SAM I Exam II Material Flashcards
1
Q
Glossopharyngeal and Vagus nerves are tested by the _____________ reflex
A
gag reflex
1
Q
In what canine breed is congenital deafness most common?
A
Dalmations
15-30% are deaf; 8% bilateral and 22% unilateral. This is the result of an autosomal recessive gene with incomplete penetrance that causes total or partial agenesis of the cochlea and its nervous inntervations
2
Q
T/F: KCS is a common sequela of canine polymyositis
A
False
3
Q
What is the predominant clinical sign associated with cervical disc disease?
A
Severe neck pain
This pain may have an acute or slower onset
3
Q
What are the most frequently observed seizures in veterinary medicine?
A
Generalized tonic-clonic seizures
Generalized tonic-clonic seizures are by far the most frequently observed seizures in veterinary medicine
3
Q
T/F: Brain stem lesions result in contralateral deficits
A
False
Brainstem lesions result in ipsilateral deficits, so if there is a lesion on the left side of the brainstem, signs would appear on the left side of the animal
4
Q
T/F: In dogs with masticatory myositis there is usually a good response to antibiotic therapy
A
False
In dogs with masticatory myositis there is usually a good response to steroid therapy
4
Q
In the case of cranial trauma, what is the first thing that should be treated?
A
Shock & life-threatening injuries
4
Q
Narcolepsy is diagnosed by:
A
EEG
5
Q
Rear limb paresis may be seen in advanced cases of lumbosacral malarticulation-malformation and dogs often have decreased extension of the hock due to involvement of what nerve?
A
Sciatic nerve
5
Q
T/F: Contralateral conscious proprioception deficits are often seen associated with central vestibular disease
A
False
5
Q
What is the 1st drug of choice for anticonvulsant therapy in dogs?
A
Phenobarbital
- Phenobarbital enhances GABA action and thus inhibits spread of seizure activity and elevates seizure threshold*
- **Phenobarbital is contraindicated in liver disease***
6
Q
Paresis associated with Canine Wobblers is most pronounced in the __________ limbs
(thoracic, pelvic)
A
Paresis associated with cervical spondylomyelopathy (Canine wobblers) is most pronounced in the _pelvic_ limbs
6
Q
Elevated CK levels and hypergammaglobulinemia are consistent with:
A
canine polymyositis
7
Q
T/F: Adult heartworms usually die within a few hours after treatment with Melarsomine
A
False
Worms mostly die between 3 and 21 days after therapy is completed
9
Q
T/F: Severe peripheral nerve injuries may result in hyperesthesia and hyperreflexia
A
False
Severe peripheral nerve injuries may result in _an_esthesia and _a_reflexia
9
Q
The tensilon test is used to screen for:
A
Myasthenia Gravis
10
Q
Decreased capacity for physical sensation is termed:
A
hypesthesia
10
Q
Why must hypercapnia be avoided in cases of cranial trauma?
A
Hypercapnia and hypoxia induce vasodilation, which increases intracranial pressure
11
Q
T/F: Spontaneous recovery is often seen with Feline Hyperesthesia Syndrome
A
False
The condition is progressive over one to several years and the prognosis poor despite treatment with prednisone, anti-depressants, phenobarbitone, carnitine, coenzyme Q, etc.
12
Q
What modalities are considered essential for an accurate diagnosis of cord compression in animals with canine wobblers?
A
Myelography or MRI
In many cases, survey radiographs may appear normal
12
Q
T/F: Granulomatous meningoencephalomyelitis (GME) can cause focal or multifocal neurological signs
A
True
12
Q
Seizures in dogs typically have three phases. What are those three phases?
