NAVLE Test Sample Questions II Flashcards

Question

**What is the treatment of choice for nasal aspergillosis in dogs?** - Systemic antifungal therapy (i.e. traconazole) - Systemic corticosteroids - Surgery and antibiotics - Topical antifungal therapy (i.e. Clotrimazole)

Answer 1

Answer: **Topical antifungal therapy (i.e. Clotrimazole)** Explanation The correct answer is topical antifungal therapy. Topical antifungal therapy is considered more efficacious and less costly than long-term systemic antifungal therapy. Corticosteroids would be contraindicated. Surgery and antibiotics would not be successful in controlling a fungal infection. The currently recognized treatment of choice is clotrimazole, a synthetic imidazole that has an 80% cure rate with single administration. The main potential complication is CNS exposure to the drug if there has been erosion of the cribriform plate.

Answer 2

Answer: **85%** Explanation 70-90% of all feline mammary tumors are malignant. Spaying a cat before 6 months of age reduces the risk for mammary tumors by 7 fold. The statistics for dogs is a 50:50 chance of malignancy for a single mammary mass.

Answer 3

Answer: **Patent ductus arteriosus** Explanation The correct answer is patent ductus arteriosus. PDAs results from the failure of ductus closure after birth resulting in a shunt (usually left-to-right) from the aorta to the pulmonary artery. The shunting causes excess volume in the pulmonary arteries, veins, left atrium, left ventricle, and aortic arch. The signalment of the dog and described clinical features and diagnostic findings are classic for PDA. In addition to the enlarged left heart and pulmonary vasculature, there is also usually an aneurysmal bulge of the aorta near the PDA on the DV view. The bounding pulses result from a widened pulse pressure (difference between systolic and diastolic pressure) because of the run-off of blood from the aorta to the pulmonary artery. PDAs are the most common congenital heart defect in dogs. The most common congenital heart defect in other domestic species is ventricular septal defect.

Answer 4

Answer: **Anhidrosis** Explanation Anhidrosis is the inability to sweat, which can be fatal if not addressed. The cause is unknown. It tends to occur in hot humid climates, and may occur in horses raised in the climate, or more commonly, horses brought into the climate. The most successful treatment is to move the horse back to a more favorable climate.

Answer 5

Answer: **Omeprazole** Explanation The correct answer is omeprazole. Omeprazole is a proton pump blocker (hydrogen-potassium ATPase). Cimetidine is an H2 antagonist as well as ranitidine and famotidine. Sucralfate protects the mucosa by binding to ulcers and protecting from further damage. PgE1 analogs (misoprostol) increase gastric blood flow, decrease gastric secretion of acid, and increase mucous and bicarbonate secretion.

Answer 6

Answer: **The lesion should resolve with topical antibiotic treatment** Explanation Most acral lick lesions are solitary and affect the carpus or metacarpus. About 50% will be diagnosed as idiopathic or psychogenic, but other diseases must be ruled out first including bacteria, fungal, demodicosis, trauma, allergy, and underlying joint disease. A full work-up may include skin cytology, fungal culture, biopsy, diet trial, skin testing, radiographs of the joint, and addressing behavioral disorders. Most of these lesions will have a deep bacterial infection and treatment should include systemic antibiotics based on a deep culture sample. Topical antibiotics may not penetrate the area well enough to resolve the infection. Management also includes treating the underlying cause. Many veterinarians will also prescribe topical or intralesional steroids. If no cause is found, then antidepressants or anxiolytics may be started. These lesions will rarely go away unless the underlying cause is identified and properly treated.

Answer 7

Answer: **Monitor as the lesions will most likely spontaneously regress** Explanation Contrary to cutaneous mast cell tumors in dogs, young Siamese cats (less than 4yr) with the histiocytic subtype of mast cell neoplasia will typically have their tumors spontaneously regress. Therefore, as long as the patient is not suffering it is reasonable to wait for these to resolve on their own. In general, it is safe to say that feline mast cell neoplasia is much less aggressive than is seen in dogs. Cutaneous mast cell tumors do not need the aggressive surgical margins that are typically recommended for Grade Il or Ill canine mast cell tumors. Furthermore, follow up radiation therapy is rarely indicated.

Answer 8

Answer: **Mesenchymal origin; sarcoma** Explanation This is an **osteosarcoma**. The classification scheme for tumors by cell of origin and cytologic description is: **Sarcoma**- These tumors come from **mesenchymal cells** and are named by the specific cell type such as fibroblasts (fibrosarcoma) and osteoblasts (osteosarcoma). Cytologically, they tend to appear as isolated spindle-shaped cells with elongated cytoplasm and often oval nuclei. Those are the features you should have identified in the image. If you identified several cells that have pink areas in the cytoplasm which likely represent osteoid, well done! **Carcinoma**- These tumors come from **epithelial cells** including cells of glandular tissues such as salivary glands, mammary glands, and cells lining most tissues including squamous cells or transitional cells. The cytologic appearance is that of cohesive clusters of cells. Cells are often polygonal in shape. **Round cell tumors**- There are 5 round cell tumors and most but not all come from blood cells. They are lymphoma, mast cell tumors, plasma cell tumors, histiocytic tumors, and transmissible venereal tumors. Remember, these are sometimes also referred to as sarcomas (i.e. lymphosarcoma or histiocytic sarcoma). Cytologically, they appear usually as large populations of cells that are not in defined clusters. The cells have a round shape, often with unique identifiable features such as the purple granules in mast cell tumors.

Answer 9

Answer: **Culicoides** Explanation The correct answer is Culicoides. Culicoides hypersensitivity, also referred to as sweet itch, occurs due to allergy to the saliva of the gnat. It recurs seasonally in the warmer months and tends to worsen with age. Typically, horses are pruritic and develop lesions on the poll, mane, and tail from self trauma, although ventral midline dermatitis can occur as well. More chronically, scarring can occur. Treatment is to decrease exposure to the gnat and to treat with steroids. Habronemiasis is a condition where the larvae of the stomach worm migrate and emerge creating granulomatous lesions, usually around the eye, male genitalia, or lower extremities. Inside the granulomas, you can find dead larvae. Haematobia irritans is a bigger problem in cattle than horses (they reproduce in cow feces) but can affect horses, especially ones that are near cattle. It typically causes ventral midline dermatitis with wheals with a central crust that progress to alopecia and ulceration with fairly focal lesions, rather than more diffuse lesions caused by Culicoides. Onchocerca can cause dermatitis in the horse due to hypersensitivity to dying microfilariae. Lesions include alopecia and scaling of the ventral midline, face, and pectoral region. Often, lesions are diamond shaped and there may be a "bull's eye" lesion on top of the head. Onchocerca is nonseasonal, in contrast to Culicoides hypersensitivity, and variably pruritic. Ocular lesions can also occur with Onchocerca including uveitis, conjunctivitis, and keratitis. Lastly, Hypoderma is also a bigger problem in cattle but can occur in horses and typically creates nodules on the dorsum that have a pore on top.

