2023 JVIM ✔️ Flashcards

Question

Clinical features of muscle stiffness in 37 dogs with concurrent naturally occurring hypercortisolism

Answer 1

Concurrent SMS and HC is uncommon. May affect only dogs with pituitary dependent disease. Most <20kg - large Pelvic limbs most common Development of SMS might occur before or after diagnosis of HC. Does not affect clinical picture/ survival. MST with SMS - 965d Muscle weakness usually resolves with HC treatment SMS does not.

Answer 2

Capillary rarefaction (decrease in capillary size and percent capillary area) is present in kidneys of cats with CKD and is positively correlated with renal dysfunction (ex: creat) and histopathologic (ex: glomerulosclerosis, inflammation, fibrosis) lesions.

Answer 3

3mo Beagle progressive caudotentorial encephalopathy MRI - diffuse, bilateral, T2 hyperintense, T1 hypointense, non-contrast enhancing lesion in white matter of cerebellum, brainstem, spinal cord, and some forebrain. Cerebellar enlargement. Normal CSF. Euthanized due to progressive. Fibrinoid leukodystrophy = Alexander Disease

Answer 4

DOCP and prednisolone requirements in cats were higher than what is currently used in dogs. DOCP starting dose = 2.2 mg/kg q28 days - all cats in high or low dose group needed dose increase Prednisolone maintenance dose of 0.3 mg/kg/day titrated to the individual need seems warranted. Small adrenal glands (width < 2.7 mm) British Shorthaired cats CS - decreased condition, lethargy, anorexia, dehydration, obstipation, weakness, weight loss, hypothermia

Answer 5

Addition of a second immunosuppressive agent did not alter immediate outcome but might be associated with a reduction in relapse. Multiple antithrombotic agents did not reduce incidence of thrombosis. 2 drugs - no effect on PCV stabilization, duration of hosp, case fatality Higher relapse in dogs with 1 drug. Pred + mycophenolate - 1.8d longer in hospital vs. pred alone. No other differences between variables for drug protocols.

Answer 6

Impaired renal function = poor prognostic in dogs with MMVD. serum Cystatin C associated with MMVD death. High serum Cys-C - shorter survival = worse prognosis May be predictor of MMVD prognosis even in dogs with normal creat.

Answer 7

Blood-brain barrier dysfunction quantification using advanced imaging analyses has the potential to be used for assessment of brain tumor characteristics and behavior and, particularly, to help **differentiating gliomas from meningiomas**. Different patterns for intra- vs. extra-axial tumors.

Answer 8

Thyroidectomy = long life expectancy. Overall MST 802d 78% >500d Mets 8% at admission - higher fatality Thrombosis in 27% - higher risk of death Non-follicular carcinoma + chemotherapy - higher risk of death - still consider thyroidectomy

Answer 9

**Decreased gut microbiome diversity in dogs with tumors.** - decreased alpha diversity - Bacteroides decreased - Staph decreased Aggressive tumors - higher WBC, neuts - lower HCT - correlated with Coprococcus Saccharimonas correlated with albumin and Na in all groups. May be paraneoplastic.

Answer 10

Our study validated the Plateletworks ADP system on the ProCyte Dx analyzer. Samples may be analyzed up to 1h after collection.

Answer 11

Cats diagnosed with UUTU at a younger age have a more aggressive phenotype with higher risk of obstructive UUTU compared to cats over 12 years of age diagnosed with UUTU. UUTU risk factors - female - pure-breds (BSH, burmese, persian, ragdoll, tonkinese) - older than 4y Obstructive UUTU risk - female - bilateral uroliths - age -- younger is more likely to be obstructive

Answer 12

Dal agglutination cards are reliable as a cage-side test, but results should be interpreted cautiously in severely anemic patients. 98% DAL positive DAL negative common in - dobermans - dalmations Cage side agreed with Gel PCV >20 - more reliable interpretation

Answer 13

Although rare, AGD should be considered in dogs with suspected GIB after a negative conventional endoscopy or surgical exporation. Video capsule endoscopy appears to be a sensitive test to identify AGD within the GI tract. AGD - diagnosed in 5% with 80% of these dogs having overt GI bleeding. 73% had hematochezia 40% had microcytic, hypochromic anemia AGD missed in 9/9 endoscopy and 3/3 explore dogs. AGD - stomach 3 - SI 4 - colon 13

Answer 14

9mo DSH - progressive tonic-clonic seizures, episodes of circling PE: inconsistent menace MRI - multifocal intra-axial white matter cysts Increased excretion of 2-hydroxyglutaric acid. ** L2HGDH gene nonsense varriant ** - encodes for L-2-hydroxyglutarate dehydrogenase ** Pathogenic gene (L2HGDH) variant in L-2-hydroxyglutaric aciduria in cats and describe for the first time multicystic cerebral lesions on MRI. *** Treated with Keppra, died 10d later.

Answer 15

Improved QOL by median 69% Decreased cough frequency, duration, and severity. Feasibility improved with continued use. This study supports the utility of fluticasone propionate by inhalation in management of cough in dogs with IAD and AWC.

Answer 16

Hypofolatemia is an inferior biomarker of CE compared to hypocobalaminemia.

Answer 17

5% developed post-attenuation seizures Risk factors - age - WBC - expression of hepatocyte growth factor activator, LysM, putative peptidoglycan-binding-domain-containing protein 2 model predicting clinical recovery - best model predicting complete recovery

Answer 18

**Circulating alternative RAS activity, specifically the surrogate measure of ACE2 activity, was increased in dogs with stage B2 MMVD as compared to normal dogs. ** Equilibrium dialysis results are analogous to immediate protease inhibition in dogs. Core RAS and aldosterone did not differ among groups Alternative and classical RAS differed.

Answer 19

75% RESP dogs had VFSS abnormalities. Penetration aspiration score more common in respiratory dogs. Aerodigestive disease - common Video fluoroscopic swallow study has diagnostic value.

Answer 20

Neutrophil extracellular traps, especially citH3, are increased in cats with HCM and CATE. - possible biomarker of thrombosis CATE = higher cell free DNA Citrullinated histone 3 (citH3) = HIGHER in those with CATE, correlated with risk factors.