A
Preictal, Ictal, and Post-ictal
12
Q
Bacterial Meningitis is usually caused by __________ and has a __________ prognosis
A
Bacterial Meningitis is usually caused by Staphylococcus intermedius and has a poor prognosis
12
**Dysautonomia** is associated with toxoinfection by:
***Clostridium botulinum***
13
T/F: Dogs with **diskospondylitis** usually have depression, pyrexia, weight loss, head tilting, and hyperesthesia
**False**
* Dogs with diskospondylitis usually have _depression, pyrexia, weight loss, and hyperesthesia_.*
* The head tilting part is nonsense - read a book.*
14
All of the following are progressive diseases except:
* Feline Hypesthesia
* Coonhound Paralysis
* Cerebellar Abiotrophy
* IVDD
* Hydrocephalus
**Coonhound Paralysis**
15
**Bromide** is commonly used in veterinary medicine as an add-on drug for epilepsy that is poorly controlled with phenobarbital alone. With what condition in dogs is bromide contraindicated?
**renal insufficiency**
16
What canine breed is most predisposed to **thoracolumbar intervertebral disc disease**?
**Dachshunds**
*(70% of cases)*
16
A dog has a lesion between T3 and L3.
Will it have a patellar reflex?
**Yes, and it will be exaggerated**
17
Complete severance of a nerve and degeneration of the distal portion and its Schwann cells is termed:
**Neurotmesis**
17
Myelin Basic Protein is usually elevated in the CSF with which condition?
**Degenerative myelopathy**
19
T/F: **Idiopathic epilepsy** is less common in cats than in dogs
**True**
20
What is the adulticide drug of choice for treatment of heartworm in dogs?
**Melarsomine**
20
When are signs of **hydrocephalus** typically noted in dogs?
**Puppies (weeks to months of age)**
*The signs are progressive and include altered mental attitude, seizures, visual and auditory impairment, tetraparesis, and ventrolateral strabismus*
20
In dogs with **atlanto-axial subluxation**, spinal cord compression occurs because of dorsal displacement of the axis by three potential mechanisms. What is the most common mechanism?
**Absence or hypoplasia of the odontoid process/dens**
20
You would NOT see ventral neck flexion in a cat with:
* Hypokalemia
* Hyperkalemia
* Hyperthyroidism
* Myasthenia gravis
* Thiamine deficiency
**Hyperkalemia**
20
T/F: KCS is a common sequela of **idiopathic facial nerve paralysis**
**True**
21
T/F: **Idiopathic peripheral vestibular disease** occurs in both cats and older dogs
**True**
23
T/F: Short term antibiotic therapy is highly effective for treatment of **diskospondylitis**
**False**
*The antibiotics should be given parenterally _for as long as possible_ to ensure high blood levels and good penetration into lesions. Treatment should be continued _until there are no radiographic signs of active infection_*
23
T/F: Left ventricular enlargement is common in dogs with **heartworm**
**False**
24
T/F: **Phenobarbital** is contraindicated for use in dogs with kidney disease
**False**
*Phenobarbital is contraindicated for use in dogs with _liver disease_*
25
T/F: **Fibrocartilaginous embolism** typically occurs in larger breed, middle-aged dogs
**True**
*It is most common in large breed dogs anywhere between 1-7 years old*
25
If you have UMN signs in all four limbs, which region of the spinal cord is most likely affected?
**C1-C5**
26
Protozoal polyradiculoneuritis is most commonly caused by __________________ infection
***Neospora caninum***
*Toxoplasmosis may also be involved*
27
Central vestibular disease occurs in mature dogs and is most often due to:
**neoplasia and encephalitis**
29
If you have normal forelimbs and UMN signs in the hindlimbs, which region of the spinal cord is most likely affected?
**T3-L3**
30
T/F: There is no effective treatment for **degenerative myelopathy** in dogs
**True**
*Corticosteroids, NSAIDs, and B vitamins have no effect on the course of the disease*
32
Which reflex tests the integrity of the **pudendal nerve**?
**Perineal Reflex**
*Pinching of the skin in the perineal region should result in contraction of the anus, lifting of the vulva and dropping of the tail. This tests the integrity of the pudendal nerve.*
33
What are the contraindications for use of **Diazepam** for seizure control in cats?
