Fundamentals of clinical practice 2 Flashcards

Question

What red cell inclusions can be seen?

Answer 1

Red Blood Cells (RBC), Hemoglobin (Hb), Hematocrit/PCV, Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin Concentration (MCHC), White Blood Cells (WBC) and differential, Platelet count.

Answer 2

Red cell mass is evaluated using PCV/Hct, RBC count, and Hgb levels. It provides evidence for effective and appropriate erythropoiesis based on size, color (MCV, MCHC), and reticulocyte count.

Answer 3

MCV indicates the average volume of red cells, suggesting their size, while RDW measures the variation in red cell size, indicating anisocytosis.

Answer 4

Anemia is classified based on cellular characteristics such as normocytic, normochromic, hypochromic, and macrocytic, which helps in determining the underlying cause and type of anemia.

Answer 5

Relative polycythemia is due to a decrease in plasma volume without an increase in RBC mass, often from dehydration. Absolute polycythemia is a true increase in RBC mass due to increased production/release of RBCs.

Answer 6

Reticulocytes are immature, non-nucleated erythrocytes released prematurely from the bone marrow during regenerative anemias. Their count helps evaluate bone marrow response and differentiate between regenerative and non-regenerative anemia.

Answer 7

It may indicate polycythemia, which is an increased number of red blood cells.

Answer 8

They indicate the bone marrow's response to anemia, helping differentiate between regenerative and non-regenerative types.

Answer 9

Dehydration can artificially raise PCV readings by reducing plasma volume, making it seem like there are more red cells than there actually are.

Answer 10

To aid in the diagnosis of disease through their characteristics, including type and concentration in the blood.

Answer 11

Neutrophils, lymphocytes, monocytes, eosinophils, and basophils.

Answer 12

There is significant species variation in the relative value and distribution of white cells, with specific reference intervals for dogs, cats, horses, and cows.

Answer 13

Leukocytosis is an increase in the number of white blood cells in the blood, caused by conditions like infections, inflammation, and stress.

Answer 14

Neutrophilia is an increase in neutrophils, often indicating inflammation, infection, or stress. Causes include bacterial infections, tissue necrosis, and reactions to steroids or epinephrine.

Answer 15

This process allows white blood cells to exit the bloodstream and enter tissues where they can engage pathogens or damaged cells. Factors influencing this include epinephrine, glucocorticoids, and infection.

Answer 16

A left shift, where immature neutrophils (bands) outnumber mature ones, indicates an active response to infection, inflammation, or stress.

Answer 17

Eosinophilia is an increased concentration of eosinophils, typically due to allergic reactions, parasitic infections, or certain diseases.

Answer 18

An increase in lymphocytes, often seen in viral infections, chronic inflammation, or in young animals as a response to vaccination.

Answer 19

Monocyte levels can indicate chronic inflammation, with an increase suggesting ongoing immune response to infection or tissue damage.

Answer 20

It signals an increase in immature neutrophils, indicating a vigorous bone marrow response to infection or disease.

Answer 21

Elevated eosinophil levels can indicate allergic reactions, parasitic infections, or certain autoimmune conditions, guiding diagnostic and treatment strategies.

Answer 22

To determine the adequacy of the sample for diagnosis, identify the type of cells present, and assess the presence of inflammation, infection, or neoplasia.

Answer 23

Sample quality, presence and preservation of cells, background characteristics (e.g., hemorrhage, protein matrix, debris), and predominant cell types.

Answer 24

By examining cell organization, population (single or mixed), cell size and shape variation, and nuclear characteristics including size, shape, and any abnormal mitoses.

Answer 25

Based on the presence of specific cell types (e.g., neutrophils) and characteristics such as septic versus non-septic inflammation.

Answer 26

Cellularity, degree of differentiation, presence of mitotic figures, and cellular atypia.

Answer 27

By assessing cell shape, arrangement, and other morphological features specific to each cell type.

Answer 28

To determine if the sample reflects normal tissue architecture or indicates pathology, such as neoplasia or inflammation. "Known tissue approach"

Answer 29

: Assessing sample adequacy, describing findings (cell types, inflammation, neoplasia), and providing a diagnosis or differential diagnoses.

Answer 30

Reference intervals are ideally determined using data from 120 clinically normal animals to account for variability across age and breeds, but this is rare. In practice, they're often based on smaller samples or extrapolated data. The central 95% of a healthy population defines these intervals, acknowledging that a small percentage of healthy animals will have values outside this range due to biological variability and measurement limitations

Answer 31

The "normal" range is defined as the central 95% of a healthy population, calculated as mean ± 2 standard deviations for normally distributed data or the 2.5th to 97.5th percentiles for skewed distributions. This accounts for natural biological variation but also means that approximately 5% of healthy individuals will have results outside this range by chance alone.

Answer 32

With each additional test performed, the likelihood of encountering at least one "abnormal" result in a healthy animal increases due to statistical probability. For example, running 15 tests might result in abnormal results 54% of the time purely by chance. This highlights the importance of interpreting test results within clinical context and considering the possibility of compound statistical anomalies.

Answer 33

Borderline results, especially those near the limits of reference intervals, require careful consideration of analytical variation. For instance, a result slightly outside the reference range might fall within it when measurement imprecision is accounted for. Clinicians should consider the entirety of clinical evidence, potentially retesting to confirm findings.

Answer 34

Assessing result plausibility involves considering pre-analytical and analytical factors such as sample handling (e.g., hemolysis, lipemia), the potential for contamination, and the limits of the testing technique. Unusual values that don't fit clinical expectations may necessitate reevaluation or additional testing to rule out artifacts.

Answer 35

nderstanding the statistical distribution helps clinicians to interpret how individual results relate to the overall health status of the population. It provides a framework for assessing the likelihood that a result reflects a true physiological deviation versus a statistical outlier or measurement error.

Answer 36

Leakage enzymes (ALT, AST, CK) increase in serum due to cell damage allowing their escape, reflecting organ damage. In contrast, function indicators (bile acid, ammonia for hepatic function; creatinine, USG for renal) assess the organ's performance in executing its physiological roles. Understanding both provides a comprehensive view of not just the presence of damage but also the affected organ's functional capacity.

Answer 37

ALT is liver-specific in dogs and cats, making it a reliable marker for hepatic damage when elevated. Its half-life (40-60 hours in dogs, 3.5 hours in cats) dictates the timing for retesting to evaluate ongoing or resolving hepatic insult. Early and higher level increases post-damage allow precise monitoring of liver health and recovery.

Answer 38

Enzyme induction refers to increased enzyme activity without direct organ damage, often triggered by drugs (glucocorticoids, barbiturates) or pathological states. This distinction is crucial as elevated enzyme activities may not always signify organ damage but could reflect adaptive responses to external stimuli, complicating the diagnosis and necessitating careful evaluation of potential inducers in the patient's history.

Answer 39

Hepatic function tests, including measurements of bile acids and ammonia, evaluate the liver's ability to perform essential metabolic processes, such as detoxification and synthesis. Unlike enzymes that leak from damaged cells, these function tests provide insight into the liver's capacity to metabolize substances, with abnormalities indicating compromised liver function rather than structural damage. These tests are particularly valuable in diagnosing liver insufficiencies that may not yet have caused significant cellular damage.

Answer 40

Organ damage indicators (e.g., leakage enzymes like ALKP, ALT, AST, CK, troponin I for cardiac damage, and PLI for pancreatic damage) are substances that leak into the bloodstream when cells are damaged. Organ function indicators (e.g., bile acid, ammonia for hepatic function; creatinine, USG for renal function; NT-proBNP for cardiac function) measure the ability of an organ to perform its physiological functions.

Answer 41

Biochemical parameters are assessed based on their location (e.g., within the liver, other tissues, or cells), persistence in serum, degree of change, and their relation to disease or dysfunction. For example, enzyme activities (ALT, AST) indicate liver health, while creatinine and USG assess renal function. Parameters must be interpreted in the context of the animal's overall health and specific condition.

Answer 42

Elevated levels of ALT (alanine aminotransferase) and ALKP (alkaline phosphatase) in dogs and cats can indicate liver damage or dysfunction. ALT is more liver-specific, especially in dogs and cats, and increases earlier and to a higher degree following hepatic damage. ALKP can be induced by impaired biliary flow and medications, and is not liver-specific due to iso-enzymes present in bone and intestinal tissues.

Answer 43

Renal function is evaluated using creatinine levels, urine specific gravity (USG), and the presence of proteinuria. Elevated urea with normal creatinine suggests pre-renal effects like dehydration or post-prandial states. A USG less than 1.030 in dogs or 1.035 in cats with azotemia suggests inappropriate dilution, indicating renal dysfunction.

Answer 44

Different species metabolize and respond to substances differently, necessitating species-specific biochemical indicators. For example, ALT elevations are more concerning in cats than in dogs due to their shorter half-life in cats. Urea is not a reliable renal function indicator in equidae and ruminants due to GI tract and other clearance mechanisms. Acute phase proteins and electrolyte balance also vary significantly among species, influencing test selection and interpretation.

Answer 45

Enzymes like ALT and AST leaking into the bloodstream indicate cell damage.

Answer 46

Liver damage is indicated by enzymes like ALT, while function tests involve bile acids and ammonia levels.

Answer 47

Creatinine levels reflect the kidney's ability to filter waste from the bloodstream.

Answer 48

Metabolic differences across species dictate which tests are relevant for assessing organ health.

Answer 49

It can indicate liver damage or dysfunction, but it's not exclusively liver-specific due to other sources like bone growth.

Answer 50

Immune-Mediated Hemolytic Anemia (IMHA) Internal bleeding Coagulopathy, possibly due to rodenticide toxicity

Answer 51

Hepatic neoplasia Acute hepatitis Drug-induced hepatopathy (considering meloxicam use)

Answer 52

Pyometra Septic peritonitis Severe systemic infection leading to sepsis

Answer 53

Toxicological exposure to calcipotriene (a vitamin D analogue) or other topical medication containing steroids, leading to acute renal failure and hypercalcemia.

Answer 54

Differential Diagnoses: Exertional rhabdomyolysis, dehydration, acute renal failure. Treatment Options: IV fluids for rehydration, analgesics for pain management, and careful monitoring of renal function and muscle enzymes.

Answer 55

Differential Diagnoses: Acute renal failure, dehydration, sepsis, electrolyte imbalances. Treatment Options: IV fluids to address dehydration and renal function, antibiotics if sepsis is suspected, monitor electrolytes, supportive care.

Answer 56

Differential Diagnoses: Hepatic disease, hemolytic anemia, intestinal parasitism. Treatment Options: Supportive care including IV fluids, nutritional support, possibly corticosteroids for liver inflammation, anthelmintics if parasitism is suspected.

Answer 57

Differential Diagnoses: Hypocalcemia (Milk Fever), hypomagnesemia (Grass Staggers). Treatment Options: IV calcium borogluconate for immediate relief, oral calcium supplements for maintenance, magnesium supplementation if necessary.

Answer 58

Differential Diagnoses: Bovine Respiratory Disease Complex (Shipping Fever), parasitic lung infections. Treatment Options: Antibiotics for bacterial infection, anti-inflammatories, supportive care, and stress reduction strategies.

Answer 59

Haemostasis is the process by which blood clots form at sites of vascular injury to prevent excessive bleeding. Its primary objective is to seal damaged blood vessels through a series of events involving platelet aggregation and the coagulation cascade, which are divided into primary, secondary, and tertiary stages.

Answer 60

The three traditional stages of haemostasis are: 1) Primary haemostasis, where platelets aggregate to form a plug at the site of injury; 2) Secondary haemostasis, where the coagulation cascade stabilizes the platelet plug with fibrin strands; 3) Tertiary haemostasis (fibrinolysis), where the clot is dissolved after it has served its purpose.

Answer 61

Primary haemostasis involves the adhesion, activation, and aggregation of platelets, facilitated by endothelial cells and von Willebrand factor (vWF). Key inhibitors include aspirin and NSAIDs, which inhibit thromboxane production, and clopidogrel, an ADP receptor antagonist, affecting platelet function.

Answer 62

Clinical signs include petechiae, ecchymosis, and purpura, indicating ineffective platelet function. Evaluation tests include platelet count, plateletcrit, Buccal Mucosal Bleed Time (BMBT), and assays for vWF antigen and activity for specific breed-related conditions.

Answer 63

Thrombocytopenia can result from decreased production, immune-mediated destruction, consumption (e.g., DIC), sequestration, or loss, while thrombocytosis can be reactive (secondary to inflammation, neoplasia, or GI disease), drug-induced, or due to increased platelet production. Both conditions can be inherited or acquired.

Answer 64

The three stages are primary haemostasis (platelet plug formation at a damaged vessel wall), secondary haemostasis (coagulation cascade forming fibrin strands to hold the plug together), and tertiary haemostasis or fibrinolysis (dissolution of the clot after it served its purpose).§

Answer 65

Clinically measurable components include platelet count and function, coagulation factors, and fibrin degradation products like D-Dimers. These measurements help evaluate the body's ability to form and dissolve blood clots.

Answer 66

Primary haemostasis involves platelets and endothelial cells (producing vWF) in events like adhesion (platelets to exposed matrix proteins), activation (promoting platelet recruitment and shape change), and aggregation (mediated by fibrinogen).

Answer 67

Clinical signs include petechiae, ecchymosis, and purpura. Key tests include platelet count, plateletcrit, Buccal Mucosal Bleeding Time (BMBT), and assays for von Willebrand factor (vWF) antigen and activity.

Answer 68

Thrombocytopenia can be inherited or acquired due to decreased production, destruction (e.g., immune-mediated), consumption (e.g., DIC), sequestration, or loss. Thrombocytosis can be primary or secondary, caused by increased platelet production or decreased clearance.

Answer 69

Thrombopathia, an abnormal platelet function, is uncommon and difficult to diagnose, with normal or mildly reduced platelet count. vWD is the most common inherited disorder of haemostasis, characterized by deficient or abnormal vWF, diagnosable through vWF antigen concentration tests and BMBT.

Answer 70

The intrinsic pathway is activated by contact with collagen, the extrinsic by tissue factor (TF), and both lead to the common pathway, where factor X is converted to thrombin, which then forms fibrin.

Answer 71

Clinical signs of hypo- and hypercoagulability include haematoma, haemorrhage, and thrombosis. Tests include Prothrombin Time (PT) for extrinsic and common pathways, Activated Partial Thromboplastin Time (aPTT) for intrinsic and common pathways, and Activated Clot Time (ACT) for a quick in-house screening.

Answer 72

Inherited disorders include haemophilia A (factor VIII deficiency) and haemophilia B (factor IX deficiency), while acquired disorders include anticoagulant rodenticide toxicosis and conditions affecting coagulation factors like liver disease.

Answer 73

Vitamin K is essential for synthesizing coagulation factors II, VII, IX, and X. Inhibition (e.g., rodenticide toxicosis) leads to prolonged PT and aPTT, mimicking factor deficiencies and indicating significant liver pathology or dysfunction.

Answer 74

Fibrinolysis is the process of dissolving blood clots, primarily through the action of plasmin converting fibrin into fibrin degradation products like D-dimers. Greyhounds may experience delayed bleeding post-surgery due to premature or excessive fibrinolysis, suggesting that clots formed are weak or dissolved too quickly. Treatments like tranexamic acid or epsilon aminocaproic acid (EACA) can be effective in preventing or reducing plasmin formation, thus improving the condition.

Answer 75

Mammary gland pathologies include mastitis in farm animals, caused by various pathogens (bacterial, viral, mycoplasma), and mammary tumors in small animals. Mammary tumors can be benign (often adenomas with a benign histological appearance) or carcinomas (with a wide range of types, grading based on factors like differentiation, tubule formation, and mitotic rate).

Answer 76

Conditions include congenital lesions (like segmental aplasia), inflammatory disorders (endometritis, metritis, pyometra), and neoplasms (leiomyoma, endometrial carcinoma). External genitalia may also be affected by neoplasms like squamous cell carcinoma and transmissible venereal tumors.

Answer 77

Granulosa cell tumors are the most common type of sex cord-stromal tumor, typically benign, and can occur in any species. They feature a variety of histopathological patterns, including solid sheets, islands, and Call-Exner bodies, and may present with both solid and cystic areas, sometimes including areas of hemorrhagic necrosis.

Answer 78

Ovarian pathologies include ovotestis, cysts (follicular, luteinized, cystic rete ovarii, cysts of the subsurface epithelial structures), and neoplasms (sex cord-stromal tumors like granulosa cell tumors, tumors of the surface epithelium, germ cell tumors like teratoma and dysgerminoma, and rare tumors like yolk sac tumors).

Answer 79

DSDs are conditions involving atypical development of chromosomal, gonadal, or anatomical sex. Classification is based on karyotype (XX, XY, or variations) and includes true hermaphroditism, male and female pseudohermaphroditism, with diagnoses often requiring assessment of sex chromosomes, gonadal type, and genital phenotype.

Answer 80

Conditions involving abnormal development of chromosomal, gonadal, or anatomical sex. Classified based on karyotype and includes true hermaphroditism and pseudohermaphroditism.

Answer 81

A rare condition where both ovarian and testicular tissue are present in the same individual, often associated with true hermaphroditism.

Answer 82

A type of sex cord-stromal tumor originating from the granulosa cells of the ovary, often hormonally active and potentially malignant.

Answer 83

A serious reproductive condition in females characterized by the accumulation of pus within the uterine cavity, often secondary to infection.

Answer 84

Inflammation of the mammary gland, typically due to bacterial infection, leading to swelling, pain, and reduced milk production.

Answer 85

A benign tumor of smooth muscle origin, commonly found in the uterus (uterine fibroids) and sometimes in the external genitalia.

Answer 86

A type of cancer that originates from the lining of the uterus (endometrium), more common in older females.

Answer 87

A genetic condition where an individual has cells from two different zygotes, leading to mixed genetic profiles within the body.

Answer 88

Neoplasms occurring in the mammary glands, ranging from benign (adenomas) to malignant (carcinomas), with varying prognoses based on type and grade.

Answer 89

: Developmental anomalies, degeneration, inflammation, and neoplasia.

Answer 90

Cryptorchidism is the incomplete descent of one or both testes, often leading to hypoplasia and an increased risk of tumor formation.

Answer 91

Testicular hypoplasia is characterized by underdeveloped testes, often due to congenital or pre-pubertal factors like nutrition, genetics, or endocrine abnormalities, leading to absent or incomplete spermatogenesis.

Answer 92

Caused by factors like infections, increased scrotal temperature, and nutritional deficiencies, it's characterized by a reduction in testicular size with firm consistency and microscopic findings similar to hypoplasia, possibly with fibrosis.

Answer 93

Epididymitis, often caused by ascending infection, primarily affects the tail of the epididymis and can lead to secondary testicular degeneration/atrophy, while orchitis involves direct inflammation of the testes.

Answer 94

Cryptorchidism; increases tumor risk.

Answer 95

Absent/incomplete spermatogenesis with hypoplastic tubules.

Answer 96

Infections and environmental factors leading to decreased size and firmness.

Answer 97

Tail of the epididymis, often leading to secondary testicular issues.

Answer 98

Similar to hypoplasia, potentially with fibrosis.

Answer 99

Haematogenous (descending) and urinary (ascending).

Answer 100

Viral: Canine herpesvirus, Canine Adenovirus. Bacterial: Leptospira, E. coli. Parasitic: Toxocara canis, Leishmania spp.

Answer 101

Non-suppurative involves lympho-histiocytic inflammation, while suppurative involves pus formation and can lead to embolic nephritis or pyelonephritis.

Answer 102

Causes include various infectious agents. Acute shows kidneys swollen and pale tan, chronic shows fibrosis.

Answer 103

Primarily caused by acute leptospirosis, leading to lympho-histiocytic inflammation.

Answer 104

Caused by bacteremia with agents like Actinobacillus equuli, leading to septic emboli and possibly abscesses or infarcts.

Answer 105

Begins with ascending infection, showing necrotic epithelium, neutrophil infiltration, and in chronic cases, severe fibrosis.

Answer 106

Descending (leading to nephritis or pyelonephritis) and ascending.

Answer 107

Ureteritis is rare without cystitis, cystitis is the most common lower UTI, and urethritis is often linked to obstructions.

Answer 108

Bacterial agents like Leptospira and E. coli.

Answer 109

Suppurative involves pus formation, non-suppurative involves immune cell inflammation.

Answer 110

Necrotic epithelium with neutrophil and bacterial infiltration.

Answer 111

Ascending infections from the urethra.

Answer 112

Through ascending infection leading to pyelonephritis or descending infection causing nephritis.

Answer 113

Triage is the process used to prioritize patients based on the severity of their condition, aiming to do "the greatest good for the greatest number" by directing therapy where it's most needed.

Answer 114

Effective triage means timely and appropriate prioritization, influenced by experience, a clear plan, stress management, leadership, and agile decision-making.

Answer 115

Optimization methods include practice, developing and following algorithms, and leveraging experienced triage officers supported by their team.