Answer 21

**Prednisone-induced gastric bleeding. Co-admin of omeprazole partially mitigated bleeding. Probiotic did not. ** Fecal scores higher in pred group after tx. Diarrhea in the pred+omep group Increased GI lesion scores over time for all groups. - pred and pred + probiotic groups differed from placebo - pred + omep NOT significantly different from placebo Ulcers in pred group alone

Answer 22

Pet whippets in peak athletic condition have larger hearts than do less conditioned whippets, but measures of systolic function are similar. - LV larger and more mass in conditioned dogs Whippet pet athletes may show eccentric LV hypertrophy at peak condition. Normal values for cardiac size and function in North American whippets might be considered abnormal if population-specific whippet reference intervals are not used in analysis.

Answer 23

telmisartan suppression test to dx hyperaldosteronism Healthy cats - 2mg/kg decreased aldosterone at T1 and T1.5 compared to T0 PHA - 2mg/kg did NOT change aldosterone at T1 or T1.5 No AE with telmisartan dosing

Answer 24

Left atrial enlargement and high pulmonary vascular resistance on echo were independent prognostic factors in dogs with MMVD and detectable tricuspid regurgitation. Higher PVR and LAE - lower survival rates

Answer 25

Ultrafiltration during IHD in dogs with AKI is overall safe. Higher prescribed ultrafiltration rates were associated with increased risk of complications. Decrease in central venous oxygen saturation is associated with ultrafiltration-related complications, emphasizing the utility of in-line blood monitoring. mean fluid removal rate = 8.1mL/kg/hr Complications 25% - hypotension rare - no death

Answer 26

Laboratory choice for UPC measurement can result in different IRIS substaging for the same cat. Urine storage at room temperature for 1 day or in the refrigerator for up to 7 days does NOT clinically affect UPC. Long term storage (6-12mos) has an affect in 27% cats.

Answer 27

Hyperlipasemia is frequent and often marked - 30% at admit - 55% during hospitalization Only small subsection diagnosed with panc (less than 15%) 33% DGGR >10x URL Hyperlipasemia - associated with AKI severity, did not correlate with creat Tx with HD not associated with DGGR Survival to discharge 65% Survival to 30d 60% **High IRIS grade and hyperlipasemia were associated with nonsurvival.**

Answer 28

Altered trace element status could be involved in the pathophysiology of IE in dogs. Antiseizure drugs might affect trace element and arsenic metabolism. IE - lower hair phos - higher hair copper, zinc, Cu:Zn, selenium, and arsenic KBr - higher hair arsenic

Answer 29

Shear wave velocity increased with volume overload. Shear wave velocity positively correlated with right atrial pressure. Shear wave velocity decreased after diuretic. May be helpful with R heart failure

Answer 30

** Structural and functional right heart variables are associated with echo and clinical severity in dogs with PS. ** Associated with gradient >80mmHg - increased RV end-diastolic **free wall thickness** - decreased aorta to PA velocity time integral ratio Associated with severity - decreased tricuspid annular plane systolic excursion - increased RV end-diastolic area

Answer 31

Additional stains allow for better identification of IF compared to routine HE staining. ***Vimentin and mason's trichrome*** **POS Vimentin and MT - decreased liklihood of clinical remission - increased risk of death ** Mucosal fibrosis - 51% duodenum - 76% colon Vimentin and MT - identified 65% and 58% additional IF duodenum cases

Answer 32

We report preliminary reference intervals for plasma and urinary metanephrines in cats using LC-MS-MS and the potential clinical applicability of these biomarkers for the diagnosis of PCC in cats. Pheo cat had higher plasma and urine metanephrines when compared to healthy. No change if 24h refrigerated or frozen immediately.

Answer 33

NT-proBNP concentration and POCUS help distinguish between cardiogenic vs. non-cardiogenic non-hemorrhagic ascites. NT-proBNP HIGHER with cardiogenic - higher in non-pericardial disease Cutoff 4092 - sens 54% - spec 85% No significant difference for cTnI Cardiac ascites group - hepatic venous and caudal vena cava distension No difference in groups for gall bladder wall edema.

Answer 34

Cats - definitive host of toxo Increase in human incidence 36% cats shed T-gondii like oocysts - both feral and client owned Humans transmission of Toxo to the fetus in the first trimester - spontaneous abortion - stillbirth - mental retardation - blindness, - hearing and neurological disorders Higher prevalence in Syria than in Lebanon.

Answer 35

E. coli 52% Subclinical bacteriuria 60% Enterococcus more likely to be subclinical E. coli more likely to be sporadic bacterial cystitis. Recurrent - increased risk of resistance to clavamox Percent susceptibilities - clav 72% - cefazolin 49% - enrofloxacin 61% - tms 75% MDR - highest for enterococcus faecium isolates (65%) **No antimicrobial achieved >90% susceptible**

Answer 36

Hypercoagulability was common in SARDS and controls **SARDS were significantly more hypercoagulable on TEG (75%) ** - increased G value - hyperfibrinogenemia

Answer 37

Obstruction - urolith 73% - strictures 14% - pyonephrosis 14% Median creat presentation = 4 MM outcome successful 30% / MST 1188d partial success 13% / MST 518d failure 57% / MST 234d More successful in pyon and strictures than uroliths Median time to successful outcome 16d Distal and smaller (<1-2mm) = more success higher success rate for MM of BUO than previously reported.

Answer 38

Pituitary apoplexy - hemorrhage or infarction in pituitary resulting in acute neurologic abnormalities variety of acute neuro signs - altered mentation 69% - gait / posture changes 85% - cranial neuropathies 65% - hyperpathia 46% - hyperthermia 31% 38% lacked evidence of endocrinopathy MRI findings - hemorrhage 84% - pituitary mass 60% - brain herniation 56% - obstructive hydrocephalus 52% Survival to discharge 58% - med management mst 143d - meds and radiation mst 973d

Answer 39

The RIA was easy to perform and had good sensitivity (81%) and excellent specificity (95%) in this group of dogs. Sensitivity increased with more colonies. Positive = more likely to have malodorous urine, bacteriuria, pyuria

Answer 40

Culture sensitivity cats - 52% dogs - 79% Specificity 100% Culture not positive in any cases with negative antigen testing or cytopathology. Susceptibility testing might help identify isolates for which fluconazole is less likely to be effective. - 25% resistance

Answer 41

Sarcomas have - lower blood volume - lower blood flow - lower size reduction in early RT (versus carcinomas) Perfusion parameters may not be correlated with survival.

Answer 42

The NDS is a novel clinical measure for objective assessment of neurological dysfunction. Used: seizure activity, ambulation, posture, and cerebellar vs. cerebral vs. brainstem vs. visual functions. Good reliability prospectively. No association with outcome.