**liver disease**
*Hepatotoxicity is not a recognized side effect of diazepam in humans or in dogs but _idiosyncratic hepatotoxicity has been described in cats_ given oral diazepam for behavioral problems*
34
T/F: Surgical debridement of infected tissue is the only effective treatment for dogs with **diskospondylitis**
**False**
*Dogs with minimal neurological dysfunction can be treated with analgesics and antibiotics*
36
What is the treatment of choice (initially) for dogs with **cervical disc disease** that do not have marked neurological deficits?
**cage rest**
## Footnote
*If dogs improve, they should be kept in their cages until 2 weeks after all signs have resolved. If cage rest does not improve their condition, surgery is indicated*
37
T/F: **Ivermectin** can not be used as heartworm prophylaxis in Collies
**False**
*At prophylactic doses, Ivermectin can be safely given to collies*
38
T/F: Hemilaminectomy is the surgery of choice to relieve pressure on the spinal cord for treatment of **cervical disc disease**
**False**
*Ventral fenestration or ventral decompression are the surgical techniques of choice for treatment of cervical disc disease*
40
T/F: Prednisolone can be used instead of cage rest in dogs that are mildly effected by **thoracolumbar intervertebral disc disease**
**False**
*Corticosteroids given without cage rest often results in temporary improvement and then relapse with far more severe signs*
43
T/F: A lesion at L4-S2 can cause LMN signs in the pelvic limbs
**True**
44
T/F: Medical therapy is successful in most cases of **Canine wobblers**, with a more than 70% recovery rate
**False**
*Medical therapy is only palliative as the condition is progressive - 40-60% recover, 30% are stable, 20-30% deteriorate*
44
Dorsiflexion of the neck with extension of all four limbs is consistent with __________ rigidity
**decerebrate rigidity**
45
T/F: Irregular respiration and unresponsive bilateral mydriasis indicate a poor prognosis in the case of **cranial trauma**
**True**
* When the brainstem is severely damaged, the respiratory pattern becomes irregular in rate and amplitude and is associated with bradycardia.*
* Bilateral unresponsive mydriasis is usually indicative of irreversible midbrain damage or cerebellar herniation.*
46
**Brain edema** is best treated with:
**mannitol**
48
Chronic progressive monoparesis with neurogenic muscle atrophy and 'root signature' is highly suggestive of:
**Nerve Root Neoplasia**
49
T/F: Hyperesthesia is typically associated with LMN signs
**False**
49
What intervertebral space is typically affected in Dobermans with **cervical disc disease**?
**C6/C7**
49
What is the most common **inflammatory myopathy** in dogs?
**Autoimmune polymyositis**
50
T/F: **Degenerative myelopathy** is very painful and urinary and fecal incontinence is very common
**False**
*Pain and urinary & fecal incontinence usually does not occur until very very late in the progression of the disease*
50
What canine breed is most associated with **X-linked dystrophinopathy**?
**Golden Retreivers**
51
T/F: A lesion between C1 and C5 will show LMN bladder signs
**False**
*A lesion between C1 and C5 will show _UMN bladder_ signs*
52
T/F: Dogs should be cage rested for 1-2 weeks after heartworm adulticide treatment
**False**
*Dogs should be cage rested for at least 4-6 weeks after heartworm adulticide treatment*
54
Which nerve is being tested with the **extensor carpi radialis reflex**?
**Radial nerve**
55
List the common signs associated with LMN lesions:
* **Paresis or paralysis**
* **Loss of muscle tone**
* **Hyporeflexia (or areflexia)**
* **Muscle atrophy (rapid & severe)**
56
T/F: **Heartworm** prophylaxis is indicated for all dogs at risk, starting from 6-8 weeks of age
**True**
57
**Cerebellar hypoplasia** in cats is due to intrauterine infections with:
**panleukopenia parvovirus**
58
What canine breed is most associated with **caudal occipital malformation syndrome (COMS)**?
