NAVLE Exam Prep Questions | 100% Correct Answers | Verified | Latest 2024 Version, Exams of Veterinary medicine

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NAVLE Exam Prep Questions | 100% Correct

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A person calls to say she adopted a friend's dog and requests a copy of the dog's medical record and radiographs. The former owner is a client at your clinic. Which one of the following choices is the most appropriate action to take? A - Require original owner consent or court order to release information B - Give caller a copy of medical record only C - Give caller a copy of medical record and radiographs D - After physical exam, start a new medical record documenting previous issues E - Give a summarized record with personal identifiers (vet, owner names) blocked out - ✔✔A According to the AVMA's Principles of Veterinary Medical Ethics (2008 revision) "Ethically, the information within veterinary medical records is considered privileged and confidential. It must not be released except by court order or consent of the owner of the patient. Veterinarians should secure a written release to document that request." A 5 year old domestic short-haired spayed female cat is presented with the complaints of anorexia, chronic vomiting, and weight loss. Physical examination reveals icterus, dehydration, and fever. Thickened small intestinal loops are appreciated with abdominal palpation, and serum biochemistry shows increased bilirubin and liver enzymes. The cat is diagnosed with extrahepatic biliary obstruction with accompanying cholangitis and inflammatory bowel disease. Which one of the following normal anatomic features may predispose cats to this triad of diseases? A - Narrowing of the duodenum distal to the entry of the common bile and pancreatic ducts B - Common opening of the pancreatic and common bile ducts into duodenum

C - Enlarged duodenal papilla in comparison to other species D - Decreased proportion of alpha-smooth muscle actin in muscle fibers of the wall of the gall bladder in cats E - Decreased diameter and increa - ✔✔B In cats, there is a common opening of the pancreatic and common bile ducts into the duodenum. It is thought that this may predispose them to ascending cholangitis and pancreatitis after vomiting associated with inflammatory bowel disease, resulting in extrahepatic biliary obstruction. Other possible etiologies of EHBO include neoplasia, biliary stricture, duodenal obstruction, diaphragmatic hernia, and parasitic infection. In all cases, there is a lack of bile entry into the intestinal tract, leading to decreased absorption of fat and fat soluble vitamins such as vitamin K, potentially resulting in coagulopathies. Except in transient cases that are related to acute pancreatitis, surgical intervention to relieve the obstruction is required as well as appropriate supportive care, antimicrobial treatment, and vitamin K administration. Most of a litter of European wild boar at a zoological park have died. The surviving piglets are in lateral recumbency with a frothy nasal discharge. Necropsy of the piglets reveals pulmonary edema and copious fluid in the trachea and bronchi along with grayish- white necrotic foci on the myocardium. Which one of the following diseases is the most likely diagnosis? A - Edema disease B - Encephalomyocarditis C - Glasser's Disease D - Porcine Respiratory and Reproductive Syndrome E - Pseudorabies - ✔✔B Encephalomyocarditis virus (EMCV) is caused by a cardiovirus in the family picornaviridae. Confusingly, the virus is named for its effects on mice.

Think of rodents and exotic zoo mammals with EMCV. Pig-to-pig contact, contamination of swine feed and water by rodents or ingestion of dead rodents may cause disease. See pulmonary edema and copious transudate in the respiratory tract, causing cardiac failure. Zoo outbreaks of EMCV have included lions, African elephants, rhinos, hippos, sloths, llamas, antelope and nonhuman primates. An outbreak of lion deaths at a Florida zoo in the USA occurred after feeding them the carcass of an African elephant that had died of EMCV. Edema disease is a neurologic disease caused by a hemolytic Escherichia coli producing Shiga toxin e and F18 pili resulting in high mortality in recently-weaned pigs. Glasser's Disease, caused by Hemophilus parasuis is usually an acute disease of 6 to 8 week-old pigs which causes fibrinous arthritis, polyserositis, and meningitis. Porcine Reproductive and Respiratory Syndrome (PRRS), is an arterivirus causing reproductive failure and post-weaning respiratory disease. What is the main mode of transmission for feline leukemia virus? A - Aerosol transmission B - Shedding of virus via feces C - Fomite transmission D - Shedding of virus via saliva - ✔✔D The correct answer is shedding of virus via saliva. The main mode of transmission is via saliva. It requires prolonged, close contact. Cats may shed the virus for months to years. Transmission may also occur through reuse of instruments and blood. Virus is shed in saliva, tears, urine, and feces. You are working with a farmer who is having trouble with calves between the age of 2 weeks and 6 months. They are alert, but weak, dyspneic and die suddenly. On necropsy they have pale cardiac and skeletal muscles. What is the farmer's problem? A - Copper deficiency B - Sorghum toxicity

