Small Animal Flashcards
An obese 6 year-old neutered male Pomeranian presents with a 2-year history of intermittent dry, honking cough. This morning he started retching. The dog never boards in a kennel and has not traveled recently. On physical exam, a cough can be elicited by pressing on the trachea. A heart murmur is noted, loudest on the left at the 5th-6th intercostal space. The rest of the exam was unremarkable. What diagnosis is at the top of the differential list?
T: 102.5 HR: 120 RR: 80 CRT: 2sec MM pink
A. Congestive heart disease
B. Tracheal collapse
C. Chronic bronchitis
D. Tracheobronchitis
E. Tracheal obstruction
B
A litter of 1 day old kittens presents with anemia, icterus and tail tip necrosis. Which one of the folllowing choices is the most likely differential diagnosis A. Liver disease B. Neonatal isoerythrolysis C. Neonatal septicemia D. Pyruvate kinase deficiency E. Hemobartonella felis infection
B Neonatal isoerythrolysis (NI) is a disease of newborns with a blood type different from the dam. NI is more common in kittens with blood type A or AB born to type B queens, as anti-A antibodies occur naturally without prior exposure in type B cats. Nursing kittens ingest anti-A antibodies in the colostrum produced by the queen. Hemolysis leads to hemoglobinuria, icterus, and anemia; weakness, gasping, tail tip necrosis, and eventually death is seen within 48 hours. Certain purebred breeds have a higher incidence of type B blood type than the general population.
Which one of the following hormones can induce neoplastic transformation of hypertrophied mammary tissue in cats?
A - Progesterone B - Estrogen C - Oxytocin D - Testosterone E - Prolactin
A
Exogenous progesterone administration can lead to neoplastic transformation of mammary hyperplasia in intact or neutered male or female cats. Patients undergoing progesterone therapy that develop mammary hyperplasia should have the enlarged mammary gland(s) removed and submitted for histology in addition to the cessation of progesterone therapy.
What is the average length of estrus in the cat?
A - 2-3 days B - 4-5 days C - 9-10 days D - 6-7 days E - 21 days
D
Estrus in the cat generally lasts 6-7 days (range 1-10 days).
Cats are seasonally polyestrous and induced ovulators. The length of feline estrus is affected by whether a male is present. If a male is present, estrus typically lasts 1-4 days. Without a male, estrus lasts 7-10 days and recurs in 2-3 weeks.
UNlike dogs, the feline estrus cycle is controlled by day length. In North America, cats go through an anestrus period in December and January when day length is less than 12 hours.
Which one of the following choices is the mechanism of action of omeprazole?
A - Cyclooxygenase blocker B - Beta-adrenergic receptor agonist C - Synthetic prostaglandin E1 analog D - H2-receptor antagonist E - Proton pump inhibitor
E
Omeprazole is a proton pump inhibitor that decreases gastric acid secretion. Omeprazole inhibits the sodium/potassium proton pump at the luminal surface of parietal cells.
Parietal cells normally secrete hydrogen ions into the stomach, a key component of acidic HCL.
Other drugs that decrease gastric acid secretion include the H2-receptor antagonists cimetidine, ranitidine, and famotidine and a synthetic prostaglandin E1 analog called Misoprostol.
Carprofen, Etodolac, Deracoxib, Meloxicam and Firocoxib are all nonsteroidal anti-inflammatory drugs (NSAIDS) that may CAUSE gastric acid secretion.
Hyperadrenocorticism is suspected in a 9-year old female spayed dog with a two-month history of increased appetite, thirst and urinary accidents.
Which of the following diagnostic test is most reliable when results are positive?
Urine Cortisol Creatinine Ratio (UCCR). Sensitivity=90% , Specificity =25%
ACTH Stimulation. Sensitivity=80% , Specificity =85%
Low Dose Dexamethasone Suppression. Sensitivity=95% , Specificity =50%
A - Low Dose Dexamethasone Suppression (LDDS)
B - ACTH Stimulation
C - Urine Cortisol Creatinine Ratio
D - Cannot say without knowing the positive predictive value
E - Cannot say without knowing the negative predictive value
B
ACTH Stimulation. The two diagnostic screening tests used most commonly for diagnosis of hyperadrenocorticism are the ACTH stimulation test and the LDDS. Remember your Ps and Ns.
ACTH Stim is the most sPecific (fewer false Pos, so trust a POS test more).
Click here for a diagram
LDDS is more seNsitive (fewer false Negs, so trust NEG test more).
Either way, these 2 tests are useful to screen for Cushing’s, but a confirmatory test is usually required if you get a positive, to differentiate between a pituitary HAC or an adrenal HAC case [high-dose dexamethasone suppression test (HDDST) or ACTH concentration].
The Urine Cortisol Creatinine Ratio (UCCR) has a low specificity (~25%), which means high false positives. 75% of dogs with non-adrenal illness will have a UCCR result consistent with HAC.
