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| A 10 year old male castrated Shetland Sheepdog presents to you with progressive neurologic signs including ataxia and seizures. Bloodwork and serum chemistry values are within normal limits. You are preparing to anesthetize the dog for imaging of the brain to determine if there is an intracranial mass. The Cushing's reflex describes what response to increased intracranial pressure in a dog? |
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Definition
| The correct answer is bradycardia and hypertension. In order to perfuse the brain when there is increased ICP, the body needs to increase systemic blood pressure to overcome that pressure. This occurs primarily through reflex vasoconstriction. The increase in blood pressure leads to decreased heart rate. Therefore, Cushing's reflex is when increased ICP leads to hypertension and bradycardia. |
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Term
| In an animal with pleural effusion, which radiographic view will give you the best view of the heart? |
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Definition
| The correct answer is ventrodorsal. Pleural effusion obscures the heart completely on a dorsoventral radiograph and at least partially on lateral radiographs. Ventrodorsal positioning usually moves the pleural fluid away from the heart and allows for a radiographic view of the heart to be obtained. Of course, in dyspneic animals, it may not be wise to position them ventrodorsally. |
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| What additional radiographic view in addition to a standard respiratory series should be taken to assess suspected intrathoracic tracheal collapse? |
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Definition
| The correct answer is end expiratory thorax. An end inspiratory view should be part of any normal thoracic radiograph series. An end-expiratory view is needed to document tracheal collapse in order to demonstrate intrathoracic tracheal narrowing because intrathoracic pressure is highest at end expiration which may worsen intrathoracic airway collapse. Standing lateral views are sometimes used to look for pleural effusion or pneumothorax. Oblique thorax projections are not used. |
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| What is the difference between stertor and stridor? |
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Definition
| The correct answer is that stertor is a gurgling noise usually generated in the nasal passages while stridor is a high-pitched sound usually generated near the larynx. This is always a source of confusion for veterinary students. Both noises are audible without the aid of a stethoscope and indicate an extrathoracic problem. |
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Term
| Which of the following is the treatment of choice for a Taenia infection in dogs? |
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Definition
| The correct answer is praziquantel. Pyrantel and ivermectin are not known to be effective against Taenia infections. Fenbendazole is effective against Taenia pisiformis, but not other subspecies of Taenia, making it a less desirable answer choice. |
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Term
| Immune-mediated hemolytic anemia is classically associated with which type of hypersensitivity reaction? |
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Definition
Type II
Type II (aka cytotoxic) occurs when an antigen on a cell surface binds with an antibody and is then recognized by the body as being foreign. The antigen on the cell may have been a normal feature of the cell or it may have been acquired, such as a drug binding to the cell. Macrophages or dendritic cells then recognize the cell and "present the antigen" which then causes B cell proliferation and production of IgG and IgM antibodies. The antibodies bind to the cell and activate the complement cascade which results in cell lysis/destruction. |
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Term
| A dog presents to your clinic for fever and lymphadenopathy. You perform an aspirate and see large, bipolar staining coccobacilli. The owner mentions that he saw his dog eating a rat a few days ago. What is causing the dog's illness? |
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Definition
| The correct answer is Yersinia pestis. In order to make this determination remember that Yersinia pestis is usually transmitted to cats and dogs as a result of ingesting infected rodents or via bites from the prey's fleas. Dog and cat fleas are poor vectors of Plague. Dogs usually recover and you may lance the "buboes" and flush it, but dispose of organic material properly. |
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Term
| A 7-year old, male, castrated shepherd mix presents for polyuria and polydipsia. The physical exam reveals a body condition score of 4/9 and 5% dehydration. The urine specific gravity is 1.006. The urinalysis, chemistry panel, and CBC are otherwise unremarkable. Which of the following is the most likely diagnosis? |
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Definition
| central diabetes insipidus. |
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Term