Answer 116

: The drawbacks include the challenge of remembering what each letter stands for and the lack of incorporating point-of-care ultrasound (POCUS), which is crucial for immediate assessment.

Answer 117

The algorithm includes assessing hypovolaemia through symptoms and diagnostics like ultrasound for blood loss, POCUS for pulmonary contusions, and evaluating reduced perfusion with oxygenated blood through blood pressure, lactate, and blood gas analysis.

Answer 118

Allows immediate assessment of trauma or internal bleeding.

Answer 119

Isotonic crystalloids like Hartmann's and 0.9% saline are used for fluid resuscitation in hypovolemia and dehydration due to their rapid equilibration across membranes. However, their effect on intravascular volume expansion is short-lived, necessitating repeated administration or alternative therapy for sustained effects.

Answer 120

Hypertonic saline (7.2%) is used for rapid volume expansion and managing raised intracranial pressure with minimal volume, but risks inducing hypernatremia. Hypotonic saline (0.45%) can correct hypernatremia but may cause cerebral edema if hypernatremia is corrected too rapidly, leading to serious neurological complications.

Answer 121

Whole blood is used for significant blood loss when packed red blood cells (pRBCs) aren't available, targeting anemia. pRBCs are selected for anemia with no donor. Fresh frozen plasma addresses coagulopathies and supports oncotic pressure, while albumin is used in severe hypoalbuminemia to manage anaphylaxis and prevent acute kidney injury.

Answer 122

Colloids, like hetastarch and geloplasma, are used to improve oncotic pressure in hypoalbuminemia and vascular leak conditions. However, their use can exacerbate interstitial edema and minimal volume expansion due to vascular leakage, with potential risks including acute kidney injury and coagulopathy. Their use is cautioned against unless no alternatives are available.

Answer 123

For hypovolemia, initial therapy involves micro boluses followed by larger boluses (10-15ml/kg for larger animals, 5-10mls/kg for cats), potentially including hypertonic saline. Dehydration correction prioritizes hypovolemia first, aiming for weight gain equivalent to the deficit over 24 hours. Endpoints for resuscitation include improved oxygen supply, mentation, blood pressure, lactate levels, and POCUS findings indicating improved volume status.

Answer 124

For rapid equilibration in hypovolemia and dehydration, despite short-lived vascular expansion effects.

Answer 125

For rapid volume expansion in large animals and managing raised intracranial pressure, with careful monitoring to avoid hypernatremia.

Answer 126

Addresses coagulopathies and supports oncotic pressure in hypoalbuminemia.

Answer 127

Risk of exacerbating vascular leakage and interstitial edema, with potential for acute kidney injury.

Answer 128

Monitoring involves assessing mentation, blood pressure, lactate levels, and volume status via POCUS, aiming for specific clinical improvement endpoints.

Answer 129

Calculate the initial bolus using the formula: patient weight in kg x 10 mL/kg. For a 9.1kg dog, the initial bolus would be approximately 91 mL, adjusted on the drip pump to ensure precise delivery over 15 minutes.

Answer 130

Increase the bolus to 15 mL/kg over 15 minutes based on patient response, with continuous monitoring of vital signs and lactate levels to guide further adjustments.

Answer 131

Calculate the total fluid deficit based on the difference between the current and previous healthy body weight, subtracting the volume already administered. Adjust the ongoing fluid rate to cover the deficit plus maintenance needs over 24 hours.

Answer 132

: Increase the fluid rate to account for ongoing losses plus maintenance, continuously reassessing urine output and adjusting the rate accordingly to prevent fluid overload.

Answer 133

Gradually reduce the fluid rate based on urine output and clinical signs, aiming to maintain a stable weight without causing hypervolemia. Consider additional diagnostics to assess for complications like hypoalbuminemia or vascular leak syndrome.

Answer 134

Investigate potential causes of edema, such as hypoalbuminemia or reduced oncotic pressure, through diagnostic tests like biochemistry and urinary protein:creatinine ratio. Adjust the fluid therapy accordingly, possibly incorporating nutritional support and physiotherapy to manage edema.

Answer 135

Assisted feeding refers to providing nutritional support to animals unable to meet their daily nutritional requirements due to inability to eat normally or absorb nutrients from certain GI tract sections. It's needed when animals cannot consume enough nutrients on their own.

Answer 136

Enteral nutrition involves using the gastrointestinal tract for feeding, preferred for its physiological benefits and lower infection risk. Parenteral nutrition, including TPN (Total Parenteral Nutrition) and PPN (Partial Parenteral Nutrition), is administered directly into the venous circulation, indicated when the GI tract is not functional or cannot be used.

Answer 137

The decision is based on the animal's ability to use its GI tract, the nutritional status, and the specific health condition. Factors include GI tract functionality, risk of aspiration, and the need for immediate nutrition without GI involvement.

Answer 138

Types include naso-oesophageal, naso-gastric, oesophagostomy, gastrostomy (including PEG tubes), and enterostomy tubes, each chosen based on the patient's condition, required feeding duration, and specific nutritional needs.

Answer 139

Calculate the Resting Energy Requirement (RER) using the formula RER = 30 x (body weight in kg + 70). Determine the caloric density of the chosen diet (Kcal/ml) and plan the feeding regimen to match the animal's energy needs within clinic working hours, ensuring not to exceed 50ml/kg/feed.

Answer 140

Problems include blockages, tube dislodgement, trauma, infection, and over-granulation. Solutions involve regular tube flushing, careful handling to prevent dislodgement, maintaining good surgical site hygiene, and addressing infections promptly with antibiotics.

Answer 141

Parenteral feeding is complex, requiring meticulous calculation of nutrient needs and monitoring for complications like infections at the catheter site. It's chosen when enteral feeding is contraindicated but requires careful balance to avoid metabolic disturbances.

Answer 142

Hypovolaemic shock is a condition of inadequate organ perfusion due to acute loss of intravascular volume, leading to a critical drop in cardiac preload and negative consequences for tissue metabolism. Causes include traumatic blood loss, haemorrhage, and fluid loss from severe vomiting, diarrhoea, or polyuria.

Answer 143

Clinical signs include tachycardia (increased cardiac output), peripheral vasoconstriction (pale mucous membranes, prolonged capillary refill time, poor pulse quality), and reduced mentation due to decreased cerebral oxygen supply.

Answer 144

Diagnosis is based on clinical signs, history, low blood pressure, elevated lactate levels, and point-of-care ultrasound findings like a collapsing caudal vena cava and a poorly filling heart.

Answer 145

Treatment focuses on restoring volume with isotonic fluids and transfusions (blood/plasma) as needed. Speed is crucial to prevent rapid onset of hypoxia and potential brain death.

Answer 146

Distributive shock is a state of relative hypovolemia resulting from pathological redistribution of intravascular volume, often due to loss of vascular tone regulation or disordered permeability. Common causes include sepsis/SIRS leading to vasodilation and increased vascular permeability.

Answer 147

Signs include vasodilation (injected mucous membranes, shortened CRT, bounding/hyperdynamic pulse, tachycardia), and increased permeability (peripheral oedema, pulmonary oedema, cavitatory effusions).

Answer 148

Diagnosis involves clinical signs, history, low blood pressure, elevated lactate, POCUS findings (collapsing caudal vena cava, poorly filling heart, septic focus, evidence of vascular leak).

Answer 149

Treatment targets vascular tone and permeability, requiring volume support (fluid bolus), vasopressor support (e.g., noradrenaline or dopamine), and ensuring adequate oncotic pressure (checking albumin levels, considering plasma transfusion, starting feeding).

Answer 150

Cardiogenic shock is a reduction in cardiac output due to myocardial failure (e.g., dilated cardiomyopathy), arrhythmias, or valvular disease, leading to systemic hypoperfusion.

Answer 151

Signs include poor pulses, pale mucous membranes, prolonged capillary refill time, reduced temperature, with heart rate variations based on the underlying cause.

Answer 152

Diagnosis is based on clinical signs, history, low blood pressure, elevated lactate, point-of-care ultrasound showing a poorly contracting heart, and ECG findings of arrhythmias.

Answer 153

Treatment depends on the cause and may include managing hyperkalemia, splenic disease, and providing positive inotrope therapy (e.g., pimobendan, dobutamine).

Answer 154

Obstructive shock results from physical obstruction of the heart or great vessels, such as cardiac tamponade, pulmonary thromboembolism, or severe aortic stenosis, leading to reduced cardiac output.

Answer 155

Similar to cardiogenic shock, with additional signs depending on obstruction location, including distension or compression of the vena cava and reduced diastolic filling.

Answer 156

Diagnosis involves clinical signs, elevated lactate, and point-of-care ultrasound findings indicative of specific obstructions like pericardial effusion or pulmonary hypertension.

Answer 157

Treatment focuses on relieving the obstruction (e.g., pericardiocentesis for cardiac tamponade, thoracocentesis for tension pneumothorax) and supportive care, including fluid therapy and oxygen.

Answer 158

POCUS was initially developed to help ER doctors quickly diagnose severe abdominal trauma by identifying free abdominal fluid, primarily blood, without the delays of traditional imaging. Despite being less sensitive than CT for detecting false negatives, it significantly speeds up the identification of severely bleeding patients.

Answer 159

POCUS use has expanded beyond its original purpose to include fluid detection in other cavities with Thoracic FAST scans and lung disease assessment with the Bedside Lung Ultrasound Examination (BLUE). Its use now also encompasses basic echocardiography and specific vessel assessments, such as the inferior vena cava.

Answer 160

The Global FAST approach, developed by Gregory Lisciandro, involves a comprehensive assessment of both thoracic and abdominal cavities in small animals. It combines VetBLUE for lung examination, TFAST for thoracic assessment, and AFAST for abdominal evaluation, aiming for a holistic view of the patient's condition.

Answer 161

FLASH (Fast Localised Abdominal Sonography of Horses) is a 7-point scan designed to assess abdominal and thoracic free fluid and small intestinal loops in horses. It has shown high sensitivity and specificity for diagnosing small intestinal obstruction, highlighting its importance in equine emergency care.

Answer 162

POCUS is crucial for rapidly assessing severe conditions in emergency veterinary patients, aiding in decision-making. It requires familiarity with a specific protocol to ensure consistent, speedy, and accurate examinations. A global assessment approach is recommended for thorough evaluation.

Answer 163

It allows for the rapid identification of critical conditions, such as internal bleeding, without the need for traditional, time-consuming imaging techniques.

Answer 164

It ensures a comprehensive assessment of both the thoracic and abdominal areas, facilitating a more accurate and quicker diagnosis.

Answer 165

It enables the effective detection of abdominal and thoracic fluid and intestinal issues, crucial for diagnosing and managing equine emergencies.

Answer 166

Initially focused on detecting abdominal trauma, POCUS now includes assessments of thoracic conditions, lung diseases, heart function, and blood vessels, making it a versatile tool in emergency medicine.

Answer 167

Consistency in using a specific POCUS protocol enhances the speed, accuracy, and reliability of emergency assessments, improving patient outcomes.

Answer 168

Critical illness induces physiological stress and inflammatory responses, leading to protein catabolism and impaired healing. This results in poorer outcomes and increased complication rates, making nutrition a pivotal part of patient management.

Answer 169

Assess nutritional status using body condition score (focusing on fat stores) and muscle condition score (focusing on lean mass, which is probably more useful in critical illness). Repeat assessments daily and consider measuring muscle belly size with a tape measure for a more accurate evaluation.

Answer 170

Begin nutritional support at the latest by 3 days of anorexia or 7 days of hyporexia. Early intervention is always better, and immediate nutritional support is crucial for hypoalbuminemic patients, such as those with sepsis.

Answer 171

Omega-3 fatty acids have anti-inflammatory properties and may benefit early sepsis, though human studies show mixed results. Antioxidants can address oxidative damage but may cause harm in some cases. Glutamine offers anti-inflammatory and antioxidant effects, but veterinary literature is minimal. Probiotics have weak evidence for benefits in critically ill patients and concerns about antibiotic resistance.

Answer 172

To identify and mitigate the adverse effects of critical illness on the body, such as muscle wasting and impaired healing.

Answer 173

Early intervention can prevent further nutritional decline and support the body's healing process, potentially improving patient outcomes.

Answer 174

Nutritional plans are tailored based on the patient's condition, including the urgency for intervention (e.g., hypoalbuminemia) and specific needs (e.g., omega-3 for inflammation).

Answer 175

They may modulate inflammation and oxidative stress, though their efficacy varies by case and existing literature.

Answer 176

They help assess nutritional status and guide the development of a targeted nutritional intervention plan.

Answer 177

Head trauma in animals commonly results from crushing injuries, such as running into a tree, being hit by a vehicle, or experiencing a major fall.

Answer 178

The first consideration is whether the animal can breathe, assessing for crushed nasal bones or soft tissue damage. The second consideration is the condition of the brain, looking for evidence of traumatic brain injury or skull fractures.

Answer 179

Assess the respiratory rate, effort, signs of cyanosis, and pulse oximetry. For emergency therapy, provide oxygen if the airway is patent, or perform rapid induction and intubation if not. Have suction available to clear the airway and consider emergency tracheostomy if intubation fails.

Answer 180

Primary injuries include concussion, contusion, hematoma, and laceration, leading to increased intracranial pressure (ICP). Secondary injuries result from the neurological tissues' excitation, causing ATP depletion, pro-inflammatory state, neuronal damage, and disruption of the blood-brain barrier, making the brain sensitive to peripheral blood pressure changes.

Answer 181

Through neurological assessment of mentation and eyes, including observing the pupillary light reflex (PLR) and checking for signs like bilateral miosis or unilateral mydriasis, which indicate varying prognoses.

Answer 182

The main considerations include reducing the intracranial pressure (ICP) and normalizing perfusion. This can involve the use of hypertonic fluids like hypertonic saline or mannitol and managing blood pressure to maintain normal MAP.

Answer 183

Thoracic injuries can be blunt (causing bruising, contusions, lung rupture, diaphragm rupture, or orthopedic injuries) or penetrating (causing direct injury to lungs, airways, major vessels, the heart, external contamination, or esophageal injury).

Answer 184

Assess if the animal can breathe properly.

Answer 185

PLR helps in prognosticating the outcome based on the response.

Answer 186

Through the administration of hypertonic saline or mannitol.

Answer 187

It helps in preventing further neuronal damage by ensuring adequate cerebral perfusion.

Answer 188

Blunt injuries are primarily concussive, while penetrating injuries directly damage internal structures.

Answer 189

Abdominal injuries can be blunt, causing concussions, contusions, swelling, and possibly organ ruptures, or penetrating, which may directly injure organs or major vessels and lead to external contamination.

Answer 190

: POCUS (Point-of-Care Ultrasound) is crucial for triaging abdominal trauma, as it helps in identifying free fluid and guiding further diagnostic procedures like abdominocentesis.

Answer 191

Management usually involves conservative measures such as fluid therapy, potentially using hypertonic saline and blood products if necessary. Surgical intervention is rare unless an organ has ruptured.

Answer 192

: Tranexamic acid is an anti-fibrinolytic that stabilizes clot formation. It has shown a survival benefit when administered within 3 hours post-trauma in humans, with veterinary studies indicating its utility in reducing bleeding during surgeries, though with varying outcomes in non-surgical case

Answer 193

Pneumoperitoneum, usually resulting from blunt or penetrating trauma, indicates gastrointestinal tract damage. It often requires surgical intervention, with diagnosis challenging via POCUS and management including antibiotic cover and exploratory laparotomy.

Answer 194

The main concern is hyperkalemia, treated with glucose and insulin, alkalinizing fluid therapy, and potentially draining the abdomen and placing a urinary catheter to allow healing before any necessary surgery.

Answer 195

Spinal trauma diagnosis requires careful radiographic examination with orthogonal views, and management includes supportive care, pain relief, nutritional support, and physiotherapy, with surgical intervention considered based on the severity and type of injury.

Answer 196

Within 3 hours post-trauma to stabilize clot formation.

Answer 197

Free gas in the abdomen indicates damage, confirmed by radiography.

Answer 198

Hyperkalemia is the primary threat, treated with glucose, insulin, and alkalinizing fluids.

Answer 199

Oxygen therapy is indicated for SpO2 <93%, PaO2 <70mmHg, and lactate >2.0mmol/l, signaling reduced oxygen supply to tissues and the potential need for anaerobic respiration avoidance.

Answer 200

Conditions include ventilation/perfusion mismatch, pleural space pathology (e.g., pneumothorax), lung pathology (e.g., pneumonia), perfusion abnormalities (e.g., hypovolemic shock), distributive shock (e.g., sepsis/SIRS), anaemia, acid-base disturbances affecting the Hb/Sat curve, and right to left shunts.

Answer 201

Each modality has unique benefits and limitations. For example, flow-by is non-invasive but less efficient, while intubation offers direct oxygen delivery but requires sedation or anesthesia and carries a risk of complications.

Answer 202

Pneumothorax and pneumonia.

Answer 203

It provides precise oxygen delivery directly to the airways.

Answer 204

To ensure adequate oxygenation without causing oxygen toxicity.

Answer 205

Acidosis reduces hemoglobin's affinity for oxygen, increasing oxygen offloading to tissues.

Answer 206

Fluid overload increases interstitial fluid, impairing oxygen and nutrient diffusion, adversely affecting renal and lung function. Fluid deficit impairs perfusion and promotes catabolism, insulin resistance, and cellular stress.

Answer 207

Hypoalbuminemia leads to poor oncotic pressure, causing fluid loss to the interstitial space, hypovolemia, peripheral and pulmonary edema. Management includes increasing protein intake, plasma transfusion, and careful use of synthetic colloids due to the risk of acute kidney injury.

Answer 208

Hypokalemia and hyponatremia are common, leading to weakness and mentation disturbances. Management involves fluid supplementation and careful correction, especially for sodium due to the risk of osmotic changes.

Answer 209

Mentation assessment provides clues about perfusion status and potential intracranial issues, utilizing tools like the Modified Glasgow Coma Scale for standardization.

Answer 210

Cardiac issues like bradycardia and arrhythmias indicate systemic or myocardial disease. Monitoring includes ECG, and management may involve anti-arrhythmics, positive inotropes, and assessing cardiac output via POCUS.

Answer 211

Blood pressure measurement helps identify hypovolemia, distributive shock, or poor cardiac contractility, informing the management approach.

Answer 212

Hypo- and hyperthermia result from various causes like anesthesia or inflammation, respectively. Management focuses on gradual temperature correction and addressing the underlying cause.

Answer 213

Monitoring includes mucous membrane color, respiratory rate, and pulse oximetry, with advanced tools like blood gas analysis. Management involves oxygen therapy and addressing any identified respiratory issues.

Answer 214

Critical illness can weaken the immune response, heightening secondary infection risk. Management includes identifying infection sources, sampling for culture, and appropriate antibiotic use.

Answer 215

Local anesthetics work by interacting with receptors within the Na+ channel close to the cytoplasm in their ionized charged form. This blocks nerve conduction by preventing sodium ions from entering the nerve ending, thus inhibiting the initiation and propagation of nerve impulses.

Answer 216

: Local anesthetics are classified into two main types based on their chemical link: amides and esters. Amides are metabolized by the liver, whereas esters are broken down by plasma cholinesterases.

Answer 217

Procaine has a rapid onset with a duration of 40-60 minutes and moderate toxicity. Lidocaine also has a rapid onset, but its duration is longer, lasting 1-2 hours, with similar toxicity levels.

Answer 218

Adrenaline (epinephrine) is added to local anesthetics to prolong their duration of action. It causes vasoconstriction, which reduces blood flow in the area, slowing the absorption of the anesthetic and extending its effects.

Answer 219

Lidocaine is versatile and used in various applications like spray for cat intubation, cream for skin numbing, eye drops for cornea anesthesia, and as part of infiltration techniques for surgical sites.

Answer 220

Intratesticular blocks involve injecting a local anesthetic directly into the testicle, targeting the spermatic cord and associated structures. This method provides intraoperative pain relief and postoperative analgesia, particularly effective during castrations.

Answer 221

These epidurals are indicated for surgeries in the tail, perineal, and genital areas, including tail amputations, perineal urethrostomies, and anal sacculectomies. They provide effective analgesia for procedures in these regions.

Answer 222

Femoral nerve blocks offer an alternative with a reduced risk of urine retention and lower postoperative opioid consumption. They also tend to have less impact on mean arterial blood pressure, suggesting a potentially lower risk of hypotension during anesthesia.

Answer 223

Local anesthetics are drugs that cause temporary loss of sensation in a specific area. They work by blocking nerve signals in the body.

Answer 224

Amide local anesthetics are metabolized by the liver, and ester local anesthetics are broken down by plasma cholinesterases.§

Answer 225

Adrenaline is added to prolong the effect of local anesthetics by slowing their absorption through vasoconstriction. | slowsabsorption

Answer 226

It's a technique of injecting anesthetic into the testicle for pain relief during and after procedures like castrations.

Answer 227

They reduce the need for systemic opioids, minimize postoperative pain, and can lower the risk of certain anesthesia-related complications.