C - Lightning strike D - Selenium deficiency - ✔✔D The correct answer is selenium deficiency. The pale muscle and clinical signs are classic for vitamin E and selenium deficiency. This is important to remember! Other things that should be on your differential list for this case include cardiotoxic plants. A 6-year old intact male domestic short haired cat presents with acute onset exophthalmos of the right eye in the past 2 days. He is painful on palpation around his eye and head. The eye can be retropulsed with minimal resistance. He has not been eating in the past day and has a rectal temperature of 103.4F (39.7 C). What is the most likely diagnosis? A - Orbital neoplasia B - Retrobulbar abscess C - Anterior uveitis D - Glaucoma - ✔✔B The answer is a retrobulbar abscess. Acute, painful exophthalmos is usually due to retrobulbar abscessation. These lesions are usually painful and may be swollen. These animals are frequently systemically ill with fever and leukocytosis. Causes of retrobulbar abscesses include penetrating wounds, foreign bodies, spread from dental or sinus infection, and hematogenous spread. Glaucoma does not cause exophthalmos, although, chronically it can cause buphthalmos which may appear similar. Anterior uveitis also does not cause exophthalmos. You are an associate veterinarian paid a base salary of $55,000 annually, plus a 8 % bonus based on receipts above your monthly production goal of $23,000. Bonuses are paid quarterly. Your last three month's production were: $23,000, $28,000, and $27,000. How much is your quarterly bonus? A - $

B - $

C - $

D - $

E - $900 - ✔✔C $

If $23,000 is the monthly production goal, then the month you brought in $23,000 does not count towards a bonus. In the second month, $ 28,000 = $5000 above goal In the third month $ 27,000 = $4000 above goal Total above production goal = $5000+$4000= $ $9000 X (0.08 bonus rate) = $720. Many practices use a combination system with a base salary and a production-based bonus if you bring in more than a monthly production goal, but no penalty if you are below that monthly goal, which is good if you are a new graduate, and helps in low traffic months at the clinic. A 10-year old female spayed Siamese cat presents for a new lump the owner found a month ago. She was spayed last year before she was adopted from the shelter. The owner states that the lump has grown over the last month, and it doesn't seem to bother the cat. On exam, the 2 cm lump is located on the left 2nd mammary gland, and no other lumps are noted. The lump is freely moveable, and chest radiographs are clear. What is the chance that this tumor is malignant? A - 5% B - 50% C - 20% D - 85% - ✔✔D

70 - 90% of all feline mammary tumors are malignant. Spaying a cat before 6 months of age reduces the risk for mammary tumors by 7 fold. The statistics for dogs is a 50:50 chance of malignancy for a single mammary mass. This 25 year old Quarter Horse mare is presented for evaluation in July in the northern hemisphere. She is diagnosed with pituitary pars intermedia dysfunction. Which one of the following medications would be most likely to be beneficial to this mare? A - Isoxsuprine B - Glucocorticoids C - Pentoxifylline D - Pergolide E - Methimazole - ✔✔D Pergolide is the treatment of choice for pituitary pars intermedia dysfunction (PPID). PPID is characterized by degeneration of dopamine producing neurons in the hypothalamus that normally exert an inhibitory action on the pituitary pars intermedia, resulting in functional adenomas in the pars intermedia that produce high levels of adrenocorticotropin hormone. Clinical signs and laboratory findings include hypertrichosis, poor muscle tone, laminitis, hyperglycemia and insulin resistance, and increased susceptibility to infection. Diagnosis is commonly made by documenting increases in plasma adrenocorticotropin hormone levels in affected animals. An aged intact female potbellied pig presents for evaluation of abdominal distension. A large mass contiguous with the uterine wall is discovered with ultrasound exam of the abdomen. Which of the following choices is the most likely cause of this finding? A - Uterine leiomyoma B - Endometritis C - Adenocarcinoma of the cervix D - Lymphosarcoma