**Cavalier King Charles Spaniels**
59
T/F: Phenobarbital is contraindicated in dogs with existing liver disease
**True**
61
What is the most common brain tumor in cats?
**Meningioma**
*Lymphomas and gliomas are the other common primary tumors*
63
What are the main signs associated with **vestibular disease**?
**head tilt, circling (to the affected side), and nystagmus**
64
T/F: **Fibrocartilaginous emboli** is associated with paresis or paralysis that is lateralizing and not painful
**True**
66
T/F: Botulism, tick paralysis, and coonhound paralysis all cause **flaccid paralysis** in the dog
**True**
67
T/F: Cage rest helps most dogs with Grade I, II, and III **thoracolumbar intervertebral disc disease**
**True**
*Strict cage rest for 2 weeks is usually successful in 80-100% of patients. Only ~33% of patients treated with cage rest will have a recurrence of signs*
69
What diagnostic modality is typically used to determine the severity of **heartworm disease** in a patient?
**Radiographs**
70
T/F: Surgery is indicated for decompression of the spinal cord and stabilization of vertebrae fractured by **trauma**, but only if the injury occurred less than 4 hours before surgery
**True**
*If the injury is more than 4 hours old and there is no deep pain the prognosis is grave and surgery probably will not help*
72
Complete loss of voluntary motor function *in a single limb* is termed:
**Monoplegia**
73
What are the indications for placing an animal on **anticonvulsant threrapy**?
* Seizures occuring more frequently than once every 6-8 weeks
* Clusters of seizures
* Prolonged seizures
* Status epilepticus
* Symptomatic epilepsy caused by active CNS disease
75
What are the most appropriate fluids to use in the case of **cranial trauma**?
**hypertonic saline or hetastarch**
*These will increase cerebral perfusion and at the same time decrease intracranial pressure by their osmotic drag effect*
76
An abnormal increase in sensitivity to a stimuli is termed:
**hyperesthesia**
77
List the common signs associated with UMN lesions:
* **Paralysis/paresis**
* **Normal to hyperreflexia**
* **Normal to increased muscle tone**
* **Minimal (disuse) atrophy**
79
T/F: Deafness is a common congenital problem in Dalmations. It is typically recommended that bilaterally deaf puppies be euthanized
**True**
80
For **cervical spondylomyelopathy (Canine wobblers)**, long-term treatment benefits are usually provided by:
**surgical decompression and/or surgical stabilization**
*(70-90% of dogs show improvement)*
81
T/F: UMN and LMN lesions both result in paralysis or paresis
**True**
82
T/F: **Peripheral vestibular disease** is usually associated with otitis
**True**
*Usually bacterial infections are responsible and are diagnosed by otoscopy and radiographs.*
83
T/F: Spontaneous recovery may be seen with **Tick Paralysis**
**True**
84
What surgical techniques may be used to treat **cervical disc disease**?
**ventral fenestration or ventral decompression**
85
T/F: Surgery is the treatment of choice for dogs that are paralyzed as a result of **thoracolumbar intervertebral disc disease**
**True**
*Surgery success rates are usually over 90%. _Dorsolateral hemilaminectomy is the technique of choice and the affected disc and those on either side can be fenestrated to decrease the possiblity of a relapse_. Patients generally do not require a second surgery.*
86
What is the drug of choice for seizure control in cats?
**Phenobarbital**
*Liver toxicity has not been reported in cats and there is no liver induction (no elevation of ALP, no acceleration of the phenobarbital hepatic metabolism during the first months of therapy)*
87
Complete loss of voluntary motor function *in all four limbs* is termed:
**tetraplegia**
89
T/F: Clinical signs associated with **fibrocartilaginous emboli** typically develop over a number of days, possibly even weeks
**False**
*Clinical signs associated with fibrocartilaginous emboli develop peracutely, frequently (60%) during or after vigorous exercise*
90
Which reflex tests the integrity of the **sciatic nerve**?