Answer 10

Answer: **Administer milk to dilute the stomach contents** Explanation The correct answer is to dilute the stomach contents with milk. Bleach, even when diluted can be corrosive as can many household cleaners. This can result in severe burning of the mouth, esophagus, and stomach. Lesions from acids usually appear soon after exposure, while lesions from alkalis may not appear until 8-12 hours later. Do not induce vomiting with apomorphine because further damage can occur to the esophagus. Activated charcoal does not bind to these products and shouldn't be used. IV fluids is unlikely to be of any benefit immediately following the ingestion of the bleach unless the animal happens to already be sick or dehydrated. NSAIDs may help with pain or discomfort but can also contribute to the formation of ulcers within the GI tract. The recommended course of action is to dilute with milk or water and start Gl protectants for several days. If the patient becomes depressed or anorectic, evaluate it for ulcers.

Answer 11

Answer: **Prednisone and diazoxide** Explanation This ferret's clinical signs and blood glucose are most consistent with insulinoma. Medical management consists of prednisone and diazoxide alone or in combination. Dietary management with a high protein and low carbohydrate diet is also important. Surgical removal of the tumor is also an option in otherwise healthy ferrets. ***PowerPage: Ferret Neoplastic Diseases

Answer 12

Answer: **Immunosuppressive doses of glucocorticoids** Explanation This is a classic clinical presentation for juvenile cellulitis (puppy strangles). This disease is characterized by sterile granulomas and pustules that respond dramatically to glucocorticoids. The cause is thought to be an underlying immune dysfunction. Immunosuppressive glucocorticoid therapy should not be started until other infectious diseases have been ruled out. At a minimum a deep skin scrape, skin cytology, and trichogram should be performed to rule out Demodex, bacteria, and fungal infection.

Answer 13

Answer: **Cloacal papilloma** Explanation The correct answer is cloacal papilloma. This is the most common gastrointestinal tumor of birds, and is seen most commonly in Amazons and macaws. A viral etiology is suspected but not proven. Treatment is surgical removal or chemical cautery. Egg binding can cause cloacal prolapse, but does not cause fleshy proliferations. Enteritis and PDD are unlikely to cause prolapse.

Answer 14

Answer: **Oestrus ovis infestation** Explanation The correct answer is Oestrus ovis infestation. Adult flies deposit larvae around the animals' nostrils; the larvae then migrate up the nasal passages into the turbinates and sinuses. With time and multiplication of the larvae, hypersensitivity develops with the marked clinical signs of nasal discharge and face rubbing and shaking. Secondary bacterial infection can occur. The discharge usually contains numerous eosinophils and mast cells, which confirms the diagnosis in this case. Further confirmation could be achieved with radiographs showing mineralized bots or with endoscopy, but this is not usually necessary. Enzootic nasal tumor could have similar clinical signs but tends to cause more dyspnea and would not have the eosinophils and mast cells seen in the discharge. Fusobacterium causes necrotic laryngitis in sheep when there is perforation to the mucous membranes. Clinical signs are more of coughing and dyspnea; there would not be nasal discharge. Actinomyces pyogenes infection is also unlikely to cause nasal discharge and if it did, you would not observe eosinophils and mast cells in the discharge. Treatment of Oestrus ovis is with ivermectin.

Answer 15

Answer: **Continue to monitor carefully without disturbing her and have the dog return in 24 hours if she has not delivered the puppies** Explanation Based on the history and clinical examination findings, this dog has presented in stage 1 of labor. This stage is typically 6-12 hours of length and can persist for up to 36 hours. In this stage, it is expected for the dog to exhibit panting, trembling, nesting behavior, and restlessness. Occasionally dogs will also vomit. At this point, there is sub-clinical uterine contraction and dilation of the cervix. Stage 2 will also last approximately 6-12 hours (and persist up to 36hr) and is characterized by abdominal straining which coincides with uterine contraction. Puppy delivery occurs during Stage 2 at an interval of 30-60min (up to 4 hours). Stage 3 involves the expulsion of fetal membranes as well as involution of the uterus. Fetal membranes are usually passed 5-15 minutes after birth of a pup before another puppy can be delivered from the same horn. Thick greenish discharge (lochia) is seen in all stages of labor and may persist for up to three weeks. Complete uterine involution and endometrial recovery occurs in approximately 3 months.

Answer 16

Answer: **Carprofen** Explanation Carprofen is a non-steroidal anti-inflammatory and has analgesic properties but may exacerbate the chronic renal disease by causing decreased blood perfusion to the kidneys by vasoconstricting the afferent arteries by diminishing the effects of prostaglandins. Dexmedetomidine and ketamine can each be used as a constant rate infusion to provide pain control. Butorphanol is an opioid that has partial agonist and antagonist effects on the mu and kappa receptors. Tramadol is a synthetic opioid. Remember Tramadol is now a controlled substance. Gabapentin is an anticonvulsant that is often used for its analgesic effects, particularly against neuropathic pain.

Answer 17

Answer: **Tritrichomonas foetus, Ronidazole** Explanation Tritrichomonas foetus is a flagellated parasite most commonly found in kittens that have had an unresponsive diarrhea. The parasite can be very difficult to diagnose. It is most often responsive to Ronidazole. Paragonimus is a lung fluke. The eggs are typically passed in the feces. Fenbendazole and Praziquantel have been effective against this parasite. Giardia is unlikely if the ELISA is negative as it is a very sensitive test. Taenia is a tapeworm and is not a flagellated parasite. It is treated with Praziquantel. Cryptosporidium is a coccidian that invades the small intestinal villi after ingestion of infected oocysts. It can be diagnosed with PCR. It is treated with clindamycin, azithromycin, or tylosin most commonly. It is usually an opportunist, so evaluation for underlying disease is appropriate. Enterobius vermicularis, or pinworm, is a parasite of people and primates but not cats and dogs.

Answer 18

Answer: **Collect gestation and lactation feed samples for mycotoxin testing** Explanation The correct answer is to collect gestation and lactation feed samples for mycotoxin testing; specifically zearalenone testing. The indications of a prolonged heat cycle suggest high estrogens. This is a case of cystic ovarian disease. High levels of zearalenone mycotoxins in the feed are the most common cause of cystic ovaries in swine. Although, parvovirus causes reproductive problems, it usually causes a high incidence of mummies. Leptospirosis manifests as late term abortions. Influenza virus infections cause an acute respiratory outbreak with high fevers and abortions. Clinical signs associated with nitrate poisoning include high respiration rate, increased incidence of diarrhea, reduced feed intake, poor growth, and increased abortions.

Answer 19

Answer: **Respiratory acidosis** Explanation The correct answer is respiratory acidosis. There is bound to be some sort of acid-base question on the exam. This question might look tricky, but it is truly simple. Think about the information you are given; all you know is the dog is hypoventilating. So there is build up of CO2; in effect the dog is in respiratory acidosis. Remember, CO2=Acid. Since you have no other information, there is no way to diagnose a metabolic acidosis or alkalosis. Some causes of respiratory acidosis include airway obstruction, open pneumothorax or flail chest, neuromuscular disease, abdominal enlargement, pleural space disease, and bicarbonate therapy.

Answer 20

Answer: **Doxorubicin** Explanation The correct answer is doxorubicin. Perivascularization of this drug causes a severe irreversible tissue slough that may require amputation. Some other chemotherapy drugs such as vincristine cause a more localized severe reaction if perivascularized. L-Asparaginase can be safely given subcutaneously or intramuscularly. Cisplatin can be given intralesionally. Carboplatin is always given IV but if perivascularized, does not cause a severe reaction.