Answer 228

To provide localized pain relief during and after surgical procedures on horses, minimizing systemic medication use.

Answer 229

Local anesthetics work by interacting with receptors within the Na+ channel close to the cytoplasm in their ionized charged form. This blocks nerve conduction by preventing sodium ions from entering the nerve ending, thus inhibiting the initiation and propagation of nerve impulses.

Answer 230

Local anesthetics are classified into two main types based on their chemical link: amides and esters. Amides are metabolized by the liver, whereas esters are broken down by plasma cholinesterases.

Answer 231

Procaine has a rapid onset with a duration of 40-60 minutes and moderate toxicity. Lidocaine also has a rapid onset, but its duration is longer, lasting 1-2 hours, with similar toxicity levels.

Answer 232

Adrenaline (epinephrine) is added to local anesthetics to prolong their duration of action. It causes vasoconstriction, which reduces blood flow in the area, slowing the absorption of the anesthetic and extending its effects.

Answer 233

The primary purpose of equine regional anesthesia is to provide localized pain relief during surgical procedures or diagnostic interventions by blocking sensory nerve signals in specific areas of the horse's body.

Answer 234

Main types include peripheral nerve blocks (for limbs and tail), paravertebral blocks (for flank and thorax), and epidural anesthesia (for procedures involving the caudal part of the body).

Answer 235

A supraorbital nerve block is performed by injecting anesthetic near the supraorbital foramen to desensitize the forehead and the area around the eyes.

Answer 236

Complications can include inadvertent vascular injection, local anesthetic toxicity, and nerve damage, leading to temporary or permanent loss of sensation or motor function.

Answer 237

Factors include the desired duration of anesthesia, the specific area to be anesthetized, potential side effects, and any pre-existing health conditions of the horse.

Answer 238

It allows for pain-free surgical and diagnostic procedures in a targeted area, improving animal welfare and procedural outcomes.

Answer 239

Veterinarians choose the injection site based on the anatomical origin of the nerve supplying the area requiring anesthesia.

Answer 240

Ultrasound helps in visualizing the nerve and surrounding structures for more precise and safer administration of the nerve block.

Answer 241

Yes, it can be used for chronic pain management, especially in cases of limb lameness or other persistent pain conditions, by providing targeted relief.

Answer 242

Safety precautions include proper patient restraint, choosing the correct anesthetic agent and dose, and monitoring the horse for adverse reactions post-procedure.

Answer 243

Local blocks are crucial for performing surgeries on farm animals while they are standing, minimizing the stress and risks associated with general anesthesia. They provide targeted pain relief and allow for a variety of surgical and diagnostic procedures to be performed with the animal conscious but comfortable.

Answer 244

Key considerations include the type of surgery or procedure, the specific area requiring anesthesia, the animal's size and condition, potential side effects of the anesthetic agents, and the ability to manage any complications that may arise.

Answer 245

he three main techniques are the "Line" block, which involves direct injection along the surgical site; the "Inverted L" block, which creates an anesthetic field in the shape of an inverted L around the surgical area; and Paravertebral anesthesia, which targets the spinal nerves supplying the flank area, providing a wider area of anesthesia.

Answer 246

Options include the "Ring" block, where anesthetic is injected in a ring around the top of the hoof to numb the entire foot, and Intravenous Regional Anesthesia (IVRA), where anesthetic is injected into a vein of the limb after applying a tourniquet, numbing the area distal to the tourniquet.

Answer 247

The Retrobulbar block targets nerves behind the eye for procedures on the eyeball itself, the Peterson block is used for anesthesia of the deeper eye structures, and the Auriculopalpebral block is motor only, used to paralyze the eyelid muscles without affecting sensation.

Answer 248

Local anesthesia for teat surgery can be achieved through a "Ring" block at the base of the teat or through Intravenous Regional Anesthesia (IVRA) for more extensive procedures, with or without the use of additional local infiltration techniques.

Answer 249

It allows for pain management and stress reduction during procedures, improving animal welfare and surgical outcomes.

Answer 250

A "Line" block is a straight line of anesthesia at the surgery site, while an "Inverted L" block encircles the area in an inverted L shape for broader coverage.

Answer 251

It involves injecting anesthetic near the spinal nerves to numb a large area of the body, such as the flank or abdomen, by blocking nerve signals to and from that region.

Answer 252

IVRA is preferred for surgeries on limbs or teats where it's necessary to numb the entire area below a tourniquet, providing a bloodless field and extensive numbness.

Answer 253

Key steps include monitoring for signs of toxicity or allergic reactions, being prepared to support respiratory and cardiovascular functions, and knowing how to treat local anesthetic systemic toxicity (LAST).

Answer 254

For analgesia during difficult calving, consider using epidural anesthesia with local anesthetics like lidocaine or bupivacaine to provide pain relief to the pelvic area. Also, systemic analgesics such as NSAIDs (e.g., flunixin meglumine) can be administered to manage pain and inflammation.

Answer 255

The cost can be justified by comparing it to the overall value of the animal's health, productivity, and welfare benefits from effective pain management. The cost of the protocol is often significantly less than the potential loss from complications arising from inadequate pain management.

Answer 256

Potential complications include systemic effects of opioids, risk of infection with invasive procedures, and local anesthetic toxicity. Management alterations might include monitoring for adverse effects, adjusting dosages, and employing multimodal analgesia to minimize risks.

Answer 257

The protocol includes local infiltration anesthesia or a regional block for the surgical site, systemic analgesics like NSAIDs for pain and inflammation, and potentially sedatives to maintain standing sedation. Specific medicines, doses, and routes should be selected based on the animal's condition, the expected surgery duration, and legal regulations for drug use in food-producing animals.

Answer 258

An effective plan includes premedication with a sedative and an opioid for pain relief, induction with an injectable anesthetic agent suitable for young calves, maintenance of anesthesia with inhalant anesthetics via intubation if needed, and local infiltration at the surgery site. Post-operative analgesia should include NSAIDs and careful monitoring for recovery.

Answer 259

Pain management is crucial for animal welfare, reducing stress, and facilitating recovery, leading to better health outcomes and productivity.

Answer 260

Factors include the type of procedure, the animal's health status, potential drug side effects, and regulations on drug use in food-producing animals.

Answer 261

By evaluating the benefits of pain management against potential losses from inadequate care and leveraging cost-effective drugs within legal guidelines.

Answer 262

Multimodal analgesia involves using multiple drugs and techniques to control pain, minimizing the risk of side effects while maximizing pain relief.

Answer 263

Potential complications necessitate a careful selection of drugs and techniques, balancing effective pain control with the risk of adverse effects.

Answer 264

A sedation protocol for standing castration in a colt could include the use of an alpha-2 agonist like detomidine or xylazine, combined with butorphanol for additional analgesia. Dosing should be calculated based on the horse's weight (300kg), considering the specific drug concentrations and manufacturer guidelines. Administration is typically intravenous, using a suitable gauge and length needle for equine IV access.

Answer 265

The protocol should include premedication with an alpha-2 agonist and butorphanol, induction with a combination of ketamine and midazolam to ensure a smooth transition to recumbency, and maintenance with an appropriate volatile agent like isoflurane or sevoflurane. Doses should be calculated based on the mare's weight (480kg). Consideration for local blocks around the stifle may provide additional analgesia and reduce the need for systemic analgesics.

Answer 266

Combining midazolam, a benzodiazepine, with ketamine provides muscle relaxation, reduces the dose of ketamine required for induction, and may result in a smoother induction and recovery phase. This combination can help mitigate some of ketamine's dissociative effects and enhance patient safety during the transition to recumbency.

Answer 267

For TECA, local anesthetic blocks such as the auriculopalpebral nerve block, which provides analgesia to the ear, can be used to significantly reduce intraoperative and postoperative pain. An appropriate volume of a local anesthetic like bupivacaine or lidocaine can be used, taking care to calculate the dose based on the dog's weight and the maximum safe dose of the local anesthetic.

Answer 268

Effective analgesia can be provided through a multimodal approach, combining systemic analgesics such as NSAIDs and opioids with local anesthetic blocks. This approach targets pain at multiple pathways, offering more comprehensive pain control and potentially reducing the amount of systemic medication required.

Answer 269

Premedication helps calm the animal, provides initial pain relief, and can make induction smoother and safer by reducing the doses of induction agents needed.

Answer 270

Local blocks provide targeted pain relief, can reduce the need for higher doses of general anesthetics, and help in postoperative pain management.

Answer 271

Multimodal analgesia involves using different types of pain management strategies together to more effectively control pain, minimize side effects, and improve recovery outcomes.

Answer 272

Calculating drug doses based on weight ensures the medication is effective while minimizing the risk of overdose and side effects.

Answer 273

Safety during induction is ensured by careful dosing, monitoring the animal's vital signs, and preparing for emergency interventions if needed.

Answer 274

Breathing systems deliver oxygen and anesthetic gases, remove carbon dioxide from exhaled breath, and allow for patient ventilation if needed. They are categorized into non-rebreathing and rebreathing systems, chosen based on patient size and other factors.

Answer 275

Non-rebreathing systems are ideal for small patients (less than 10kg) due to their low resistance and reliance on high fresh gas flows. They are commonly used for their simplicity and efficiency in oxygen delivery.

Answer 276

Rebreathing systems are efficient for larger patients (over 10kg) as they recycle exhaled gases (after CO2 removal), reducing the need for high fresh gas flows. They warm and humidify the gas, making them suitable for longer procedures.

Answer 277

Calculate the fresh gas flow (FGF) by multiplying the patient's minute volume (MV) by the system factor (SF). For a non-rebreathing system like the T-piece, with an SF of 2.5, FGF = MV x SF.

Answer 278

The T-piece is suited for very small patients (<10kg), the Bain system works for medium-sized patients (10-30kg) with its tube-within-a-tube design, and the Circle system is versatile for patients ranging from 2-150kg, featuring CO2 absorption capabilities.

Answer 279

Patient size determines the breathing system's efficiency in delivering and removing gases, with smaller patients requiring systems that provide minimal resistance and larger patients benefiting from CO2 absorption capabilities.

Answer 280

By recycling exhaled gases (after removing CO2), reducing the need for continuous high fresh gas flow, making it more efficient and cost-effective for larger patients or longer surgeries.

Answer 281

SF adjusts the calculation of fresh gas flow needed to ensure the patient receives enough oxygen and anesthetic gas while minimizing waste, tailored to the specific breathing system used.

Answer 282

For buprenorphine at 0.02mg/kg and acepromazine at 0.03mg/kg, calculate the doses in milligrams, then convert to the volume based on the concentration of the drugs available. Ensure to adjust for micrograms if necessary.

Answer 283

Consider a multimodal approach, including NSAIDs for pain relief, physical therapy, and environmental modifications to reduce joint stress. Adjust the treatment based on effectiveness and the goat's tolerance.

Answer 284

Use a topical anesthetic like proparacaine for initial examination. For more invasive procedures, consider a retrobulbar block to desensitize the deeper structures of the eye and an auriculopalpebral block to immobilize the eyelid.

Answer 285

In the yard, consider NSAIDs, standing support wraps, and soft footing. In the hospital, more advanced pain management like regional limb perfusion with antibiotics or analgesics and systemic opioids may be appropriate.

Answer 286

For acepromazine (0.03mg/kg) IM, romifidine (0.08mg/kg), and morphine (0.1mg/kg) IV, calculate the total milligrams required. Then, for ketamine (3mg/kg) and midazolam (0.06mg/kg) induction, determine the volume to draw up based on the concentrations available.

Answer 287

Accurate calculation ensures the animal receives the optimal effect of the medication, minimising risks of underdosing or overdosing, which can impact the safety and effectiveness of anesthesia.

Answer 288

Consider the type of pain, the animal's overall health, potential side effects of medications, and the need for a multimodal approach to provide effective and sustainable pain relief.

Answer 289

Local blocks provide targeted anesthesia, reducing stress and pain for the animal, and allow for a thorough examination or procedure without the need for general anesthesia.

Answer 290

It targets different pain pathways, offering more comprehensive pain control, improving patient comfort, and potentially reducing the need for high doses of any single medication.

Answer 291

This ensures that each animal receives a dose tailored to its specific needs, maximizing the efficacy of the medication while minimizing the risk of adverse effects.

Answer 292

Adjusting the animal's living conditions to reduce strain on affected joints can significantly improve comfort and mobility, complementing medical treatments.

Answer 293

Continuous monitoring allows for immediate detection of and response to any physiological changes, ensuring the animal's safety and facilitating a smooth recovery.

Answer 294

Effective communication helps ensure that pet owners understand their animal's condition, the rationale behind treatment plans, and their role in managing their pet's pain at home, leading to better outcomes.

Answer 295

Administer fluid therapy considering the rabbit's weight, assessing for shock, and deciding between subcutaneous or intravenous routes based on the severity of dehydration or shock.

Answer 296

: Prescribe gut motility drugs to prevent gastrointestinal stasis, a common complication in stressed rabbits, ensuring the drugs are safe for rabbits.

Answer 297

Provide analgesia suitable for rabbits, considering NSAIDs or opioids depending on pain severity and ensuring dosages are rabbit-specific.

Answer 298

Initiate feeding with easily digestible, high-fiber foods to support gut health, and consider critical care formulas if the rabbit is not eating voluntarily.

Answer 299

Choose antibiotics carefully to avoid those harmful to rabbits' gut flora and monitor for signs of infection or adverse reactions to medication.

Answer 300

Calculate fluid needs based on bird's weight and condition, choosing the route (subcutaneous, intravenous) based on severity of dehydration or shock.

Answer 301

Administer bird-appropriate analgesics, carefully dosed to manage pain without impairing recovery or causing toxicity.

Answer 302

Provide a diet that meets the nutritional needs of a carnivorous bird, initially through assisted feeding if necessary, and ensuring the food is easily digestible.

Answer 303

Monitor the bird's vitals, pain level, and response to treatment; stabilize the fracture minimally until further definitive treatment can be planned.

Answer 304

Ensure a quiet, stress-free environment to promote recovery, with appropriate enclosure sizing and perch adjustments to accommodate the injury, alongside planning for further diagnostic tests or specialist referral for the fracture.

Answer 305

Differential Diagnoses: Neonatal sepsis, hypoxic-ischemic encephalopathy, prematurity. Diagnostic Plan: Complete blood count, blood culture, IgG levels, ultrasound of the thorax, arterial blood gas analysis. Treatment Plan: IV fluids for dehydration, broad-spectrum antibiotics for suspected sepsis, supportive care including warming and nutritional support. Outcome and Prognosis Considerations: Prognosis depends on timely identification and treatment of underlying causes; monitoring for improvements or complications is critical.

Answer 306

Differential Diagnoses: Foreign body obstruction, pancreatitis, toxic ingestion. Diagnostic Plan: Physical examination, radiography, complete blood count, serum biochemistry, abdominal ultrasound. Treatment Plan: Fluid therapy, antiemetics, analgesics, and, depending on diagnosis, surgical intervention or specific antidotes for toxins. Outcome and Prognosis Considerations: Early intervention can significantly improve outcomes; prognosis varies with the underlying cause and response to initial treatment.

Answer 307

Definition: Hypoxic-ischemic encephalopathy (HIE) is a condition resulting from inadequate oxygen and blood flow to the brain near the time of birth, leading to neurological dysfunction. Differential Diagnoses: Sepsis, intracranial hemorrhage, metabolic disorders. Diagnostic Plan: Clinical observation, MRI or CT scan to assess brain injury, EEG for seizure activity, blood tests to rule out metabolic causes. Treatment Plan: Supportive care (maintaining normal blood glucose, temperature, and blood pressure), therapeutic hypothermia (cooling therapy) for eligible neonates to reduce neurological damage, seizure management with anticonvulsants. Outcome and Prognosis Considerations: Prognosis varies; early intervention with therapeutic hypothermia has been shown to improve outcomes in some cases. Long-term follow-up for developmental and neurological assessment is essential.

Answer 308

Hysteresis is the phenomenon whereby the individual curves for inflation and deflation are not the same

Answer 309

The main objectives are to understand how to optimize ultrasonographic images by manipulating various machine settings and to be able to label and store images for future review.

Answer 310

Selecting the appropriate preset (e.g., cardiac, abdomen, superficial structures) is crucial because using a mismatched preset, like a cardiac preset for an abdominal scan, will make it difficult to obtain a good image.

Answer 311

Enter patient details, reduce ambient light if possible, prepare the animal appropriately, select the correct transducer type, and select the suitable transducer frequency.

Answer 312

Set an approximate depth of penetration (labeled as 'magnification' or with in/out arrows), and adjust overall gain and power settings (if available) to mid/low values.

Answer 313

Adjust the depth of penetration so the organ fills the screen and adjust the focal zone to the middle of the organ.

Answer 314

TGC adjusts the gain at different depths to compensate for sound attenuation in deeper tissues, ensuring even echotexture and visibility throughout the image.

Answer 315

Adjusting TGC ensures that tissues have an even consistency across different depths, improving the diagnostic quality of the ultrasound image.

Answer 316

The transducer can be moved in standard and non-standard planes, slid in various directions, angled, or rotated to capture the best possible image.

Answer 317

Knobology refers to the skill of adjusting machine controls like frequency, depth, focal depth, and TGC to optimize imaging for different organs.

Answer 318

Use the machine's freeze function to capture images, label them appropriately (e.g., orientation), and then store or print. For dynamic imaging, pressing 'store' during scanning saves a video clip.

Answer 319

Ultrasound machines provide cursors for measuring linear lengths, areas, or peripheries, and selecting a body system allows for specific measurements like 'renal length.'

Answer 320

It transforms measurements into biological values, such as estimating gestational age or predicting the date of parturition, enhancing diagnostic accuracy and planning.

Answer 321

Use appropriate personal protective equipment (PPE), ensure proper restraint of the animal, consider the need for analgesia or sedation, and adjust the examination setting based on the animal's size and the area being examined.

Answer 322

Clip hair, clean the skin with alcohol, apply ultrasound gel, and ensure good contact between the transducer and skin to allow sound penetration.

Answer 323

Linear transducers emit parallel sound lines creating a rectangular beam for full cross-sectional images, requiring full contact. Curved transducers emit diverging sound lines for a larger cross-sectional image with a smaller contact area, useful for areas like between ribs.

Answer 324

Stand-offs, such as gel pads or extra gel, move superficial structures further from the transducer to reduce near-field noise, essential for imaging superficial structures like equine tendons.

Answer 325

Higher frequencies provide better resolution but less depth penetration, suitable for shallow structures like the eye, while lower frequencies offer deeper penetration but lower resolution, used for deeper structures like sheep pregnancy detection.

Answer 326

To improve imaging of superficial structures by reducing near-field noise and enhancing image clarity.

Answer 327

Radiographs should only be taken when there is definite clinical justification. It's imperative to obtain a standard view for accurate interpretation.

Answer 328

Once x-ray equipment is switched on, the radiography room becomes a Controlled Area, permitting only authorized personnel to enter while radiography is being performed.

Answer 329

Key components include the tube head for generating x-rays, lead shutters for beam area control, a light beam diaphragm for positioning, cassettes for image capture, and a grid for improved image quality in deeper tissues.

Answer 330

Safety measures include staying at least 2 meters away from the primary beam, wearing PPE, using a personal dosimeter, recording all exposures, ensuring equipment is in good order, and avoiding radiography if pregnant.

Answer 331

Radiographs are often taken with the animal conscious and standing, requiring multiple people (machine operator, plate holder, animal handler), and usually done at the client's premises, demanding careful safety planning and technique due to the horizontal beam and large patient size.

Answer 332

The risks include the potential for the beam to travel further, creating more scatter and requiring higher exposures than in small animals. This necessitates the use of protective clothing and adherence to the inverse square law for safety.

Answer 333

Ensure correct machine settings, patient positioning, labeling, focal distance, beam centering, and collimation. Perform a final safety check to ensure everyone is correctly positioned.

Answer 334

The cranial aspect of the animal should be on the left of the image, and the proximal aspect on the upper part of the image. Lateromedial views of specific areas like the tarsus are standard.

Answer 335

Oblique views are used to provide additional perspectives on joints, highlighting medial and lateral aspects that may not be visible in standard projections, such as the dorsolateral-palmaromedial oblique view.

Answer 336

An imaging report should detail the findings ('What have you got?'), describe the observable details ('What can you see?'), and conclude with the clinical significance ('What does it mean?').

Answer 337

Abnormalities should be described using specific radiographic and ultrasonographic descriptors, such as "fluffy new bone on the distal patellar groove," indicating mild osteoarthritic changes.

Answer 338

Common pitfalls include overinterpretation, using wrong terminology, concluding without adequate observations and interpretations, and failing to provide or consider adequate context for the findings.

Answer 339

Adhering to a basic structure ensures clarity, comprehensiveness, and relevance, facilitating accurate diagnosis and appropriate clinical decision-making.

Answer 340

Precise terminology prevents misunderstandings and ensures clear communication among veterinary professionals.

Answer 341

It may lead to incorrect diagnoses or unnecessary treatments, emphasizing the need for a balanced and evidence-based approach.