Answer 43

**Primary defect in conversion of homocysteine to methionine in Greyhounds.** Impaired folate generation Ineffective cycling by methionine synthase could lead to secondary cobalamin depletion. **Low serum folate and cobalamin concentrations can be observed in Greyhounds without signs of intestinal disease.** Greyhounds - homocysteine higher - cobalamin lower - methionine lower cobalamin and folate inversely correlated with HCy

Answer 44

70% acute and progressive Hyperesthesia variable TL hemorrhage in 65% Underlying cause in 65% Angiostrongylus vasorum 18% - french heartworm SRMA 13% 65% good to excellent outcome - better outcome for SRMA (100%) than A. vasorum or idiopathic Higher % recovery with pain intact. Severity did not impact outcome.

Answer 45

Cytokine alterations, acute phase response signaling, and lipid metabolism are likely involved in pathogenesis of CE. Marked variation in protein relative abundance. Higher fold change with IBD vs. food responsive.

Answer 46

D. repens - similar glomerular lesions Urinary albumin to creat. ratio higher in infected group. Proteinuria = 23% Albuminuria = 35%

Answer 47

Effusion cell count higher in cats Neuts with bacteria higher in cats (93%) Penetrating trauma to chest in 75% dogs and cats Cats - higher number of bacteria per patient - anaerobes more often

Answer 48

Detection of anti-histoplasma IgG antibodies via EIA - sensitivity 81% cats / 77% dogs - specificity 95% cats / 93% dogs EIA - useful Immunodiffusion = NOT RECOMMENDED - low sensitivity

Answer 49

**Rate control affects survival - target mean HR <125 bpm ** Structural heart disease and CHF present in most. 46/60 died. Median time to death 160d - >125 MST 33d - <125 MST 608d !!!! Higher risk of death - congenital disease - NT-proBNP Failure to achieve rate control - increased LA size - increased CRP - low BP

Answer 50

Consensus statement Histopath needed

Answer 51

Sibling chihuahuas 9mo hx of tachypnea - did not respond to deworm, abx, steroids Lung changes Ocular changes Aspirates - pneumocystis trophozoites Confirmed with rRNA PCR on tissue TX: TMS

Answer 52

Males > females median onset 10 months 91% younger than 3y electrodiagnostic - motor axon polyneuropathy 87% immune mediated on histology Prognosis - good to excellent 28% multiple episodes Similar outcome with no tx vs. pred/L-carnitine Muscle weakness Similar to Guillain-Barré syndrome

Answer 53

Bexagliflozin - SGLT2 inhibitor 84% tx success - decrease in glu, fructosamine, B-hydroxybutyrate, neuro status, musculature, hair coat AE - vomiting, diarrhea Euglycemic ketoacidosis!!! Decreased hyperglycemia and observed clinical signs in cats newly diagnosed with DM

Answer 54

AKI with AmB is common but does not always preclude continued treatment. Deoxycholate - AKI 42% - cumulative dose 6.9mg/kg Lipid complex - AKI 36% - cumulative dose 22.5mg/kg ICU hosp and inpatient status associated with decreased odds of AKI 84% continued treatment

Answer 55

Follicular cystitis - inflammatory change with formation of tertiary lymphoid structures in submucosa Large breed Female dogs Recurrent UTIs - median 7mo - median 5 UTIs **Chronic inflammation associated with an intramural E. coli infection in the urinary bladder wall represents a possible trigger** Mostly submucosa, some urothelium.

Answer 56

Most = subclinical infections. Serology is poorly associated with clinical disease. 88% had titers for duration of follow up. Excretion of organisms appears rare except in whelping bitches --> milk Not ID in blood, urine, saliva, or preputial swabs. Clinical management using antibiotics with or without surgery is recommended.

Answer 57

Parvo and non-parvo acute diarrhea - lower cobalamin MMA - similar between groups. Based on serum MMA (methylmalonic acid) concentrations - cellular cobalamin deficiency was not apparent. Increased methylmalonic acid = cellular cobalamin deficiency. - Cobalamin essential co-factor in MMA --> Succinyl CoA ----> can't convert, increase in MMA with low cobalamin

Answer 58

Insulin concentration DOES NOT differentiate dogs with or without mets. Insulin levels not associated with survival.

Answer 59

Hyperlipidemia - larger gall bladder volume before and after feedings - volume worse for severe cases Ejection fraction not significantly different. = GB distention in dogs which could lead to retention of bile and gallbladder disease.

Answer 60

Treatment combining clopidogrel and rivaroxaban (DAT) safely decreases platelet activation, platelet response to agonists, and thrombin generation in feline platelets more effectively than monotherapy with either clopidogrel or rivaroxaban. No AE.

Answer 61

No difference in survival between the PDH and non-PDH. Longer survival = higher Gy delivered. - definitive better than palliative

Answer 62

MST 419d Hx hemoabdomen and pre-tx volume to body weight associated with overall survival. Mean reduction 51% Pre-tx volume to body weight correlated with volume reduction %

Answer 63

Arterialization - heating the blood in veins - comparable to arterial collection Arterialized saphenous closer to true arterial blood samples than arterialized cephalic. ***The saphenous vein is suitable for “arterialization".***

Answer 64

4.5y Rhodesian - abnormal mentation, unilateral absent PLR, neck pain. MRI - non-obstructive hydrocephalus with no primary mass Necropsy - disseminated choroid plexus tumor = carcinomatosis

Answer 65

Tumor size - important prognostic factor Canine Lung Carcinoma Stage Classification - subdivide tumor sizes Median progressive free interval = 754d MST 716d LN mets, CS, margins, histologic grade = associated with progressive free interval age, CS, margin, LN mets = associated with overall survival time Tumor size classification - associated with progression free interval Tumor size greater than 7cm = associated with overall survival

Answer 66

Brachycephaly is associated with SDB. The neckband system is a feasible way of characterizing SDB in dogs. Higher obstructive respiratory event index and snore percent

Answer 67

Treatments involving IR/IE have wide applicability in veterinary medicine but large, rigorous, and comparative studies describing these procedures are lacking.

Answer 68

Specific neural antibodies were not detected using mouse and human target antigens in dogs with epilepsy and dyskinesia of unknown origin. These findings emphasize the need for canine-specific assays and the importance of control groups.