**Cranial tibialis reflex**
*Here the belly of the cranial tibialis muscle is given a sharp tap and the hock should flex. This reflex tests the integrity of the sciatic nerve.*
92
T/F: Definitive diagnosis of **diskospondylitis** can be made with spinal radiographs
**True**
*However, this diagnosis is often difficult because radiographic changes may only be seen 4-6 weeks post-infection*
93
T/F: Severe **peripheral nerve injuries** may result in anesthesia and areflexia
**True**
95
T/F: **Milbemycin** is effective against adult heartworms, but is more effective against microfilaria
**False**
*Milbemycin _has very poor activity against adults_ but is highly effective against microfilaria*
95
If you have normal forelimbs and LMN signs in the hindlimbs, which region of the spinal cord is most likely affected?
**L4-S2**
96
What canine breed is most associated with **extraocular myositis**?
**Golden Retreivers**
97
What is the surgical technique of choice for dogs that are paralyzed as a result of **thoracolumbar intervertebral disc disease**?
**Dorsolateral hemilaminectomy**
*The affected disc (and at least those on either side) can be fenestrated or treated with lasers to decrease the possibility of a relapse. Surgery success rates are usually over 90%*
98
What condition is associated with **myelin basic protein in CSF** and **SOD 1 gene mutation**?
**Degenerative myelopathy**
100
In what order is neurological function lost as a result of **spinal cord compression**?
1. **Conscious proprioception**
2. **Motor function**
3. **Superficial pain sensation**
4. **Deep pain sensation**
101
T/F: Muscle pain and increased CK are hallmarks of myopathies
**False**
*In some cases (but not all), there may be muscle pain, swelling/atrophy, and elevations in CK.*
103
T/F: Heartworm disease usually results in left-sided heart failure
**False**
*Heartworm disease may result in _right-sided heart failure_*
104
What is 'root signature'?
**hy**_per_**esthesia with limb palpation or manipulation**
105
T/F: In endemic areas, heartworms are less common in cats than in dogs
**True**
106
What is the treatment of choice for dogs with **hydrocephalus**?
**Shunts**
*Shunts can be implanted to drain CSF to the abdominal/peritoneal cavity or jugular vein.*
108
What are the two most common primary brain tumors in dogs?
**Gliomas and Meningiomas**
109
The most common cause of **infectious myelopathy** is:
***Toxoplasma***
111
What intervertebral space is typically affected in *Dachshunds* with **cervical disc disease**?
**C3/C4**
113
What is the most common emboli responsible for causing spinal cord injury?
**Fibrocartilaginous emboli**
114
T/F: Occult heartworm infections are very rare in cats
**False**
*Occult heartworm infections are very common in cats (up to 80%)*
115
T/F: In the *preictal phase* of **tonic-clonic seizures**, the patient may have a sudden loss of consciousness and simultaneously fall to the ground
**False**
* In the _preictal phase_ of tonic-clonic seizures, there may be subtle behavioral changes such as seeking out the owner, restlessness, or anxiety*
* In the _ictal phase_ (the seizure itself), the patient may have a sudden loss of consciousness and simultaneously fall to the ground*
116
What age/breed do we typically observe **lumbosacral malarticulation-malformation**?
**Older, large breed dogs**
*Occurs in older (5-8 years) large breed dogs, especially working dogs (GSDs and Border Collies) and very rarely in cats*
117
Definitive diagnosis of **degenerative myelopathy** is only possible by:
**histopathology**
*Clinical diagnoses depend on appropriate signs and exclusion of inflammatory and compressive causes*
118
T/F: A lesion at C6-T2 may cause UMN signs in the pelvic limbs and LMN signs in the thoracic limbs
**True**
119
What canine breed is most associated with **exercise induced collapse**?