E - Endometrial hyperplasia - ✔✔A The most likely cause of a large uterine mass in an intact female potbellied pig is a uterine leiomyoma. These tumors do not typically metastasize so a cure may be achieved by surgical removal of the uterus. A 10-year old German Shepherd presents to you with the complaint of licking the anal area and scooting. On examination, you find numerous ulcerated tracts in the perianal area that are draining purulent fluid. What is the diagnosis? A - Perianal fistula B - Clostridial colitis C - Anal sac abscess D - Anal sac impaction - ✔✔A The correct answer is perianal fistula. This is seen mainly in older German Shepherds, and licking the anus is a common presenting complaint. The key finding is the presence of multiple draining tracts in the perianal region that can actually be quite deep. Damage to the left recurrent laryngeal nerve is associated with "roaring" in horses. The left recurrent laryngeal nerve is a branch off of which cranial nerve? A - Glossopharyngeal (CN 9) B - Facial (CN 7) C - Trigeminal (CN 5) D - Hypoglossal (CN 12) E - Vagus (CN 10) - ✔✔E Damage to the recurrent laryngeal nerve (a branch of the Vagus (CN 10)) causes laryngeal hemiplegia - a paralysis of the abductor muscle (dorsal cricoarytenoid muscle) controlling the glottic cleft in the larynx.

This allows the vocal fold (usually left side) to evert into the lumen of the larynx, obstructing airflow, leading to a roaring sound, and most importantly, slowing the horse. Oral administration of which of these drugs has been implicated as a cause of esophageal strictures in cats? A - Doxycycline B - Azithromycin C - Diazepam D - Potassium bromide - ✔✔A The correct answer is doxycycline. There is also evidence that clindamycin can cause stricture formation. For this reason, it is recommended that after pilling a cat with doxycycline, it is followed with a small volume (5-10 mls) of water. A 5 year old female spayed Cocker Spaniel is presented with a strange expression. Her right ear and lip appear to droop. There is ptosis O.D. (right eye) and the dog is drooling on the exam table. What anatomic structure is damaged? A - Right side inner ear B - Left side inner ear C - Trigeminal nerve D - Facial nerve E - Left side medulla, motor tract - ✔✔D Think of facial nerve paralysis (CN 7) with a unilaterally droopy face. Remember the facial nerve is motor to the muscles of facial expression (explaining the right side drooped ear, lip and eyelid) and innervates the lacrimal and salivary glands. Loss of innervations can lead to a dry eye, and possibly to exposure keratitis if animal losses ability to close eyelid from damage to facial nerve innervation of the orbicularis oculi muscle. Idiopathic in 75% of canine cases (25% of cats).

Can also see these signs with middle ear damage (from otitis media), from facial nerve trauma (ear surgery in dogs, or pressure from halter buckles in anesthetized horse), or neoplasia. Think more of a dropped jaw with trigeminal nerve neuropathy (CN 5-dogs, horses). You see an 8-month old kitten with the effusive form of feline infectious peritonitis and perform euthanasia. The kitten was having severe diarrhea around the house when it became ill. The owner has a 2 year old cat at home and wants to know what this cat's prognosis is since it has been exposed to the sick kitten. Currently this cat is clinically healthy. What do you tell her? A - You recommend a coronavirus titer to determine it the cat is actively infected B - Her other cat may develop symptoms within the next two weeks because FIP is highly contagious C - Feline infectious peritonitis is not contagious and because her other cat died of FIP does not mean this cat will succumb to the disease D - Place the cat on L-lysine to prevent or suppress any infection with FIP E - Perform a PCR on the cat's feces to see if the virus is being shed - ✔✔C Feline infectious peritonitis is not a contagious disease. It is a disease that is caused by a mutation of feline enteric coronavirus. It is unknown why in some patients this virus mutates and causes the FIP syndrome. It is most likely to occur in young or immunocompromised cats. Her other cat is not necessarily going to get FIP just from exposure. In fact, the majority of the cat population has been exposed to the feline enteric coronavirus. Because most cats in the general population have been exposed, it makes interpretation of coronavirus titers difficult. The titers can be elevated due to prior exposure and not from FIP. The titers can only be interpreted in lieu of clinical signs, blood results, etc. L-lysine is an anti-viral medication that may have some benefit for suppression of herpes virus but would not be a prevention or treatment choice for coronavirus. The coronavirus is shed in the cat's feces during active infection with coronavirus. Some infected cats do not shed the virus. The virus attacks the intestinal tract and causes GI upset. PCR on the feces would