Answer 342

It standardizes reporting, ensuring all necessary information is conveyed and interpreted correctly for optimal patient care.

Answer 343

Lateral (medio-lateral) view and caudo-cranial view.

Answer 344

In lateral recumbency with the leg to be imaged against the table.

Answer 345

In ventral recumbency with the limb extended caudally.

Answer 346

The limb to be radiographed is flexed 90 degrees, with the upper limb moved cranially or laterally out of the way using a rope tie or sandbag.

Answer 347

Avoid pulling the leg too far cranially or laterally as it can rotate the pelvis and thus the lower leg and stifle.

Answer 348

A foam pad under the hock to keep the tibia parallel to the table and a sandbag to hold the hock in position.

Answer 349

Include 50% of the femur and 50% of the tibia-fibula, with collimation centered at the stifle joint or slightly more distal.

Answer 350

The femoral condyles should be superimposed and not rotated.

Answer 351

Rotate the limb so the patella is in the midline, with the center of collimation at the middle of the stifle joint.

Answer 352

The femoral condyles are of equal size with the patella in the midline, ensuring no limb rotation and good visualization of the joint space.

Answer 353

Lateral (medio-lateral) and caudo-cranial views.

Answer 354

The dog is placed in lateral recumbency with the leg to be imaged against the table.

Answer 355

The dog is placed in dorsal recumbency, and the limb is extended cranially.

Answer 356

The limb is pulled into extension, the upper limb is moved caudally, and the neck is flexed dorsally to avoid superimposition over the shoulder joint.

Answer 357

Use a foam pad under the chest for alignment, include the distal 50% of the scapula and proximal 50% of the humerus, and collimate around the shoulder joint.

Answer 358

Clear visualization of the joint space without overlying tissue from the neck, other limbs, or the cervical spine.

Answer 359

The dog is in dorsal recumbency, limb extended and slightly away from the midline, with the head and neck slightly pushed away if needed for clarity.

Answer 360

The horse should be well-restrained, preferably held rather than tied, using a headcollar or bridle/chifney as needed, with the examination ideally conducted in stocks or a stable.

Answer 361

Sedation may be required for horses that are spooky or dislike the ultrasound machine to ensure they remain quiet and not fidgety during the exam.

Answer 362

Use a linear probe with a high frequency (8.5-10 MHz), a standoff pad if available, and obtain both transverse and longitudinal views.

Answer 363

Start at the proximal metacarpus/metatarsus, image in transverse and then longitudinal sections from proximal to distal, and identify any abnormalities based on their location and appearance.

Answer 364

Proper limb preparation includes clipping, applying spirit gel, and using appropriate pressure to ensure good image quality, remembering that ultrasound waves do not travel well through air.

Answer 365

: For CT, ionizing radiation; for MRI, magnetic fields, implanted medical devices, metallic implants, missile risk, and magnetic media.

Answer 366

By understanding applied anatomy, recognizing deviations from normal structure, and identifying specific signs of diseases like spinal fractures, calcified disc extrusion, neoplasia, discospondylitis, spinal tumors, and fibrocartilaginous embolisation.

Answer 367

Vertebrae, intervertebral discs, spinal cord, and surrounding soft tissues.

Answer 368

By looking for discontinuities in the vertebral bodies, misalignment, or abnormal spacing between vertebrae.

Answer 369

It enhances the visualization of spinal structures, allowing for detailed analysis of complex anatomies and pathologies.

Answer 370

Calcified disc extrusion shows as hyperdense areas on CT, whereas discospondylitis may show disc space narrowing, endplate irregularities, and possible abscess formation.

Answer 371

The report should detail the findings ("What have you got?"), describe the observed abnormalities ("What can you see?"), and interpret the clinical significance ("What does it mean?").

Answer 372

Factors include the type of tissue being examined, the presence of metal implants, patient condition, and the specific clinical question being addressed.

Answer 373

CT is preferred for imaging bone structures, detecting acute bleeding, and situations requiring rapid imaging, such as emergencies.

Answer 374

MRI is preferred for detailed soft tissue contrast, imaging of the brain and spinal cord, and situations where radiation exposure is a concern.

Answer 375

MRI does not use ionizing radiation, making it a safer option for pregnant patients and repeated imaging scenarios.

Answer 376

MRI provides superior soft tissue contrast compared to CT, making it ideal for imaging ligaments, tendons, and the brain.

Answer 377

CT provides superior detail of bone structures, including fractures and bony pathology.

Answer 378

MRI is often contraindicated or limited by the presence of metal implants due to artifact creation, whereas CT may be less affected.

Answer 379

Look for signs of joint effusion, cranial movement of the tibia indicating cranial cruciate ligament rupture, chronic stifle arthrosis, and osteochondrosis.

Answer 380

Joint effusion is indicated by an increased soft tissue density around the joint capsule, often accompanied by displacement of the fat pad.

Answer 381

Progressive cranial displacement of the tibia relative to the femur, assessed through different stages from mild to severe.

Answer 382

Features include the presence of osteophytes, joint effusion, and, although the underlying cause may not be evident, it could be secondary to trauma.

Answer 383

Look for radiolucent defects with surrounding sclerosis, which could evolve into chronic arthrosis over time.

Answer 384

Medial shoulder luxation, osteochondrosis, and chronic shoulder arthrosis.

Answer 385

By the displacement of the humeral head medially compared to the glenoid cavity, often due to trauma.

Answer 386

Loss of the rounded contour of the caudal surface of the humeral head, radiolucent defects, possibly with surrounding sclerosis or calcified free bodies in the joint.

Answer 387

Presence of new bone formation (osteophytes) around the joint, with the underlying cause often not evident.

Answer 388

In the sensitization phase of Type 1 Hypersensitivity, exposure to an allergen via respiratory or skin routes leads antigen-presenting cells to capture antigens, causing naïve T cells to differentiate into T helper 2 cells, which favor a humoral response. These Th2 cells release cytokines (IL-4, IL-10, IL-5, IL-9, IL-13) that induce B cell proliferation and class switching from IgM to IgE. IgE then binds to mast cells, which relocate to the area of initial allergen encounter, without causing clinical signs initially.

Answer 389

Upon re-exposure to the same allergen, primed IgE-coated mast cells bind the allergen, leading to the release of cytoplasmic granules containing histamine, heparin, and serotonin. This causes symptoms like pruritis, bronchoconstriction, and edema within 15 minutes (immediate hypersensitivity). The late phase reaction occurs 4-24 hours later, characterized by eosinophil infiltration, as seen in cytological examinations, indicating a sustained inflammatory response.

Answer 390

Type 2 Hypersensitivity is mediated by antibodies (IgG subtype) that recognize cell surface or extracellular matrix antigens, activating the classical complement pathway and leading to cell destruction or dysfunction. This differs from Type 1, where IgE binds to mast cells. An example of Type 2 reaction is autoimmune hemolytic anemia, where antibodies target cell surface antigens, leading to cell lysis and anemia.

Answer 391

Type 3 Hypersensitivity involves the formation of antigen-antibody (immune) complexes, which deposit in tissues, activating the complement system and attracting neutrophils. However, neutrophils cannot ingest these complexes, leading to tissue damage through the release of toxic granules. This mechanism can result in conditions like vasculitis, where small complexes deposit in capillaries, indicating the severity of tissue damage due to immune complex deposition.

Answer 392

Type 4 Hypersensitivity, also known as delayed-type hypersensitivity, is mediated by T cells rather than antibodies. Upon re-exposure to an antigen, sensitized T cells (Th1) are reactivated and release cytokines like interferon-gamma, which recruit macrophages and lead to inflammation. This response can cause granulomatous lesions and tissue damage, seen in conditions like tuberculosis, where mycobacterium tuberculosis triggers a prolonged immune response.

Answer 393

Type 1 hypersensitivity Causes acute systemci manifestation Breakdown of mast cells Broncho or pulmonary oedema

Answer 394

Liver due to hepatic vein issues

Answer 395

Atopic dermatitis Prurititc skin disease

Answer 396

Antibody mediated cytotoxicity Mediated by antibodies that recognise antigens on a cell surface or in the space between cells Intrinsic or extrinsic antigens This uses the classical complement pathway

Answer 397

Binds to extrinsic antigens igG binds and causes activation of the complement system This destructs red blood cells and leads to anaemia Autoimmune anaemia Impacts cellular adhesion, nutrition and waste disposal

Answer 398

Antibody excess- lots of IgG Antigen excess - less circulating igG- capillary depostion = vasculitis and thrombosis

Answer 399

type 3 hypersensitivity

Answer 400

type 3 hypersensitivity

Answer 401

Cell mediated not antibody mediated Prolonged onset

Answer 402

Type 4 Sensitised T helper cells Lateral skin on neck in cattle for testing

Answer 403

Inherited or congential Occurs when there is a mutation in a gene that is associated with the immune response

Answer 404

Clinical apparent in early life Increase mortalitiy Breed associated Very rare Lack of research here Depends on the impact of the mutation

Answer 405

Severe combined immunodeficiency is primary immune def

Answer 406

Canine leukocyte adhesion deficiency Primary immunodeficiency

Answer 407

Blood work Low lymphocyte levels - low in some cases due to stress response so not always helpful Breed susceptibilities Many markers

Answer 408

Age related decline decline in CD4+ Specific infections such as FIV (greater 4% incidence) Chronic stress - glucocorticoids suppress immune response increases infection susceptibility) Malnutrition causes decrease in leptin and T lymphocytes

Answer 409

Immune deficiency is an impairment in parts or functions of the immune system, rendering an animal more susceptible to infectious diseases. This condition can be due to inherent genetic defects (primary) or acquired factors (secondary) such as age, chronic disease, infection, or therapeutics.

Answer 410

Primary immune deficiencies are inherited or congenital, often presenting early in life with increased susceptibility to infection and possibly increased mortality. Secondary immune deficiencies are acquired, common, and can arise from physiological or pathological changes within the immune system, like age, chronic diseases, or specific treatments, leading to diminished immune responses.

Answer 411

CLAD, common in Irish Setters, is an autosomal recessive disorder due to a mutation in the beta-2 integrin gene, leading to impaired immune response and abnormal blood clotting. SCID affects dogs, horses, and is characterized by mutations affecting cytokines (IL-2, 4, 7, 9, 15) or lymphocyte formation, resulting in a complete failure of the immune system.

Answer 412

Diagnosis involves assessing blood work for signs like neutrophilia or lymphopenia, considering breed susceptibilities, evaluating response to vaccination, and monitoring for recurrent infections. Distinguishing between chronic stress effects and genuine immunodeficiency markers is crucial for accurate diagnosis.

Answer 413

Secondary immune deficiencies result from age-related decline in CD4+ memory cells, chronic stress leading to suppressed immune response via glucocorticoids, malnutrition affecting T lymphocyte function, and specific infections like FIV that directly compromise the immune system.

Answer 414

Clinical signs - may not be pathognomic Detect pathogen Detect host response to pathogen = antibodies Narrow window for detection of pathogen

Answer 415

DNA via PCR RNA via reverse transcription and PCR/ qPCR

Answer 416

Based on latex agglutination test these are an animal side test Depends on the availability of pathogens

Answer 417

Indirect ELISA Antibody on the plate is much more accurate than indirect Capture may work better than indirect

Answer 418

Dont need a specific antibody Multispecies test

Answer 419

Agglutination/haemagglutination inhibition Singla radial haemolysis Complement fixation

Answer 420

ELISA (Enzyme-Linked Immunosorbent Assay) is a plate-based assay technique designed for detecting and quantifying soluble substances such as peptides, proteins, antibodies, and hormones. In veterinary diagnostics, ELISA is utilized for antigen detection by capturing the target antigen from the sample with a specific antibody coated on the plate, followed by detection using a secondary antibody conjugated with an enzyme. This method is widely used due to its sensitivity and specificity for various pathogens.

Answer 421

Laboratory tests, such as PCR, qPCR, and ELISA, offer high specificity and sensitivity, allowing detailed analysis and quantification of pathogens' genetic material or proteins. Animal-side tests, including lateral flow devices and latex agglutination tests, provide rapid results and are useful for on-site screening. However, they may have lower specificity and sensitivity compared to laboratory tests, making them more suited for preliminary diagnosis rather than definitive identification.

Answer 422

IgM antibody capture (IMAC) ELISA is a diagnostic method used to measure active infection by specifically detecting IgM antibodies, which are typically produced early in the body's immune response to infection. This technique involves capturing IgM antibodies from the sample onto the plate, followed by detection of specific antigens. It is particularly significant for diagnosing acute infections and for screening diseases like toxoplasmosis in cats.

Answer 423

Tuberculosis in cattle is diagnosed using the Single Intradermal Comparative Cervical Tuberculin (SICCT) test, a type IV hypersensitivity reaction that measures the skin's response to tuberculin antigens. The Interferon Gamma (IFNγ) test is another method that measures the release of IFNγ from blood cells in response to tuberculosis antigens. Both tests have high sensitivity and specificity, with the IFNγ test providing a rapid and early diagnosis compared to the SICCT test.

Answer 424

Effective sampling is vital because it directly impacts the accuracy and reliability of diagnostic tests. The right type of sample, collected correctly from the appropriate location and animal at the optimal time, ensures that the sample accurately represents the disease state or pathogen presence, minimizing false negatives or positives.

Answer 425

Considerations include the suspected disease (bacterial, parasitic, viral), the most likely site of infection, and the stage of the disease. Blood, mucosal swabs, respiratory tract samples, and less invasive options like milk or saliva can all be appropriate, depending on the pathogen and the diagnostic goal.

Answer 426

Timing affects the detection of pathogens, especially in relation to the disease's progression and the immune response, like seroconversion. Improper handling or timing can lead to degradation of the sample or its components, leading to inaccurate diagnostic outcomes.

Answer 427

Fibrinogen C reactive protein Serum amuyloid A in th cat horse cow and dog Haptaglobin in cows Pigs also have p-MAP

Answer 428

Vaccines in veterinary medicine are categorized as inactivated (killed), attenuated (live), subunit, vectored, DNA, and mRNA vaccines. Inactivated vaccines contain killed pathogens and are safe but often require adjuvants. Attenuated vaccines contain live, weakened microbes, offering robust immunity but with a risk of reverting to virulence. Subunit, vectored, DNA, and mRNA vaccines target specific parts of the pathogen to stimulate an immune response, with variations in their effectiveness and safety profiles.

Answer 429

Adjuvants enhance the immune response to the antigen present in the vaccine. Common types include aluminium salts, oil emulsions, saponins, immune-stimulating complexes (ISCOMs), liposomes, microparticles, non-ionic block copolymers, derivatised polysaccharides, cytokines, and bacterial derivatives. They work by forming a depot of antigen, stimulating cytokine and chemokine secretion, enhancing immune cell recruitment, and promoting antigen uptake, processing, and presentation.

Answer 430

Adverse vaccine reactions can be categorized as vaccine-induced, vaccine-potentiated, programmatic errors, or coincident effects. Strategies to mitigate these include using non-adjuvanted or recombinant vaccines when possible, adhering to vaccine site recommendations, varying the injection site annually, and avoiding unnecessary vaccinations. Feline Injection Site Sarcoma (FISS) is a specific concern, with recommendations to avoid adjuvanted vaccines and use specific sites for injections.

Answer 431

Type I hypersensitivity involves an immediate allergic reaction (e.g., anaphylaxis), mediated by IgE. Type II involves cytotoxic reactions, such as bovine neonatal pancytopenia. Type III hypersensitivity, mediated by immune complexes, can lead to reactions like cutaneous vasculitis. Type IV, or delayed hypersensitivity, is T-cell mediated, leading to granuloma formation. Each type has different timeframes from exposure to reaction, ranging from within an hour to weeks.

Answer 432

Vaccines primarily activate the adaptive immune system through two pathways: the humoral immune response, mediated by B cells that produce specific antibodies against pathogens, and the cell-mediated immune response, involving T cells that eliminate infected host cells or help B cells. Live attenuated vaccines often stimulate both responses, while inactivated and subunit vaccines mainly provoke a humoral response unless combined with adjuvants to enhance cell-mediated immunity.

Answer 433

Dogs Core vaccines- Rabies, Canine distemper virus, Canine parvovirus, Canine adenovirus Dogs non core – leptospirosis, bordatell bronchiseptica, canine influenze Cats core vaccines- Rabies, feline herpes virus, feline calcivirus, feline panleukopenia Cats non core- Feline leukemia virus, bordetella bronchiseptica

Answer 434

Vaccine development involves several stages, starting with research to identify antigens that can induce immunity. Pre-clinical trials in cell cultures or animal models assess safety and efficacy. Clinical trials in the target species follow, with Phase I focusing on safety, Phase II on immunogenicity and dosing, and Phase III on efficacy against disease. Regulatory review and approval are required before a vaccine can be marketed, and post-marketing surveillance monitors adverse effects in the wider population.

Answer 435

Vaccine scheduling ensures that animals are immunized at the appropriate age and intervals to establish and maintain protective immunity throughout their lives. Protocols may be adapted based on an animal's health status, breed, exposure risk, and lifestyle. Tailoring vaccine schedules helps optimize protection while minimizing the risk of adverse reactions.

Answer 436

Vaccines play a crucial role in disease eradication and control by reducing the incidence of infectious diseases, cutting down the pathogen's spread, and building herd immunity. Successful vaccination campaigns can lead to the complete eradication of diseases, as seen with rinderpest in cattle.

Answer 437

Laws and regulations ensure the safety, efficacy, and quality of vaccines before their market approval. They govern clinical trials, manufacturing processes, distribution, and post-market surveillance. Compliance with regulatory standards protects animal health and supports public confidence in vaccine programs.

Answer 438

Recent advances include mRNA vaccines, vectored vaccines, and nanotechnology-based delivery systems. These technologies offer the potential for more rapid development, improved efficacy, and better safety profiles. They may enable more targeted and effective immunization strategies against emerging and zoonotic diseases, enhancing animal and public health.

Answer 439

Inactivated Attenuated Subunit- Recombinant- purified OspA encoded by a gene from borrelia burgdorferi protects dogs against Lyme disease

Answer 440

Bovine neonatal pancytopenia

Answer 441

Vaccine-induced hypersensitivity reactions are adverse immune responses that occur in some animals following vaccination, manifesting as allergic reactions that can range from mild (e.g., skin rash, itching) to severe (e.g., anaphylaxis). Identification involves monitoring for symptoms post-vaccination, and management includes pre-vaccination assessment of hypersensitivity history, judicious use of vaccines (especially those known to have higher risks), and having emergency treatments available for immediate intervention.

Answer 442

In developing veterinary vaccines, researchers consider potential hypersensitivity by selecting antigens and adjuvants that minimize the risk of adverse immune reactions. This involves rigorous preclinical testing for immunogenicity and safety, including assessments for hypersensitivity potential. Modern vaccine technologies, such as recombinant vaccines, are designed to reduce unnecessary immunostimulatory components, thereby lowering the risk of hypersensitivity reactions.

Answer 443

For animals with known hypersensitivity disorders, vaccination strategies include careful selection of essential vaccines only, to minimize exposure to potential allergens. Timing of vaccinations may be adjusted to ensure the animal is in optimal health, and split dosing or titer testing may be employed to reduce the immune system's burden. Close monitoring and readiness to manage allergic reactions are critical components of these strategies.

Answer 444

Allergen specific immunotherapy

Answer 445

Veterinarians consider factors like animal species, age, health status, exposure risk, and geographical location to select the most appropriate vaccine. Tailoring vaccine choice to individual needs optimizes efficacy and safety.

Answer 446

Prophylactic vaccines prevent diseases, therapeutic vaccines treat existing diseases, and immunocontraceptive vaccines control population by inducing infertility. Each is used based on specific goals, whether preventing infection, treating an ongoing disease, or managing wildlife populations.

Answer 447

Herd immunity involves vaccinating a significant portion of the population to reduce disease spread, protecting unvaccinated individuals. It's influenced by vaccine efficacy, population density, and vaccination coverage.

Answer 448

Ring vaccination involves vaccinating all susceptible individuals in the vicinity of an outbreak to contain the disease. Imperfect vaccines may not prevent infection but can reduce disease severity and transmission.

Answer 449

Core vaccines are essential for all animals, providing protection against diseases with widespread risk. Non-core vaccines are recommended based on individual risk assessments, including lifestyle and geographical exposure.

Answer 450

Different routes (intramuscular, subcutaneous, intradermal, intranasal) offer advantages in terms of immune response, ease of administration, and vaccine type suitability. The choice depends on the vaccine's formulation and targeted immune response.

Answer 451

The timing of vaccinations is critical and must consider the animal's age, pregnancy status, and specific disease risks. Proper scheduling ensures effective immunity development without interfering with maternal antibodies or compromising animal health.

Answer 452

Best practices include storing vaccines at recommended temperatures, avoiding exposure to light, and rotating stock to use older vaccines first. For example, live vaccines are particularly sensitive and must be kept refrigerated and used promptly once reconstituted.