**Labradors**
120
T/F: Prognosis with **Coonhound paralysis** is poor
**False**
*Prognosis with Coonhound paralysis is good*
121
If a vestibular patient has **horizontal and vertical nystagmus**, the lesion is likely __________ and could be caused by \_\_\_\_\_\_\_\_\_\_
If a vestibular patient has horizontal and vertical nystagmus, the lesion is likely **_central_** and could be caused by **_neoplasia_**
122
T/F: Conscious proprioceptive deficits are consistent with cerebellar lesions
**False**
123
T/F: Anorexia is a side effect of **phenobarbital**
**False**
*It isn't.*
124
**Feline Ischemic Encephalopathy** is caused by:
***Cuterebra***
*It is presumed that the condition results from a Cuterebra larva entering the nasal passages and migrating through the cribriform plate, inducing vasospasm of brain arteries*
125
Which has a poorer prognosis?
* Neurotmesis
* Axonotmesis
* Neuropraxia
* All are equally bad
**Neurotmesis**
*Complete severance of a nerve and degeneration of the distal portion and its Schwann cells. Regeneration usually does not occur. Usually anesthesia and paralysis*
126
T/F: In the postictal phase of **tonic-clonic seizures**, animals very rapidly regain consciousness and soon appear normal
**False**
* This phase is a gradual return to consciousness with varying degrees of depression, fatigue, fright, dazed appearance, aimless pacing, thirst, or hunger. Occasionally, neurological deficits such as blindness, paresis and/or incoordination may occur during this period.*
* Postictal depression may last for seconds to days (average about 5 hours)*
127
Partial loss of voluntary motor function *in a single limb* is termed:
**Monoparesis**
128
T/F: **Brain herniation** is a possible complication of a CSF tap
**True**
130
Dorsiflexion of the neck with extension of the thoracic limbs and flexion of the pelvic limbs is consistent with _____________ rigidity
**Decerebellate rigidity**
131
What canine breed is most associated with **episodic falling**?
**Cavalier King Charles Spaniels**
132
T/F: **Canine wobblers** occurs most commonly in younger Great Danes and older Dobermans
**True**
*Cervical spondylomyelopathy (Canine wobblers) is most often seen in Great Danes (3-18 months) and Dobermans (5-8 years)*
133
What canine breed is most associated with **Shaker Dog Disease**?
**Maltese**
*Also West Highland White Terriers*
134
Most thoracolumbar disc protrusions are between what spinal cord segments?
**T11 and L2**
135
T/F: **Fibrocartilaginous embolus** is typically not associated with pain
**True**
136
What are the most common agents associated with **diskospondylitis**?
***S. intermedius, Brucella canis, Streptococcus* spp.**
137
T/F: Early signs of **lumbosacral malarticulation-malformation** are of lumbosacral pain with difficulty rising and negotiating stairs
**True**
138
Crossed-extensor reflex in a dog in lateral recumbency is indicative of a ____ lesion
## Footnote
**(UMN/LMN)**
**UMN**
*There are long spinal reflexes between limbs that are usually suppressed by UMNs. Damage to the UMNs releases this inhibition and flexion of one limb in response to a noxious stimulus is accompanied by extension of the contralateral limb.*
139
T/F: Dyspnea in a dog post-heartworm adulticide treatment is an emergency and requires strict cage rest, oxygen therapy, prednisolone, and perhaps bronchodilators
**True**
140
T/F: Surgery is contraindicated to treat **lumbosacral malarticulation-malformation**
**False**
*Good results are obtained with _lumbosacral dorsal laminectomy_ and removal of the ligaments and bone putting pressure on the nerves*
141
**Pentoxifylline** is used for treatment of *what inflammatory condition*?
**Dermatomyositis**
142
Degeneration of axons, but intact endoneurium and Schwann cells is termed:
**Axonotmesis**
*Degeneration of axons but the endoneurium and Schwann cells remain intact allowing regeneration of the axon (1 mm/day) and return of function. Usually paresis and hypesthesia*
