs of oestrus are not apparent) or complete failure to cycle.
Scenario: A stud dog has a history of cryptorchidism (retained testicle).
Lead-in: What is the primary concern regarding a retained testicle?
Options:
a) Increased risk of testicular torsion.
b) Reduced testosterone production.
c) Increased risk of testicular neoplasia.
d) Inability to produce sperm.
e) Increased risk of epididymitis.
Answer: c) Increased risk of testicular neoplasia.
Explanation: Cryptorchid testicles have a significantly higher risk of developing testicular cancer (especially Sertoli cell tumours and seminomas) compared to normally descended testicles.
Scenario: A bitch has a history of false pregnancies (pseudopregnancy) after her oestrous cycles.
Lead-in: Which hormone is primarily responsible for the clinical signs associated with pseudopregnancy in bitches?
Options:
a) Oestrogen.
b) Progesterone.
c) Prolactin.
d) Relaxin.
e) Luteinizing hormone (LH).
Answer: c) Prolactin.
Explanation: Prolactin, secreted by the pituitary gland, plays a key role in the development of maternal behaviours and mammary gland changes seen in pseudopregnant bitches.
Scenario: A bitch is presented for artificial insemination with chilled semen.
Lead-in: What is the optimal timing for insemination with chilled semen relative to ovulation?
Options:
a) At the onset of oestrus.
b) 24 hours before ovulation.
c) 24-48 hours after ovulation.
d) Immediately after the LH surge.
e) 5-7 days after the LH surge.
Answer: c) 24-48 hours after ovulation.
Explanation: Chilled semen has a longer lifespan than fresh semen but shorter than frozen semen. Therefore, insemination is typically recommended 24-48 hours after ovulation to maximise the chances of fertilisation.
Scenario: A bitch has a history of recurrent embryonic resorption early in pregnancy.
Lead-in: Which of the following diagnostic tests might be useful in investigating this issue?
Options:
a) Routine haematology and biochemistry.
b) Vaginal cytology during oestrus.
c) Measurement of basal body temperature.
d) Testing for Brucella canis.
e) Abdominal radiography before mating.
Answer: d) Testing for Brucella canis.
Explanation: Brucella canis is a bacterial infection that can cause embryonic resorption, abortion, and stillbirth in dogs. Testing for this pathogen is important in cases of repeated pregnancy loss.
Scenario: A bitch has successfully whelped a large litter but is now showing signs of lethargy, muscle tremors, and facial pruritus approximately 3 weeks post-partum.
Lead-in: What is the most likely underlying cause of these clinical signs?
Options:
a) Eclampsia (hypocalcaemia).
b) Mastitis.
c) Metritis.
d) Retained placenta.
e) Post-partum haemorrhage.
Explanation: Eclampsia, or puerperal tetany, is caused by a sudden drop in blood calcium levels (hypocalcaemia) in heavily lactating bitches, typically occurring 1-4 weeks after giving birth. The clinical signs include restlessness, panting, muscle tremors, and potentially seizures.
Scenario: A 4-year-old Labrador Retriever is at term pregnancy and presents for elective Caesarean section.
Lead-in: Which of the following induction agents is considered most suitable for this patient to minimise neonatal depression?
Options:
a) Ketamine
b) Propofol
c) Isoflurane
d) Medetomidine
e) Acepromazine
Answer: b) Propofol
Explanation: Propofol is a rapid-acting induction agent with minimal placental transfer, making it a suitable choice for Caesarean sections to reduce neonatal depression. Ketamine can cause neonatal depression. Isoflurane is a maintenance agent. Medetomidine and acepromazine can cause cardiovascular depression in the dam and are not ideal for this scenario.
Scenario: A pregnant bitch is positioned in dorsal recumbency for a Caesarean section.
Lead-in: What is the primary cardiovascular concern associated with this positioning in late pregnancy?
Options:
a) Increased cardiac output
b) Decreased heart rate
c) Compression of the vena cava
d) Increased systemic vascular resistance
e) Development of hypertension
Answer: c) Compression of the vena cava
Explanation: In dorsal recumbency, the enlarged uterus can compress the vena cava, leading to decreased venous return to the heart and potentially causing hypotension. This is less significant in animals compared to women but should still be considered.
Scenario: A healthy bitch has just given birth to 8 puppies. One puppy is not breathing spontaneously.
Lead-in: What is the most appropriate first step in resuscitating this neonate?
Options:
a) Administer oxygen via a face mask.
b) Begin chest compressions.
c) Clear the airway by removing membranes and fluids.
d) Administer a dose of doxapram.
e) Gently swing the puppy to clear fluids.
Answer: c) Clear the airway by removing membranes and fluids.
Explanation: The first step in neonatal resuscitation is to establish a clear airway. This involves removing any amniotic membranes or fluids from the puppy’s mouth and nose using a bulb syringe or gentle suction.
Scenario: A newborn puppy has a heart rate of 160 bpm, a respiratory rate of 5 breaths per minute, shows a moderate response to stimulation, has some muscle tone, and a pale mucous membrane colour.
Lead-in: Based on the modified APGAR score, what is the likely prognosis for this puppy without intervention?
Options:
a) High survival prognosis
b) Medium survival prognosis
c) Low survival prognosis
d) Excellent survival prognosis
e) Survival prognosis cannot be determined.