Answer 453

Vaccine protocols must consider the unique physiology and disease risks of each species. For instance, rabies vaccine is core for dogs, cats, and ferrets due to public health implications, but vaccination strategies for livestock focus on diseases affecting food safety and herd health, such as foot-and-mouth disease.

Answer 454

Veterinarians should monitor for immediate and delayed reactions post-vaccination, manage reactions according to severity (from antihistamines for mild reactions to epinephrine for anaphylaxis), and report incidents to vaccine manufacturers and regulatory bodies. Maintaining detailed vaccination records helps in identifying patterns that might indicate a problem with a particular vaccine batch or type.

Answer 455

Ethical considerations include weighing the benefits of vaccination against potential risks, especially for non-core vaccines. Veterinarians must consider the individual animal's health status, exposure risk, and the potential impact on public health while respecting owner's preferences and informed consent. Decisions should be guided by evidence-based medicine and the principle of doing no harm.

Answer 456

IgM Followed by IgG which is longer lasting and more effective with a higher affinity

Answer 457

Maternally derived antibodies

Answer 458

Split into cat 1 and cat 2 which are core and non core

Answer 459

Multiplex vaccines such as canine vaccines can be reconstituted with dilent or lepto2 for DHPPI-L2 Cant combine vaccines from different manufacturers

Answer 460

submucosal

Answer 461

No pregnant people should be involved in vaccination Both are Cat 1 vaccines by NOAH 2 separate vaccines but can be given at the same time. Cannot be mixed One off vaccination so not annual etc Should be given 3 weeks prior to mating/tupping

Answer 462

Course needs restarting as the time passed Needs DHPPi as eurican This practice only stocks canigen and therefore needs to restart Adult restart means 2 doses of lepto 4 weeks apart ( animal is in kennels in 3 weeks) DHPPI needs 1 injection as an adult Kennel cough can also be given Going to kennels in 3 weeks so potentially may not be able to go to the kennels Vaccine lapse may affect insurance Onset of immunity for kennel cough is 3 weeks so this may affect kennels DHPPI and Lepto can be mixed in a syringe and given subcut Immunocompromised people should stay away for 3 weeks as they are attenuated vaccines

Answer 463

Beef cows are not handled as often so multiple vaccinations can cause stress BVD should be vaccinated for due to shared boundaries Cows should be vaccinated with leptavoid H and bravoxin 10 Handling system potentially needs updating Vaccinate when TB is being read TB vaccine and lepto can be given on the same day and mixed Other options include double fencing to avoid mix with neighboring cows

Answer 464

They should vaccinate both against Equine influenza, strangles (if mixing with other horses water etc), Tetanus vaccine Equine influenza can be mixed with tetanus. Immunity is longer with tetanus so first use a mix and then less commonly. Just equine influenza following Herpes vaccine can be administered- can cause abortions and the vaccine isnt always effective. Owner choice and assess repro health.

Answer 465

The backbone meant that rabbits that had been vaccinated once with RHD 1 may have an averse reaction to RHD2 Vax with inactivated type 2 and then vaccinated with type 2 followign

Answer 466

Pathogens enter host cell Viral genes and enzumes are released into the host cell Host cell internally replicated viral components Viral particulates are then further released into the body Makes development of antivirals challenging To increase efficacy antiviral should target common viral proteins

Answer 467

Feline Immunodeficiency Virus (FIV) affects cats by targeting their immune system, specifically CD4+ T lymphocytes. FIV binds to the CD134 (OX40) receptor on activated T cells during the initial stages of infection and subsequently uses the CXCR4 chemokine receptor to gain entry into the cells. This viral entry leads to the depletion of CD4+ T lymphocytes, which are crucial for mounting an effective immune response. The progressive depletion of these cells compromises the cat's immune system, making it susceptible to secondary infections, chronic diseases, and a decrease in overall health.

Answer 468

: FIV targets and depletes CD4+ T lymphocytes, leading to an imbalanced immune response. This depletion compromises the cat's ability to fight off infections, making them susceptible to secondary infections and diseases.

Answer 469

In the acute stage, cats may experience mild illness with a decrease in CD4+ cells. The sub-clinical stage is often asymptomatic but characterized by a continual reduction in CD4+ cells and an increase in CD8+ cells, leading to a higher CD8+ to CD4+ ratio. The terminal stage involves severe immunodeficiency, resulting in secondary infections, weight loss, and potentially neurological disease.

Answer 470

The incidence of FIV varies by geographic location and cat population, being higher in feral cats (average 4%) compared to domestic cats (average 1%). Sexually intact males have an increased risk due to their propensity for fighting and bite-wound transmission.

Answer 471

Management focuses on supportive care and treatment of secondary infections, with no specific antiviral treatment for FIV itself. PCR diagnostics are used for confirmation. While a vaccine exists, it is not licensed in all countries, including the UK.

Answer 472

Secreted modulators or toxins Modulators on the pathogen surface Hide from immune surveillance Antigenic hypervariability Subvert or kill immune cells Block acquired immunity Inhibit complement Inhibit cytokines/chemokines or interferons Modulate apoptosis Interfere with TLRs Block antimicrobial small molecules Block intrinsic cellular pathways

Answer 473

Pathogens secrete substances like virokines and toxins that mimic host molecules to disrupt immune responses, including interfering with cytokine function or directly damaging immune cells.

Answer 474

Surface modulators, including complement inhibitors and molecular mimics like viroceptors, help pathogens avoid detection or neutralization by the immune system.

Answer 475

Pathogens evade the immune system by hiding in immunoprivileged sites, entering latency, or altering surface antigens to avoid recognition by immune cells.

Answer 476

Through mechanisms like error-prone replication or gene reassortment, pathogens frequently change their surface antigens, evading antibody recognition and T cell responses.

Answer 477

Pathogens can infect and kill immune cells, produce superantigens that overstimulate the immune response, or block the killing pathways of cytotoxic cells, thereby impairing the immune defense.

Answer 478

They produce soluble inhibitors, degrade complement components, or alter their surface to prevent complement activation and membrane attack complex formation.

Answer 479

Pathogens can block cytokine production, inhibit receptor-ligand interactions, and divert or disrupt signaling pathways essential for effective immune responses. | Cytokine production, Ligand receptor reactions, disrupt signal pathways

Answer 480

They may inhibit apoptosis to prolong cell survival, activate apoptosis in immune cells, or alter autophagy processes to facilitate their replication or survival within host cells.

Answer 481

Pathogens block or alter TLR signaling, modify TLR ligands, or mimic host molecules to reduce their recognition and dampen inflammatory responses.

Answer 482

They may inactivate enzymes like iNOS, degrade antimicrobial peptides, or alter their surface to resist peptide insertion, among other mechanisms.

Answer 483

Commensal organisms, which do not invade tissues under normal circumstances, play a crucial role in controlling pathogens by competing for living spaces and priming the immune system. In females, they are found in areas from the perineum to the uterus, with greater numbers towards the outside. In males, they are located on the preputial skin, lining, and less commonly, within accessory sex glands.

Answer 484

Innate immunity maintains the balance of commensal bacteria and pathogens in both males and females. In females, it also addresses introduced bacteria, allogenic sperm, and the immunologically distinct fetus.

Answer 485

A reproductive pathogen affects the reproductive tract, and transmission can occur via semen or vaginal secretion (venereal pathogens) or through other routes such as the respiratory tract (non-venereal).

Answer 486

Herpes viruses can cause respiratory tract disease and, in the context of reproduction, may lead to pregnancy loss due to placental invasion. They may also cause reproductive tract disease by transmitting venereally and causing local vesicular disease.

Answer 487

Routine screenings vary by species. For horses, stallions and mares are screened for bacterial venereal pathogens and EHV. Dogs and cats have no routine reproductive screening but have vaccination regimes. Cows undergo brucella surveillance and serology for diseases affecting reproduction, while sheep, pigs, and other animals have specific screenings for diseases like PRRS, Brucella, and more.

Answer 488

Via semen or vaginal secretion

Answer 489

Repro pathogens that can be transmitted via other routes (eg respiratory)

Answer 490

Congenital disease

Answer 491

Incomplete ossification of cuboidal bones

Answer 492

a developmental joint disease Osteochondrosis dissecans The bone doesnt mineralise and instead turns into soft necrotic tissue

Answer 493

1) Traumatic wounds, 2) Iatrogenic causes, 3) Haematogenous spread.

Answer 494

Horses and farm animals are commonly affected, mainly through wounds, haematogenous spread, and iatrogenic causes. It's rare in small animals and exotics.

Answer 495

Neonates are at high risk due to their lack of natural immunity and the potential failure of passive transfer, leading to bacteraemia and the sequestration of pathogens in the synovial membrane.

Answer 496

History, clinical examination, synovial fluid analysis (appearance, nucleated cell count % neutrophils, total protein, and culture & sensitivity).

Answer 497

Early treatment for better outcomes, involving lavage ('the solution to pollution is dilution'), antibiotics (local and systemic based on C&S), and addressing the underlying cause.

Answer 498

Lavage is used to dilute and remove inflammatory agents, debris, and bacteria from the joint, following the principle that "the solution to pollution is dilution."

Answer 499

Antibiotics are selected based on culture and sensitivity results and are administered both locally and systemically to combat the infection.

Answer 500

Successfully treating joint sepsis requires identifying and resolving the primary source of the infection to prevent recurrence and ensure complete recovery.

Answer 501

Arthritis is the inflammation of the joint affecting the cartilage, synovial fluid, sub-chondral bone, synovial membrane, and joint capsule.

Answer 502

Incomplete ossification of cuboidal bones.

Answer 503

Osteochondritis Dissecans (OCD) and subchondral bone cyst.

Answer 504

Osteoarthritis and osteochondral fragmentation (OCF).

Answer 505

Canine immune mediated polyarthritis (IMP), especially in sight hound dogs like Whippets.

Answer 506

Septic arthritis.

Answer 507

History, clinical exam, radiography (bones), ultrasonography (soft tissues), advanced imaging (MRI, CT, Nuclear Scintigraphy), and synovial fluid analysis.

Answer 508

Treatment is disease-specific and multifaceted, including medical and surgical approaches, systemic and local treatments, short or long-term management, anti-inflammatory and analgesic medications, disease-modifying agents, and lifestyle changes.

Answer 509

Osteoarthritis begins with cartilage damage, leading to an inflammatory response. This inflammation causes further damage to the cartilage and underlying bone, resulting in joint pain, stiffness, and decreased mobility.

Answer 510

OCD forms when a piece of cartilage, along with a thin layer of the bone beneath, separates from the end of a bone due to insufficient blood supply, causing joint pain and instability.

Answer 511

Subchondral bone cysts develop due to an imbalance in bone formation and resorption, often following joint stress or injury. The cysts form in the subchondral bone, causing pain and affecting joint function.

Answer 512

In immune-mediated polyarthritis, the body's immune system mistakenly attacks its own joint tissues, leading to inflammation without the presence of an infection. This results in joint swelling, pain, and reduced mobility.

Answer 513

Septic arthritis occurs when bacteria or other pathogens infect a joint, either through direct contamination (injury, surgery) or by spreading from another part of the body, leading to severe joint inflammation and damage.

Answer 514

Systemic options include NSAIDs (for all species) and bisphosphonates (equine), with intra-articular options like corticosteroids, glycosaminoglycan derivatives (including hyaluronic acid), synthetic hydrogels, and biological products (stem cells, IRAP, PRP).

Answer 515

Systemic antibiotics and NSAIDs, intra-articular antibiotics, and regional options like intravenous regional perfusion (IVRP) with antibiotics.

Answer 516

Systemic corticosteroids and immunomodulators.

Answer 517

Consider the cascade and competition withdrawal times for equines, and evaluate efficacy and evidence of treatment options.

Answer 518

Treatment involves systemic and intra-articular antibiotics, NSAIDs for systemic management, and may include regional options like IVRP with antibiotics.

Answer 519

Treatment typically involves systemic corticosteroids and immunomodulators to control the immune response.

Answer 520

Osteoarthritis

Answer 521

Osteochrondral fragmentation

Answer 522

Canine immune mediated polyarthritis

Answer 523

Traumatic wounds

Answer 524

systemic arent always the best options

Answer 525

anogenic or autogenic stem ells PRP - platelet rich plasma

Answer 526

Systemic Intraarticular Regional options

Answer 527

withdrawal times for races : The horse was diagnosed with osteoarthritis in small tarsal joints bilaterally, with a racing event in 16 days, necessitating careful selection of treatment to comply with competition withdrawal times. corticosteroid administered with shorter withdrawal time.

Answer 528

Arthrocentesis of the tibiotarsal joint revealed a nucleated cell count of 5x10^9 cells/l with 30% neutrophils and a total protein of 20g/l, indicating joint disease that requires a comprehensive diagnostic and therapeutic approach. multiple joints affected. Intraarticular wouldnt work so corticosteroids would be the best option

Answer 529

Generation of diverse T-cell (TCR) and antibody (FAB region) receptors, understanding of tolerance, and the roles of innate and specific (adaptive) immune responses.

Answer 530

: An immune response may be wrongly targeted against the body’s own healthy cells and organs, leading to conditions like pemphigus foliaceus and immune-mediated kidney disease.

Answer 531

Through central tolerance (deletion of reactive T-cells in the thymus) and peripheral tolerance (anergy, activation-induced cell death, and suppression by regulatory T-cells).

Answer 532

Auto-immune or immune-mediated haemolytic anaemia (IMHA), immune-mediated thrombocytopenia (IMT), and immune-mediated polyarthritis (IMPA).

Answer 533

Understanding immunopathological mechanisms like antibody-mediated cytotoxicity, immune complex hypersensitivity, and cell-mediated immunity.

Answer 534

Idiopathic (Type I), associated with infection (Type II), inflammatory GI disease (Type III), and neoplastic disease (Type IV).

Answer 535

It occurs when the immune response targets more than one organ, as seen in SLE-like syndromes in dogs, which may involve concurrent diseases affecting multiple systems.

Answer 536

IMHA is caused by the body's immune system mistakenly identifying its own red blood cells (RBCs) as foreign and producing antibodies against them. This results in the destruction of RBCs by the immune system, a process known as hemolysis. The destruction can occur within the blood vessels (intravascular hemolysis) or in the liver and spleen (extravascular hemolysis). The antibodies involved are typically of the IgG or IgM class, which bind to the surface of RBCs, marking them for destruction. The exact trigger for this autoimmune response is often unknown, but it can sometimes be linked to underlying conditions, infections, or exposure to certain drugs.

Answer 537

IMT involves the immune system producing antibodies against the body's own platelets, leading to their premature destruction and resulting in a significantly reduced platelet count (thrombocytopenia). Platelets are crucial for blood clotting, and their reduction increases the risk of bleeding. Similar to IMHA, the triggers for IMT can include infections, drugs, or other underlying diseases, but often, the exact cause remains idiopathic. The destruction of platelets primarily takes place in the spleen, mediated by macrophages that recognize and ingest platelets coated with antibodies.

Answer 538

IMPA is a condition where the immune system attacks the synovial joints, leading to inflammation and arthritis. Unlike osteoarthritis, which is primarily due to wear and tear of the joints, IMPA is an autoimmune response where the immune system mistakenly targets the joint's synovium, leading to pain, swelling, and stiffness. There are several types of IMPA, categorized based on the underlying cause or associated conditions, ranging from idiopathic (where no cause is identified) to those linked with infections, cancer, or gastrointestinal diseases. The immune response in IMPA often involves a combination of cell-mediated immunity (T cells) and humoral immunity (antibodies) targeting the joints.

Answer 539

Immune-mediated pancreatitis is when the body's immune system mistakenly attacks the pancreas, causing inflammation. This damage can disrupt the production of digestive enzymes and hormones like insulin, leading to digestive problems and possibly diabetes. The exact causes are unclear, but genetics, environmental factors, and past infections may play roles. This condition is a type of autoimmune disease affecting the gastrointestinal system.

Answer 540

Genetic predisposition involves inherited genetic factors that increase the susceptibility of an individual to develop immune-mediated diseases. Specific genes can influence the immune system's regulation, making it more likely to misidentify self cells as foreign, leading to conditions such as IMHA, IMT, or IMPA.

Answer 541

Infections can trigger immune-mediated diseases by activating the immune system in a way that leads to cross-reactivity with self-tissues (molecular mimicry), or by causing persistent inflammation that disrupts immune tolerance. Bacterial, viral, and parasitic infections are known triggers for diseases like IMPA and IMHA.

Answer 542

Certain drugs and medications can act as haptens, triggering immune responses against modified self-cells or directly inducing autoimmunity through mechanisms that are not fully understood. Examples include antibiotics and anticonvulsants that can lead to conditions like drug-induced lupus or IMHA.

Answer 543

Environmental factors, including exposure to chemicals, pollutants, and dietary components, can influence the development of immune-mediated diseases by altering the immune system's function or by triggering inflammatory responses that disrupt immune tolerance.

Answer 544

Stress and hormonal changes can modulate the immune system's responsiveness, potentially leading to an increased risk of autoimmunity. Stress-induced hormones and changes in the endocrine system can alter immune regulation, potentially triggering or exacerbating immune-mediated diseases.

Answer 545

Neoplastic diseases can trigger immune-mediated responses through the production of tumor antigens that the immune system targets, leading to collateral damage to healthy tissues or by inducing systemic inflammation that disrupts immune tolerance, contributing to conditions like paraneoplastic syndromes.

Answer 546

Evans Syndrome in veterinary medicine is an autoimmune condition characterized by the concurrent occurrence of immune-mediated hemolytic anemia (IMHA) and immune-mediated thrombocytopenia (IMT), where the body's immune system mistakenly attacks and destroys its own red blood cells and platelets. This leads to a combination of symptoms related to both anemia (such as lethargy, weakness, and pale mucous membranes) and thrombocytopenia (such as increased bleeding and bruising). The syndrome can be triggered by a variety of factors, including infections, certain medications, cancer, and possibly genetic predisposition, though in many cases, the exact cause remains unknown. Treatment typically involves immunosuppressive therapies aimed at reducing the immune system's attack on blood cells, along with supportive care to manage symptoms.

Answer 547

Many immune-mediated diseases lack identifiable causes (primary disease) and require management to reduce pain, loss of function, and tissue damage. For secondary diseases, controlling both the immune response and the primary cause (e.g., infection) is necessary.

Answer 548

Immunomodulatory drugs can stimulate, suppress, or modify the immune system. Types include interferons for severe infections (immune stimulation), allergy immunotherapy for increasing T-regulatory cells (immune modification), and broad treatments like steroids or targeted treatments like Lokivetmab for IL-31 (immune suppression).

Answer 549

Steroids are the most commonly used immunosuppressive agents, affecting many parts of the immune system. They bind to glucocorticoid receptors, causing activation or inhibition of gene transcription, and have a wide range of effects, including anti-inflammatory and immunomodulatory actions.

Answer 550

Azathioprine works by damaging DNA, affecting rapidly growing bone marrow and immune cells. Side effects include myelosuppression, pancreatitis, and hepatotoxicity. It's metabolized into 6-mercaptopurine and further processed by enzyme systems (TPMT) , with variations in metabolism affecting side effect likelihood.

Answer 551

Chlorambucil is an orally administered alkylating agent with cytotoxic effects, used for immunosuppression in small dogs and cats. It's less toxic than azathioprine but still can cause myelosuppression, anorexia, vomiting, and diarrhea.

Answer 552

Mycophenolate mofetil inhibits de novo purine synthesis, suppressing T and B cells. It's fast-acting, with limited evidence for use in dogs or cats with immune-mediated diseases. Adverse effects include gastrointestinal toxicity and potential for hepatitis.

Answer 553

Ciclosporin is a potent T-cell suppressor, used for atopic dermatitis in dogs and cats. It binds to cyclophilin, inhibiting calcineurin and reducing the activation of IL-2 and related cytokines, leading to reduced effector T-cell function.

Answer 554

Leflunomide inhibits DHODH, preventing the expansion of activated and autoimmune lymphocytes. It's used for conditions like immune-mediated polyarthritis and has potential adverse events like diarrhea, lethargy, and increased liver enzymes.

Answer 555

Oclacitinib inhibits JAK-1, blocking cytokine signaling and is licensed for canine atopic dermatitis. It's used for a range of immune-mediated diseases, with side effects including diarrhea and haematological abnormalities.

Answer 556

Omega 3 fatty acids reduce production of inflammatory mediators and may play a role in early sepsis and inflammatory diseases. Vitamin E acts as an adjunct antioxidative treatment, potentially useful in specific conditions like sterile pyogranulomatous panniculitis.

Answer 557

Consider the effects on pregnancy and the fetus, including teratogenesis and effects at birth, alongside the balance between treating the dam and potential harm to the fetus.

Answer 558

Changes in absorption, distribution, metabolism, and excretion due to pregnancy can significantly alter drug plasma levels. This includes reduced abdominal space, increased gastric pH, and altered metabolism and excretion.

Answer 559

Datasheets provide crucial information on the safety and contraindications of medications during pregnancy, aiding in the selection of safe treatment options.