detect coronavirus, but does not distinguish between the enteric coronavirus and the mutated FIP form of the virus. A 10-year old male intact Doberman mix dog is presented with one testicle that is grossly enlarged and nonpainful and the other atrophied. What condition(s) are expected to be seen in association with this presentation? A - Benign prostatic hypertrophy, constipation B - Hypothyroidism C - Increased aggression, territoriality D - Feminization syndrome E - Penile hypertrophy, hirsutism - ✔✔D Feminization syndrome. Nonpainful unilateral testicular swelling in an old dog should make you think of neoplasia, especially an estrogen-secreting sertoli cell tumor, which can cause feminization syndrome. See gynecomastia, penile atrophy, pendulous prepuce, attraction of other males, blood dyscrasias, +/-bone marrow depression (via high estrogen), bilateral alopecia. Remember that cryptorchidism increases risk of sertoli cell tumor: About 25-29% of sertolis develop feminization syndrome and ~ 70% of intra-abdominal testicular tumors, regardless of type, cause feminization syndrome. May see prostate hypertrophy with sertoli, but it is due to squamous metaplasia, not the classic (and common) benign prostatic hypertrophy (BPH). Hypothyroidism and BPH are common older dog conditions, but not associated with unilateral testicular hypertrophy. Remember that sex hormones are also secreted by the zona reticularis of adrenal cortex and can see feminization or virilism with excess secretion. Tommy, a 4-year old male neutered domestic short hair, presents to you for frequent urination. Urinalysis reveals 4+ struvite crystals. An abdominal radiograph shows a 1 cm round calculus in the bladder. Tommy does not have a urethral blockage, and urine culture is negative. The owner says surgery to remove this stone is not an option due to finances. Which of the following would be the most important treatment for Tommy?

A - Potassium citrate B - Alkalinizing diet C - Clavamox D - Acidifying diet E - Metacam - ✔✔D This cat most likely has a struvite bladder stone. This cannot be determined without a stone analysis, but based on the signalment of the patient, the crystalluria, and the radiograph, this is the most likely type. These types of stones typically form in urine with a high pH. Therefore, an acidifying diet would be appropriate for stone dissolution. Calcium oxalate stones are the most common type of stone to form in acidic urine. For this type, an alkalinizing diet would be the most appropriate. Clavamox would only be indicated if this cat had a urinary tract infection sensitive to this antibiotic. This cat had a negative urine culture. Metacam can be used short-term to help with pain and inflammation associated with the cystitis from this condition but unfortunately Metacam is no longer recommend for use in cats in the United States. Potassium citrate is a supplement that can be given in addition to an alkalinizing diet to prevent the formation of calcium oxalate stones. This would be contraindicated in this case. What is the primary factor associated with pregnancy toxemia in ewes and goats? A - Young age at parturition B - Clostridium perfringens C - Polioencephalomalacia D - Inadequate nutrition E - High sulfur, Low thiamine diet - ✔✔D

Pregnancy toxemia in ewes and goats is a severe form of ketosis most associated with inadequate nutrition and TWINS in OLDER animals. Can occur in either thin or fat animals whose dietary intake does not meet the high energy demands of late gestation. Animals present off-feed in late gestation, often thin. Severe cases show neurologic dysfunction progressing to recumbency, death. High sulfur and low thiamine are associated with polioencephalomalacia, on your DDX for a neurologic sheep/cattle. What tumor type is a cat predisposed to developing at vaccination sites? A - Squamous cell carcinoma B - Fibrosarcoma C - Melanoma D - Lymphoma - ✔✔B The correct answer is fibrosarcoma. Vaccine-associated fibrosarcomas are very well documented in cats. Which breeds are predisposed to mitral regurgitation? (The number one cause of congestive heart failure in dogs). A - Cavalier King Charles spaniel, Cocker spaniel B - Wirehaired fox terrier, Border collie C - Great Dane, Afghan hound D - Miniature schnauzer, German shepherd E - Doberman pinscher, Boxer - ✔✔A Think of mitral regurgitation/insufficiency in a Cavalier King Charles Spaniel of any age, or in old male Cockers with a Hx of cough, labored breathing, and exercise intolerance. Remember that chronic obstructive pulmonary disease with fibrosis can cause similar signs-primarily older animals. Here are 4 other big cardio predispositions:

If you see an intermittently fainting Boxer, think of Boxer cardiomyopathy. A rapid, irregular heart rate in a middle-aged, depressed, coughing, exercise-intolerant Doberman, suggests dilated cardiomyopathy (DCM). Think of Sick Sinus Syndrome (SSS) when you hear "Fainting Female Min. Schnauzer". Also see SSS in dachshunds, cockers, west highland whites. Think Tetralogy of Fallot in a young Bulldog, Keeshond, Wirehaired Fox Terrier with cyanosis, exercise intolerance. Remember young Min. Schnauzers and Wirehaired Fox Terriers are predisposed to Mega-esophagus. Which one of the following sets of conditions predispose a cow to metritis? A - Dystocia, overfeeding in dry period, Ca-P imbalance in feed B - Agalactia, milk fever, bovine vibriosis C - Strep. agalactiae mastitis, retained placenta, laminitis D - Milk fever, malnutrition, excess dietary zinc E - Contaminated calving environment, abortion, hypomagnesemia - ✔✔A Cows are predisposed to post-parturient bovine metritis by many things, including:

• Dystocia
• Overfeeding in dry period
• Ca-P imbalance in feed Cows are also predisposed to metritis by:
• Retained placenta
• Contaminated calving environment

• Abortion
• Malnutrition In cattle, the causative bacterial organisms isolated most often are Trueperella pyogenes alone or with Fusobacterium necrophorum or other gram-negative anaerobes. Note the name changes - Trueperella pyogenes used to be called Arcanobacterium pyogenes and before that it was classified as Corynebacterium pyogenes. Specific diseases associated with bovine metritis or endometritis include brucellosis, leptospirosis, trichomoniasis, and bovine campylobacter. In canine patients with primary hyperparathyroidism, a chemistry panel would show: A - Hypocalcemia, hyperphosphatemia B - Hypercalcemia, hyperphosphatemia C - Hypocalcemia, hypophosphatemia D - Hypercalcemia, hypophosphatemia - ✔✔D The correct answer is hypercalcemia, hypophosphatemia. Patients with primary hyperparathyroidism would have hypercalcemia and normo to hypophosphatemia due to the law of mass action in which phosphorus decreases as calcium increases and vice versa. A horse presents to your clinic after ingesting a large amount of grain. What is your major concern? A - Torsion B - Acidosis C - Impaction D - Choke E - Laminitis - ✔✔E

The correct answer is laminitis secondary to endotoxemia. Laminitis, endotoxemia, and diarrhea are commonly associated with grain overload and appropriate therapy to evacuate any remaining stomach contents, ameliorate endotoxin and prevent laminitis should be instituted immediately. Laxatives such as mineral oil are commonly administered. A 2-year old male castrated mixed breed dog presents for an altered gait after being hit by a car. On physical exam, the thoracic limbs had decreased biceps and triceps reflexes and decreased muscle tone. The pelvic limbs had hyper-reflexive patellar and gastrocnemius reflexes and increased muscle tone. Where is the spinal cord lesion? A - L4-S B - C1-C C - T3-L D - C6-T2 - ✔✔D The correct answer is C6-T2. In a dog, the spinal cord is divided into the four regions listed above. Upper motor neuron signs include hyper-reflexia of spinal reflexes and increased muscle tone. Lower motor neuron signs include decreased or absent spinal reflexes and decreased muscle tone. A lesion between the C6-T2 spinal cord segments would result in lower motor neuron signs in the thoracic limbs and upper motor neuron signs in the pelvic limbs, as described in the patient in the question. A lesion between C1-C5 spinal cord segments would manifest as upper motor neuron signs in the thoracic and pelvic limbs. Lesions between T3-L3 spinal cord segments would not affect the thoracic limbs, but would manifest as upper motor neuron signs in the pelvic limbs. Lesions between L4-S3 spinal cord segments would result in normal thoracic limbs and lower motor neuron signs in the pelvic limbs. Which of the following is a causative agent of infectious bovine keratoconjunctivitis as shown in this image? A - Thelazia

B - Histophilus somni C - Moraxella bovis D - E. coli - ✔✔C The correct answer is Moraxella bovis. Thelazia is the eye worm. Histophilus somni is a cause of many syndromes, but is rarely found in the eye. E. coli is not an ocular pathogen. An 11-year old Peruvian Paso presents with a history of progressive weight loss. Serum chemistry shows elevation in sorbitol dehydrogenase, lactate, alkaline phosphatase, and a decrease in albumin. A vast amount of Crotalaria spp. is seen in the pasture. What type of toxin does Crotalaria spp. possess? A - Nitrate B - Organophosphate C - Cyanide D - Pyrrolizidine alkaloid - ✔✔D The correct answer is pyrrolizidine alkaloid. The clinical signs described are typical for pyrrolizidine alkaloid toxicity. Consumption of this plant typically results in abnormalities in hepatic cell division; thus resulting in large hepatocytes known as megalocytosis. Acromegaly is associated with what 3 diseases in cats? A - Hypoadrenocorticism, Congestive heart failure, Hepatic lipidosis B - Hyperadrenocorticism, Pleural effusion, Lameness C - Diabetes mellitus, Cardiomyopathy, Renal disease D - Prognathism, Pulmonary edema, Pulmonary Hypertension E - Vertebral spondylosis, 3rd degree heart block, Glomerulonephritis - ✔✔C Think first of Diabetes mellitus in OLDER MALE cats (ave. 10 yr, 90% male) with Feline acromegaly. First presenting sign may be PU/PD, polyphagia of diabetes. WEIGHT GAIN in an unregulated diabetic cat STRONGLY SUGGESTS acromegaly. Think also of Cardiomyopathy (~50%; see weakness, dyspnea, systolic