Answer 21

Answer: **This effusion is strongly suggestive of FIP** Explanation The correct answer is that this effusion is strongly suggestive of FIP. FIP causes a classic straw or gold colored effusion with high protein content (about equal to serum protein) and moderate cell counts. An exudate would tend to have somewhat higher cell counts and lower protein. The protein content is not consistent with chyle or neoplasia. ***PowerPage: Feline Infectious Peritonitis and Enteric Coronavirus

Answer 22

Answer: **The specific etiology is still unknown** Explanation As the name implies, these patients have a mixed population of lymphocytes and plasma cells when biopsied. Many consider the condition to be an idiopathic immune-mediated disorder. PCR studies have been performed in affected patients in search of parainfluenza virus-3, canine adenovirus-2, Bartonella, and Chlamydophila. None of these agents were found to be a potential cause. Typical clinical signs include a history of unilateral or bilateral nasal discharge of several months duration. Large-breed dogs are more often affected and the age may vary.

Answer 23

Answer: **The cat's long-term prognosis is poor since most mammary carcinomas in cats will metastasize** Explanation Mammary tumors in cats are almost always malignant and the large majority of them will eventually metastasize. This is in contrast to mammary tumors in dogs, in which 50% are malignant, and 50% of those that are malignant will eventually metastasize. Similar to dogs, cats that are spayed after they have had one or more heat cycles have a much greater risk of developing mammary tumors. If staging shows no visible evidence of metastasis, treatment is generally aimed at surgical removal of the tumor followed by chemotherapy to try and slow the development of metastasis. Generally, the type of surgery that is recommended is a unilateral mastectomy to remove all of the glands on the affected side to reduce the risk of recurrence in those glands. The tumor is also greater than 2 cm in size, which is associated with a worse prognosis in cats.

Answer 24

Answer: **A 5-month old calf which was persistently infected as a fetus with a non cytopathic (nonCPE) biotype of BVD virus is superinfected with a cytopathic (CPE) biotype of BVD due to rearranging of the parent non-CPE viral RNA.** Explanation This is the correct answer because it describes the current understanding of the pathogenesis of both mucosal disease and chronic BVD. A 5-month old calf is infected with CPE biotype of BVD virus and then superinfected with a nonCPE biotype of BVD virus is incorrect because it does not say that there was persistent fetal infection; also, the order of the superinfection is the reverse of what causes mucosal disease or chronic BVD. A 5-month old calf which was persistently infected with the nonCPE biotype of BVD virus as a fetus forms antigen-antibody complexes which cause a fatal immune-mediated disorder is incorrect because this is not the mechanism by which mucosal disease or chronic BVD occur. All other answer choices are incorrect because they each describe one of the acute clinical syndromes from primary infection, rather than either mucosal disease or chronic BVD. ***PowerPage: Bovine Viral Diarrhea

Answer 25

Answer:: **Pacheco's disease** Explanation The correct answer is Pacheco's disease, caused by a herpes virus. The incubation for this disease can be longer than most quarantine periods. The clinical findings and necropsy results are consistent with this infection, and the finding of the inclusion bodies confirms the diagnosis. Marek's disease is also caused by a herpesvirus, and is characterized by lethargy and unilateral leg paresis. Avipoxvirus infection causes scabbing skin lesions or diptheric lesions in the respiratory tract. Infectious coryza is a bacterial disease that causes nasal discharge and facial swelling. Newcastle virus causes signs that can range from respiratory, Gl, or neurologic signs. ***PowerPage: Psittacine Viral Diseases

Answer 26

Answer: **Encephalitozoon cuniculi** Explanation The correct answer is Encephalitozoon cuniculi. There is a high prevalence of E. cuniculi although it only infrequently causes disease. Head tilt and torticollis are the common clinical signs. Treponema cuniculi is the causative agent for rabbit syphilis. Bordetella bronchiseptica is part of the normal flora of the rabbit respiratory tract and does not generally cause clinical signs. Myxomavirus can be a common cause of pneumonia.

Answer 27

Answer: **75 true positive, 95 true negative, 25 false negative, 5 false positive** Explanation The correct answer is 75 true positive, 95 true negative, 25 false negative, 5 false positive. Specificity is determined by the percentage of true negatives versus false positives in cats that do not have the disease of interest. ***PowerLecture: Epidemiology - Sensitivity

Answer 28

Answer: **Feline panleukopenia virus** Explanation The correct answer is feline panleukopenia virus. These clinical signs most closely correlate with panleukopenia. One must piece together the signalment, history, and clinical findings. Usually a cat with a foreign body will not have diarrhea and a fever. It is unlikely for a 4-month old kitten to have FIV due to maternal antibody protection. It is also unlikely for FIP to present in such a manner. With the wet form of FIP, you may see dyspnea due to pleural effusion and abdominal distention due to ascites. With the dry form of FIP it will depend on the organ that is affected. You may see a hepatopathy, splenomegaly, renal failure, etc.

Answer 29

Answer: **Mycoplasma bovis** Explanation M. bovis may be spread to young calves via milk. In very young dairy calves it can cause otitis media with aural discharge, head tilt, nystagmus, ataxia, and even facial nerve paralysis. It also causes respiratory disease and can cause arthritis and tenosynovitis in older calves. Mastitis, abortion and other signs can also be caused by M. bovis.

Answer 30

Answer: **Cheyletiella** Explanation Cheyletiella mites are large mites that affect cats, dogs, rabbits, and humans. This mite is highly contagious which is why all of her cats are itching after introduction of the new kitten (likely the source of infection). The incidence of Cheyletiella has declined in the United States due to the use of topical flea preventatives. The mites live in the stratum corneum and, unlike Sarcoptes, these mites do not burrow. This mite can be found with acetate tape impressions, fecal examination (identify the eggs), or using a flea comb. Lime sulfur dips or flea products can be used for treatment. Demodex canis and cati live in hair follicles and you would not find these mites on acetate tape. They would require a deep skin scrape. Also, Demodex canis only affects dogs and Demodex cati is not contagious. A good differential for this case would be Demodex gatoi, which is contagious and can be found on acetate tape since it lives in the stratum corneum. Sarcoptes rarely infects cats. This mite is very difficult to find. Superficial skin scraping would be needed since this mite burrows into the stratum corneum. Pneumonyassoides caninum is a nasal mite that can result in facial pruritus. Dogs are mainly affected. Diagnosis is by mite identification grossly with rhinoscopy or in nasal flushes.

Answer 31

Answer: **Euthanize the colony** Explanation The correct answer is to euthanize the colony. LCM is caused by an RNA arenavirus. The disease is a zoonotic concern, so euthanasia is recommended for animals affected with the disease.