| The 6-year old 13 kg male cryptorchid Schnauzer in the image below presents for weakness, lethargy, intermittent epistaxis and melena of 1 week's duration. Physical findings include gynecomastia, a pendulous prepuce, symmetrical truncal alopecia, a palpable mid-abdominal mass, pale mucous membranes and a fever of 103.5 F (39.7 C). The dog's hematocrit is 14% (35-57%), with a total protein of 7.0 g/dl (5.4-7.5 g/dl). A blood smear reveals normocytic, normochromic anemia with a platelet count of 34,000/microliter (211,000-621,000/ul). The white blood cell count is 2,500/microliter (5,000-14,100/ul). Which of the following is most likely responsible for this dog's signs? |
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Definition
Estrogen excess
This dog's presentation should lead you to the presumptive diagnosis of an estrogen secreting tumor; likely a Sertoli cell tumor or seminoma. The dog was described as cryptorchid; dogs with cryptorchidism are prone to testicular tumors. The signs of male femininization such as gynecomastia and the signs of bone marrow suppression are most suggestive of estrogen toxicity. |
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Term
| You have a 6-year old female spayed Golden Retriever patient with inappetence and vomiting. You diagnose diabetic ketoacidosis based on a blood glucose of 641 mg/dL (76-119 mg/dL), 3+ glucose (normal- negative) and 3+ ketones (normal- negative) in the urine, and blood pH of 7.12 (7.35-7.45). You would like to treat with the shortest acting, most potent insulin type. Which of the following would you choose? |
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Definition
| Listed from shortest acting and most potent to longest acting and least potent: Regular, NPH, Lente, PZI, Ultralente. The treatment of DKA involves IV fluids and regular insulin, given either by CRI or the intermittent IM dosing technique. Regular insulin is continued until the patient is eating well and is hydrated, and can be switched to a longer-acting insulin, to be given SQ at home. |
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Term
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Definition
The disorder is caused by an IgG autoantibody that binds to intracellular adhesion molecules (desmoglein) causing a loss of cohesion between keratinocytes resulting in acantholysis, vesicle formation, and eventually ulceration.
The treatment is immunosuppressive therapy with corticosteroids and frequently additional immunomodulatory or immunosuppressive drugs such as azathioprine, cyclophosphamide, chlorambucil, or others. Unfortunately, long-term therapy is generally required and these treatments cause serious side-effects long-term. Prognosis is poor and euthanasia is often performed. |
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Term
| What causes cutaneous larval migration in humans? |
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Definition
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Term
| What is the isotonic crystalloid total "shock dose" in dogs? |
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Definition
| The isotonic crystalloids shock dose in dogs is 90 ml/kg. 1/4 to 1/3 of this volume should be administered initially and the patient reassessed. In cats, the isotonic crystalloids shock dose is 40-60 ml/kg. Synthetic colloids can be administered at a dose of 10-20 ml/kg in dogs and 5-10 ml/kg in cats and hypertonic saline at a dose of 5 ml/kg. |
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Term
| The best diagnostic test to differentiate pituitary dependent hyperadrenocorticism from adrenal dependent hyperadrenocorticism in dogs is which of the following? |
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Definition
| The correct answer is high-dose dexamethasone suppression test. HDDST will suppress cortisol secretion in about 75% of PDH patients 3-6 hours post dexamethasone administration. Cortisol secretion does not become suppressed with dexamethasone administration with adrenal dependent hyperadrenocorticism. If cortisol secretion is suppressed with a HDDST, PDH is diagnosed. If cortisol is not suppressed, there is a 50-50 chance that the hyperadrenocorticism is due to PDH or an adrenal tumor. |
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Term
| Keratoconjunctivitis sicca, as seen in the image, comes from an abnormality in which of these structures? |
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Definition
| The correct answer is lacrimal gland and gland of the 3rd eyelid. KCS comes from a decrease of the aqueous portion of the tear film. This is produced by the lacrimal gland and the gland of the 3rd eyelid. Remember, there are three layers of the tear film. The mucous portion lies against the cornea and keeps the tear film adhered to it. This is made by conjunctival goblet cells. The aqueous portion has nutritional and immunologic factors and is in the middle. It is produced by the lacrimal gland and the gland of the 3rd eyelid. The lipid portion of the tear film is the most outer part, and it allows for even spreading and prevents evaporation of tears. It is produced by the meibomian glands. |
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Term
| A 2-year old female spayed mixed breed dog presents in acute oliguric renal failure. The dog has a history of drinking ethylene glycol two days ago. What step should be taken next? |
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Definition