murmur, cardiomegaly/CHF, pulmonary edema ). Think also of RENAL disease (~50%; see proteinuria, USpG 1.015-1.025, (and glucosuria from Dm)). May see prognathism (long mandible), lameness (esp. cats), marked vertebral spondylosis. You diagnose a dog with mites. Which of the following mites is not contagious to other dogs? A - Demodex spp. B - Cheyletiella spp. C - Sarcoptes spp. D - Psoroptes spp. - ✔✔A The correct answer is Demodex. Demodex mites are a natural inhabitant of skin. Clinical signs of a Demodex infection usually occur in puppies or immune-suppressed animals. The other mites listed are considered contagious. A 7 year old female spayed Border Collie is presented with two very goopy, gunk-covered eyes. A Schirmer tear test finds less than 10 mm/minute of wetting, a decreased result from the normal of at least 15mm / minute of wetting. The owner reports that the dog has been on "some kind of medicine" for the last 10 days, but it is actually his girlfriend's dog, and he doesn't know what the medicine is. Keratoconjunctivitis sicca (KCS) secondary to the drug is suspected. Which drug may be causing the KCS? A - Amitraz B - Trimethoprim sulfa C - Griseofulvin D - Itraconazole E - Prednisolone - ✔✔B

Systemic sulfonamides like trimethoprim sulfa have been associated with keratoconjunctivitis sicca (KCS), sometimes irreversibly. Another drug-associated cause of TRANSIENT KCS is the combination of recent general anesthesia and atropine. Other causes of KCS include: Distemper, Immunologic (think ATOPY), Breed (Pugs, Yorkies), and trauma (Proptosed eyeball). Retained placenta and metritis can predispose to which one of the following secondary conditions in horses? A - Laminitis B - Postpartum dysgalactia syndrome C - Contagious equine metritis D - Cystic endometriosis E - Colic - ✔✔A In horses, retained placenta and septic metritis can cause acute laminitis. Other causes of equine laminitis include: Grain overload Overeating lush spring grasses Insulin dysregulation Colic, endotoxemia Exposure to black walnut (Juglans nigra) shavings Over-exercise on hard surfaces Lameness on one limb requiring overdependency on opposite leg, which then develops laminitis.

A 5-year old male castrated Mastiff presents for left pelvic limb lameness. The medial aspects of both stifles are thickened. Manipulation of the left stifle reveals cranial motion of the tibia relative to the femur and a clicking sound from the joint on flexion and extension. What is the most likely diagnosis? A - Left luxating patella B - Left cranial cruciate ligament rupture with meniscal cartilage tear C - Left cranial cruciate ligament rupture with no meniscal cartilage tear D - Left caudal cruciate ligament rupture with no meniscal cartilage tear - ✔✔B The correct answer is left cranial cruciate ligament rupture with meniscal cartilage tear. The cranial motion of the tibia and medial thickening of the joint (also known as medial buttress) is consistent with the commonly torn cranial cruciate ligament. The clicking heard on flexion and extension is consistent with damaged medial meniscus cartilage found in the stifle. Which of the following drugs is known for stimulating appetite in small animals? A - Cyproheptadine B - Acyclovir C - Omeprazole D - Tetracycline - ✔✔A The correct answer is cyproheptadine. Other appetite stimulants used for stimulating food consumption include mirtazipine, diazepam and oxazepam. An unweaned 2-month old calf is presented for necropsy. The calf collapsed and suddenly died after she escaped and was chased around the back pasture for 45 minutes by her owner. Among other things, white myocardial and endocardial streaking in the left ventricle of this calf's heart are discovered. What advice should be given the farmer? A - Put all the calves off ionophore-containing feed B - Start the other calves on Ceftiofur (Naxcel ®)