Answer 32

Answer: **Apply full-length fiberglass cast and Thomas splint** Explanation A calf this age will tolerate a cast and splint well and the bones tend to heal rapidly, usually in 6 to 10 weeks (even this ugly tibial fracture). The cast must be changed every two to three weeks as the calf is growing rapidly at this stage. The cast can reach from the bottom of the foot up to the stifle. The Thomas splint goes from the pelvis to the foot and minimizes stifle movement. Annotations: Green Circle. There is moderate soft tissue swelling surrounding the fracture. Complete, closed, markedly comminuted fracture of the left tibia Orange line: Fissures line Radiographs provided by Adrien Hespel, DVM, MS, DACVR and University of Tennessee College of Veterinary Medicine

Answer 33

Explanation Normally, when light is directed into the eye, the signal is transferred from the retina, through the optic nerve, past the chiasm and down the optic tract. From there, it is directed to both oculomotor nerves to cause pupil constriction bilaterally. When there is a pre-chiasmal lesion, light shining in the abnormal eye will have an interrupted signal that cannot get past the chiasm and both pupils stay dilated. When light is shone into the normal eye, both pupils will constrict due to cross-over fibers that stimulate the oculomotor nerve of the abnormal eye.

Answer 34

Answer: **Brachyspira hyodysenteriae** Explanation The correct answer is *Brachyspira hyodysenteriae* (formerly known as Serpulina hyodysenteriae). Swine dysentery causes mucohemorrhagic diarrhea. Fibrinonecrotic typhlitis and colitis occur, but the small intestine is unaffected. Those affected include 3 week olds to adults that were previously unexposed. Lawsonia intracellularis causes proliferative enteropathies. Trichuris suis is a whip worm. Corona virus causes porcine epidemic diarrhea and transmissible gastroenteritis. ***PowerLecture: Gastrointestinal Diseases **Swine Dysentery - Comprehensive Study Guide** Definition: • Swine Dysentery: Mucohemorrhagic diarrheal disease of pigs affecting the large intestine. Causative Agents: • Brachyspira hyodysenteriae • Brachyspira hampsonii • Brachyspira suanatina Physiopathology: • Transmission: Fecal-oral route from infected pigs, contaminated water, and vehicles. • Infection Process: Brachyspira spp. proliferate in the large intestine, causing mucosal degeneration, inflammation, mucus hypersecretion, and hemorrhage. Leads to diarrhea due to impaired mucosal reabsorption. Clinical Signs: • Initial Signs: Anorexia, soft feces. • Progression: Severe mucohemorrhagic diarrhea with mucus and blood, dehydration, hollow flanks, weight loss. • Morbidity and Mortality: Morbidity >50%, high mortality if untreated. Lesions: • Localization: Cecum, spiral colon, rectum. • Gross Lesions: Mesocolonic edema, swollen mucosa, mucus, blood, fibrin, necrotic debris. • Microscopic Lesions: Superficial neutrophilic inflammation progressing to lymphoplasmacytic inflammation with goblet cell hyperplasia. Diagnosis: • Methods: Clinical signs, postmortem examination, anaerobic culture, PCR assays. • Histopathology: Typical lesions in the large intestine. • Differential Diagnoses: Intestinal spirochetosis, proliferative enteropathy, intestinal salmonellosis, whipworm infections. Treatment and Control: • Antimicrobials: Pleuromutilins, carbadox, lincomycin, tylosin based on minimum inhibitory concentration testing. • Biosecurity Measures: Rodent control, proper sanitation, and disinfection. • Eradication: Persistent antimicrobial treatment of carrier pigs and cleaning of facilities. • Dietary Management: Reducing insoluble fiber (e.g., distillers dried grains with solubles) and increasing soluble fiber (e.g., sugar beet pulp) to reduce disease expression. For more detailed information, visit the [Merck Veterinary Manual](https://www.merckvetmanual.com/digestive-system/intestinal-diseases-in-pigs/swine-dysentery?query=swine%20dysentery)

Answer 35

Answer: **Swine pox** Explanation The correct answer is swine pox. The disease is caused by a poxvirus that causes the skin lesions described in the question. All ages can be affected, but it is more commonly seen in young and growing pigs. The disease is often transmitted by biting insects, particularly lice. The disease usually does not require treatment, unless the lesions become secondarily infected. Broad-spectrum antibiotics may be helpful in this situation. Hog lice and insect vectors should be investigated and eliminated to help control swine pox. Erysipelas causes diamond-shaped skin lesions and necrosis of the ears and tail. Greasy pig disease or exudative epidermitis is caused by Staphylococcus hyicus. It causes dark, greasy, brown skin lesions in the axilla, groin, head, and face. Pseudorabies affects the CNS, respiratory system, and causes reproductive failure. ***PowerLecture: Dermatology

Answer 36

Answer: **Whirling disease** Explanation The correct answer is whirling disease. The causative agent is Myxobolus (aka Myxosoma) cerebralis which is a myxosporean parasite of salmonid fish. Rainbow trout are most commonly affected and the parasite can cause deformation of the head and spine resulting in the inability to swim properly. Skeletal deformation is not seen in the etiologies of the other potential answers. Ich results from a protozoan parasite that causes white spots on the gills and skin, along with erratic behavior. Hole in the Head disease is seen in tropical fish, especially cichlids, with pitting-like lesions of the head and lateral line. The etiologic agent of Hole in the Head is still controversial and likely includes multiple factors including poor water quality, improper nutrition, and heximita infection. Gill rot is a fungal disease caused by Branchiomyces spp. with clinical signs related to respiratory distress due to thrombosis and necrosis of the gills.

Answer 37

Answer: **Sheep and goats** Explanation The cutaneous abscesses caused by this organism also affect cattle. Horses experience pectoral abscesses, internal abscesses, and other sites, as well ulcerative lymphangitis (also caused by C. pseudotuberculosis) of the limbs. ***PowerLecture: Caseous Lymphadenitis

Answer 38

Answer: **Continue the antibiotics for another 2 weeks.** Explanation Deep pyodermas involve tissues deeper than the epidermis including the dermis and even subcutis. Most often deep infections have resulted from an uncontrolled superficial infection. Deep lesions usually heal on the surface before the deeper infection is resolved; making clinical cure difficult to assess. Therefore, antibiotic treatment should be continued for 7-21 days after the tissues return to normal. In general, deep infections can require 6-8 weeks of antibiotic treatment and even 12 weeks for severe cases. Superficial infections require 3-4 weeks of antibiotic therapy or one week past clinical resolution. Culture results will often be positive in normal dogs since normal dogs will have bacteria on their skin surface and in hair follicles. It is better to manage based on clinical signs. Cytology can miss deeper infections and it is better to extend antibiotic treatment even if cytology is negative. It is not necessary to continue the antibiotics until resolution of demodicosis. Keep in mind that many Demodex patients will require several months of treatment. It is better to prevent recurrence of bacterial infections with topical therapy such as benzoyl peroxide shampoos.

Answer 39

Answer: **Cortisol** Explanation Cortisol levels are usually within normal limits. Therefore, many of the tests that are used in small animals to diagnose Cushing's disease (corticotropin stimulation test, dexamethasone suppression test) are not useful for ferrets. Adrenocortical hyperplasia/neoplasia should be considered in any ferret that presents with a non-inflammatory alopecia. The prevalence of this disease in the United States is estimated at 70%. Genetic factors, early sterilization, and prolonged photoperiod from indoor housing likely contribute to the high incidence. In ferrets, adrenal gland disease is most often due to hyperplasia followed by adenocarcinoma and then adenomas. Other clinical signs include pruritus, lethargy, sexual aggression, vulvar swelling, dysuria/stranguria, tenesmus, and mammary gland enlargement. Treatment of choice is adrenelectomy. Other treatment options include leuprolide acetate (long acting gonadotropin releasing hormone agonist) and deslorelin acetate (GnRH analog).