| The correct answer is tell the owner the dog has a guarded to poor prognosis and may need hemodialysis. 4-MP and ethanol act by preventing alcohol dehydrogenase from converting ethylene glycol to its toxic metabolites. In animals where oliguric renal failure has already begun, most of the ethylene glycol will already have been metabolized, so there is no benefit to giving ethanol or 4-MP. Activated charcoal should only be given if the ethylene glycol was ingested within 2 hours. |
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| An 8 year old female spayed Golden Retriever presents for inability to get up in the pelvic limbs. Your physical exam reveals normal spinal reflexes, motor function, and conscious proprioception in the thoracic limbs. The pelvic limbs show no voluntary motor function, hyperreflexive spinal reflexes, absent conscious proprioception and increased muscle tone. Where is the anatomic localization of the dog's lesion in the central nervous system? |
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Definition
| The correct answer is T3-L3 of the spinal cord. Since the thoracic limbs are normal, the lesion is unlikely to be between C1-C5 or C6-T2. The hyper-reflexive spinal reflexes and increased muscle tone in the pelvic limbs are consistent with an upper motor neuron lesion, which can be localized to T3-L3. An L4 and caudal lesion would result in lower motor neuron signs in the pelvic limbs. Remember: C1-C5 lesions cause upper motor neuron signs in all limbs; a C6-T2 lesion causes lower motor neuron signs in the thoracic limbs and upper motor neuron signs in the pelvic limbs; a T3-L3 lesion causes only upper motor neuron signs in the pelvic limbs; and an L4 caudal lesion will only cause lower motor neuron signs in the pelvic limbs. Beware that multiple lesions in different areas of the spinal cord may cause confusion as to where the lesion should be localized. |
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Term
| What is the approximate resting energy requirement for a 25 kg dog? |
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Definition
The correct answer is 800 kcal/day. There are many formulas for calculating RER and they all should work out to be pretty close to this. The formula used here is body weight (kg) to the 0.75 power times 70. (70 * BW^0.75).
Another formula that has been recommended for this calculation is (30 * BW + 70). Note that the results will be different compared to the (70 * BW^0.75) formula but they both should get you close enough to the correct answer.
You will have access to an "on screen" calculator during the exam if necessary. |
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Term
| Dogs with which endocrinopathy have an increased incidence of sudden acquired retinal degeneration syndrome (SARDS)? |
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Definition
| The correct answer is hyperadrenocorticism. SARDS is frequently seen in middle-aged obese spayed females and often have signs of PU/PD and polyphagia as well as increased liver enzymes and cholesterol. The reason for the association of Cushing's disease and SARDS is poorly understood. |
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Term
| A positive Ortolani sign occurs in affected dogs when manipulating this bone. |
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Definition
The correct answer is femur. During manipulation of the femur one may hear/feel a "clunk" which is actually subluxation of the coxofemoral joint. This test is important to perform in puppies in order to assess for hip dysplasia. The positive Ortolani sign indicates joint laxity.
Tibial thrust is a finding associated with cranial cruciate rupture |
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Term
| Zinc toxicity from ingestion of pennies minted after 1983 can cause which of the following? |
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Definition
| hemolysis. Zinc causes a heinz body anemia and hemolysis |
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Term
| What is the maximum rate of intravenous potassium that would be considered safe to administer to this dog? |
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Definition
| The maximum safe rate of potassium infusion is 0.5 mEq/kg/hr. As this dog weighs 12 kg, the maximum is 6 mEq/hr. This is one of those rates that you need to know. Administering potassium more rapidly than this can result in fatal arrhythmias. |
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Term
| Which of the following drugs and potential side effects are paired correctly together? |
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Definition
L-asparaginase is a protein enzyme and therefore may elicit an immune response. Anaphylaxis is rare but usually would occur only after a patient had received a prior dose and developed antibodies to it.
Vincristine is associated with paralytic ileus.
Lomustine is associated with hepatotoxicity.
Doxorubicin is associated with cardiotoxicity.
Cystitis is associated with cyclophosphamide.
Pancreatitis is associated with L-asparaginase or doxorubicin. |
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Term
| When trying to diagnose a bile peritonitis what is the method of choice for making a diagnosis? |
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Definition
| The correct answer is comparison between bilirubin concentration in the fluid and in the serum. A concentration of bilirubin that is twice as high as serum is considered diagnostic. |
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