So, a positive UCCR is not useful to identify HAC, however, a negative is very useful to rule-out HAC as dogs with a normal UCCR cannot have HAC.
Which description correctly matches gonitis?
A - Inflammation of the mesorchium, parietal tunic and testicle
B - Avulsion of the extensor process of the third phalanx
C - Inflammation of the stifle leading to degenerative joint disease
D - Infection of the crop and sinuses with Trichomonas gallinae
E - Progressive unilateral or bilateral wide-angle glaucoma
C
Histopathology findings show intestinal crypt necrosis and lymphoid depletion of Peyer’s patches.
The sample came from a 4 month old male Rottweiler puppy that died following a severe illness with vomiting, fever and neutropenia.
Which one of the following choices is the most likely diagnosis?
A - Enterotoxigenic E. coli B - Thymic hypoplasia C - Distemper D - Parvovirus E - Canine adenovirus-1
D
Parvovirus. Expect to see intestinal crypt necrosis, lymphoid depletion of Peyer’s patches, shortened, blunt villi and collapse of the lamina propria with canine parvovirus.
Puppies with parvo are severely neutropenic and lymphopenic which may help you remember that feline panleukopenia is ALSO caused by a parvovirus.
Think of canine distemper with intracytoplasmic eosinophilic inclusion bodies, catarrhal enteritis and mucopurulent oculonasal discharge.
Canine adenovirus-1 is the causative organism of infectious canine hepatitis.
NOTE: If you hear of necrotic Peyer’s patches from necropsy of a cow with severe diarrhea, stomatitis and fever think of the foreign disease, rinderpest. In 2011, the United Nations Food and Agriculture Organization (FAO) and the World Organisation for Animal Health (OIE) officially declared that rinderpest was eradicated globally. But because it is a classic, severe, reportable, stomatitis-type disease, it’s unlikely that vets will be allowed to forget rinderpest on DDXs for years. Click here to see images of bovine rinderpest.
A 9 year old female spayed Brittany is presented with a 1 week history of apparent disorientation and bumping into things around the house. The owners report recent weight gain, increased appetite, increased water-drinking and frequent urinary accidents.
The dog is obese but otherwise appears healthy and afebrile. The pupils are dilated and poorly responsive to light. The ocular fundus appears normal OU (both eyes).
In addition to routine labwork (CBC, biochemistry panel, urinalysis) what other diagnostic test should be considered?
A - Genetic testing for rod-cone photoreceptor dysplasia B - ACTH stimulation C - Serum, urine ornithine concentration D - Gradual water deprivation test E - Tonometry
B
ACTH stimulation. Sudden-onset blindness in an older dog with normal fundi suggests Sudden Acquired Retinal Degeneration (SARD).
Typically, SARD is associated with metabolic abnormalities-PU/PD, polyphagia, obesity and hyperadrenocorticism. An ACTH stimulation test (or an LDDS) can help you determine if the dog has hyperadrenocorticism and SARD.
SARD and progressive retinal atrophy (PRA) are often categorized together as forms of retinal degeneration.
A dog is presented with the following findings.
Blood Gas
PCO2 venous=28.3 mm Hg….[N=35-44], pH=7.27..[N=7.31-7.53]
PO2 arterial=85.2 mm Hg….[N=85-95] HCO3-=13.9 mEq/l..[N=25-35]
Blood chemistry
Na=136.2 mEq/L……………..[N=146-156], Cl=91.3 mEq/L..[N=109-122]
Ca=9.1 mEq/L…………………[N=9.6-11.6], K=3.5 mEq/L..[N=3.8-5.6]
P=9.3 mEq/L…………………..[N=2.5-6.2], TCO2=14.2 mEq/L..[N=17-27]
ALT=331 U/L……………….[N=8.2-57], LDH=354 U/L..[N=24-219]
AST=14 U/L………………..[N=13-15], SDH=6 U/L..[N=3.1-7.6]
GGT=20 U/L………………..[N=1.0-9.7], Bilirubin (total)=0.3 mg/dl….[N=0.0-0.4]
Alk Phos=1018 U/L……….[N=1-114 U/L]
BUN=28 mg/dL (10 mmol/L)……….[Normal: 7.0-26 mg/dl (2.5- 9.29 mmol/L)]
Glucose=150 mg/dl or 8.3 mmol/L………[N 63-132 g/dl or 3.5-7.3 mmol/L]
What is the anion gap?
A - 28.1 B - 34.5 C - 28.3 D - 31.2 E - 42.2
B
Anion gap= (Positives)-(Negatives) = (Na+ and K+) -(Cl- and HCO3-).
If you did not do a blood gas analysis, then substitute TCO2 for HCO3-, and the AG value is about the same, (34.2 in this case).
Anion Gap (AG) = [136.2 (Na+) + (3.5(K+)] - [91.3 (Cl-) + 13.9(HCO3-)]
AG= [139.7 cations] - [105.2 anions]=34.5 anion gap.