Answer 40

Answer: **Inject eggs with piperacillin** Explanation A normal, healthy egg should hatch sterile. Occasionally, eggs may be infected by low level bacterial contamination. Infection may occur as a result of ovarian, oviductal or cloacal infection. Contamination is by minute cracks or pin-holes in the shell at the time of handling or egg collection. All eggs should be candled so that any non-viable eggs may be removed from the incubator prior to possible contamination of healthy eggs. The incubator should be sanitized. Pseudomonas infection in eggs can be treated by injection of an appropriate antibiotic such as piperacillin. A small hole is drilled, using a sterile 27 gauge needle over the air cell, and the antibiotic is injected into the air cell. The hole is sealed with white, water-soluble glue (being careful not to cover additional areas of the shell as this would reduce water loss from the egg during incubation). Any chick that hatches should be cultured for bacteria immediately upon breaking open the shell, and antibiotic therapy should be commenced depending on the culture results. Nystatin should be given concurrently at 100,000 U per 400 g of body weight to prevent secondary infections with Candida spp.

Answer 41

Answer: **Apply full-length fiberglass cast and Thomas splint** Explanation A calf this age will tolerate a cast and splint well and the bones tend to heal rapidly, usually in 6 to 10 weeks (even this ugly tibial fracture). The cast must be changed every two to three weeks as the calf is growing rapidly at this stage. The cast can reach from the bottom of the foot up to the stifle. The Thomas splint goes from the pelvis to the foot and minimizes stifle movement. Annotations: Green Circle. There is moderate soft tissue swelling surrounding the fracture. Complete, closed, markedly comminuted fracture of the left tibia Orange line: Fissures line Radiographs provided by Adrien Hespel, DVM, MS, DACVR and University of Tennessee College of Veterinary Medicine

Answer 42

Answer: **Left atrial and left ventricular enlargement with pulmonary hyperperfusion** Explanation The correct answer is left atrial and left ventricular enlargement with pulmonary hyperperfusion. In dogs with a VSD, the shunt occurs during systole when both ventricles are contracting so blood is shunted from the left ventricle almost directly into the pulmonary artery. The right ventricle acts as a conduit between the left ventricle and pulmonary artery and is less commonly affected by the shunted blood. The excess blood flow is found in the pulmonary vasculature, left atrium, and left ventricle, thus enlarging these structures.

Answer 43

Answer: **Ingestion of moldy feed containing aflatoxins** Explanation This is a case of photosensitization based on the skin lesions confined to the nonpigmented areas. Primary photosensitization can occur when photodynamic agents are absorbed from the G.l. tract such as Hypericum perforatum (St. John's wort), Fagopyrum esculentum (buckwheat), Ammi majus (bishop's weed), and Cymopterus watsonii (spring parsley). Secondary (hepatogenous) photosensitization occurs when the liver's excretion of phylloerythin is impaired due to liver damage. Phylloerythin is derived from the breakdown of chlorophyll by rumen microbes. The best answer in this question is aflatoxins because they are known to cause liver damage. Bracken fern toxicity causes acute hemorrhagic syndrome in cattle. Lupine toxicity primarily causes birth defects. Quercus (oak) toxicity causes Gl and renal dysfunction.

Answer 44

Answer: **Intestinal impactation** Explanation This is an image of a Parascaris equorum egg. It is almost spherical in shape with a brown color and contains a single-celled zygote. In foals, a significant ascarid burden with Parascaris equorum can lead to intestinal impaction and associated colic. Thrombosis of the mesenteric artery occurs with Strongylus vulgaris infestations. Immune mediated hypersensitivities may occur in adult horses with Parascaris equorum infestations but is unlikely to be a significant cause of the morbidity seen in foals. Larval migration can occur with Parascaris equorum but typically will affect the lungs or liver and this stage of the parasite does not lead to colic. Enteroliths are not caused by gastrointestinal parasitism.

Answer 45

Answer: **Intestinal impactation** Explanation This is an image of a Parascaris equorum egg. It is almost spherical in shape with a brown color and contains a single-celled zygote. In foals, a significant ascarid burden with Parascaris equorum can lead to intestinal impaction and associated colic. Thrombosis of the mesenteric artery occurs with Strongylus vulgaris infestations. Immune mediated hypersensitivities may occur in adult horses with Parascaris equorum infestations but is unlikely to be a significant cause of the morbidity seen in foals. Larval migration can occur with Parascaris equorum but typically will affect the lungs or liver and this stage of the parasite does not lead to colic. Enteroliths are not caused by gastrointestinal parasitism.

Answer 46

Answer: **Beta mannosidosis** Explanation Beta mannosidosis is a disorder of Anglo-Nubian goats that causes fatal neurological symptoms in newborns and is an autosomal recessive mode of inheritance. Inability to stand, intention tremors, joint contractures, facial dysmorphisms, domed skull, and hypothyroidism. Scrapie is a prion-caused disorder. In sheep, scrapie can be controlled by genetic testing to eliminate the susceptible animals. To date that is not possible with goats. Corynebacterium pseudotuberculosis is a bacterial disease known as boils. Papillomas are viral.

Answer 47

Answer: **Avocado** Explanation A toxin, known as persin, is a phytochemical found in the Guatemalan type of avocado which causes myocardial necrosis in the budgerigar, parrot and possibly other pet bird species. Blueberries and peppers (even "hot" peppers) are not toxic to psittacines. Chicken and cheese are high in fats and are not appropriate to feed parrots, but there is no toxicity associated with them. ***PowerPage: Toxicities of Pet Birds

Answer 48

Answer: **Hepatocutaneous syndrome** Explanation Hepatocutaneous syndrome refers to a necrotizing skin disorder that is often associated with metabolic or vacuolar liver diseases. Diseases that potentially cause this syndrome in the dog include glucagonoma, phenobarbital-induced hepatopathy, mycotoxin hepatopathy, copper-associated hepatitis, glucagon-secreting hepatic tumors, and hepatopathies of unknown origin. Hepatocutaneous syndrome is most often associated with some sort of hepatopathy in the dog. Your clues in this patient were the history of phenobarbital use, elevated liver enzymes, and the skin lesions. Skin biopsy and histology are required for definitive diagnosis of this condition. Abnormalities include marked, diffuse parakeratotic hyperkeratosis, intercellular and intracellular edema, keratinocyte degeneration, and hyperplastic basal cells. These changes create a characteristic red, white, and blue histologic appearance (see image). Biopsy samples should be taken from multiple sites, with footpad samples included. Ultrasound of the liver often shows a pathognomonic honeycomb appearance.

Answer 49

Answer: **Microscopic examination of a hair/skin scraping from edge of the lesions** Explanation You should be most suspicious of ringworm based on the lesion appearance and distribution. Microscopic examination from the periphery of the lesions is likely to reveal fungal hyphae of Trichophyton spp. Dermatophyte culture would also be a good option. Ringworm will typically regress over many months without treatment but untreated lesions may present risk of transmission including zoonotic transmission. Topical treatments including 4% lime sulfur, 0.5% sodium hypochlorite (1:10 household bleach), 0.5% chlorhexidine, 1% povidone-iodine, natamycin, and enilconazole may be options and likely work best if any crusts are removed prior to application.