Answer 69

T2-Flair mismatch - easily identified on routinely sequences - specific biomarker - associated with low-grade, non-enhancing All dogs with T2FMM had oligodendrogliomas = mostly low grade

Answer 70

The oral telmisartan suppression test using a single dose of 2 mg/kg telmisartan DID NOT discriminate cats with PHA from healthy middle-aged cats or cats with diseases that may result in secondary hyperaldosteronism.

Answer 71

Damage to the gut lining released marker proteins of chronic inflammation that were detectable in serum samples of cats. THBS1 (thrombospondin-1) = a candidate biomarker for chronic inflammatory enteropathy in cats. >50 fold increase in abundance in cats with CE

Answer 72

***Radiograph and MRI results could be discrepant in dogs with discospondylitis. Prior trauma - associated with relapse Steroids - associated progressive neurological dysfunction*** Male dogs L7-S1 Staphylococcus species Agreement between rads + CT Poor agreement between rads + MRI

Answer 73

Rickets - disorder of bone development - dietary vs. genetic CS: lameness, bone deformities, dyspnea, death Generalized widening + irregular margination of the physes Decrease in bone opacity Swelling of chostochondral junctions Low 1,25 (OH)2D3 Secondary hyperparathyroidism Adequate 25-hydroxyvitaminD Mutation in 1a-hydroxylase gene Genetic Vitamin D Disorders - Type 1A = impaired conversion of 25(OH)D3 to 1,25-dihydroxyvitamin D3 - Type 1B = failure of conversion of vitamin D to 25(OH)D3 - Type 2A = vitamin D receptor gene

Answer 74

6y FS Great Dane Acute onset cluster seizures MRI: Mass in olfactory bulb with mucoid component Histopath: tyrosine crystalline rich, fibrous meningioma with high mitotic index MRI 6mo post-op = no recurrence Clinically normal 10mo after sx

Answer 75

Cervical spondylomyelopathy - disk associated - osseous associated Combo type? Large breed 58% Giant breed 37% Median age 7y 67% had concurrent disease - more likely to have high neurologic grade 80% was the main compression site substantial % with cervical spondylomyelopathy present with concomitant IVD protrusion and osseous proliferations, most at the same site.

Answer 76

6 dogs + 2 cats - CPA or anesthetic complication resuscitated 7 showed progressive neurologic improvement within 72h 1 dog euth due to cerebral cortical swelling and brainstem compression 4 recovered, 3 persistent defects Indications of likelihood of recovery - Duration insult - Diffuse brainstem involvement - MRI features - Rate of neurological recovery (within 72h or no)

Answer 77

Visceral HSA in cats - rare, aggressive, poor prognosis 4y MN DSH 3mo hx hematuria + stranguria AUS - large bladder mass Excision via partial cystectomy Dx - HSA, via vWF IHC Tx: cyclophosphamide, thalidomide, meloxicam for 8mo No evidence of local recurrence or mets Alive at 895d

Answer 78

9y mastiff presented for acute vomiting, cough Mechanical ileus Pleural effusion and pulm. edema DCM phenotype During anesthesia - afib Electrical cardioversion 2 weeks later - echo showed right atrial mass tx - clopidogrel and enoxaparin 2mos later - resolution

Answer 79

Addison's - ddx for hypercalcemia Prevalence 34% - increased risk if if typical, azotemic, or higher albumin Occurs due to dehydration / hemoconcentration or decreased GFR? Odds of hyper iCa - increased with low K - increased risk with younger age

Answer 80

Home sampling of urine is a valid alternative to cystocentesis in cats. However, because clinically relevant differences in UPC (28%) and USG (18%) of cats, respectively, same collection method for monitoring each cat is advised. Cysto - higher UPC - lower USG

Answer 81

Feeding a specially formulated diet for 365 days was not associated with a significantly different rate of change of left heart size in dogs with subclinical DMVD as compared to control. **NOT HELPFUL**

Answer 82

Remdesivir is a prodrug of GS Effective to use both remdesivir and GS Clinical response in 88% median of 2d 81% alive at end of 12 weeks 18% died or euth - 2/3 within 3d of tx

Answer 83

Evaluate for acute phase proteins in feces that my be biomarkers for CE LOWER in CE alpha-1-acid-glycoprotein (AGP) HIGHER in CE fecal haptoglobin pancreatitis-associated protein-1 (PAP- 1) ceruloplasmin **AGP lower in IBD and food responsive versus cats with small cell lymphoma ** **Ceruloplasmin reduces after tx -- may be helpful to monitor response **

Answer 84

3rd heart sounds associated with HCM 3rd systolic heart sound heard with systolic anterior motion (SAM) of the mitral valve with HCM may indicate obstructive HCM

Answer 85

Start with remdesivir - continue at a lower dose or transition to GS Both options effective and well tolerated. 86% survived 6 months 3 cats died with 48h excluding these - 96% survivial Remission by day 84 in 56% 3 cats - re-treatment AE: injection site discomfort and skin irritation First half of treatment - improvement of CS marks response second half of treatment - improvement in labs marks response

Answer 86

**Vasculitis 37% ** lymphatic/venous obstruction 22% hypoalbuminemia 18% R-CHF 5% Localized 72% Generalized 27% - more likely associated with hypoalbuminemia Concurrent abdominal effusion (29%) more common than pleural or pericardial - more common with hypoalbuminemia and R-CHF

Answer 87

upper limit for gall bladder wall thickness in fasted dogs less than 40kg = **1.30mm**

Answer 88

Fail to achieve clinical remission at 6mo - higher USS at diagnosis Epaxial muscle loss + coat condition - most predictive of not achieving clinical remission

Answer 89

Serum miR-223-3p = distinguish between GI cancer and CE sensitivity 90% specificity 77% May differentiate between GI lymphoma and CE No difference in fecal miRNAs

Answer 90

Dogs with AP have lower Vitamin D and Vitamin D receptor (VDR) levels than controls. No difference in vitamin D binding protein VDR levels differed for survivors vs. non. Negative correlation in VDR, CRP, and cPL with AP.

Answer 91

All cats male 80% had UO 25% had positive urine culture - Staph felis - Proteus 75% negative culture - different etiology from encrusting cystitis All cats had AUS suggestive of mineralization Mucosal erosions in 58% Medical management (most) with some surgical 77% survive to discharge 5/12 cats with follow up had relapse

Answer 92

**NOT HELPFUL** Did not improve pain, lameness, or QOL Did not decrease pain med requirements No changes in clin path values after 90d Body weight negatively associated with lameness score and requirements for rescue pain relief.