Answer: b) Medium survival prognosis
Explanation: Using the modified APGAR score, this puppy has a heart rate (1), respiratory rate (1), response to stimulation (1), muscle tone (1), and mucous membrane colour (1), resulting in a total score of 5. A score of 4 to 6 indicates a medium survival prognosis.
Scenario: A bitch had a Caesarean section 24 hours ago and is now panting excessively and appears restless. Her puppies are suckling normally.
Lead-in: Which of the following is the most likely cause of these clinical signs in the post-operative period?
Options:
a) Mastitis
b) Uterine infection (metritis)
c) Eclampsia (hypocalcaemia)
d) Post-operative pain
e) Haemorrhage
Answer: d) Post-operative pain
Explanation: While eclampsia can occur post-partum, it typically presents with more severe signs like tremors and seizures. Mastitis usually involves a specific mammary gland being painful and inflamed. Metritis would likely involve a foul vulval discharge and fever. Haemorrhage would typically cause pale mucous membranes and lethargy. Panting and restlessness are common signs of post-operative pain.
Scenario: A puppy in a large litter is consistently smaller and weaker than its siblings and is failing to gain weight appropriately.
Lead-in: What is the most important initial step in managing this “fading puppy”?
Options:
a) Administer antibiotics.
b) Provide supplemental feeding with puppy milk replacer.
c) Immediately separate the puppy from the litter.
d) Administer corticosteroids.
e) Reduce the environmental temperature.
Answer: b) Provide supplemental feeding with puppy milk replacer.
Explanation: Fading puppies often have failure to suckle effectively, leading to malnutrition and dehydration. Early supplemental feeding with a suitable milk replacer is crucial to provide the necessary nutrition and energy.
Scenario: A nursing bitch is being fed her regular adult maintenance diet.
Lead-in: What key nutritional component is likely to be insufficient in this diet to meet the demands of lactation?
Options:
a) Fibre
b) Protein and calcium
c) Carbohydrates
d) Fat-soluble vitamins
e) Water
Answer: b) Protein and calcium
Explanation: Lactation places high demands on the bitch’s body, requiring increased energy, protein, and calcium to produce milk for the puppies. Most adult maintenance diets do not contain sufficient levels of these nutrients to support lactation.
Scenario: A puppy that was successfully resuscitated after birth is now weak and unable to suckle effectively.
Lead-in: Besides ensuring warmth and a clear airway, what is another critical immediate step in supporting this puppy?
Options:
a) Early vaccination
b) Administration of broad-spectrum antibiotics
c) Providing a source of energy, such as dextrose
d) Frequent handling to stimulate activity
e) Application of cold packs to improve circulation
Answer: c) Providing a source of energy, such as dextrose
Explanation: Neonates have limited energy reserves, and puppies that are weak or have undergone resuscitation are at risk of hypoglycaemia. Providing a source of glucose can help stabilise their condition.
Scenario: A bitch has a history of primary uterine inertia in previous pregnancies. She is now at term again. Monitoring of her progesterone levels shows a drop below 2 ng/ml, and her rectal temperature has decreased.
Lead-in: Based on these indicators of impending parturition, what is the recommended course of action for this high-risk pregnancy?
Options:
a) Allow natural labour to progress and monitor closely.
b) Administer a low dose of oxytocin at the onset of contractions.
c) Schedule an elective Caesarean section.
d) Supplement her diet with calcium.
e) Induce labour with prostaglandin.
Answer: c) Schedule an elective Caesarean section.
Explanation: Bitches with a history of primary uterine inertia are at high risk of experiencing it again. Given the indicators of impending parturition, an elective Caesarean section is the safest option to ensure timely delivery of the puppies.
Scenario: During resuscitation of a newborn puppy, despite clearing the airway and providing oxygen, the heart rate remains below 100 bpm.
Lead-in: What is the next recommended step in the resuscitation protocol?
Options:
a) Increase the oxygen flow rate.
b) Administer naloxone.
c) Begin trans-thoracic cardiac compressions.
d) Administer a higher dose of dextrose.
e) Perform acupuncture at the GV26 point.
Answer: c) Begin trans-thoracic cardiac compressions.
Explanation: A heart rate below 100 bpm in a neonate indicates severe hypoxia. If oxygen supplementation alone is ineffective, the next step is to provide trans-thoracic cardiac compressions to support circulation.
Scenario: A bitch had an emergency Caesarean section due to prolonged dystocia. The puppies are healthy and suckling well. The bitch is bright and responsive but has a persistent green vulval discharge 36 hours post-surgery.
Lead-in: What is the most likely cause of this clinical sign?
Options:
a) Normal post-partum discharge
b) Retained foetal membranes
c) Incisional infection
d) Mastitis
e) Eclampsia
Answer: b) Retained foetal membranes
Explanation: A persistent green vulval discharge after parturition suggests the possibility of retained foetal membranes or placenta. Normal post-partum discharge is typically red to brown and not green. Incisional infection would usually involve local signs of inflammation. Mastitis affects the mammary glands, and eclampsia presents with neurological signs.
Scenario: A 5-year-old Border Collie bitch, who whelped a litter of 7 puppies 5 days ago, is presented with a purulent, foul-smelling vulval discharge, lethargy, and a temperature of 40.5°C.
Lead-in: What is the most likely diagnosis in this post-partum bitch?