Answer 50

Answer: **Ascaris suum** Explanation The correct answer is Ascaris suum. Ascaris suum are found in the small intestine of pigs. If there is a large burden of the worms, they can cause obstruction of the intestine, migrate into the bile ducts and cause icterus. Migration through the liver causes fibrosis or "white spots." Pulmonary edema can also be a sequela of the larvae, causing abdominal breathing or "thumps." Ascaris suum infections are common in outdoor swine due to high environmental contamination. Trichuris suis is a whipworm found in the cecum and large intestine. Metastrongylus is a lung worm. Stephanurus dentatus is the kidney worm of pigs. Fasciola hepatica is a liver fluke. ***PowerPage: Swine Diarrhea ***PowerLecture: Respiratory Diseases

Answer 51

Answer: **Free T4 by equilibrium dialysis** Explanation The correct answer is free T4 by equilibrium dialysis. Free T4 is the thyroid hormone not bound to plasma proteins and can enter cells. Its measurement gives a more consistent assessment of thyroid function than total T4. The equilibrium dialysis method of measuring free T4 is more accurate than radioimmunoassay. Measurement of T3 in hypothyroid dogs can often be high, low, or normal, and thus difficult to interpret. ***PowerPage: Hypothyroidism

Answer 52

Answer: **Approximately 2.5 years** Explanation The correct answer is approximately 2.5 years of age. A good rule of thumb is that the permanent incisors are in wear at 1.5, 2.5, 3.5 and 4.5 years of age (permanent incisors 1, 2, 3, and 4 respectively).

Answer 53

Answer: **Services are provided after extended waiting periods** Explanation A significant amount of value that is perceived by veterinary clients has nothing to do with the quality of medicine you are practicing. Clients appreciate practices that provide services in a timely manner that do not keep them waiting for extended periods. They enjoy a clean, attractive hospital that is free of clutter and odors. They perceive value in printed materials from the practice and the ability to receive comprehensive care for their pet from a single location. They also appreciate having the opportunity to offer their opinions.

Answer 54

Answer: **The prognosis is very good with small ventricular septal defects and no treatment is needed.** Explanation The correct answer is the prognosis is very good with small ventricular septal defects and no treatment is needed. The prognosis of small VSDs is very good. Some will close by themselves within the first year of life. It is unlikely that a small VSD will cause any significant problems such as heart failure, though follow-up evaluation is warranted to monitor cardiac size and function. Large VSDs carry a guarded prognosis and require cardiac bypass for surgical correction or novel device closure via transcatheter techniques; neither of which are commonly employed in animals. Small VSDs cause a relatively more turbulent jet of blood through the small defect, causing a louder murmur than a large VSD.

Answer 55

Answer: **Chlorhexidine scrub and warm compressing** Explanation The correct answer is chlorhexidine scrub and warm compressing. The described lesion is an equine eosinophilic granuloma, also known as nodular necrobiosis of collagen, or collagenolytic granuloma. The lesions are nodular, non-ulcerative, and are not pruritic. The masses are histologically similar to eosinophilic granulomas in cats. The etiology of the lesions is believed to be associated with insect bites, trauma, or multifactorial causes. Treatment may include systemic antibiotics, surgical excision, or sublesional corticosteroid injections.

Answer 56

Answer: **Transitional cell carcinoma** Explanation The most common urinary bladder tumor is transitional cell carcinoma. You can often see abnormal cells on the urinalysis, but use the caution in diagnosing on urinalysis alone, as inflammation can cause a similar appearance with a much more positive prognosis. Biopsy is needed for definitive diagnosis. Chemotherapy can help these patients shrink the tumor for a time (for a better quality of life); however, the overall prognosis is grave.

Answer 57

Answer: **Inform the owner you would like to re-evaluate in one month for another skin scrape; if the skin scrape is negative, we can then discontinue Ivermectin** Explanation The correct answer is re-evaluate in one month for another skin scrape. If the skin scrape is negative you can discontinue Ivermectin use. Resolution of demodicosis and cessation of treatment requires two negative skin scrapes one month apart even if all clinical signs have resolved. Benzoyl peroxide is an antimicrobial and is used as an adjuvant treatment in patients who have Demodex. Benzoyl peroxide has no effect on the mite.

Answer 58

Answer: **Baylisascaris** Explanation The correct answer is Baylisascaris. Baylisascaris procyonis is an ascarid parasite of raccoons that causes mild signs in raccoons but can undergo aberrant migration in humans and cause fatal central nervous system signs.

Answer 59

Answer: **5 days after surgery** Explanation The correct answer is 5 days after surgery. If you remember the principles of healing, 3-5 days corresponds to the end of the lag phase of intestinal healing. After that point, there is typically enough collagen that has been incorporated into the healing intestine such that dehiscence will not occur. The mortality rate for patients that have intestinal dehiscence is 73-80%. Risk factors that have been associated with an increased chance of dehiscence include traumatic intestinal injuries, intestinal foreign bodies, peritonitis at the time of surgery, and serum albumin less than 2.5 g/dl. ***PowerLecture: Intestinal Obstruction

Answer 60

Answer: **Unsweetened baking chocolate** Explanation The correct answer is unsweetened baking chocolate. This contains about 7 times more theobromine than milk chocolate. White chocolate has very little methylxanthines. Semi-sweet chocolate is in between.

Answer 61

Answer: **Atleast 20 mg/dl less than the blood glucose** Explanation The correct answer is at least 20 mg/dL less than the blood glucose. The image depicts a perforated colon, which will result in a septic abdomen due to the normal colonic flora emptying into the abdomen. A concentration difference > 20 mg/dL between blood and peritoneal fluid glucose concentration provides a rapid and reliable means to differentiate a septic peritoneal effusion from a nonseptic peritoneal effusion in dogs and cats.

Answer 62

Answer: **Caudal superficial epigastric flap** Explanation The correct answer is caudal superficial epigastric flap. This is an axial pattern flap and as with all axial pattern flaps, it is named after its primary blood supply. The caudal superficial epigastric flap provides the primary blood supply to the 3rd, 4th, and 5th mammary glands. With familiarity of the dog's anatomy you can preserve the blood supply and rotate the area of skin to cover a defect as was done with this patient. A full thickness skin graft is a section of skin that is completely elevated from one region and applied to a defect. A skin graft is a poor choice for this patient since the wound is in a high motion area. Skin grafts do not survive in high motion areas. A microvascular free transfer flap involves elevating a section of skin and isolating its blood supply and then re-anastomosing its blood supply with vasculature in the area of the defect. These procedures require an operating microscope and are very difficult to perform. Both the genicular and deep circumflex iliac flaps are axial pattern flaps that are in different regions.

Answer 63

Answer: **Neospora caninum** Explanation The correct answer is Neospora caninum, a protozoan parasite. The definitive host is the dog (or coyote or other canidae) which acquires the infection by eating infected meat and spreads it to cows by shedding oocysts in the pasture or feed. Although clinical signs are mainly seen as abortions and abnormal calves in herbivores, dogs may suffer from neurologic and muscular abnormalities. Infection to other dogs is usually as a result of transplacental spread. IFA is usually performed to make the diagnosis.