Answer 93

**36% prescribed at least 1 abx** 10% prescribed without evidence of infection Potentiated penicillins dogs and cats 33% #2 cats - fluroroquinolones (24%) dogs - cephalosporins (27%) #3 cats = cephalosporins (14%) dogs = fluroquinolones (15%) Indications: skin, resp, urinary, peri-op

Answer 94

Interstitial glucose and BG correlated when normoglycemic and in rate of change. IG underestimated BG in euglycemia IG OVERestimates BG in cats - different from other reports

Answer 95

thromboembolic disease in 52% of cancer dogs - microthrombi 50% Intratumor microthrombi 68% Distant thrombi 32% Macrothrombi - 3 dogs. Dogs with microthrombi - D-dimer higher - Platelets lower D-dimer >500ng/mL - 80% sensitive - 40% specific for microthrombi

Answer 96

Molnupiravir may be an effective and safe treatment at a dose of 10-20mg/kg BID 4 cats (effusive) died or euth within 1 week. Remaining completed treatment and in remission. Elevated ALT noted and resolved Jaundice (2 cats) - one on day 37 - one with anemia at start of tx

Answer 97

Many dog owners alter their dog's nutritional intake after a cancer diagnosis. 55% alter diet or supplements or both Most common info resource - vet in 54% Home-prepped diets increased. Joint supplements most common supplements given before and after dx.

Answer 98

Storage can affect results. POC analyzer - reliable if stored at 4C for 24h but not at room temp or for 7d at 4C. Difference 2.3 between analyzers found. Reference lab stable over time.

Answer 99

Dogs with striatin mutation had more VPC in 24 and greater increase in high sensitivity cTnI after exercise. 37% of dogs had >100 VPC/24h After exercise - these dogs had more VPC/24h than dogs with <100. **Exercise increases VPC and hs-cTnI in affected dogs **

Answer 100

PH secondary to respiratory disease occurs due to pulmonary vascular remodeling and hypoxia. Pulmonary arterial enlargement - most common finding Associated with symptoms - RV dysfunction and dilation - decreased stroke volume Restricted lung disease may cause more severe disease than obstructive.

Answer 101

Globoid cell leukodystrophy - progressive limb paresis, tremors, muscle atrophy Lack of degradation of glactocerebroside (lipid component of myelin sheath) Accumulation of psychosine - toxic metabolite Westie and Cairn Terrier mutation Irish setter mutation GALC novel missense variant homozygous in affected animals Either unique to this family or extremely low prevalence in general population

Answer 102

Heritable connective tissue disorders 14 week M DMH - Skin hyper-extensibility and fragility - Tragic facial expression - Chronic pruritus - mild hyperesthesia Histology - disorganized, sparse collagen and increase in cutaneous mast cells COL5A1 gene defect exon 4

Answer 103

spec cPL not consistently increased in dogs that develop multiple acquired PSS NOT A BIOMARKER

Answer 104

Ante-mortem dx is presumptive Diagnosis - testing for superoxide dismutase mutation - MRI Treatment - exercise / rehab

Answer 105

Overestimated moderate transportability excellent discriminatory ability

Answer 106

Hyperthyroidism - does not affect USG Iatrogenic hypothyroidism - does not affect USG USG <1.035 pre-I-131, more likely to develop azotemia after tx and unmask kidney dz

Answer 107

cytosine arabinoside (Ara-C) - immunomodulatory cyarabine ocfosfate (CO) is a prodrug of Ara-C that can be administered PO - provides prolonged serum concentrations of Ara-C Induces functional changes in peripheral leukocytes

Answer 108

short strided gait temporary recumbency after startle Hereditary myotonia Missense variant in CLCN1 gene (exon 9) - responsible for first chloride channel extracellular loop

Answer 109

Overshunting and hemispheric collapse are complications after VPS overshunting prevalence 18% Risks for overshunting - biventricular hydrocephalus (but not tri- or tetra-) - increased ventricle brain ratio decompressive surgery for hemispheric collapse to remove the subdural hematoma

Answer 110

changing diet induced long-term remission in dogs with non-PLE CE (85%) Cobalamin and folate concentrations maintained with diet. Hydrolyzed fish diets helped with PLE

Answer 111

Urine pH varied over time USG, protein, bacterial diversity consistent for each dog over time. Antimicrobial resistance - amoxicillin Bacteriuria even at high concentrations = not indication for UTI

Answer 112

Hypernatremia = common (56%) and clinically relevant (associated with higher mortality) Within 6h post-op = 7.7x higher odds of non-survival All dogs with >160 peak after surgery did not survive. delta change from admission to post op of >10 = 3.3x higher mortality APPLE scores and hospitalization time not different GB mucocele - more likely to develop post-op hypernatremia

Answer 113

Elemental diet - 70% responders overall Fecal bacterial communities changed with feeding elemental diet in responders No change in biomarker concentrations aside form ALP

Answer 114

Overall survival = 441d Disease specific survival time = 482d Acute morbidities 3% Fistulas in 7%, chronic issue (400+ days out) Possible chronic rhinitis developed in 61%

Answer 115

Stenting left priciple bronchus and lobar bronchus 2 success in all cases improved QOL decreased impairment at 4 weeks Complications - pneumothorax - recurrent pneumonia - new onset cough Ongoing cough is expected, but mild and manageable

Answer 116

mean lung congestion score = 8.4 corrected LCS = 0.48 **Mostly symmetric and focal caudal If asymmetric - right sided ** initial diagnosis of CHF to death = 150 **no association between corrected LCS and readmission or survival = different from other studies ** Negative association between time of furosemide admin and corrected LCS

Answer 117

improved long term outcome with half body radiation Radiation = 2y disease free rate 56% median duration 730d 2y survival rate 78% Chemo = 2y disease free rate 0% median duration 261d 2y survival rate 11%

Answer 118

Stage B and C/D heart disease had higher calculated osmolality than healthy dogs. Osmolality inversely related to Cl- correction. - useful in assessing relative body water content Poor agreement between calculated osmolality and direct osmolality. Heart-failure associated hypochloremia - dilution secondary to water retention - diuretics

Answer 119

Cat bile does not harbor a core microbiota. Bacterial taxa that could not be explained, associated with E. coli infection. - possible co-infections not identified by culture

Answer 120

2 liter mates started around 6mos Progressive weakness, joint contracture, distal limb joint hyperlaxity Dystrophic phenotype of muscle Absence of staining fo r collagen-6 COL6A3 gene - frameshift variant Ullrich like recessively inherited form of congenital muscular dystrophy

Answer 121

SVT - different anatomy and physiology but similar ECG findings Analyzing atrial deflection on 12-lead electrocardiogram is helpful in differentiating the most common SVTs in dogs.