Options:
a) Normal lochia
b) Sub-involution of placental sites
c) Post-partum metritis
d) Eclampsia
e) Mastitis
Answer: c) Post-partum metritis
Explanation: The clinical signs of fever, lethargy, and a purulent, foul-smelling vulval discharge 5 days post-partum are highly suggestive of post-partum metritis, a bacterial infection of the uterus. Normal lochia is typically red/green/brown and not foul-smelling. Sub-involution of placental sites presents with prolonged haemorrhagic discharge. Eclampsia typically involves neurological signs and hypocalcaemia. Mastitis involves inflammation of the mammary glands.
Scenario: A bitch whelped 48 hours ago and is now showing signs of restlessness, panting, and muscle tremors. She is a small breed dog and has a large litter.
Lead-in: What is the most likely underlying cause of these clinical signs?
Options:
a) Post-partum haemorrhage
b) Retained placenta
c) Eclampsia (hypocalcaemia)
d) Mastitis
e) Uterine inertia
Answer: c) Eclampsia (hypocalcaemia)
Explanation: The clinical signs of restlessness, panting, and muscle tremors in a small breed bitch with a large litter in early lactation are highly suggestive of eclampsia, caused by hypocalcaemia. Post-partum haemorrhage would typically present with weakness and pale mucous membranes. A retained placenta might cause a discoloured vulval discharge and fever. Mastitis would involve signs of mammary gland inflammation. Uterine inertia occurs during labour.
Scenario: A bitch had an unwanted mating 5 days ago. The owner is seeking options to prevent pregnancy.
Lead-in: Which of the following medications is commonly used in the UK for medical termination of pregnancy in the post-mating period in bitches?
Options:
a) Oestradiol benzoate
b) Prostaglandin F2 alpha
c) Aglepristone
d) Cabergoline
e) Dexamethasone
Answer: c) Aglepristone
Explanation: Aglepristone (Alizin) is an anti-progestin licensed for use in the UK for the medical termination of pregnancy in bitches up to 45 days after mating. Oestradiol benzoate (Mesalin) is off the market. Prostaglandin F2 alpha can be used but has more side effects. Cabergoline is a prolactin inhibitor used for pseudopregnancy and pregnancy termination later in gestation. Oxytocin is an ecbolic agent.
Scenario: A bitch had an unwanted mating 35 days ago. The owner is seeking options to prevent pregnancy.
Lead-in: Which of the following medications is commonly used in the UK for medical termination of pregnancy in the post-mating period in bitches?
Options:
a) Oestradiol benzoate
b) Prostaglandin F2 alpha
c) Methylprednisolone
d) Cabergoline
e) Dexamethasone
D
Scenario: A bitch is diagnosed with pyometra with a closed cervix.
Lead-in: Besides surgical removal of the uterus and ovaries, which other aspect of the patient’s condition requires immediate and careful management prior to anaesthesia?
Options:
a) Hypoglycaemia
b) Hyperkalaemia
c) Dehydration and electrolyte imbalances
d) Bradycardia
e) Hypothermia
Answer: c) Dehydration and electrolyte imbalances
Explanation: Bitches with pyometra, especially with a closed cervix, can develop significant dehydration, azotaemia, and electrolyte imbalances due to the systemic effects of the uterine infection and endotoxins. Stabilising these parameters with intravenous fluids and electrolyte correction is crucial before anaesthesia.
Scenario: A bitch with pyometra is undergoing anaesthesia for ovariohysterectomy.
Lead-in: Which class of premedication should be used with caution or avoided in this patient due to potential cardiovascular compromise?
Options:
a) Opioids
b) Benzodiazepines
c) Alpha-2 adrenergic agonists
d) Non-steroidal anti-inflammatory drugs (NSAIDs)
e) Anticholinergics
Answer: c) Alpha-2 adrenergic agonists
Explanation: Alpha-2 adrenergic agonists can cause significant cardiovascular depression, including decreased cardiac output and vasoconstriction, which can be detrimental in a patient with pyometra who may already have compromised cardiovascular function due to sepsis.
Scenario: A queen has been showing regular oestrous cycles every 2-3 weeks since March and has been mated multiple times since May but has not become pregnant by August.
Lead-in: What is the most likely initial differential diagnosis to investigate in this case of failure to conceive?
Options:
a) Abnormal uterine environment
b) Inadequate mating technique
c) Male factor infertility
d) Incorrect timing of mating
e) Ovarian cysts
Answer: c) Male factor infertility
Explanation: Given the regular cycling and multiple matings with the same stud, male factor infertility (poor semen quality) is a strong initial differential diagnosis to investigate. Other possibilities include abnormal uterine environment or infectious causes, but male factor should be assessed early in the workup.
Scenario: A 2-week-old puppy is presented for failure to thrive. On examination, it is thin, feels cold to the touch, and has pale mucous membranes.
Lead-in: What is the most immediate and critical aspect of treatment for this neonate?
Options:
a) Administration of broad-spectrum antibiotics
b) Providing a warm environment
c) Oral supplementation of electrolytes
d) Subcutaneous fluids with dextrose
e) Nutritional support via tube feeding
Answer: b) Providing a warm environment
Explanation: Neonatal puppies have limited thermoregulatory abilities, and hypothermia can rapidly lead to a downward spiral and death. Providing a warm environment to raise the puppy’s body temperature is the most immediate and critical step.