Answer 560

Treatment options must consider the absorption of corticosteroids and the teratogenic potential of gentamicin. Datasheets or pharmaceutical companies should be consulted, weighing the risk-benefit of treatment and potential for off-label use.

Answer 561

Consider the effects on the neonate, impact on lactation, the drug's licensing, metabolic status of the dam, new routes of elimination, and milk withdrawal times.

Answer 562

Lactation introduces a new route of drug elimination, especially affecting drugs that are lipid-soluble, basic non-ionised, and have low plasma protein binding. Mastitis can also influence drug excretion by altering milk pH and blood flow.

Answer 563

Meloxicam is contraindicated during lactation; thus, any use requires careful risk-benefit analysis, informed written consent, and close monitoring of the offspring. Alternatives, such as opiates or paracetamol, may be considered.

Answer 564

If a drug can be absorbed orally it is likely to cross the placenta.

Answer 565

Aurixon Canaural Easotic Otomax ear drops Surolan ear drops Always review the data sheet

Answer 566

Pyrexia, depressed demeanor, purulent discharge, changes to white blood cell/neutrophil count, and acute phase proteins.

Answer 567

Antibiotics susceptible to Staphylococcus hyicus should be selected based on susceptibility test results, considering what is licensed in the pig.

Answer 568

Usually, antimicrobials are not treated; biosecurity considerations are crucial.

Answer 569

Culture and sensitivity testing, requiring 48h for culture and 72h+ for sensitivity.

Answer 570

The method depends on the infection's location, including peritoneal tap, cytology, and material for culture and sensitivity, like corneal swabs or scrapes.

Answer 571

Straw-colored fluid is good, while red indicates infection is present.

Answer 572

Presence of PMN, MAC, LYM, RBC, and phagocytosed bacteria in a PMN.

Answer 573

Gram-positive bacteria stain purple, and gram-negative bacteria stain pink, based on cell wall properties.

Answer 574

Not required for clean surgery, such as neutering. Rational choices for contaminated or high-risk surgery include protective measures.

Answer 575

Age of the wound, whether it's clean/contaminated/dirty, exposure of bone/tendon/joint, signs of infection, and culture.

Answer 576

Commensal organisms form stable communities on body surfaces without causing disease. Pathogens must find a niche within a host, overcome host defenses, and express virulence factors to cause disease.

Answer 577

Pathogenicity exceeding defenses, leading to tissue damage through bacterial toxins (local/systemic), inflammatory response, immune response, and invasion (organism-dependent).

Answer 578

k: Systemic presentations like pyrexia, and local responses such as pain, heat, swelling, erythema, pus formation (acute), and granulomas (chronic).

Answer 579

Through blood neutrophil numbers, left-shift (younger neutrophils), toxic change, acute phase proteins (Fibrinogen, CRP, SAA, Haptoglobin), cardiovascular effects (acid-base, metabolic acidosis, lactate), tissue responses, coagulopathy, and neutrophil degeneration.

Answer 580

Dogs and cats typically show severe lesions with neutropenia, while cows show neutropenia in inflammation regardless of severity. Species differ in marrow reserve, regenerative capacity, and typical inflammation response.

Answer 581

: Marginalisation, adhesion, and migration, influenced by various factors like epinephrine, glucocorticoids, infection, and stress.

Answer 582

A left shift indicates a regenerative response with increased segmented over immature neutrophils, pointing towards a severe bacterial infection or rapid neutropoiesis.

Answer 583

Features like foamy cytoplasm, dispersed organelles, diffuse cytoplasmic basophilia, presence of Döhle bodies, and asynchronus nuclear maturation indicate toxic change.

Answer 584

Bacterial endocarditis is the inflammation of the inner layer of the heart, including the heart valves, typically caused by bacteria such as Streptococcus spp., Staphylococcus spp., and Enterococcus spp. It often results from bacteria entering the bloodstream and adhering to previously damaged heart valves or endothelium.

Answer 585

Clinical signs include fever, heart murmur, lethargy, weakness, weight loss, and possibly signs of congestive heart failure due to valve dysfunction. Peripheral signs like petechiae, splinter hemorrhages, and Osler's nodes may also be present.

Answer 586

Diagnosis is based on clinical signs, echocardiographic evidence of vegetative lesions on heart valves or endocardium, positive blood cultures, and indicative changes in blood tests, such as elevated white blood cell count and inflammatory markers.

Answer 587

Bacterial pericarditis is caused by the infection of the pericardium, often secondary to spread from lung infections, trauma, or surgery. Symptoms include chest pain, pericardial friction rub, and signs of cardiac tamponade (distended jugular veins, hypotension, muffled heart sounds).

Answer 588

Moving towards immature cells

Answer 589

Degenerate vs non degenerate neutrophils non degenerate on the left

Answer 590

Outbreaks can occur due to a susceptible population, changes in the virus, short-lived immunity, and inadequate vaccines.

Answer 591

Changes reflect the body systems affected, ranging from acute to chronic responses, and may include host responses that help clear the disease or contribute to its pathogenesis.

Answer 592

Diagnosis can be based on clinical examination, detection of virus antigen or nucleic acid, detection of antiviral antibody, and specific diagnostic tests like PCR.

Answer 593

Biosecurity, husbandry improvements, vaccination, and understanding the role of colostrum and all-in-all-out policies on farms are crucial for disease control.

Answer 594

Biosecurity measures like closed herds, "stamping out" strategies, and adherence to biosecurity principles on farms are vital in preventing the spread of viral diseases.

Answer 595

Avian Influenza, notably H5N1, has seen continued outbreaks affecting poultry. It's characterized by high mortality in birds, zoonotic potential, and significant economic impact. Control measures include biosecurity, surveillance, and vaccination where available.

Answer 596

CRD is a multifactorial disease with mixed viral and bacterial infections. Clinical signs include coughing, nasal and ocular discharge, pyrexia, and depression. It poses significant economic losses due to treatment costs and reduced productivity.

Answer 597

FIP is a viral disease caused by a mutation of feline enteric coronavirus. It leads to an immune-mediated response, with "wet" (effusive) and "dry" (noneffusive) forms. Diagnosis is challenging due to variable clinical presentations and requires a combination of clinical signs, serology, and specific tests like the Rivalta test.

Answer 598

Canine Parvovirus causes severe gastrointestinal illness, with symptoms including vomiting, bloody diarrhea, pyrexia, and neutropenia. Diagnosis can be confirmed with a cage-side antigen SNAP test, PCR, and supportive clinical signs.

Answer 599

PI calves play a crucial role in the spread of BVD on farms. Identifying and managing PI calves through testing (virus positive, antibody negative) is essential for controlling the virus, improving herd health, and reducing economic losses.

Answer 600

Diagnosis involves collecting tracheal, oropharyngeal, and cloacal swabs or fresh tissue samples, with virus detection performed via RT-qPCR. Confirmatory typing identifies the virus subtype, essential for control measures and epidemiological tracking.

Answer 601

Tissue mycoses include superficial, subcutaneous (deep), and systemic infections, each varying in severity and depth of tissue involvement.

Answer 602

Acute suppurative inflammation with micro-abscess formation, chronic inflammation (pyogranulomatous or granulomatous), and necrosis, especially if fungi invade blood vessels.

Answer 603

Dermatophytosis (e.g., alopecia, claw disease), Malassezia infection (e.g., erythema, hair loss, lichenification), and Candida infection (e.g., ulcers/erosions with tenacious exudate).

Answer 604

They present as cutaneous papules or nodules with possible ulceration and discharge, commonly due to traumatic implantation. Regional lymphadenopathy is common.

Answer 605

Systemic mycoses can affect any organ system, leading to granulomas, pyogranulomas, necrosis, and systemic illness due to widespread fungal infection.

Answer 606

Techniques include direct microscopic examination, fungal culture, histopathology, PCR, and Wood’s lamp for dermatophytosis.

Answer 607

Mycotoxicosis results from fungal toxin production, leading to a range of clinical presentations depending on the toxin, such as hepatotoxicity, immunosuppression, and neurotoxicity.

Answer 608

It involves hypersensitivity reactions, mainly type 1, to fungi or molds, presenting as chronic cough, nasal discharge, or pruritus. Diagnosis is based on history, physical examination, and potentially IgE serology or intradermal testing.

Answer 609

Fungi are eukaryotic organisms that may grow as yeast (unicellular), mold (multicellular with filamentous hyphae), or both (dimorphic). They digest food externally and absorb nutrients through their cell wall, which consists of chitin and other polysaccharides. Reproduction is via spore formation, both asexual and sexual.

Answer 610

Over 100,000 species of fungi are known, with more than 300 reported as animal pathogens. Most fungi are saprophytic, with some causing opportunistic infections.

Answer 611

Fungi can be classified as geophilic (found in soil/environment), zoophilic (found on animals), and anthropophilic (found on humans).

Answer 612

: Fungi can produce disease through tissue invasion (mycosis), toxin production (mycotoxicosis), and the induction of hypersensitivity.

Answer 613

Mycosis can be categorized into superficial, subcutaneous (deep), and systemic mycoses, each affecting different parts of the body.

Answer 614

: Dermatophytosis, caused by dermatophytes like Microsporum spp. and Trichophyton spp., is a common superficial mycosis affecting keratinized structures. It is highly contagious with zoonotic potential.

Answer 615

Subcutaneous mycosis often follows the penetration of foreign bodies, introducing environmental saprophytes, leading to chronic, usually localized lesions.

Answer 616

Cryptococcosis, caused by Cryptococcus spp., is an example of systemic mycosis. The organism is usually inhaled and can spread to internal organs, causing a range of infections.

Answer 617

Mycotoxicosis is caused by toxins produced by certain fungi on crops, pasture, or stored feed, such as Penicillium, Aspergillus, and Claviceps. The effects vary but can include acute or chronic ingestion symptoms, with potential for accumulation in tissues of food-producing animals.

Answer 618

Hypersensitivity reactions to fungal infections are rare but can be associated with chronic pulmonary disease in cattle and horses or as allergens in recurrent airway obstruction (RAO) and atopic dermatitis in dogs and cats.

Answer 619

Dermatophytosis, also known as ringworm, is caused by dermatophytes such as Microsporum spp. and Trichophyton spp. It affects keratinized structures like skin, hair, and nails. Common presentations include circular areas of hair loss (alopecia), scaling, and crusting. Highly contagious and has zoonotic potential, affecting cats, cattle, horses, and less commonly dogs.

Answer 620

Malassezia dermatitis is caused by the overgrowth of Malassezia yeasts, part of the normal skin flora, leading to skin and ear infections. Clinical signs include erythema, scaling, hair loss, and intense itching (pruritus), often secondary to other skin diseases. Commonly affects dogs, sometimes cats.

Answer 621

Cryptococcosis is a systemic fungal infection caused by Cryptococcus neoformans or C. gattii, usually inhaled from contaminated soil or bird droppings. It can cause respiratory, cutaneous, neural, and ocular infections in cats; disseminated disease with neural and ocular signs in dogs; and nasal granulomas, mastitis, and other systemic infections in cattle and horses. It has zoonotic potential but is not usually contracted from animals.

Answer 622

Subcutaneous mycoses typically occur due to traumatic implantation of fungi from the environment, leading to localized infections. Presentations include cutaneous papules, subcutaneous nodules, and occasionally ulceration with discharging sinuses. Chronic granulomatous inflammation is common, and regional lymphadenopathy may occur.

Answer 623

Aspergillosis is caused by Aspergillus spp., commonly A. fumigatus, and can result in local respiratory infections like guttural pouch mycosis in horses and nasal aspergillosis in dogs. It can also cause keratitis in horses and mastitis in cattle via direct inoculation. Haematogenous spread from the GI tract can lead to mycotic placentitis and abortion in cattle.

Answer 624

Mycotoxicosis results from the ingestion of mycotoxins produced by fungi on crops, pasture, or stored feed, involving fungi like Penicillium, Aspergillus (aflatoxicosis), Fusarium, and Claviceps (ergotism). Clinical findings vary but can include hepatotoxicity, immunosuppression, mutagenesis, teratogenesis, ill-thrift in animals, and acute/chronic ingestion symptoms.

Answer 625

Fungal hypersensitivity is rare but can be linked to chronic pulmonary diseases in cattle and horses, such as recurrent airway obstruction (RAO) caused by fungal spores. In dogs and cats, it can manifest as skin conditions due to hypersensitivity to saprophytic fungi or Malassezia.

Answer 626

Direct microscopic examination involves inspecting hair plucks, skin scales, or other samples under a microscope after staining (e.g., with KOH) to visually identify fungal elements. It's particularly used for diagnosing dermatophytosis and can be the first step in identifying superficial fungal infections.

Answer 627

Fungal culture involves growing fungi from samples (e.g., hair, skin scrapings) on specific media like Sabouraud dextrose agar. It's crucial for identifying the fungal species causing the infection and for testing fungal sensitivity to antifungal drugs. Incubation times and conditions vary between fungi, and it's used for both superficial and deep mycoses.

Answer 628

Histopathology involves examining tissue samples under a microscope after staining with special fungal stains (e.g., Periodic acid-Schiff (PAS), Grocott-Gomori methenamine silver (GMS)). It's essential for confirming fungal infections by demonstrating fungi within tissues, used primarily for subcutaneous and systemic infections.

Answer 629

PCR is a molecular technique that amplifies fungal DNA from clinical samples, allowing for the rapid and specific identification of fungal species. It's highly sensitive and can be used when traditional culture methods are slow or when fungal species are difficult to grow.

Answer 630

Wood's lamp examination emits ultraviolet light to inspect skin and hair for fluorescence, which can indicate a fungal infection (e.g., some strains of Microsporum canis). It's a quick, non-invasive method used primarily for screening dermatophytosis.

Answer 631

Cytology involves examining cells from impression smears, swabs, or fine-needle aspirates stained with dyes (e.g., Diff-Quick) under a microscope. It's useful for identifying yeast infections, such as Malassezia dermatitis, by visualizing the yeast cells on the skin or in ear secretions.

Answer 632

Serological tests detect antibodies against fungi in the blood, indicating exposure to or infection by the fungus. Tests like ELISA and latex agglutination for cryptococcal antigen are used for specific fungal infections, helping in diagnosing systemic mycoses.

Answer 633

After identifying the fungal species via culture, sensitivity testing determines the effectiveness of various antifungal drugs against the isolated fungus, guiding appropriate and effective treatment.

Answer 634

An anti-viral agent helps the body fight off viruses. Interferon is the only anti-viral licensed in veterinary species, often associated with large costs.

Answer 635

Anti-viral drugs work by stopping the replication of the virus within cells, blocking the virus's ability to attach to or enter host cells, or enhancing the immune response.

Answer 636

Azoles, such as itraconazole and ketoconazole, inhibit the cytochrome P450-dependent synthesis of ergosterol in fungal cell membranes, disrupting cell integrity.

Answer 637

Allylamines, such as terbinafine, inhibit the synthesis of ergosterol in fungal cells by inhibiting the enzyme squalene epoxidase.

Answer 638

Polyenes, like Amphotericin B and Nystatin, bind to ergosterol in fungal cell membranes, creating pores that lead to cell lysis.

Answer 639

Pyrimidine analogues, such as 5-fluorocytosine, are converted by fungal cells into 5-fluorouracil, disrupting fungal RNA and protein synthesis.

Answer 640

Cellular toxins, like silver sulfadiazine and chlorhexidine, release concentrations toxic to bacteria and yeasts or bind to the skin forming a protective layer, respectively.

Answer 641

Nystatin, Miconazole, Clotrimazole, Terbinafine, and Posaconazole are used, often combined with steroids and antibiotics. Terbinafine should not be used in cats.

Answer 642

Options include Miconazole (shampoo), Climbazole (wipes), Itraconazole (oral, systemic), Ketoconazole (oral, shampoo), and Chlorhexidine (various forms).

Answer 643

Itraconazole, Ketoconazole, Enilconazole (rinse), Miconazole (shampoo), Chlorhexidine, Clotrimazole, Terbinafine, and Fluconazole are options, with varying licenses and applications across species.

Answer 644

Amphotericin B, Fluconazole, and Flucytosine are used, though these diseases are rare in the UK and treatments are often off-license.

Answer 645

Information can be found in the VMD Product Information Database, NOAH Compendium, and BSAVA formulary/app, covering licensed and unlicensed products.

Answer 646

Bovine tuberculosis (bTB) is a chronic bacterial infection caused by Mycobacterium bovis, affecting cattle and other species, including humans. Major challenges include its persistence in wildlife reservoirs, the economic impact of control measures, and the need for effective vaccination and testing strategies.

Answer 647

The prevalence of bTB started to increase in the mid-1980s. Around 30,000 cattle were culled due to bTB last year, with an average cost of £34,000 per herd TB breakdown, costing the taxpayer approximately £500 million over the last ten years.

Answer 648

The strategy includes creating three management zones (High risk, Edge, and Low risk areas), increasing testing frequency, implementing badger culling and vaccination, biosecurity advice, risk-based trading, and financial penalties for overdue tests.

Answer 649

Focus areas include biosecurity, increased industry ownership, enhancing test sensitivity, research into cattle vaccines and tests (DIVA/bulk milk tests), genetic resistance in cattle, and a shift towards vaccination over badger culling.

Answer 650

The Skin Test (SICCT) with avian and bovine tuberculin, IFN gamma testing for blood, occasionally supplemented by antibody tests, and detailed post-mortem inspections. Sensitivity and specificity vary, highlighting challenges in accurate diagnosis.

Answer 651

Vaccination efforts include developing a BCG vaccine for cattle, despite causing TB test reactions, requiring a DIVA test. Badgers are also vaccinated to reduce disease spread, with oral vaccines in development.

Answer 652

Measures include risk-based trading, pre- and post-movement testing, wildlife proofing (e.g., badger-proof feed stores), environmental management, and using ibTB to assess TB risk.

Answer 653

Challenges include improving test frequency and sensitivity, managing cattle movements, enhancing biosecurity, developing effective vaccines, and addressing wildlife reservoirs of the disease.

Answer 654

A prion is a misfolded protein that can cause disease by inducing other normal proteins in the brain to also misfold, leading to transmissible spongiform encephalopathies (TSEs).

Answer 655

TSEs are a group of progressive, invariably fatal, conditions that affect the brain and nervous system of many animals, including humans. Examples include BSE in cattle, scrapie in sheep, and CWD in deer.

Answer 656

Key veterinary prion diseases include Bovine Spongiform Encephalopathy (BSE) in cattle, scrapie in sheep and goats, and Chronic Wasting Disease (CWD) in deer and elk.

Answer 657

Clinical signs include weight loss, behavioral changes, pruritus (in scrapie), ataxia, tremors, licking lips, grinding teeth, and changes in posture and gait. Some animals may be found dead without prior observed illness.

Answer 658

The BSE epidemic reached its peak in the late 20th century, with a significant number of cattle affected. Efforts to control the disease have reduced incidence, but isolated cases still emerge, such as one found in 2021.

Answer 659

Classical scrapie is controlled by the National Scrapie Plan, which includes genetic selection against susceptible genotypes and culling of affected animals.

Answer 660

CWD has been identified in European cervids, posing a significant threat to wildlife populations and potentially impacting other species through environmental reservoirs.

Answer 661

Surveillance includes monitoring for rare clinical disease cases, managing isolated cases of BSE, controlling farm outbreaks of scrapie, and maintaining vigilance for CWD threats to UK deer.

Answer 662

Myxomatosis and Rabbit Haemorrhagic Disease (RHD) strains 1 and 2. Prevention includes vaccination with an initial vaccine at 7 weeks old and yearly boosters.

Answer 663

Swelling, redness, ulcers, nasal and eye discharge, blindness, respiratory signs (e.g., dyspnoea), lethargy, and anorexia.

Answer 664

Originally released in France to control wild rabbit populations, it's now worldwide with new strains developing resistance.

Answer 665

Sudden death, anorexia, lethargy, neurological signs, internal bleeding, and jaundice.

Answer 666

History and husbandry review, full clinical exam, vaccination at 7 weeks old with yearly boosters, offer neutering, and consider social needs. Also, assess the necessity for guinea pig vaccinations.

Answer 667

Treat individuals and recommend management options to prevent disease spread, focusing on hygiene, isolation, and possibly vaccination.

Answer 668

Panacur (fenbendazole), Baycox (toltrazuril) for coccidia, anthelmintics, Advantage (imidacloprid), Stronghold (selamectin), Advocate (imidacloprid/moxidectin), and Xeno (Ivermectin). Frontline (Fipronil) is toxic to rabbits.

Answer 669

Avoid routine preventive worming; use faecal egg counts to determine treatment necessity. Treat ectoparasites only when clinically necessary, following proper diagnostic workup.

Answer 670

Assess the need for antibiotics, likely bacteria involved, safety, efficacy, licensing in rabbits, and if they are first-line options.

Answer 671

Trimethoprim/sulfamethoxazole (oral Sulfatrim), Penicillin G (Injectable Norocillin), Enrofloxacin (oral Baytril), Co-amoxyclav (Synulox oral drops), and Metronidazole (oral suspension).