Answer 64

Answer: **Polysaccharide Storage Myopathy (PSSM)** Explanation Based on the breed and clinical signs, PSSM should be a top consideration. A subset of horses have a storage disorder in which there is an accumulation of glycogen and abnormal polysaccharide within the skeletal muscle. PSSM has been linked to an autosomal dominant mutation of the glycogen synthase gene in Quarter Horses. However, other breeds, such as Paint, Appaloosas, Warmbloods and draft horses can also be affected. Horses with PSSM often have elevations in creatine kinase and aspartate aminotransferase; rhabdomyolysis in PSSM likely results from an energy deficiency within the contracting muscles. **Key Information on Exertional Myopathies in Horses** General Overview: • Types: Sporadic and chronic exertional myopathies, including type 1 and 2 polysaccharide storage myopathy (PSSM), malignant hyperthermia, recurrent exertional rhabdomyolysis. • Common Signs: Muscle fatigue, pain, cramping, excessive sweating, tachypnea, tachycardia, muscle fasciculations, and reluctance to move. Sporadic Exertional Rhabdomyolysis: • Causes: Exercise exceeding training, dietary imbalances, respiratory disease outbreaks. • Diagnosis: Elevated serum CK, AST activities. • Treatment: Immediate cessation of exercise, fluid therapy, NSAIDs, muscle relaxants. Chronic Exertional Rhabdomyolysis: • Forms: • Type 1 PSSM: Genetic mutation in GYS1 gene. • Type 2 PSSM: Abnormal glycogen storage without GYS1 mutation. • Myofibrillar Myopathy: Muscle pain, stiffness, elevated serum CK, AST. • Malignant Hyperthermia: Mutation in RYR1 gene, severe response to stress or anesthesia. • Recurrent Exertional Rhabdomyolysis: Abnormal calcium regulation, stress-related. Diagnosis and Management: • Testing: Genetic tests, muscle biopsies, exercise challenge tests. • Dietary Management: High-fat, low-starch diets, vitamin and mineral supplements. • Pharmacological Management: Dantrolene, phenytoin for calcium regulation. For detailed information, visit the [Merck Veterinary Manual](https://www.merckvetmanual.com/musculoskeletal-system/myopathies-in-horses/exertional-myopathies-in-horses?query=polysaccharide%20storage%20myopathy%20in%20horses) **Type 2 polysaccharide storage myopathy** occurs in light breeds such as Arabians, Morgans, Thoroughbreds, a variety of Warmblood breeds, and some Quarter Horses. A diagnosis is made by identifying an abnormal pattern of glycogen storage in muscle biopsies in a horse with a negative GYS1 genetic test. Chronic episodes of muscle stiffness, soreness, and muscle atrophy with normal to modest increases in serum CK activity are common in horses with type 2 PSSM. Many cases of type 2 PSSM in Arabian and Warmblood horses have been reclassified as myofibrillar myopathy.

Answer 65

Answer: **Glanders** Explanation The horse's presentation is also consistent with the *nasal form of glanders*. Glanders is a bacterial disease caused by Burkholderia mallei (previously known as Pseudomonas mallei). It is thought to be endemic in regions of the Middle East, Asia, Africa, and South America. In addition to horses, glanders can be seen in donkeys, mules, and small ruminants. Glanders is primarily a concern in horses because they can be chronic or occult carriers that intermittently shed this deadly and potential zoonotic pathogen. Burkholderia mallei causes 3 different forms of disease; nasal glanders, pulmonary glanders, and cutaneous glanders (also referred to as Farcy). The nasal form presents with high fever, loss of appetite and labored breathing with cough. Viscous mucopurulent discharge or crusting may be present around the nares. There may be ulceration of the upper respiratory passages that resolve in the form of star-shaped cicatrices ("stellate scars"). Regional lymph nodes may be enlarged and indurated and may rupture or adhere to deeper tissues. The pulmonary form often develops over several months, beginning as a fever with dyspnea and cough. Lung lesions commence as light colored nodules surrounded by hemorrhage or as diffuse pneumonia. The nodules may become caseous or calcified and discharge contents to the upper respiratory tract. Nodules may also be found in other organs. The cutaneous form develops over several months, beginning with cough and dyspnea as well. Eventually, nodules develop in subcutaneous tissue along the course of the lymphatics of the legs, costal areas, and ventrum. They can rupture and excrete infectious purulent exudate. Infected lymphatics may form thickened cord-like lesions that sometimes coalesce into a string of beads appearance known as "farcy pipes". Nodular lesions of other organs may also be found. Burkholderia mallei can be identified in smears made from fresh lesions as mainly extracellular straight Gram-negative rods with rounded ends. Several diagnostic tests exist including PCR, ELISA, and Western Blot but the two that you actually need to know about because they are used in international trade are complement fixation (CF) serology and the mallein test. The mallein test is considered the most reliable, sensitive, and specific test; it involves injection of mallein purified protein derivative intradermally into the lower eyelid. The test is read at 24 and 48 hours and a positive reaction is characterized by edematous swelling or purulent discharge. Horses should not be treated; local authorities should be notified if a case is suspect and if disease is confirmed, horses must be humanely destroyed and affected carcasses should be burned and buried. Dourine is a trypanosomal venereal disease. Surra is a trypanosomal disease causing primarily fever, weakness, and lethargy. Rift Valley Fever is a viral disease primarily of ruminants causing influenza-like signs and hepatic lesions. African Horse Sickness is a viral respiratory disease of horses but signs are primarily pulmonary whereas the horse in this case has nasal signs and mandibular lymph node enlargement.

Answer 66

Answer: **Sertoli cell tumor** Explanation The correct answer is Sertoli cell tumors. The tumor sometimes secretes estrogen and other hormones, which can lead to this syndrome.

Answer 67

Answer: **Oral surgeries cause significant bacteremia, which may be an endogenous source of wound infection.** Explanation The correct answer is oral surgeries cause significant bacteremia, which may be an endogenous source of wound infection. In an otherwise healthy dog, the increased length of anesthesia in combining two procedures should not significantly increase the risk of anesthesia. The order in which the procedures are performed does not eliminate the risk of infection associated with the bacteremia. Changing gloves and instruments between procedures helps maintain sterility exogenously, but does not eliminate risk of infection associated with the endogenous bacteremia.

Answer 68

Answer: **Hyperkalemia** Explanation The correct answer is hyperkalemia. This patient is showing a classic presentation of urinary tract obstruction. You would expect the patient to have post-renal azotemia due to the urethral obstruction; you would also expect elevated blood glucose due to stress. Elevated liver enzymes may be present if the cat has not been eating. Hepatic lipidosis is an important concern (since the eating history is unknown); however, there is no evidence of that at this time. Low blood albumin levels should not occur in this case. With the non-expressible firm bladder and bradycardia, you should be extremely concerned about hyperkalemia, which is life-threatening if left untreated. Hyperkalemia results from the inability to excrete potassium in the urine. Hyperkalemia changes the ability of the cell wall to repolarize, resulting in decreased cell membrane potential. This can result in decreased myocardial excitability and conduction and then severe bradycardia.

Answer 69

Answer: **Collies** Explanation The correct answer is collies. Collies and Shetland Sheepdogs are predisposed to canine familial dermatomyositis. The disease causes atrophy of muscles and erosion, crusting, and alopecia of skin, which is exacerbated by heat and sun exposure. Treatment is often unrewarding and includes high doses of corticosteroids, vitamin E, and omega-3 fatty acids.