Scenario: A bitch had a litter of 10 puppies three days ago and is now showing signs of lethargy and inappetence. Her mammary glands are firm and slightly painful to the touch, but there is no obvious discolouration of the milk.
Lead-in: What is a likely differential diagnosis for the bitch’s condition?
Options:
a) Retained placenta
b) Eclampsia
c) Mastitis
d) Sub-involution of placental sites
e) Post-partum haemorrhage
Answer: c) Mastitis
Explanation: The signs of lethargy, inappetence, and firm, slightly painful mammary glands in a post-parturient bitch are consistent with mastitis, an inflammation of the mammary glands. While other conditions are possible, mastitis is a common post-partum issue, especially in bitches with large litters.
Scenario: A bitch experienced pregnancy loss at approximately 4 weeks gestation. The owner is concerned about future pregnancies.
Lead-in: Which of the following diagnostic tests would be most appropriate to investigate a potential infectious cause of this early pregnancy failure?
Options:
a) Measurement of progesterone levels during the next oestrous cycle
b) Abdominal ultrasound examination during the next pregnancy
c) Testing for Brucella canis
d) Vaginal cytology during the next oestrous cycle
e) Measurement of thyroid hormone levels
Answer: c) Testing for Brucella canis
Explanation: Brucella canis is a known infectious cause of abortion and embryonic loss in dogs. Testing for this bacterium is a relevant step in investigating pregnancy failure. The other options may provide some information but are less directly targeted at identifying a common infectious cause of early pregnancy loss.
Scenario: A bitch had a litter of 10 puppies three days ago and is now showing signs of lethargy and inappetence. Her mammary glands are firm and slightly painful to the touch, but there is no obvious discolouration of the milk. You diagnose mastitis.
What is an appropriate anti-biotic choice?
What is an appropriate NSAID to prescribe?
Do not use trade names.
Abx:
Cefalexin
Amoxicillin/clavulanate
TMPS
NSAID
None are specifically licenced, any NSAID that is given as a one off dose could be used, eg:
Meloxicam
Carprofen
Firocoxib
Robenacoxib
Scenario: A 6-month-old German Shepherd puppy is significantly smaller than its littermates. On physical examination, it has a soft, puppy-like coat and delayed dental eruption.
Lead-in: Which of the following congenital conditions is most likely in this puppy?
Options:
a) Congenital hypothyroidism
b) Pituitary dwarfism
c) Skeletal dwarfism
d) Juvenile diabetes mellitus
e) Porto-systemic shunt
Answer: b) Pituitary dwarfism
Explanation: Pituitary dwarfism (hyposomatotropism) is characterised by stunted growth, retention of puppy coat, and delayed dental eruption in affected breeds like German Shepherds.
Scenario: A 4-year-old neutered female Miniature Schnauzer is diagnosed with congenital hypothyroidism.
Lead-in: Which of the following clinical signs is least likely to be associated with this condition?
Options:
a) Disproportionate dwarfism
b) Macroglossia
c) Epiphyseal dysgenesis
d) Hyperactivity
e) Lethargy
Answer: d) Hyperactivity
Explanation: Congenital hypothyroidism typically presents with disproportionate dwarfism, macroglossia, epiphyseal dysgenesis, and signs similar to adult hypothyroidism such as lethargy. Hyperactivity is not a typical sign.
Scenario: During a routine ovariohysterectomy in a 1-year-old rabbit, the uterus appears small and is difficult to locate.
Lead-in: What anatomical feature can assist in locating the uterus in young rabbits?
Options:
a) The round ligament
b) The broad ligament
c) The mesometrium fat
d) The ovarian bursa
e) The suspensory ligament
Answer: c) The mesometrium fat
Explanation: In rabbits, the mesometrium, which attaches to the uterus, is a principal fat-storage site. This fat is denser than other body fat and can help in identifying the small uterus, especially in young animals.
Scenario: A 4-month-old kitten presents with stunted growth, episodes of lethargy and disorientation, and hypersalivation, particularly after eating a meat-based meal.
Lead-in: Which of the following congenital conditions is most likely?
Options:
a) Pancreatic acinar atrophy
b) Juvenile diabetes mellitus
c) Congenital hypothyroidism
d) Porto-systemic shunt
e) Vascular ring anomaly
Answer: d) Porto-systemic shunt
Explanation: The combination of stunted growth, neurological signs (lethargy, disorientation), and gastrointestinal signs (hypersalivation) that worsen after eating, especially a protein-rich meal, is highly suggestive of a porto-systemic shunt.
Scenario: A 6-week-old puppy presents with regurgitation of solid food shortly after weaning.
Lead-in: Which of the following congenital structural defects is a likely differential diagnosis?
Options:
a) Cleft palate
b) Umbilical hernia
c) Persistent right aortic arch (PRAA)
d) Hydrocephalus
e) Cryptorchidism
Answer: c) Persistent right aortic arch (PRAA)
Explanation: Persistent right aortic arch (PRAA) is a vascular ring anomaly where the persistent right aortic arch compresses the oesophagus, leading to regurgitation of solid food soon after weaning.
Scenario: An entire female guinea pig, approximately 2 years old, presents with bilateral symmetrical alopecia of the flanks and increased mounting behaviour towards other females.
Lead-in: What is the most likely underlying reproductive condition?