Answer 672

: Treatment includes identifying and addressing the underlying cause, providing analgesia, syringe feeding with probiotics, and using prokinetics like Metoclopramide, Ranitidine, and Cisapride.

Answer 673

Ectoparasites are considered important due to their direct impact on the welfare of the host, potential to cause or predispose the host to other diseases, act as vectors for disease transmission, and their zoonotic and economic significance.

Answer 674

Common ectoparasites include fleas, ticks, lice, and mites (e.g., Sarcoptes, Cheyletiella). These parasites may cause pruritus, alopecia, and secondary infections, and can be vectors for diseases like babesiosis and myxomatosis.

Answer 675

The diagnostic plan should include history taking, clinical examination, identification of parasites on the host or in the environment, and specific diagnostic tests like skin scrapings, coat brushings, and serological tests.

Answer 676

Ectoparasites like fleas and mites can transmit diseases to humans (zoonotic importance) and cause significant economic losses in livestock due to diseases like sheep scab (Psoroptes ovis), which is notifiable in some regions.

Answer 677

Clinical signs include pruritus, alopecia, erosions, crusts, scale, secondary bacterial infections, and in severe cases, anemia or neurological signs due to toxins or blood loss.

Answer 678

Parasites like fleas, lice, and surface mites are often found on their host and cause visible signs such as pruritus, alopecia, and secondary skin infections.

Answer 679

Some ectoparasites, such as certain mites and ticks, spend only short periods on the host or have a significant part of their lifecycle in the environment, making them harder to detect directly on the animal.

Answer 680

Diagnostic procedures include direct observation of parasites or their effects on the host, use of diagnostic tests such as skin scrapings or tape strips, and environmental examination for parasites like the poultry red mite (Dermanyssus gallinae).

Answer 681

Management includes the use of appropriate antiparasitic medications, environmental control measures to reduce parasite populations, and supportive care for affected animals.

Answer 682

Veterinarians should consider the clinical presentation, species, age, and husbandry conditions when diagnosing ectoparasitic diseases, select appropriate diagnostic tests, and implement effective treatment and control strategies.

Answer 683

Disease occurs when the skin's protective mechanisms are compromised due to mechanical damage, immunocompromise, defects in skin barrier function, and changes to the skin microclimate.

Answer 684

Coagulase-positive Staphylococci, Dermatophilus congolensis, Mycobacteria from soil, and less commonly, Gram-negative bacteria.

Answer 685

Manifestations can range from surface and superficial pyoderma to deep pyoderma, bacterial granulomatous dermatitis, and systemic infections.

Answer 686

Canine intertrigo (skin fold pyoderma), acute moist dermatitis (hotspots), and bacterial overgrowth syndrome.

Answer 687

Superficial pyoderma involves infection within the epidermis and/or hair follicle, presenting as papules, pustules, crusts, and sometimes alopecia.

Answer 688

Deep pyoderma involves infection beyond the epidermis or hair follicle epithelium, often due to follicle rupture, penetrating wounds, or haematogenous spread, leading to thickening of skin, nodules, and draining sinuses.

Answer 689

Diagnostic tests include cytology, culture, and histopathology, with the choice depending on the depth of the lesion.

Answer 690

Treatment involves killing the organism (minimizing antibiotic use and focusing on topical antibacterials), addressing underlying causes, and enhancing the body's defenses.

Answer 691

Identifying and addressing the underlying cause is crucial for effective treatment and to prevent recurrence of the infection.

Answer 692

Clinical presentations vary. Dogs may show pruritus especially on the caudal/dorsal body. Cats may exhibit four cutaneous reaction patterns: head and neck pruritus, symmetrical alopecia, eosinophilic granuloma complex (EGC), and miliary dermatitis. Fleas can also be vectors of diseases and are zoonotic.

Answer 693

Sarcoptic mange causes intense pruritus, crusts on the pinnal margins/hocks/elbows, and positive pinnal-pedal reflex. It is zoonotic, capable of causing temporary skin lesions in humans.

Answer 694

Cheyletiella mites cause truncal scale, and in rabbits, can lead to significant scaling with little to no pruritus. They are zoonotic, causing dermatitis in humans.

Answer 695

Caused by Staphylococcus hyicus, Greasy Pig Disease presents with exudative dermatitis, erythema, and greasy skin in pigs. It requires prompt antibiotic treatment.

Answer 696

Dermatophilosis, also known as rain scald or mud fever, is caused by Dermatophilus congolensis. It is predisposed by wet skin conditions and presents as crusted scabs that peel off with tufts of hair.

Answer 697

Canine pyoderma is classified into surface, superficial, and deep. Treatment includes topical antibacterials for mild cases and systemic antibiotics for deep infections, always based on culture and susceptibility tests.

Answer 698

Differential Diagnosis for Case 1: Superficial bacterial pyoderma. Malassezia dermatitis. Environmental/dietary atopic dermatitis. Dermatophytosis. Sarcoptic mange. Demodicosis. Flea infestation/FAD. Cheyletiellosis. Pediculosis. Additional Information: Cytology was consistent with bacterial pyoderma. Further investigations revealed environmental atopy as the underlying cause.

Answer 699

Differential Diagnosis for Case 2: Dermatophytosis. Dermatophilosis ("lumpy wool"). Ectoparasites (e.g., psoroptic mange, chorioptic mange, lice). Staphylococcal folliculitis. Additional Information: The diagnosis was dermatophytosis (Trichophyton verrucosum), suggested by the evidence of contagion and zoonosis.

Answer 700

Skin commensals (e.g., Malassezia) can cause colonization. Transient contaminants, such as environmental saprophytes and occasionally dermatophytes, can carry fungi. Active pathogens (e.g., dermatophytes) can cause clinical disease. Fungi are a part of the normal skin microbiome but can also lead to skin disease through tissue mycosis, which can be superficial, subcutaneous, deep, or lead to hypersensitization, especially in atopic dogs.

Answer 701

Dermatophytes are classified as geophilic (environment-adapted), zoophilic (mammal-adapted, most common source of animal disease), and anthropophilic (human-adapted). Infection stages include inoculation and germination of infective arthrospores due to skin microtrauma & moisture, leading to penetration of the stratum corneum and growth of fungal hyphae, resulting in lesions within 5-7 days. They are contagious through direct or indirect contact.

Answer 702

Furunculosis resembles deep pyoderma with nodular swelling. Fungal kerion is a nodular inflammatory mass in hunting/working dogs. Pseudomycetoma, especially in Persian cats and Yorkshire Terriers, features subcutaneous/deep mycosis with nodular granulomas. Onychomycosis involves claw disease.

Answer 703

Direct examination of hair/scales with gentle skin scrape or plucking hair from lesion margins, placed in liquid paraffin on a microscope slide. Infected hairs appear distorted, paler, and wider than normal under a microscope.

Answer 704

Fungal culture involves sampling with a new toothbrush (McKenzie toothbrush technique) and can be performed in-house using dermatophyte test-medium (DTM) or at an external lab. Fungal PCR is a very sensitive test providing faster results but cannot distinguish between carriage and disease.

Answer 705

Malassezia infections are usually secondary, occurring due to anatomical features, other skin diseases, systemic disease, or an imbalance in the normal microbiome (dysbiosis), leading to increased numbers and a shift towards more pathogenic strains.

Answer 706

Diagnosis involves identifying appropriate lesions, identifying Malassezia at these sites with cytology (stained acetate tape strip or impression smear), and assessing the response to antifungal therapy. The presence of organisms such as "peanuts," "snowmen," or "Russian dolls" is noted under a microscope.

Answer 707

Dermatophytes are contagious pathogens causing alopecia, scale, and crust, diagnosed through microscopy, fungal culture, or possibly PCR. Malassezia is usually a commensal organism leading to disease through dysbiosis, causing pruritic dermatitis/otitis in dogs and occasionally cats, diagnosed through cytology and response to therapy.

Answer 708

Viral skin diseases are more common in large animals and equines than in small animals, often leading to serious economic losses due to their notifiable status. Many of these diseases require no treatment but lead to the slaughter and disposal of infected animals, movement restrictions, and initiation of quarantine, disinfection, vaccination, eradication, and surveillance programs.

Answer 709

Vesicular diseases cause vesicles and erosions/ulcers that progress to crusts, affecting the muzzle, oral mucosa, tongue, udder teats, and coronary band. These diseases can lead to the shedding of hooves and horns and affect a wide range of species, especially cloven-hooved ones, and occasionally humans.

Answer 710

Many vesicular diseases are notifiable due to the severe economic losses they can cause, with the UK's 2001 Foot and Mouth Disease (FMD) outbreak costing over £6 billion. Some vesicular diseases are also zoonotic.

Answer 711

Papilloma viruses are epitheliotropic, causing proliferative lesions or warts. They are typically host-specific, enter through microabrasions, and affect mostly young animals, which usually recover spontaneously. However, there is a rare risk of malignant transformation to squamous cell carcinomas.

Answer 712

Pox viruses cause diseases like cowpox in cats (transmitted by rodent bites and zoonotic), horsepox, swinepox, sheep pox, goat pox, lumpy skin disease in cattle, and myxomatosis in rabbits, leading to edematous thickening of various body parts and potentially death.

Answer 713

Other viral skin diseases include Post-weaning Multisystemic Wasting Disease (PMWD)/Porcine Dermatitis Nephropathy Syndrome (PDNS), Psittacine beak and feather disease, and Border disease in sheep, which can lead to a variety of skin and systemic symptoms.

Answer 714

Diagnostic methods include detecting virus/viral antigens or nucleic acids, diagnostic serology for antibodies, virus isolation, ELISA, PCR/RT-PCR, serum neutralization tests, electron microscopy, histopathology, immunofluorescence/immunohistochemistry, and more, depending on the virus and test availability.

Answer 715

Leishmaniasis, caused by Leishmania spp. and transmitted by sandflies, is more common in dogs than cats and is also zoonotic. It causes a range of skin and systemic signs with a long incubation period. Diagnosis can be challenging and involves aspirates (e.g., lymph node, bone marrow), serology/PCR, and skin biopsies. The disease can be controlled but not cured.

Answer 716

Viral skin diseases are more prevalent in large animals and equines, representing a significant potential economic loss. Many large animal viral infections are notifiable, and some are zoonotic. Protozoal skin diseases, such as Leishmaniasis, are serious vector-borne diseases increasingly common in the UK, especially

Answer 717

Immune-mediated skin diseases involve hypersensitivity reactions, with all four classes of hypersensitivity represented. These can include allergies to external antigens (e.g., flea saliva, dust mites, pollens, molds) and immune-mediated reactions against self-antigens (e.g., desmosomal proteins in pemphigus foliaceus, epidermal cells in discoid lupus, sebaceous glands in sebaceous adenitis).

Answer 718

Allergic skin disease is categorized into food and environmental induced-atopic dermatitis, flea allergy, and contact allergy. The major clinical sign across these categories is pruritus, leading to secondary infections, lesions, and behavioral changes.

Answer 719

Feline atopic skin syndrome includes reactions to house dust mites, pollens, molds, flea saliva, insect and mite hypersensitivity, and food proteins. It presents through multiple manifestations, known as feline cutaneous reaction patterns.

Answer 720

In horses, allergic skin disease includes insect bite hypersensitivity, equine atopic skin disease, food allergy, and contact allergy. Clinical signs include urticaria, pruritus, and secondary infections, along with behavioral changes.

Answer 721

Immune-mediated diseases in these species can include parasite-induced hypersensitivity, atopic dermatitis diagnosed in sheep and goats, and hypersensitivity being a major component of clinical signs, varying from protective to unhelpful.

Answer 722

The diagnostic plan involves accurate diagnosis through exclusion of common differential diagnoses, confirmation of the correct histological pattern on histopathology, and occasionally relying on exclusion alone. It includes careful history taking, rule out common differential diagnoses through tests like skin scrapes, hair plucks, dermatophyte culture, cytology, and test treatments.

Answer 723

These diseases are rare, resulting from aberrant immune function due to a failure of tolerance, leading to tissue damage. The tissue or antigen involved determines the clinical signs, which are systemic in nature and usually bilaterally symmetrical. Cutaneous immune-mediated disease may be associated with systemic disease or represent a cutaneous marker of systemic disease.

Answer 724

Duration and development of the lesions. Presence of pruritus and its duration. Health status of in-contact animals and humans. Parasite control measures in place. Any recent changes in the environment or contact with other animals.

Answer 725

Differential Diagnosis Approach: Incorporate DAMNITV to formulate potential causes. Inflammatory and Immune-Mediated conditions often predominate. Infectious causes include parasites, bacteria, fungi, protozoa, and viruses. Diagnostic Tests: Coat brushing, skin scrapes, skin cytology, dermatophyte culture, trichograms, Wood’s lamp examination. Further investigations may include blood tests, skin biopsies, microbial culture, trial therapy (antimicrobial, antiparasitic). Signalment and History Considerations: Age, sex, breed-specific predispositions. General health, lifestyle, housing, and past dermatological history. Importance of environment, contact with other animals or species, and response to past treatments. Clinical Examination: Perform both general and detailed dermatological examinations. Systematic assessment for any signs of systemic disease affecting the skin. Examination of less visible areas and mucocutaneous junctions is crucial. Diagnosis and Treatment: Aim for a definitive diagnosis through a logical stepwise approach to testing. Treatment based on diagnosis, considering potential systemic involvement. Awareness of age-specific diseases (e.g., young animals prone to immunological immaturity diseases, older animals to endocrinopathies and neoplasia).

Answer 726

DAMNITV framework highlights: Degenerative Anomalous Metabolic Neoplastic and Nutritional Inflammatory, Immune-mediated, Infectious, Idiopathic Toxic Traumatic Vascular

Answer 727

Signalment provides vital clues about possible dermatologic conditions based on age, sex, and breed, which can influence predispositions to certain diseases.

Answer 728

Coat brushing Skin scrapes Skin cytology Dermatophyte culture Trichograms Wood’s lamp examination

Answer 729

Establish what is happening to the skin and why. Determine if the dermatological disease is primary or secondary. Conduct a general and dermatological clinical examination. Formulate a differential diagnosis. Perform targeted diagnostic tests. Confirm the diagnosis and initiate appropriate treatment.

Answer 730

Age: Certain conditions are more common at specific life stages (e.g., demodicosis in young animals). Sex: Hormonal influences can affect skin condition (e.g., entire males with endocrine changes). Breed: Specific breeds have predispositions to certain dermatologic conditions.

Answer 731

General health history can reveal systemic diseases that manifest with dermatologic signs, influence the diagnostic plan, and impact treatment options.

Answer 732

Systematically approach each case without jumping to conclusions. Dermatological diagnoses often require more than visual inspection. Follow a structured diagnostic process to accurately identify the cause and provide effective treatment.

Answer 733

Dogs may scratch, chew, or lick their feet. Horses may stamp. Cats may overgroom, leading to self-induced alopecia. Small furries may exhibit barbering.

Answer 734

Hypersensitivities (environmental atopy, food-induced atopy, contact allergy) Parasites (arachnids, mites, insects like fleas and lice) Microbial infections (bacterial pyoderma, Malassezia dermatitis) Others (drug reaction, contact irritant, neoplasia, autoimmune diseases)

Answer 735

Formulate an initial ranked differential diagnosis list based on signalment, history, and clinical exam. Perform initial diagnostic tests as needed (e.g., coat brushing, skin scrapes, cytology).

Answer 736

Treat any confirmed parasites or microbial infections. If pruritus resolves, investigate for immunosuppressive/endocrine diseases. If pruritus persists, consider an exclusion diet trial.

Answer 737

Consider environmental atopic dermatitis (AD) as a diagnosis by exclusion. Identify allergens for potential immunotherapy or allergen avoidance through intradermal allergy tests or IgE serology.

Answer 738

Be systematic in your diagnostic approach. Eliminate parasites and microbial infections first. Use diet trials judiciously to rule out food-induced atopy. Environmental AD is diagnosed by exclusion and requires a comprehensive approach for management.

Answer 739

Papule: A small, solid elevation of skin less than 1cm in diameter, often erythematous. Pustule: A small elevation of skin filled with pus, often starting as a papule.

Answer 740

Infections (bacterial, fungal) Ectoparasites (fleas, mites) Hypersensitivities (flea, environmental, food) Autoimmune diseases (e.g., Pemphigus foliaceus).

Answer 741

Consider signalment, history, and dermatological examination. Assess if lesions are follicular and their distribution. Produce a ranked differential diagnosis list.

Answer 742

Cytology (possibly with bacterial culture). Tests for ectoparasites and dermatophytosis. Consider biopsy if autoimmune diseases are suspected.

Answer 743

Scale: Rafts of immature keratinocytes, resulting from hyperkeratosis. Crust: Dried exudates on the skin surface, often a secondary lesion.

Answer 744

Infections, ectoparasites, hypersensitivities, nutritional deficiencies/metabolic diseases, autoimmune diseases, and rarely, neoplasia.

Answer 745

Perform cytology and cultures for bacterial and fungal infections. Rule out ectoparasites and consider biopsy if autoimmune diseases are suspected. Treat to eliminate secondary infections and control ectoparasites.

Answer 746

Focus on microbial infections and ectoparasites first, unless autoimmune disease is suspected. Formulate a differential diagnosis based on thorough clinical examination and history. Be systematic in your approach to diagnosis and treatment.

Answer 747

Alopecia: Loss of hair, either partial or complete, which can be primary (failure to grow) or secondary (loss after growth). True Alopecia: Direct damage to the hair follicle unit. Apparent Alopecia: Hair shaft is damaged but remains in the follicle.

Answer 748

Lack of stimulation for hair growth, leading to miniaturized or dysplastic hairs that easily break off or shed.

Answer 749

Hair follicle inflammation. Hair cycle abnormalities, often due to endocrine issues. Hair morphological abnormalities. Congenital aplasia.

Answer 750

Consider species-specific common causes, such as dermatophytosis in certain animals or demodicosis and pyoderma in dogs. Age of onset is crucial, with differentials including infections in younger animals and endocrinopathies or neoplasia in older animals.

Answer 751

Certain conditions are predisposed by species, age, sex, and breed, affecting the diagnostic approach and differential diagnosis.

Answer 752

Both general and dermatological examinations are essential, looking for systemic abnormalities and assessing the distribution and type of alopecia.

Answer 753

A trichogram can help determine if alopecia is true (easily epilated) or apparent (requires effort, with broken distal tips).

Answer 754

Skin scrapings, especially for demodicosis. Dermatophyte tests (microscopy/culture). Trichograms to assess the hair bulb and shaft for signs of disease.

Answer 755

Differentiate alopecia caused by trauma/self-trauma from other types. Common causes include folliculitis, demodicosis, pyoderma, and endocrinopathies. A systematic approach including signalment, history, examination, and targeted tests is crucial.

Answer 756

Consider swellings of non-dermatologic origins such as hernias, oedema, bursitis, emphysema, clostridial infections, and mammary tumors.

Answer 757

Inflammatory (infectious and non-infectious). Neoplastic. Cysts.

Answer 758

Abscess/cellulitis, furunculosis, bacterial granulomas, and deep/subcutaneous or systemic fungal granulomas.

Answer 759

Urticaria/angioedema, seroma, haematoma, and conditions like eosinophilic granulomas.

Answer 760

Skin neoplasms are common in older animals and include lipomas, sebaceous adenomas, mast cell tumors. Cysts are epithelial-lined cavities containing fluid or solid material.

Answer 761

Use signalment, history, and clinical examination to form a list of ranked differential diagnoses, then investigate using cytology, tissue biopsy (histopathology and/or tissue culture).

Answer 762

They provide clues about the nature of the mass, considering the species, breed/color, age, and any previous health issues or environmental exposures.

Answer 763

Look for pyrexia, peripheral lymphadenopathy, and other systemic abnormalities that might be related to the skin mass.

Answer 764

Note whether the lesions are solitary or multiple, their location, size, definition, mobility, and any signs of inflammation or drainage.

Answer 765

Fine needle aspirates (FNA) can differentiate between inflammation, neoplasia, and cyst contents, providing valuable initial information.

Answer 766

To classify the mass as inflammatory, neoplastic, or cystic, start with a thorough clinical examination, followed by cytology and, if necessary, biopsy for a definitive diagnosis.

Answer 767

Decide which tests will help narrow down differential diagnoses efficiently and cost-effectively. Prioritize tests that provide the most useful information quickly and non-invasively. Ensure good quality and adequate number of samples are taken and correctly interpret the samples, considering the limitations of each test.

Answer 768

Techniques include coat comb/brush, acetate tape strip, skin scrapings, trichograms, cytology, Wood’s lamp examination, McKenzie coat brush, and microbiological swab for culture, each targeting different aspects like parasites, microbes, or hair structure.

Answer 769

Cytology, especially fine needle aspirate cytology, can reveal bacteria, yeasts, and other cells (e.g., inflammatory, epithelial, neoplastic) under magnifications of X4-100 (Oil).