C - Treat the other calves with vitamin E/Selenium D - Check the mother for bovine leukosis by AGID E - Search the calf barn for sources of lead - ✔✔C Treat the other calves with vitamin E/Selenium. Think of white muscle disease when you see SUDDEN DEATH and endocardial PLAQUES in a young calf, lamb or kid with a history of recent VIGOROUS EXERCISE. Typically seen in young, fast-growing animals (ie: calves 2 weeks-6 mos). Clinical signs may include dyspnea (due to myocardial disease), stiff gait, arched back, weakness, recumbent but BAR (bright, alert, responsive). Sudden death may resemble enterotoxemia, should see acute bloody diarrhea, convulsions, opisthotonos in first days of life with enterotoxemia. A 1.5-year-old spayed female cat presents with a 7-day history of vocalizing, rolling, and allowing a male neutered cat in the household to mount her. The cat has gone through one similar episode 1 month ago. She otherwise has been behaving normally and has no other health problems. You performed an ovariohysterectomy on the cat at 3 months of age. You perform vaginal cytology which shows some cornified epithelial cells but is inconclusive. You measure serum lutenizing hormone of 0.2 ng/ml (normal for an ovariectomized female is >1 ng/ml). Which of the following is the most appropriate course of action? A - Order MRI of the brain to rule out a pituitary tumor B - Measure serum testosterone levels C - Exploratory laparotomy to remove the ovarian remnant D - Measure serum estrogen and progesterone levels - ✔✔C This is a classic description of ovarian remnant syndrome, which is when a cat goes into estrus after previously having an ovariohysterectomy (OVH). This can occur anywhere from weeks to years after OVH and typically the clinical signs consistent with estrus are sufficient to conclude that the cat is in estrus and has ovarian tissue present. Additional diagnostic tests that are consistent with ovarian remnant syndrome include:

Serum estrogen >70 pmol/L indicate that the cat has estrogen production from the ovary. The problem with this test is that estrogen measurements may fluctuate and can be unreliable. Serum progesterone

6 nmol/L after induced ovulation is sufficient to conclude that corpora lutea formed and released progesterone. Testing for serum LH levels can also help confirm the diagnosis. In intact queens, LH is consistently maintained at basal levels due to negative feedback from ovarian estradiol secretion. After OVH, this control is lost and LH concentrations increase. LH <1 ng/mL is consistent with the presence of an ovary as it is in this case. Surgery is the treatment of choice. Many practitioners prefer to do surgery during estrus or diestrus when the ovarian tissue is enlarged and easier to locate. Remnants may be bilateral so a complete exploratory laparatomy is necessary. Ovarian tissue is most commonly at the ovarian pedicle but can also be in the mesentery or elsewhere. You should be aware that ovarian remnant syndrome is NOT associated with new graduates or inexperienced surgeons (it is not likely the fault of the initial surgeon). It is suspected that accessory ovarian tissue separate from the ovary within the ovarian ligament or proper ligament of the ovary may become functional and cause this condition in most cases. A 4 - year old domestic short haired cat presents for anorexia and weight loss of 1 week. Physical exam reveals a body condition score of 7/9, jaundice of the skin and sclera, and dehydration of 4%. Temperature is normal. Bloodwork shows: ALT=303 (25-97 U/L) GGT=1.8 (0-6 U/L) ALP=1170 (0-45 U/L) bilirubin=3.0 (0-0.1 mg/dl) Radiographs show an enlarged liver. What is the most important treatment for the cat's likely diagnosis? A - Oral clavulanic acid and amoxicillin for 4 weeks B - Oral S-adenosylmethionine for at least 1 month C - Parenteral vitamin K injections D - Esophagostomy tube feeding - ✔✔D The cat described likely has hepatic lipidosis. Cats that are greater than 2 years of age and obese are at the greatest risk for hepatic lipidosis. Often these cats are indoor-only and have had a recent stress in their life. An obese cat that is not eating with the above symptoms is most likely to have hepatic lipidosis. An ALP elevation that greater in magnitude than GGT is also suggestive of hepatic lipidosis. A bile duct obstruction, cholangiohepatitis, lymphoma, and FIP are other differentials but are less likely with the given information.

Which one of the following choices includes the cardinal sign of trigeminal neuritis? A - Masseter muscle pain associated with chewing B - Circling and head tilt toward side of lesion, no other signs C - Dysphagia, dysphonia and stridor D - Inability to close the mouth E - Paralyzed eyelid, ear or lip on one or both sides of the face - ✔✔D Idiopathic trigeminal neuritis, cranial nerve 5, (CN 5) is characterized by acute onset of flaccid jaw paralysis. Affected animals cannot close their mouth and have difficulty eating and drinking. Seen occasionally in dogs, rare in cats. Cause is unknown. Idiopathic facial nerve paralysis, cranial nerve 7, (CN 7) results in the inability to move the eyelid, lip, or ear and dryness of the eyes and mouth. Masticatory myositis is characterized by pain on opening the mouth and swelling of the muscles of mastication (acute) or atrophy of the temporalis and masseter muscles with the inability to open the mouth due to fibrosis (chronic). Dysphagia, dyphonia, and stridor are most often associated with dysfunction of the vagus nerve, cranial nerve 10 (CN 10). Circling and head tilt toward the side of the lesion with no other signs is a common presentation of vestibulocochlear nerve, cranial nerve 8 (CN 8) lesions. Concurrent CN 7 paralysis and Horner's syndrome (ptosis, miosis, enophthalmis) may be present with middle- and inner-ear infections. A 9 year old German shepherd is presented with unchecked bleeding from a cut on the gums above the right canine tooth. The owner relates that the dog has lost weight and had an episode of collapse 3 days ago, but he recovered.