Options:
a) Uterine adenocarcinoma
b) Pyometra
c) Ovarian cysts
d) Pregnancy toxaemia
e) Cystitis
Answer: c) Ovarian cysts
Explanation: Bilateral symmetrical alopecia without pruritus and behavioural changes like mounting in an entire female guinea pig are common clinical signs of ovarian cysts.
Scenario: A 5-year-old female rabbit is presented for routine neutering. The veterinarian opts for an ovariohysterectomy via an abdominal approach.
Lead-in: What is a key consideration during abdominal surgery in rabbits to minimise post-operative complications?
Options:
a) Using absorbable skin sutures
b) Careful tissue handling to avoid adhesions
c) Performing a flank incision
d) Avoiding ligation of the uterine vessels
e) Administering high doses of intraoperative antibiotics
Answer: b) Careful tissue handling to avoid adhesions
Explanation: Rabbits are prone to forming adhesions easily, so careful and gentle handling of abdominal tissues, especially the gut, is crucial during surgery to minimise this risk.
Scenario: A male ferret is presented with symmetrical alopecia starting at the tail base and progressing cranially, as well as a swollen vulva in a housemate neutered female ferret.
Lead-in: What is the most likely underlying endocrine disease in the male ferret causing these signs in both ferrets?
Options:
a) Hypothyroidism
b) Insulinoma
c) Hyperadrenocorticism
d) Persistent oestrus
e) Diabetes mellitus
Answer: c) Hyperadrenocorticism
Explanation: In ferrets, hyperadrenocorticism leads to increased production of sex hormones, causing clinical signs like symmetrical alopecia and vulvar swelling in neutered females due to increased androgens converting to oestrogens.
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Scenario: A 5-year-old female rabbit is presented with a history of weight loss and lethargy. Radiographs reveal a large abdominal mass displacing other organs.
Lead-in: Given the high incidence in older rabbits, which of the following reproductive conditions is the most likely cause of this mass?
Options:
a) Pyometra
b) Uterine adenocarcinoma
c) Ovarian cysts
d) Pregnancy toxaemia
e) Endometritis
Answer: b) Uterine adenocarcinoma
Explanation: Uterine adenocarcinoma has a high incidence in does over 4 years old. It can metastasise and present as a large abdominal mass.
Scenario: A male guinea pig is presented for castration. The veterinarian is considering different surgical approaches.
Lead-in: Which of the following castration methods in guinea pigs is generally preferred due to improved aseptic preparation and reduced risk of post-operative complications?
Options:
a) Scrotal approach with open technique
b) Scrotal approach with closed technique
c) Pre-scrotal approach with open technique
d) Pre-scrotal approach with closed technique
e) Abdominal approach
Answer: d) Pre-scrotal approach with closed technique
Explanation: The pre-scrotal approach with a closed technique in guinea pigs allows for improved aseptic surgical preparation by avoiding incision into the delicate hemiscrotal sac and is generally preferred.
Scenario: An entire female guinea pig, approximately 2 years old, presents with hair loss over the flanks without pruritus and increased mounting behaviour.
Lead-in: What is the most likely underlying reproductive condition?
Options:
a) Uterine infection
b) Pregnancy toxaemia
c) Ovarian cysts
d) Uterine adenocarcinoma
e) Cystitis
Answer: c) Ovarian cysts
Explanation: Hair loss over the flanks without pruritus and behavioural changes like mounting are common clinical signs of ovarian cysts in entire female guinea pigs.
Scenario: A female ferret is presented with a persistently swollen vulva, pale mucous membranes, and symmetrical alopecia of the flanks and tail.
Lead-in: What is the most likely underlying condition?
Options:
a) Pyometra
b) Pregnancy toxaemia
c) Persistent oestrus
d) Hyperadrenocorticism
e) Uterine neoplasia
Answer: c) Persistent oestrus
Explanation: The clinical signs of swollen vulva, pale mucous membranes (indicating anaemia), and symmetrical alopecia in an entire female ferret during the breeding season are highly suggestive of persistent oestrus, which can lead to hyperoestrogenism and bone marrow toxicity.
Scenario: A female bearded dragon presents with a history of lethargy and a distended coelomic cavity. Radiographs reveal multiple large, round structures within the abdomen.
Lead-in: Given that bearded dragons are oviparous, what is the most likely cause of the coelomic distension?
Options:
a) Coelomitis
b) Hepatic lipidosis
c) Pre-Ovulatory Ovarian Stasis (POOS)
d) Renal failure with ascites
e) Intestinal impaction
Answer: c) Pre-Ovulatory Ovarian Stasis (POOS)
Explanation: The presence of multiple large, round structures on radiographs in a female reptile with coelomic distension is highly suggestive of follicles in Pre-Ovulatory Ovarian Stasis (POOS), a common condition in reptiles where follicles fail to ovulate and continue to grow.
Scenario: A cockatiel hen is presented with a history of straining at the vent for several hours without passing an egg.
Lead-in: Which of the following is a common husbandry-related cause of egg binding in birds?
Options:
a) Excessive exercise
b) High environmental temperatures
c) Lack of a nesting site
d) Diet high in calcium
e) Increased photoperiod
Answer: c) Lack of a nesting site
Explanation: Inadequate or inappropriate nesting sites can contribute to egg binding in birds, as the hen may delay or be unable to pass the egg if she does not feel secure in her environment.
Scenario: A parrot presents with excessive regurgitation, feather plucking, and aggression towards a specific member of the household.