Which one of the following choices is the most appropriate next step after a 3-year old stray cat tests positive for Feline Immunodeficiency Virus (FIV) on a routine FIV ELISA screening test?
A - Recheck serum by FIV complement fixation test
B - Do a Rivalta test to rule out feline coronavirus-related interference
C - Pull a blood sample for FeLV Antigen test
D - Pull a blood sample for a Western blot FIV test
E - Euthanize
D
Pull a blood sample for a Western Blot FIV test. The feline immunodeficiency virus (FIV) ELISA is the standard first-step screening test to detect if the cat has been exposed to the FIV virus and has circulating antibody.
A confirmatory Western blot antibody test for FIV is the standard confirmatory test.
Note - New PCR tests show promise for confirming FIV infection regardless of vaccination status, but are not yet the standard of clinical practice. PCR was not among the answer choices in this question to avoid confusion, and to mimic the real test.
On the real exam, you should NOT expect to see equivocal, controversial or cutting-edge new treatments or diagnostic tests. A Western blot test is especially important in areas with low FIV prevalence, where the risk of false positive FIV ELISA is higher. Click here to see table that shows why a test’s predictive value goes down as prevalence goes down. Remember that cats vaccinated for FIV will test positive for FIV antibodies by FIV ELISA and Western blot.
Kittens up to 6 months of age born to seropositive queens can also be seropositive, even though they are not infected, due to persistence of maternal antibodies. Seropositive kittens should be retested at greater than 6 months of age.
This is DIFFERENT from feline leukemia virus (FeLV) testing because the FeLV ELISA and IFA tests measure ANTIGEN, not antibody, so FeLV vaccination does NOT interfere with testing.
Which of the following correctly describes placement of the electrodes when performing an electrocardiogram on a dog or cat? (note arms = forelegs, legs = rear legs)
A - White on left arm, black on right arm, red on right leg
B - White on right arm, black on left arm, red on left leg
C - Red on right arm, green on left leg, black on left arm
D - Black on right arm, white on left leg, red on right leg
E - Red on left leg, green on right arm, black on left arm
B
You are presented with a bitch that whelped her first litter 2 weeks ago. Two of the pups have died and the remaining 2 have neurological signs, suckle poorly, and cry constantly.
Which one of the following choices is the primary differential diagnosis?
A - Canine herpes virus B - Canine parvovirus C - Neonatal septicemia D - Transplacental roundworm infection E - Congenital disease
A
Canine herpes virus (CHV) rarely causes disease other than mild respiratory signs in adult dogs
However, naïve newborn pups have high morbidity and mortality if infected at less than 3 weeks of age.
Naïve bitches should be exposed to CHV prior to breeding or the bitch and pups quarantined for 3 weeks before and after whelping
Canine parvovirus in neonates can cause vomiting, diarrhea, or acute death due to cardiovascular failure in pups 3-8 weeks old
A practice is using an FeLV test with a sensitivity of 90% and a specificity of 95%.
Assuming the prevalence of feline leukemia in the area is 5%, what is the predictive value positive (PVP) of the test?
A - 45% B - 48% C - 55% D - 88% E - 90%
B
It is 48%. The trick with this kind of question is to pick an imaginary number of animals that you test, like 1000, and fill out your 2x2 table from there. Follow the links to see diagrams step by step.
If prev is 5% then there must be 50/1000 cats with FeLV and 950 cats that are disease-free.
A 90% sensitive test will correctly call 45/50 positive (box “a”), and IN-correctly call 5/50 negative, (box “c”: these are the false negs).
If 50/1000 animals are infected, then 950/1000 are disease-free. Your 95% specific test will correctly call 902/950 disease-free (box “d”: 0.95 X 950=902) and IN-correctly call 48/950 positive, (box “b”: these are the false pos).
Now your a,b,c,d boxes are all filled, it is easy to calculate PVP =a/(a+b)=45/(45+48)=48%
A clinic’s waiting room has:
A Rottweiler dog with foreleg osteosarcoma
A white mouse with a mammary gland tumor on her belly
A Norway rat with a mammary gland tumor near her neck
A snot-nosed ferret with a chin rash and crusts around the eyes
A thin boa constrictor that can’t right itself from dorsal recumbency
Which one of these animals has the BEST prognosis?
A - Ferret B - White mouse C - Norway rat D - Rottweiler E - Boa constrictor
C
The rat has the best prognosis. MAMMARY GLAND TUMORS are typically BENIGN in rats (but MALIGNANT in mice).
As many as 50% of boid snakes (boas, pythons) harbor the retrovirus which can cause Inclusion Body Disease (IBD).
IBD can cause regurgitation, weight loss and in later stages neurologic signs, like failure to right itself.
Febrile catarrhal (mucopurulent oculonasal discharge) in a ferret is suggestive of Canine Distemper (poor Px).