Answer 770

To establish a definitive diagnosis when less invasive tests are inconclusive. To rule out certain conditions. Histopathology and tissue culture are common tests carried out on skin biopsies.

Answer 771

Choose sedation or general anesthesia based on the animal's calmness and biopsy site. Select representative lesions and avoid disturbing the skin surface. Properly prepare the sample site and decide on the biopsy type (punch, wedge/ellipse, excisional, incisional) based on the lesion.

Answer 772

Handle gently to avoid damaging the sample. Blot blood and place in 10% formalin. Provide the pathologist with a brief history and differential diagnosis list.

Answer 773

Withdraw antibiotics and topical antimicrobials before sampling. Blot the surface with alcohol and allow drying. Submit punch biopsy in sterile conditions avoiding formalin contamination.

Answer 774

Samples may not be representative of the lesion. Inflammatory reactions could be affected by therapy. Unrealistic expectations; not all diseases can be distinguished on biopsy.

Answer 775

Carefully select cases and lesions. Take high-quality samples without destroying evidence. Give a brief history and differential diagnosis list to your pathologist.

Answer 776

Pattern analysis is used to classify pathological changes based on the type and location of cellular infiltrate. This helps formulate a specific list of aetiological agents or narrow down categories of disease with a common pathogenesis.

Answer 777

Knowledge of pattern analysis enhances the utility of skin biopsies, allowing for a more precise diagnosis. Biopsies should be reserved for cases where they are likely to be most useful,

Answer 778

To kill or repel parasites using ectoparasiticides. To control or cure microbial infections with antimicrobials. To control inflammation and pruritus, particularly for atopic dermatitis and autoimmune diseases. To moisturize and improve skin barrier function. To resolve scaling. To treat otitis externa.

Answer 779

Emollients soften, lubricate, and soothe the skin, acting as occlusives to "seal in" water content and reduce trans-epidermal water loss. Examples include lanolin, coconut oil, and Vaseline. Moisturizers increase the water content of the stratum corneum, containing ingredients like colloidal oatmeal, aloe vera, urea, glycerine, and sodium or ammonium lactate.

Answer 780

Keratolytics reduce cohesion between cells of the stratum corneum, facilitating the removal of scales. Keratoplastics restore normal epidermal epithelialization and keratinization and reduce epithelial turnover. Common agents include sulfur, salicylic acid, and ammonium lactate.

Answer 781

Ear infections are often secondary to underlying issues, like allergies. Early intervention with topical corticosteroids and antimicrobial cleaners can control microbial overgrowth and inflammation without the need for antibiotics. Cytology is essential for establishing treatment.

Answer 782

The presence of organisms as identified by cytology and/or culture. The level of inflammatory activity, selecting the lowest potency glucocorticoid likely to be effective. The potential for ototoxicity if the tympanic membrane is ruptured. The nature of the exudate, with some agents being inactivated by pus.

Answer 783

Cerumenolytics dissolve or soften cerumen. Antimicrobials control microbial growth. Surfactants emulsify debris. Astringents dry the ear canal. Select a product based on the action required and the safety profile, especially if the tympanic membrane is likely to be perforated.

Answer 784

Pros: Direct delivery to skin allows for higher drug concentration. Can target therapy to specific areas. Cons: Labor-intensive, affecting compliance. May be difficult to apply based on the animal's tolerance or the area of the body affected.

Answer 785

Understand the actions of drugs to select the most appropriate product. Consider both patient and owner factors in product selection, aiming for formulations with maximum persistence and ease of use.

Answer 786

Bite and traumatic wounds, surface pyoderma, superficial pyoderma, deep pyoderma, and otitis externa are common. Treatments focus on using topical antibacterials/antibiotics where possible and choosing the narrowest spectrum and lowest EMA Category antibiotic likely to be effective.

Answer 787

Ensure bacteria are involved via cytology. Use topical treatments to minimize systemic antibiotic use. Correct the underlying cause of the infection.

Answer 788

Prefer topical antibacterials (e.g., chlorhexidine, silver sulfadiazine) if possible. Correct the underlying cause of the infection.

Answer 789

Systemic antibiotics are recommended, ideally based on bacterial culture and susceptibility testing. TMPS (trimethoprim-sulfamethoxazole) is often used where possible, with treatment duration varying by severity.

Answer 790

Selection of ear drops/creams should be based on organism present, level of inflammatory activity required, potential for ototoxicity, nature of exudate, and frequency of application for compliance.

Answer 791

Identify the fungus and predisposing conditions. Use topical antifungal rinse/shampoo and clean the environment. Consider systemic therapy for small animals but not always for farm species.

Answer 792

Topical antifungals are the mainstay of treatment, including miconazole and clotrimazole. Systemic antifungals like ketoconazole (for dogs, not cats) and itraconazole may be used, with monitoring for side effects.

Answer 793

Perform appropriate diagnostics before treatment. Prefer topical treatments where possible. If systemic antibiotics are necessary, choose the narrowest spectrum effective drug. Treat for an adequate duration to fully resolve the infection but no longer than necessary. Always address any underlying causes to prevent recurrence.

Answer 794

Control of inflammation and pruritus. Allergen avoidance and allergen-specific immunotherapy (ASIT). Improving the skin barrier. Control of flare factors.

Answer 795

Prednisolone is commonly used for its rapid, effective anti-inflammatory action but with caution due to potential long-term side effects. The goal is to use the lowest effective dose and possibly taper to an alternate-day regimen to minimize side effects.

Answer 796

Oclacitinib (Apoquel) blocks the JAK-1 pathway, offering good antipruritic and some anti-inflammatory action with a favorable long-term safety profile. Lokivetmab (Cytopoint) is a monoclonal antibody targeting IL-31, providing targeted therapy with a good safety profile and effective antipruritic action.

Answer 797

Ciclosporin is a potent anti-inflammatory agent used in the treatment of atopic dermatitis, especially for its effectiveness in the long term, though it has a slow onset of action and is costly.

Answer 798

Induction: Rapid control of lesions using systemic glucocorticoids at immunosuppressive doses. Titration: Tapering to the lowest effective maintenance dose, adding adjunctive treatments as necessary. Maintenance: Maintaining remission with minimal adverse effects, possibly using adjunctive therapies to enable glucocorticoid reduction. Monitoring: Regular check-ups to monitor lesion control and drug side effects.

Answer 799

Azathioprine (not for cats), chlorambucil, mycophenolate mofetil, ciclosporin, and potentially oclacitinib. These drugs may be slow to take effect, so they are often used alongside steroids from the start.

Answer 800

Multimodal therapy is crucial, with no "one size fits all" approach. For atopic dermatitis, control of inflammation, pruritus, and flare factors, alongside improving skin barrier function, is key. For autoimmune diseases, the goal is rapid lesion control followed by maintenance of remission with minimal drug side effects, requiring close monitoring and potentially lifelong management.

Answer 801

The Janus Kinase (JAK) pathway is a critical signaling mechanism involved in the immune response, hematopoiesis, and inflammation in animals. JAK-1, a member of the Janus kinase family, plays a pivotal role in transmitting signals from various cytokines and growth factors to the cell nucleus, influencing gene expression. In veterinary medicine, the JAK-1 pathway's significance lies primarily in its role in mediating the effects of cytokines involved in allergic responses, such as interleukin-31 (IL-31), which is directly associated with pruritus (itching) in animals, especially dogs. Oclacitinib (Apoquel) is a selective inhibitor of the JAK-1 pathway, providing a targeted approach to managing allergic dermatitis, including atopic dermatitis in dogs, by effectively reducing inflammation and pruritus without the extensive side effects associated with glucocorticoids. By blocking JAK-1, oclacitinib prevents the action of pro-inflammatory cytokines, thereby offering a novel and specific mechanism to control allergic symptoms and improve the quality of life for affected animals.

Answer 802

To document normality (BSE), estimate breeding time, confirm pregnancy, detect abnormalities (causes of infertility), and manage parturition.

Answer 803

Climate, nutrition, stress, and teratogens may impact reproductive health, and history should be specific to the species' age and clinical presentation.

Answer 804

Previous pregnancies, the possibility of current pregnancy, and the timing of the examination to avoid missing early pregnancies.

Answer 805

Puberty status, inter-oestrus intervals, and whether they are normal, prolonged, or shortened.

Answer 806

Consider zoonotic risks, transmission of venereal or other pathogens, and any notifiable conditions like Contagious Equine Metritis in mares.

Answer 807

Relevant vaccinations for diseases like Salmonella in birds, Clostridial vaccination in ewes and pigs, and Canine herpes virus post-mating to prevent abortion.

Answer 808

Bacteriological and virological screenings like CEMO, Klebsiella, Pseudomonas in mares, and FeLV in queens. Genetic tests for diseases like polycystic kidney disease in cats.

Answer 809

Body condition, dentition, feet, ventral hernias, and hereditary defects like hip dysplasia in dogs.

Answer 810

The correct number of teats, evidence of the estrous cycle stage, presence of current or previous disease.

Answer 811

Normal alignment of vulval lips, evidence of venereal pathogens, and conditions like Coital exanthema in mares or Infectious pustular vulvovaginitis in cows.

Answer 812

Normality or abnormalities, previous injuries or surgeries, presence of normal or abnormal discharge.

Answer 813

Clean vulval lips, sterile manual/digital or speculum examination, and vaginoscopic exams for conditions like urovagina.

Answer 814

Evaluation of the cervical opening, estimation of the cycle stage, normal vs. abnormal conditions like discharge or previous trauma.

Answer 815

Trans-rectal and trans-abdominal palpation, radiography, ultrasonography, uterine cytology/microbiology, endoscopic examination, and biopsy.

Answer 816

To document normality (BSE), determine prognosis for fertility (fertile, infertile, sterile), and detect abnormalities not necessarily related to fertility.

Answer 817

It helps understand the reason for presentation, especially regarding fertility, including puberty status and previous breeding success.

Answer 818

Assess for infectious disease risk, the need for bacteriological or virological screening, and any required genetic tests.

Answer 819

Age, body size, puberty status, masculinised appearance, musculoskeletal disease, concurrent illness, and hereditary defects like hip dysplasia.

Answer 820

By observing interaction with an estrous female in the normal mating environment, including interest in the female, mounting behavior, erection, intromission, ejaculation, and interest after mounting.

Answer 821

Normal or abnormal scrotal skin, mobility of testes within the scrotum, absence of abnormal contents, and ultrasound for abnormalities like hernia or fluid.

Answer 822

Palpation for size, texture, tone, and evenness; measurement of scrotal width/circumference; and ultrasound examination for volume and abnormalities.

Answer 823

Normal appearance and direction, mobility of the penis, preputial skin condition, size of orifice, presence of discharge, and ability to protrude penile tip.

Answer 824

Examination in non-erect and erect state, absence of penile-preputial adhesions, and penile deviations.

Answer 825

Detection of normality or abnormality using semen collection, rectal palpation, radiography, ultrasonography, and lavage techniques.

Answer 826

Number, motility, morphology, live staining, and presence of other cells.

Answer 827

hCG stimulation test, GnRH stimulation test, and measurement of basal oestrone sulphate in stallions. Serial plasma testosterone measurement in dogs.

Answer 828

Libido, examination of scrotum, testes, epididymides, sheath, penis, urethra, accessory glands, semen examination, and basal hormone and stimulation tests. Methods vary according to species' anatomy and size.

Answer 829

The female becomes sexually receptive, signaled by "standing to be mated by the male." Oestrus intensity, length, and timing of ovulation relative to oestrus vary across species.

Answer 830

: Oestrus occurs once puberty is initiated, after parturition/lactational anoestrus, and the resumption of cyclicity after seasonal anoestrus, typically in the latter part of the follicular phase.

Answer 831

Considerations include the introduction of a specific male, controlled mating, artificial insemination, the period of pre-ovulatory follicle growth, and increasing oestradiol that induces oestrus and the LH surge.

Answer 832

The fertilisation period is when oocytes are available to be fertilised by sperm, shortly after ovulation. The fertile period is when mating could result in pregnancy.

Answer 833

Progesterone (indicates follicular phase onset and ovulation in dogs), oestradiol (elevated during the follicular phase), and LH (surge triggers ovulation).

Answer 834

Ultrasound checks for the absence of the corpus luteum, follicular size, and morphology. Optimal ovulation timing can be inferred from changes in follicle shape and size.

Answer 835

It helps assess the reproductive tract's condition, influenced by oestrogen and progesterone dominance, indicating readiness for breeding in mares and cows.

Answer 836

These are indicators of the stage of the oestrous cycle, helping determine the optimal time for mating or artificial insemination.

Answer 837

Using GnRH to induce an LH surge or HCG for direct ovulation induction. This allows for timing mating or artificial insemination more accurately.

Answer 838

Absence of oestrus post-mating, detection of pregnancy-specific protein/endocrinological changes, and direct or indirect detection of the fetus or fetal membranes (e.g., ultrasound, radiography).

Answer 839

Pregnancy-associated glycoproteins, stable progesterone levels post-mating, species-specific hormone secretion (e.g., placental estrogens, relaxin), and physical/maternal changes due to pregnancy.

Answer 840

Tracking hormone concentration changes, fetal mineralization, the presence of the corpus luteum, placental function, and eCG levels.

Answer 841

Transrectal ultrasound from day 12, palpation from day 21, eCG from day 60-120, and transrectal ballottement from day 80.

Answer 842

Early pregnancy factor from day 3, transrectal ultrasound from day 14, milk/plasma progesterone levels, transrectal palpation from day 35, and oestrone sulfate in milk from day 100.

Answer 843

Transabdominal ultrasound from day 30, later detection of cotyledons/caruncles, foetal pulse detection with Doppler ultrasound from day 80, and abdominal enlargement from day 100.

Answer 844

Observing failure to return to oestrus by day 18-24, elevated plasma progesterone by day 22-24, transabdominal ultrasound from day 20, and foetal pulse detection from day 30.

Answer 845

Transabdominal ultrasound from day 25, plasma relaxin from day 25, abdominal palpation for swellings from day 28, and radiographic examination from day 45.

Answer 846

Transabdominal ultrasound and plasma relaxin from day 25, abdominal palpation from day 28, and radiographic examination from day 45.

Answer 847

In cows, ultrasound examination is common at 4 weeks post-mating/AI. In mares on a stud farm, ultrasound exams are typical at days 14, 21, and 35.

Answer 848

Conception failure occurs when no fertilization happens, often due to mis-timing of mating or ovulation issues. Embryonic death refers to the loss of an embryo before organogenesis, even after fertilization, due to factors like male infertility, chromosomal abnormalities, or issues during early development.

Answer 849

Early pregnancy loss, up to 40% in some cases, is significant in cattle, especially dairy cows, due to high yield/NEB (Negative Energy Balance) and has a high economic cost.

Answer 850

Embryonic death is uncommon in sheep, which generally have good fertility. Management issues can reduce twinning rates.

Answer 851

Early pregnancy failure in pigs is significant and associated with ovarian pathologies after weaning, impacting litter size due to limited uterine capacity.

Answer 852

Horses experience significant early pregnancy loss, up to 24%, with most losses occurring before day 12. Loss after this period can still occur, often associated with a lack of embryonic mobility.

Answer 853

Conception failure in cattle can be due to metabolic or physical stress, ovarian pathologies, poor estrus detection, and mis-timing of artificial insemination.

Answer 854

Negative energy balance, high NEFA or urea levels, and specific nutrient deficiencies can toxically affect the oocyte/embryo, leading to early pregnancy failure.

Answer 855

Maximizing offspring involves managing multiple conceptions, nutrition (flushing), and avoiding infectious diseases or management strategies that can lead to increased estrus return or empty rates at pregnancy diagnosis.

Answer 856

Factors include seasonal effects on fertility, ovulation failure (e.g., cystic ovarian disease), genetic aspects affecting uterine capacity, and infectious causes like Porcine Parvovirus.

Answer 857

Causes include age-related factors, nutritional or physical stress, uterine or uterine tube pathologies, inflammatory conditions, and specific infectious diseases.

Answer 858

Resorption is the death and absorption of the embryo. Fetal death can lead to expulsion, mummification (dehydrated and preserved fetus due to high progesterone and no bacteria), or maceration (autolysis or putrification of the fetus not expelled). Stillbirth is when a fetus reaches term but dies during delivery.

Answer 859

Non-infectious causes include genetic abnormalities, uterine disease, stress, maternal illness, and nutritional phytotoxins. Infectious causes include exposure to pathogens, recrudescence of latent viral infections, ascending infections, and few venereal pathogens causing abortion.

Answer 860

Pregnancy loss can affect other animals in the group or herd, often involves systemic illness in infectious cases, leads to significant financial losses (cost of treatment, lost production, mortality, prevention), and many infectious causes are potential zoonotic diseases.

Answer 861

Fetal expulsion requires a decline in progesterone and the onset of uterine contractions. If the corpus luteum is not present, expulsion is more likely. If it remains, mummification can occur unless bacteria/inflammation triggers prostaglandin release.

Answer 862

The absence of the corpus luteum typically leads to expulsion, while its presence can lead to mummification. Bacterial infection or inflammation can induce prostaglandin release, leading to expulsion.

Answer 863

Embryonic death may result in resorption or pyometra and often goes unnoticed. Fetal death without a corpus luteum leads to expulsion, while with a corpus luteum, it may lead to mummification unless bacterial infection or inflammation induces prostaglandin release.

Answer 864

Exogenous prostaglandins can induce resorption or abortion by lowering progesterone levels but do not terminate late pregnancy or induce parturition effectively.

Answer 865

A bacterial disease causing abortion or stillbirth, transmitted through infected urine or contaminated water.

Answer 866

A bacterial sexually transmitted disease caused by Taylorella equigenitalis, leading to inflammation of the reproductive tract but not necessarily abortion.

Answer 867

infectious disease risk, potentially leading to Leptospiral abortion/stillbirth in cows.

Answer 868

Infectious causes of abortion in various species, including viral, bacterial (Campylobacteriosis in cattle), and fungal pathogens. Zoonotic potential of some of these pathogens is noted. Non-infectious causes include genetic abnormalities, uterine disease, and stress.

Answer 869

Specific diseases causing embryonic death in sheep such as toxoplasmosis, Schmallenberg virus, and Border disease. Cystic ovarian disease in pigs as a cause of ovulation failure.

Answer 870

Haemorrhage, trauma/lacerations/contusions, prolapse, placental retention, metritis, and recumbency/nerve damage.

Answer 871

Profuse bleeding due to umbilicus breakage, uterine or vaginal laceration, and minor seepage from placental attachment sites.

Answer 872

Bruising of the vestibule or vulva wall, perineal laceration common in cows and mares, classified by severity from first to third degree.

Answer 873

Bladder prolapse through a vaginal tear or eversion through the urethra, distinguished by the visibility of the bladder's external or internal surface.

Answer 874

Most commonly seen in late pregnancy, not post-partum, with variations across species in prevalence and timing.

Answer 875

Common in cows and ewes post-partum, less common in sows, rare in mares, bitches, and queens, with aetiology linked to factors like hypocalcaemia.

Answer 876

Varies by species; common in cows with significant impact on metritis-endometritis-pyometra complex, less common in mares with severe consequences, uncommon in ewes, bitches, and queens with varying treatments and impacts.

Answer 877

: Associated with dystocia, assisted parturition, placental retention; treatments include fluid therapy, NSAIDs, antibiotics, oxytocin or PG administration, calcium administration, and possibly uterine lavage.

Answer 878

Cows are most commonly affected, with issues like gluteal and obturator paralysis. Treatments include NSAIDs, hobbling, and general nursing.

Answer 879

Early breeding, breed (e.g., Holstein high incidence), feto-maternal disproportion, faulty disposition, twin pregnancies, fetal monsters, and maternal dystocia due to hypocalcaemia or incomplete cervix dilation.

Answer 880

: Faulty disposition due to fetus rotation, short second stage parturition leading to obstructive dystocia, and twins at term being rare due to earlier loss.

Answer 881

Primary uterine inertia (75% of cases), faulty disposition, feto-maternal disproportion (common in brachycephalic breeds), and large fetal head relative to pelvic inlet.

Answer 882

Primary uterine inertia, faulty disposition, fetal monsters, and previous pelvic trauma narrowing the birth canal.

Answer 883

: Breed differences, litter size, feto-maternal disproportion, and faulty disposition.

Answer 884

Less common than other species, with around 40% of cases being uterine inertia and simultaneous presentation being common.

Answer 885

Deliverability of the fetus, fetal vitality, dam's condition, potential response to medical treatment, manipulation duration, and number of remaining fetuses.

Answer 886

Deliver the fetus, return it to a normal disposition, ascertain fetal vitality, and ensure the dam is not significantly debilitated.

Answer 887

When the fetus can be delivered with cuts, there's no current damage to the female tract, the fetus is not viable, and the dam is too debilitated for caesarean.

Answer 888

Inability to deliver the fetus by manipulation and traction, large litter risk in polytocous species, uterine torsion, incomplete cervix dilation, and as an elective procedure for specific breeds or conditions.

Fundamentals of clinical practice 2 Flashcards

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