Lead-in: What is the most likely underlying cause of these reproductive-related behavioural changes in a pet parrot?
Options:
a) Nutritional deficiency
b) Chronic egg laying
c) Sexual frustration due to inappropriate bonding with the owner
d) Underlying systemic illness
e) Parasitic infection
Answer: c) Sexual frustration due to inappropriate bonding with the owner
Explanation: Pet parrots can form strong bonds with their owners, and behaviours like excessive regurgitation, feather plucking, and aggression can be signs of sexual frustration if the bird is inappropriately bonded and its reproductive needs are not being met.
Scenario: A tortoise is presented with lethargy and straining at the cloaca. On physical examination, a firm, round mass is palpated within the pelvic canal.
Lead-in: Which of the following reproductive conditions is a likely cause of these signs in a female tortoise?
Options:
a) Hemipenal prolapse
b) Bladder stones
c) Pre-Ovulatory Ovarian Stasis (POOS)
d) Post-Ovulatory Egg Stasis (POES/Dystocia)
e) Cloacal impaction
Answer: d) Post-Ovulatory Egg Stasis (POES/Dystocia)
Explanation: Straining and a palpable mass in the pelvic canal of a female tortoise are highly suggestive of an egg that is unable to be passed (Post-Ovulatory Egg Stasis or Dystocia).
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Scenario: A 7-year-old entire male Labrador Retriever presents with a history of missing the last four bitches he was mated to. Semen evaluation reveals a large number of abnormal sperm. Ultrasound examination of the testes shows multiple 1-2mm diameter echogenic foci.
Lead-in: What is the most likely underlying cause of the poor semen quality in this dog?
Options:
a) Testicular neoplasia
b) Cryptorchidism
c) Testicular degeneration
d) Orchitis
e) Inguinal hernia
Answer: c) Testicular degeneration
Explanation: The ultrasound findings of multiple 1-2mm diameter echogenic foci are typical of calcification or fibrosis, consistent with the consequences of a previous testicular insult leading to testicular degeneration. This can result in a deterioration of semen quality over several months.
Scenario: A 9-year-old entire male German Shepherd Dog presents with tenesmus and haematuria. Rectal palpation reveals a symmetrical, enlarged, non-painful prostate gland.
Lead-in: What is the most likely diagnosis?
Options:
a) Acute bacterial prostatitis
b) Prostatic abscessation
c) Benign prostatic hyperplasia
d) Prostatic neoplasia
e) Testicular tumour with metastasis
Answer: c) Benign prostatic hyperplasia
Explanation: Benign prostatic hyperplasia (BPH) is common in older, entire male dogs and can cause tenesmus due to rectal compression and haematuria due to prostatic enlargement affecting the urethra. Rectal palpation typically reveals a symmetrical, enlarged, non-painful prostate.
Scenario: A 4-year-old entire male Bulldog presents with a history of straining to urinate and a narrow stream of urine. On physical examination, the preputial orifice appears smaller than normal.
Lead-in: What is the most likely condition?
Options:
a) Paraphimosis
b) Priapism
c) Phimosis
d) Balanitis
e) Posthitis
Answer: c) Phimosis
Explanation: Phimosis is characterised by an abnormally small preputial orifice, which can lead to a narrow stream of urine and difficulty in urination. It can be congenital or result from trauma or inflammation.
Scenario: A stud dog with a history of good libido now shows reluctance to mate. Physical examination reveals raised nodule-like lesions at the base of the penis.
Lead-in: What is the most likely cause of these lesions and the mating difficulty?
Options:
a) Canine herpes virus infection
b) Testicular tumour
c) Lymphoid hyperplasia
d) Balanoposthitis
e) Priapism
Answer: c) Lymphoid hyperplasia
Explanation: Lymphoid hyperplasia is a common finding in dogs, presenting as raised nodule-like lesions at the base of the penis or preputial lining. These lesions are usually benign but can bleed during mating, potentially causing discomfort and mating difficulty.
Scenario: A 6-year-old entire male Boxer presents with lethargy, vomiting, and caudal abdominal pain. Rectal palpation reveals an asymmetrical, enlarged, and painful prostate gland.
Lead-in: What is the most likely diagnosis?
Options:
a) Benign prostatic hyperplasia
b) Chronic bacterial prostatitis
c) Prostatic cysts
d) Acute bacterial prostatitis
e) Prostatic neoplasia
Answer: d) Acute bacterial prostatitis
Explanation: Acute bacterial prostatitis typically presents with systemic illness, vomiting, caudal abdominal pain, and an asymmetrical, enlarged, and painful prostate on rectal palpation.
Scenario: A 10-year-old neutered male mixed-breed dog presents with signs of urinary obstruction. Retrograde urethrocystography reveals a filling defect in the prostatic urethra.
Lead-in: Given the dog’s neutered status, which of the following prostatic conditions is least likely?
Options:
a) Prostatic neoplasia
b) Prostatic cysts
c) Chronic bacterial prostatitis
d) Benign prostatic hyperplasia
e) Urethral calculus lodged in the prostate
Answer: d) Benign prostatic hyperplasia
Explanation: Benign prostatic hyperplasia (BPH) is primarily associated with the presence of testosterone and is therefore less likely to occur in neutered male dogs. Prostatic neoplasia, cysts, chronic bacterial prostatitis, and urethral calculi can still occur in neutered dogs.