On physical exam, the gums are pale with petechiae and ecchymotic hemorrhages. There is tachycardia and a palpable cranial abdominal mass. A coagulation profile shows the following: Thrombocytes= 82,533 per microliter..[N=200,000-900,000] Buccal mucosal bleeding time (BMBT), increased Activated partial thromboplastin time (aPTT), increased Prothrombin time (PT), increased Thrombin time (TT), increased Fibrin degradation products (FDPs), increased What disorder of coagulation best fits this pattern? A - Von Willebrand's disease B - Idiopathic thrombocytopenia C - Disseminated intravascular coagulation D - Anticoagulant rodenticide toxicity E - Hepatic insufficiency - ✔✔C A lab pattern of low platelets, increased bleeding time and across the board increases in aPTT, PT, TT and FDP tests suggests disseminated intravascular coagulation (DIC). DIC is not a disease in its own right- it is a complex hemostatic defect characterized by enhanced coagulation and fibrinolysis, secondary to other diseases. Fibrinolysis and depletion of clotting factors leads to hemorrhage. Many, many diseases, all of them bad, can precipitate DIC. This case presentation (pale, older German shepherd with Hx of collapse, bleeding and an abdominal mass) suggests hemangiosarcoma. Remember your "H diseases" associated with DIC:

Heartworm Heart failure Hemolytic anemia Hemangiosarcoma Hemorrhagic gastroenteritis Hepatic disease, especially hepatic lipidosis in cats. Gastric dilatation-volvulus (GDV), mammary gland carcinoma and pancreatitis can also lead to DIC. A tourniquet was placed at mid cannon bone on this cow's leg. Lidocaine is being injected in the dorsal pedal vein. What is expected to happen? A - Anesthesia distal to tourniquet B - Bradycardia with gradual tourniquet removal C - Anesthesia only from mid-pastern to the toe D - Cessation of atrial fibrillation after tourniquet removal E - Anesthesia only of skin in the region of the injection - ✔✔A Anesthesia distal to tourniquet. This is an example of intravenous regional anesthesia, the anesthetic method of choice for most bovine digital surgical procedures. It has similar results to a nerve block, but is easier to do with reliable results. You need only one injection and no special knowledge of anatomy. 2% Lidocaine infuses down the venous system and anesthetizes the entire lower limb distal to the tourniquet within about 10 minutes. The amount of lidocaine needed is typically 10-30 ml and should not exceed a total dose of 9 mg/kg. Click here to see tourniquet sites and veins for intravenous regional anesthesia of the distal bovine hindlimb. Do not keep a tourniquet in place more than one hour. When surgery is complete, slowly release the tourniquet and then retighten it. If antibiotics are indicated, infuse them now then release the tourniquet after a few more minutes.

Some references call this a "Bier" block, after the pioneering German physician August Bier, who reported on this form of anesthesia in 1908. Lidocaine (and procainamide) are used to treat arrhythmias, but more for ventricular fibrillation in small animals and not administered from the foot. Think of quinidine sulfate to treat atrial fibrillation in symptomatic horses. A flock from a turkey farm is presented with a mysterious illness. Several dead birds are noted, mostly younger. Sick turkeys are listless, with drooping wings, unkempt feathers, yellow droppings. Sick older birds are emaciated. Necropsy shows a yellowish green, caseous exudate in the ceca, cecal ulcerations and thickening of the cecal wall. What is the diagnosis? A - Histomoniasis B - Necrotic enteritis C - Avian spirochetosis D - Coronaviral enteritis of turkeys E - Hemorrhagic enteritis of turkeys - ✔✔A This is histomoniasis. The combination of characteristic "bulls-eye" lesions on liver and cecal changes are pathognomonic. Caused by protozoan Histomonas meleagridis, transmitted in eggs of cecal nematode Heterakis gallinarum. Expect a depression/diarrhea presentation. Expect to see more sudden death with necrotic enteritis caused by Clostridium perfringens. Follow this link to see the so-called "Turkish towel" intestinal pseudomembrane of necrotic enteritis. Signs of avian spirochetosis are highly variable, may be absent: see listlessness, shivering, increased thirst, green/yellow diarrhea with increased urates early on.