Answer 122

Peripheral nerve sheath tumors = neoplasia from Schwann cells or pluripotent cell of neural crest Diagnostic imaging - hard to determine grade of malignancy **Predictive of high grade - tumor size - peripheral contrast enhancement ** NOT ASSOCIATED - muscle atrophy, heterogenous signal, tumor growth into vertebral canal

Answer 123

CS and repeat rads for monitoring tx Radiographic abnormalities on initial presentation Significant improvement in rad score and severeity of lung pattern. Clinical and rad scores not correlated.

Answer 124

Viable treatment option low recurrence (7-8%) low complication rate Concurrent bacterial otitis externa in 15%

Answer 125

Ciprofloxacin is the active metabolite of enrofloxacin. Adjustment of enrofloxacin dosage is not indicated for azotemic cats. Body weight affects volume of distribution and clearance. BUN influenced metabolic generation of enro to cipro

Answer 126

3.5y poodle idiopathic epilepsy - treated with phenobarbital Developed fever, cytopenias, proteinuria, positive ANA - all resolved within 3mos Stopped pheno, started keppra Drug associated!

Answer 127

Daily PO dosing - clinically relevant erythropoietic response in anemic cats with CKD Treated cats, HCT increased weekly 3 weeks to significant from baseline 7/14 treated cats higher at day 28 vs. 1/5 control

Answer 128

Moisture <14% = associated with CE no carb diet higher frequency in controls. Fewer dogs with CE had a read meat diet. Diet may play a role.

Answer 129

variant in canine phosphodiesterase 5A gene associated with decreased concentrations of cGMP and response to PDE5 inhibitor treatment (ex: pimobendan) **This polymorphism did not have altered platelet function or response to pimobendan.**

Answer 130

Exceeded the recommended 6th grade reading level for medical info.

Answer 131

Pulmonary stenosis - RV diastolic + systolic dysfunction - increased Gal-3 Suggests RV myocardial fibrosis.

Answer 132

4y FS MBD 2y hx of painful urination and recurrent hematuria Focal, rounded expansion of epithelial tissue in the right lateral aspect of the urethral papilla = abscess Culture = Staphylococcus pseudintermedius and Proteus mirabilis Expressed abscess Enrofloxacin 42d Carprofen 14d CS resolved in 2d Inflammation in the region of the lesser vestibular paraurethral glands = ddx for female dogs presenting with chronic dysuria.

Answer 133

Westies and larger polyps = shorter time of recurrence Westies overrepresented Median time to recurrence >2000d

Answer 134

All dogs had stranguria 45% overflow incontinence age 6.9y MALE CASTRATED 77% 26% neuro deficits - not associated with final outcome scores Multimodal tx

Answer 135

Pharmacokinetics highly variable. No significant source of variability identified.

Answer 136

PPI - can cause diarrhea and dybiosis **Concurrent probiotic unlikely to mitigate AE. ** Vomiting and diarrhea % did not change between tx groups. Calprotectin and SCFA did not differ. PPI + probiotic - significant increase in dysbiosis index.

Answer 137

Prevalence 1% Incidental 41% Symptomatic 59% Symptomatic - choleliths in multiple location - signs of obstruction **Concurrent hepatobiliary disease in 83% of symptomatic ** 74% survival to discharge **Biliary tract obstruction negatively associated with survival. ** None of the incidental cats developed CS. **Uncommon, can be asymptomatic.**

Answer 138

drugs in chop can be escalated safely with manageable AE at least 1 drug escalated in 78% 13% hospitalized at least once for AE Neutropenia most common limiting AE Median progression free interval 171 Overall survival 254

Answer 139

Shorter progression free survival (PFS) time - CCND1 - CCND3 - SMARCB1 - FANCG - CDKN2A/B - MSH6 treatment before first progression - longer PFS Also true for dogs with genomically targeted tx.

Answer 140

Fuzipladib - leukocyte function-associated antigen type -1 (LFA-1) activation inhibitor = blocks activation and adhesion/migration of neutrophils = decrease inflammation Well tolerated Modified clinical activity index (MCAI) and canine acute pancreatitis clinical severity index scores improved (CAPCSI)

Answer 141

**decrease in platelet aggregation after trazodone ** No other changes Unsure if related to trazodone vs. individual vs. dose vs. duration.

Answer 142

control 17 stable disease 24 progressive 212 ** differentiated stable vs. progressive IRIS CKD stage 1 ** NO SYSTEMIC COMORBIDITIES IN THIS STUDY

Answer 143

Achieving target goal within 3mos = associated with survival benefit 41% responded to ACEi Tx response - associated with MST (664d) and 12mo survival (79%) Worse prognosis - baseline azotemia, hypoalbuminemia

Answer 144

>82% increase in UPC = significant decrease in USG of 36% = significant

Answer 145

Spayed female odds risk 2.5 Neutered male odds risk 6.0 ** reproductive status most relevant. ** Modest effect size - canned food - lawn fertilizer - community type

Answer 146

DR-70 INCREASED with MST and oral malignant melanoma - not affected by tumor type, sex, age, BW

Answer 147

** Significant increase in diagnostic accuracy when adding history. ** From 65% to 75%

Answer 148

SB-001 = suitable single injection tx for nonregenerative anemia in cats with CKD. AE: hypertension (6), encephalopathy (4) - similar as previously described with erythropoetin stimulating agent therapy.

Answer 149

3y M Pit 4d hx of progressive tetraparesis and cervical pain MRI - extradural mass CSF - 90% eosinophilic inflammation Laminectomy performed large T cell lymphoma CHOP tx Recurrence at 37mo 39mo - neutropenic sepsis and aspiration pneumonia

Answer 150

Idiopathic episodic head tremors (IEHT) vs. Structural episodic head tremors (SEHT) SEHT lesions = middle cranial fossa and multifocal most common Secondary compression of the mesencephalic aqueduct Most common underlying condition = pituitary mass. SEHT = older, had other neuro signs, and more likely to be euthanized IEHT = improved with age

Answer 151

** Osteopontin (SPP1) involved in pathogenesis of idiopathic pulmonary fibrosis. ** SPP1 found in type 2 pnuemocytes and extracellular matrix of diseased Westies. SPP1 higher (serum and BALF) in diseased Westies. Higher in normal Westies compared to controls.