Scenario: A 6-year-old entire male Boxer presents with lethargy, vomiting, and caudal abdominal pain. Rectal palpation reveals an asymmetrical, enlarged, and painful prostate gland.
Lead-in: What is the most appropriate treatment?
Options:
a) Meloxicam only
b) Co-Amoxiclav and meloxicam
c) Enrofloxacin only
d) Marbofloxacin and meloxicam
e) Co-Amoxiclav only
D
Scenario: A veterinary surgeon is discussing the optimal time to neuter a 6-month-old female Rottweiler puppy with the owner.
Lead-in: According to current evidence, what is the earliest age beyond which neutering may be associated with a potential increased risk of osteosarcoma in this breed?
Options:
a) 6 months
b) 12 months
c) 18 months
d) 24 months
e) 30 months
Answer: b) 12 months
Explanation: Some studies suggest a potential increased risk of osteosarcoma in Rottweilers neutered before 12 months of age. Therefore, neutering beyond this age might be considered to mitigate this risk.
Scenario: A 3-year-old female cat is presented to a shelter. She is healthy and weighs 3 kg. The shelter policy is to neuter all cats before adoption.
Lead-in: What is the most appropriate age for neutering this cat from a population control perspective?
Options:
a) 6 months
b) 12 months
c) 18 months
d) At any age before adoption
e) 10-12 weeks
Answer: e) 10-12 weeks
Explanation: Prepubertal neutering (before 4-6 months) is considered the best option for cats in a shelter environment for effective population control. Neutering at 10-12 weeks is a common practice in shelters
Scenario: A 5-year-old neutered female Labrador Retriever presents with urinary incontinence.
Lead-in: According to the principles of contraception, which hormone replacement therapy might be considered for managing this condition?
Options:
a) Progesterone
b) Testosterone
c) Oestrogen
d) Prolactin
e) GnRH agonist
Answer: c) Oestrogen
Explanation: Oestrogen can increase urethral mucosal thickness and is sometimes used to manage urinary incontinence in spayed bitches.
Scenario: A 2-year-old bitch underwent an ovariohysterectomy 6 months ago. The owner reports that the bitch has recently shown signs of oestrus.
Lead-in: What is the most likely cause of this?
Options:
a) Uterine stump pyometra
b) Vaginal hyperplasia
c) Ovarian remnant syndrome (incomplete ovariectomy)
d) False pregnancy
e) Urinary tract infection
Answer: c) Ovarian remnant syndrome (incomplete ovariectomy)
Explanation: The recurrence of oestrous behaviour after an ovariohysterectomy is highly suggestive of ovarian remnant syndrome, where a small piece of ovarian tissue was unintentionally left behind during surgery and continues to function
Scenario: A veterinary surgeon is explaining the surgical procedure for a routine ovariectomy in a cat to the owner.
Lead-in: What is a key advantage of ovariectomy compared to ovariohysterectomy in a healthy cat?
Options:
a) Reduced risk of mammary neoplasia
b) Prevention of uterine neoplasia
c) Simpler, less traumatic, and faster procedure
d) Complete prevention of pyometra
e) Decreased risk of urinary incontinence
Answer: c) Simpler, less traumatic, and faster procedure
Explanation: Ovariectomy involves the removal of only the ovaries, making it a simpler, less traumatic, and faster procedure compared to ovariohysterectomy, which also involves removal of the uterus. Long-term data suggests no increased risk of pyometra in cats following ovariectomy if there is no exogenous progesterone administration.
Scenario: A 7-year-old entire male dog is diagnosed with benign prostatic hyperplasia (BPH). The owner is considering different treatment options.
Lead-in: Which of the following medical treatments for BPH in dogs is a specific 5-alpha reductase inhibitor that prevents the conversion of testosterone to dihydrotestosterone?
Options:
a) Osaterone
b) Proligestone
c) Deslorelin
d) Finasteride
e) Cabergoline
Answer: d) Finasteride
Explanation: Finasteride is a specific 5-alpha reductase inhibitor that blocks the conversion of testosterone to dihydrotestosterone, reducing prostatic size in dogs with BPH. Osaterone and proligestone are progestogens, deslorelin is a GnRH agonist, and cabergoline is a prolactin inhibitor.
Scenario: A bitch is undergoing a Caesarean section. After delivery of the puppies, the uterus needs to be closed.
Lead-in: Which of the following suture patterns is commonly recommended for closure of the hysterotomy in a bitch?
Options:
a) Simple interrupted
b) Simple continuous
c) Continuous inverting pattern (e.g., Cushing or Lembert)
d) Ford interlocking
e) Horizontal mattress
Answer: c) Continuous inverting pattern (e.g., Cushing or Lembert)
Explanation: A continuous inverting suture pattern, such as Cushing or Lembert, is commonly recommended for closure of the hysterotomy in a bitch to provide a secure and leak-proof seal. A single-layer continuous pattern is also acceptable.
Scenario: A 2-year-old male ferret is presented with alopecia, a thin skin, and increased aggressive behaviour 18 months after castration.
Lead-in: What is the most likely underlying endocrine disease causing these signs?