Answer 152

Monthly frequencies decreased (>50%) Time between seizures increased (>3 fold inc.) High proportion euthanized within 1y.

Answer 153

Adipokines - visfatin, betatrophin Visfatin = - lower in hypothyroid dogs - increased with treatment - higher in overweight dogs Betatrophin = - lower in lean or normal BCS hypothyroid dogs compared to healthy - not different between overweight dogs - decreased post treatment in overweight dogs - positively correlated with BCS and insulin concentrations in hypothyroid dogs - negatively correlated with BCS and TSH in healthy **Alterations present in hypothyroid dogs that partially resolve with thyroxine tx**

Answer 154

**IM = higher naloxone plasma concentrations compared to IN Reversal achieved with both routes. **

Answer 155

Progressive dysfunction can be distinguished from stable kidney function by using the slope of creatinine−1 or SDMA−1 Stable progressive slope cutoff - CREA: -0.0119 week x dL/mg - SDMA: -0.0007 week x dL/ug

Answer 156

No significant difference in gastric pH or serum gastrin concentrations between CKD and healthy dogs. Prophylactic gastric acid suppression in dogs with CKD not recommended.

Answer 157

in place for median 6d 62% recovered spontaneous appetite 60% appetite after removal Complication rate 65% 18% required consultation No life threatining 94% owner satisfaction

Answer 158

NCPE in hunting dogs 2 dogs - recurrent resp distress associated with hunting Bilateral, symmetrical, interstitial to alveolar pattern in caudodorsal lung fields. Exercise induced NCPE = a and b adrenergic overstimulation - treatment with sympathetic blockers (prazosin, atenolol) - 1 dog no recurrence, other recurred. RBC in BAL - exercise induced pulmonary hemorrhage Furosemide in other dog helped symptoms.

Answer 159

Good when echo is unavailable for differentiating cardiogenic vs. non. **VLAS significantly more accurate than VHS ** VLAS cutoff >2.3 vertebrae Murmur grade and VLAS associated with CHF, NOT VHS

Answer 160

30% IE drug resistant Cannabidiol - decreased total seizures and seizure days (24% ) compared to placebo at 9mg/kg/day. Liver enzymes increased. Vomiting and decreased appetite noted.

Answer 161

Microbiome similar for symptomatic vs. asymptomatic dogs with Giardia. ** NOT ASSOCIATED WITH overall DYSBIOSIS** Males - more Clostridium in diarrhea dogs Proteobacteria - more prevalent in diarrhea dogs Verrucomicrobia - less prevalent in <1y

Answer 162

Paramyxoviridae family - morbillivirus 2mo Bengal - nonsuppurative encephalitis Neurotrophism and association with enecphalitis

Answer 163

Safe and potentially efficacious Significant changes in mean body weight, BCS, MCS, BUN Panting less, improved general health 4 dogs had change in coat pigmentation Previously reported AE: bradycardia, hypotension

Answer 164

**The KCNJ10 variant & rarely the CAPN1 variant, = causal of spinocerebellar ataxia** KCNJ10 - noted in dachshunds Myokymia and neuromyotonia alone - gene variants not identified AKA NOT associated Myokymia = eye twitching Neuromyotonia = continuous muscle activity due to peripheral nerve excitability JRT - spinocerebellar ataxia Typically related to potassium channels

Answer 165

MRSI - predictive of onset of CHF and all cause death in stage B2 MSRI >156 predictive of time to CHF >173 predictive of all cause death Can substitute radiographic LA size for LA:Ao

Answer 166

6mo MN Patterdale Terrier PU/PD, pharyngeal stridor, hair growth on paws, wide facial features IGF-1 consistent with hypersomatotrophism New onset of DM Pituitary mass - removed histopath = acidophil neoplasm with positive IHC for growth hormone Post-op - resolution of CS, persistence of DM

Answer 167

**FCE uncommon in chondrodystrophic dog breeds ** Overrepresented in Boxer, Great Dane, Yorkie, Bernese, Mini Schanuzer, Rottie, Sheltie FGF4L2 allele (supportive of chondrodystrophism) negatively associated with FCE

Answer 168

adult DSH with FeLV referred for kidney failure and anemia requiring blood transfusions Major feline blood antigen system - A, B, or C (AB) - type A most common Blood typing did not show A or B bands Glass slide typing - patient blood + type A donor blood = agglutination - likely type B cat Anti-A and Anti-B titers Agglutinated with RBC from type A and B cats No appreciable A or B antigens BB genotype - CMAH variant Does not explain phenotype - failed to identify as A, B, or AB Null phenotype Similar to Bombay humans

Answer 169

Histologic liver abnormalities = common in dogs with GBM 98% at least one hepatic abnormality Hepatic fibrosis 73% Biliary hyperplasia 56% Portal infalmamtion 48% Higher portal fibrosis score = shorter survival Increase in neutrophil to lymphocyte may predict necrosis or cholangio/hep

Answer 170

Ultrafiltration - treat fluid overload Monitored with noninvasive blood volume monitors (CritLine) **CritLine provides accurate estimates of PCV and UF volume change. ** reported HCT lower than PCV when >25% and >30% Delta BV % significantly differed when +/- 20% (different at extremes)

Answer 171

18mo F DSH Poor appetite, lethargy, exaggerated swallowing, regurgitation 2 weeks after endoscopy Azotemia Hypercalcemia Na:K 27 Bilateral adrenomegaly Cytology - necrosis and inflammation ACTH stim - confirmed addison's Tx with pred and DOCP Anesthetic related adrenal necrosis ID in humans

Answer 172

Variable performance of available human D-dimer assays between species. Interspecies variation. Validations studies recommended. Monoclonal antibody DD44 - possible focus for canine-specific assay.

Answer 173

Trazodone dampens adrenocortical response to stimulation in healthy dogs. No change in eACTH No change in pre-cortisol ** Post-cortisol LOWER with traz Delta cortisol LOWER with traz **

Answer 174

Amyloid A amyloidosis - protein mis-folding disease Renal amyloid A amyloidosis is associated with kidney lesions, increased proteinuria, increased excretion of SAA in shelter cats. AA - higher UPC, urine amyloid A to creat ratio Mixed type proteinuria in 89% cats with AA Urine apolipoprotein C-III higher in cats with AA amyloidosis Kidney lesions - glomerulosclerosis and interstitial fibrosis

Answer 175

granulomatous hepatitis is a form of chronic hepatitis GH - high histopathologic grade - fever - neutrophilia - hepatomegaly - parenchymal lesions on AUS Good outcome, long term survival (635d) Median age 7y Decreased app, lethargy, fever Necroinflammatory scores - high Fibrosis scores - mild

Answer 176

inhibition of HIF-PH stimulates erythropoiesis Significant increase in HCT starting day 14 and remained higher. Well tolerated EPO concentrations increased after admin.

Answer 177

Non-convulsive seizures identified via electroencephalography (EEG) Prevalence of non-convulsive seizures (29%) / SE (16%) is high Decreased level of conciousness Overall hard to detect HIGHER Mortality rate - NCS 73% - NCSE 67% EEG monitoring recommended if cluster seizures occur

Answer 178

Excellent intra- and inter- rater reliability for LUS Perfect agreement for - pleural effusion - translobar tissue like pattern Strong agreement - A and B lines Moderate agreement - subpleural loss of aeration Weak agreement - irregularities of pleural line

Answer 179

Chronic admin of 5mg/kg better tolerated than 10mg/kg Elevated ALP No hepatic damage - but monitoring recommended Diarrhea at higher mg/kg

Answer 180

Treatment for FIP with GS CAT 1 Acute, progressive azotemia Multifocal urolithiasis - renal, ureteral, cystic calculi SUB required CAT 2 Dysuria Multifocal urolithiasis Tube cystostomy 98% consistent with GS drug

Answer 181

Duration of euthyroid sick undetermined TT4 low in - 100% @ admission - 20% @ discharge - 4% @ 2 wk - 0% @ 4 wk TT3 low in - 80% @ admission - 80% @ discharge - 8% @ 2wk - 0% @ 4wk fT4 low in - 16% @ admission - 0% @ discharge, 2wk, 4wk **Thyroid function low during illness and recovery up to 4wks. ** **fT4 via ED is reliable during illness ** TT4 can be measured 2-4 weeks after discharge

Answer 182

association between hypercalcemia and hypergastrinemia in humans **Mild gastrin increases in 18% dogs with PHPT - independent of GI signs** Gastrin not correlated with iCa Treatment did not decrease gastrin.

Answer 183

>50% PLE fail to respond to standard therapies Octreotide - prescribed mostly in dogs with PLE and lymphangiectasia that failed other treatments (89%) Median dose 20ug/kg SQ AE 17% Improvement in CS in 50%

Answer 184

**Aortic annular plane systolic excursion lower in HCM cats. ** <2.9 AAPSE Differentiating stage C from B - Sensitivity 83% - Specificity 92% Correlated with mitral annular plane systolic excursion and atrial fractional shortening - NOT LV FS.

Answer 185

Poor naturesis - diuretic resistance **Urine sodium after furosemide predicted duration of time in O2 and discontinuation of O2. ** **Lower urinary sodium = longer time in O2 and lower discontinuation of O2 ** Low urineNa correlated with PO loop diuretics, low chloride, high PCV

Answer 186

Early onset of movement disorders Progressive gait abnormalities MRI lesions in the nuclei, thalamus, hippocampus, and brain atrophy MECR missense variant in all ATG4D missense variant in 2/3

Answer 187

Listeria - food borne illness Can cause - gastroenteritis - meningoencephalitis - maternofetal infections Weight loss, sporadic vomiting and diarrhea Large LN noted on AUS and CT Surgical explore - lymph node with purulent contents Histopath - necrotizing and pyogran lymphadenitis with intralesional gram positive bacilli Listeria growth from LN Tx: clavamox (12 weeks) and marbofloxacin Resolution in CS and lymph node Listeria associated mesenteric lymphadenitis

Answer 188

baseline cortisol <2 in - 48% no steroids - 82% previous steroids ** Atypical addison's prevalence in dogs with chronic GI dz = 1% ** Prior glucocorticoids - lower C reactive protein to haptoglobin ratio - higher haptoglobin Atypical addison's - higher eACTH - lower cortisol to ACTH ratio

Answer 189

**Potential marker for severity and prognosis** lower iMg in stage D Lower 1y survival rate if low Mg (53 vs 92%) 4 fold increase in risk of death

Answer 190

3.26g/Mcal ME sodium (high salt) safe for 5y No impact on renal or cardiac parameters. High salt diet safe. Promotes urine dilution and decreased risk of urolithiasis

Answer 191

Different stages of estrus can influence the measurement of TT4 in female dogs. Hormone concentrations negatively correlated with age. **T4 higher in estrus and diestrus. ** Positively correlated with progesterone. Negatively correlated with 17-B-estradiol.

Answer 192

TK1 autoantibodies higher in malignant tumor group. Inadequate as single biomarkers screening for occult malignant tumors.

Answer 193

Platelet to lymphocyte ratio at hospital admission might be useful marker of severity / prognosis in dogs with CPV. 83% survival to discharge. ***PLR HIGHER in non-survivors. *** Lymphs / monocytes lower in non-survivors.

Answer 194

differently methylated FAM213A an <40% had good prognosis differently methylated FAM213A <40 and PHLPP1 <10% = excellent prognosis **Methylation status of prognostic CpG sites and ID cases with longer MST**

Answer 195

Proteinuric dogs with CKD may be secondary to amyloidosis, glomerulosclerosis, or immune complex-mediated glomerulonephritis miR-126 - may ID dogs needing immunosuppressive therapy without bx = immune complex mediated glomerulonephritis miR-21 and miR182 = markers for disease severity and fibrosis

Answer 196

After treatment - hypercalcemia resolved in 100% - azotemia resolved in 80% Resolution of azotemia influenced by creatinine and total hypercalcemia. Death associated with renal impairment is uncommon (15% had azotemia).

Answer 197

Cavaliers - overrepresented in thrombotic disease group TD - higher neutrophils - lower eosinophils - lower albumin Arterial thrombus higher albumin than venous. AT and VT older than PT VT higher cholesterol than PT

Answer 198

Incidence 0.44% Surgical treatment success - 62% @ 6wk - 74% @ 6mo Conservative treatment success - 54% @ 6wk - 65% @ 6mo Trauma - more successful outcome Neuro deficits remained for majority in both groups. Conservative may be similar in efficacy to surgical tx.

Answer 199

**LIKELY ipsilateral FOREBRAIN DISEASE** Ipsilateral head/body turn - Most forebrain - ALL with brainstem and cerebellar Contralateral - cerebellar - cervical spinal cord