Options:
a) Hypothyroidism
b) Insulinoma
c) Hyperadrenocorticism
d) Persistent oestrus (unlikely in a male)
e) Diabetes mellitus
Answer: c) Hyperadrenocorticism
Explanation: In ferrets, hyperadrenocorticism is a common sequelae to early neutering and results in increased sex hormone production from the adrenal glands, leading to clinical signs like alopecia, thin skin, and potentially behavioural changes.
Scenario: A veterinary surgeon is discussing the benefits of neutering a male cat with the owner.
Lead-in: Besides preventing unwanted litters, what is another significant benefit of castrating a male cat?
Options:
a) Reduced risk of mammary neoplasia
b) Prevention of pyometra
c) Reduced risk of spraying behaviour
d) Decreased incidence of diabetes mellitus
e) Prevention of uterine adenocarcinoma
Answer: c) Reduced risk of spraying behaviour
Explanation: Castration in male cats leads to a decrease in testosterone levels, which can significantly reduce or eliminate spraying behaviour, a common concern for cat owners.
Scenario: A 7-year-old female rabbit is presented for ovariohysterectomy. The surgeon is preparing for the procedure.
Lead-in: Which of the following suture materials is generally recommended for ligating the uterine vessels in rabbits?
Options:
a) Catgut
b) Silk
c) Nylon
d) Polydioxanone
e) Polyglactin
Answer: d) Monofilament absorbable suture
Explanation: Monofilament absorbable sutures are generally recommended for ligating vessels and tissues during ovariohysterectomy in rabbits to provide adequate strength and minimise tissue reaction
Scenario: A veterinary surgeon is explaining to a dog owner the different surgical options for neutering their male dog.
Lead-in: According to the provided material, what is a potential advantage of pre-scrotal castration over scrotal castration in dogs?
Options:
a) Shorter surgical time
b) Reduced risk of scrotal haematoma
c) Less post-operative pain
d) Lower risk of infection due to the incision being further from the ground
e) Easier identification of the spermatic cord
Answer: d) Lower risk of infection due to the incision being further from the ground
Explanation: Pre-scrotal castration involves an incision cranial to the scrotum, which is further away from the ground compared to a scrotal incision, potentially reducing the risk of infection. Scrotal haematoma can occur with both techniques but might be more associated with scrotal incisions if ligatures fail.
Scenario: Greta, a 6-year-old imported German Shepherd Dog, had a hysterectomy at 3 years old and continues to cycle. She now presents with a rapidly developing mammary tumour.
Lead-in: What is the most likely reason Greta continued to cycle after only undergoing a hysterectomy?
Options:
a) The breed is predisposed to continued cycling.
b) The ovaries were not removed during the procedure.
c) The uterus can produce reproductive hormones.
d) The pituitary gland is overactive.
e) There was a surgical error in identifying the uterus.
Answer: b) The ovaries were not removed during the procedure.
Explanation: A hysterectomy involves the removal of the uterus only. The ovaries are responsible for producing the hormones that control the oestrous cycle (oestrogen and progesterone). Therefore, if the ovaries are left intact, the bitch will continue to cycle.
Scenario: Trudy, a 3.5 cm poorly-defined, soft, ulcerated nodule is palpated in the left mammary gland of an 8-year-old Labrador Retriever. The left inguinal lymph node is enlarged (2.5x1.5x0.5 cm). Thoracic radiographs show no evidence of metastasis.
Lead-in: According to the WHO clinical staging of canine malignant mammary tumours, what is the most likely stage for Trudy’s tumour?
Options:
a) Stage I
b) Stage II
c) Stage III
d) Stage IV
e) Stage V
Answer: d) Stage IV
Explanation: Based on the WHO staging system, a tumour of 3-5 cm in diameter (T2 ) with regional lymph node metastasis (N1) and no distant metastasis (M
0) corresponds to Stage IV.
Scenario: Laila, a 4-week post-partum bitch who is still suckling her puppies, has developed a foul-smelling and discoloured milk discharge from one nipple. The affected mammary gland is swollen, hot, and painful.
Lead-in: Which of the following is the most appropriate first-line treatment for this condition, considering the puppies are still nursing?
Options:
a) Surgical removal of the affected mammary gland.
b) Immediate weaning of the puppies and administration of a dopamine agonist to stop lactation.
c) Hot-packing the affected gland and broad-spectrum bactericidal antibiotics safe for neonates.
d) Cold compresses and NSAIDs.
e) Intralesional injection of corticosteroids
Answer: c) Hot-packing the affected gland and broad-spectrum bactericidal antibiotics safe for neonates.
Explanation: The clinical signs are consistent with mastitis. Treatment involves addressing the infection with antibiotics that are safe for puppies via milk transfer (e.g., Co-Amoxiclav is mentioned in another document) and providing supportive care like hot-packing to encourage drainage and relieve discomfort.
Scenario: Maya, a 2-year-old bitch, has been in her first oestrus for 6 weeks. Ultrasound examination reveals multiple non-ovulating follicles in both ovaries.
Lead-in: Which of the following hormonal products might be useful in treating this prolonged oestrus?
Options:
a) Progesterone
b) Oestradiol benzoate
c) Human Chorionic Gonadotrophin (hCG)
d) Prolactin
e) Melatonin
Answer: c) Human Chorionic Gonadotrophin (hCG)
Explanation: In cases of failure to ovulate with persistent oestrus due to follicular cysts, hCG can be used to mimic the LH surge and stimulate ovulation, leading to an increase in progesterone and the cessation of oestrus signs.