Answer 70

Answer: **The patient's serum calcium should be monitored daily for about a week to check for the development of hypocalcemia** Explanation The correct answer is the patient's serum calcium should be monitored daily for about a week to check for the development of hypocalcemia. Post-operatively, it is important to monitor for hypocalcemia daily for the first seven days regardless of the absence of clinical signs for hypocalcemia. The higher the pre-operative serum calcium concentration, the more likely the patient will become hypocalcemic post-operatively. Post-operative monitoring of serum calcium should be daily for the first seven days, then weekly for 4 weeks. Vitamin D and calcium supplementation should be given accordingly. Serum calcium concentration should be maintained in the low normal range, not below normal, to stimulate production of PTH by the parathyroid cells.

Answer 71

Answer: **Beta-2 agonist** Explanation The correct answer is beta-2 agonist. Beta-2 agonists will relax bronchial smooth muscle. The one most commonly used for this purpose is terbutaline. ***PowerPage: Feline Asthma

Answer 72

Answer: **Oxytetracycline** Explanation The correct answer is oxytetracycline. The cow has Anaplasmosis, a rickettsial organism that is transmitted by ticks. Infected calves have a low mortality rate, but adult cattle have a 20-50% mortality rate with this disease.

Answer 73

Answer: **Anaplasmosis** Explanation The correct answer is Anaplasmosis. The causative agent is Anaplasma marginale. The clinical signs are fairly straight forward, and you need to pick up on a couple key features. The fact that new adults are sick is one feature because cattle are resistant to clinical Anaplasmosis as calves. Also, it should be remembered that hemoglobinuria with Anaplasmosis is never seen because it is all extravascular hemolysis. Since there is no hemoglobinuria, leptospirosis, bacillary hemoglobinuria, and anthrax can be ruled out. Additionally, icterus with anthrax is not seen.

Answer 74

Answer: **Vasopressin** Explanation The correct answer is vasopressin. Epinephrine and phenylephrine are adrenergic vasoconstrictors. Isoproterenol and dobutamine cause vasodilation. Vasopressin (also known as anti-diuretic hormone) is a V-1 receptor, non-adrenergic, vasoconstrictor.

Answer 75

Answer: **Persistent right aortic arch** Explanation Persistent right aortic arch (PRAA) is reported but pretty rare in cats. It is seen more frequently in dogs, particularly a few predisposed breeds (Irish Setters, German Shepherds, Great Danes). Despite being a relatively uncommon disease, you should have been able to reach the appropriate answer by ruling out the other options because they cause different clinical signs. This is how PRAA develops: During fetal development, there is a right and left aortic arch. Normally the left aortic arch forms the main artery that extends off the heart and travels to the abdominal region. In cases of PRAA, the right aortic arch develops into the aorta and the esophagus becomes trapped by the ligamentum arteriosum that extends from the pulmonary artery to the aorta. There are several other variants of how the vascular anomaly can occur. Clinical signs commonly are present from a very young age, often near time of weaning. Treatment is surgical and the prognosis with early surgical intervention is good. Cats born with congenital diaphragmatic hernias often have mild breathing difficulties, especially when the cat is stressed. Sometimes they are incidentally diagnosed years later, although this is less common. In another presentation there may also be mild gastrointestinal upset. In severe cases, there can be respiratory distress, abnormal heart rhythm, muffled heart and lung sounds, and other signs of systemic shock. The abdomen may feel empty when palpated. Cats born with peritoneopericardial diaphragmatic hernia (PPDH) are usually asymptomatic with discovery being made when diagnostic tests (radiographs, contrast studies, ultrasound) are performed for other reasons. Occasionally, cats will develop vomiting, diarrhea, and abdominal pain or cardiorespiratory signs. Cats born with mucopolysaccharidosis (usually Siamese cats) have an enzyme deficiency that results in problems with the joints and/or bones. Cats born with myotonia congenita (very rare) have muscle stiffness and may be heavily muscled with little body fat. ***PowerLecture: Vascular Ring Anomalies

Answer 76

Answer: **Dilated cardiomyopathy** Explanation The correct answer is dilated cardiomyopathy. Taurine is an essential amino acid for cats because they cannot synthesize it. Taurine deficiency causes dilated cardiomyopathy (DCM). Since DCM is relatively uncommon otherwise in cats, taurine deficiency should be suspected in any cat with DCM.

Answer 77

Answer: **Suppurative, nonseptic inflammation** Explanation The marked predominance of nondegenerate neutrophils without apparent intracellular organisms makes this suppurative, nonseptic inflammation. Primary differentials include immune-mediated polyarthritis and polyarthritis due to rickettsial disease. A small mononuclear cell population is normally present in joint fluid, but neutrophils are not. "Granulomatous" describes a predominantly mononuclear cell population (lymphocytes, macrophages, plasma cells), and "pyogranulomatous" describes a mixed population of neutrophils and mononuclear cells. Osteoarthritis may result in a mild increase in mononuclear cells with a few neutrophils, but should not produce markedly inflammatory joint fluid.

Answer 78

Answer: **Ethmoid hematoma** Explanation The most likely cause of the epistaxis based on the radiographs is ethmoid hematoma. These lesions are angiomatous masses that originate from the mucosal lining of the ethmoid conchae or walls of the maxillary or frontal sinus. Guttural pouch mycosis also can result in epistaxis but typically has no radiographic changes. Although horses can get tumors in the nasal passages, this is relatively rare. Exercise-induced pulmonary hemorrhage also can result in epistaxis, but the blood originates from the lungs. In the radiograph provided, notice the smooth, well-defined soft tissue mass in the sinus region of this horse. No osseous changes or fluid lines are apparent in this radiograph. In this particular case (ethmoid hematoma), the soft tissue mass is actually dorsal to the ethmoid turbinates (ethmoids are normal appearance in this case). Upon surgical removal, a definitive diagnosis of ethmoid hematoma was confirmed.

Answer 79

Answer: **Equine herpesvirus** Explanation The correct answer is equine herpesvirus. The key to answering this question is in the time frame. The foals developing clinical signs of herpesvirus infection several months prior to an abortion storm is classic for this virus. The mares are typically asymptomatic initially and then abort. It causes abortions in horses 7-11 months pregnant. Equine influenza and adenovirus do not cause abortions although they do cause respiratory signs. Equine viral arteritis is the second best choice, but it generally causes more mild respiratory signs and abortions during various stages of pregnancy. There also would not be the same lag period from when the foals got sick until when the mares started aborting. ***PowerPage: Abortion in Horses

Answer 80

Answer: **65L** Explanation To determine this answer you must figure out the deficit and calculate the horse's maintenance needs. The deficit is 35L (deficit x BW). Maintenance needs for a horse is approximately 60ml/kg/day. In this case, 30L. Adding the deficit and maintenance fluids together yields a total of 65 liters.

Answer 81

Answer: **Fog fever** Explanation The correct answer is fog fever, also called acute bovine pulmonary edema and emphysema. It is one of the atypical interstitial pneumonias. The key to making this diagnosis is the history, but the clinical signs are important too. This bull has atypical pneumonia (diffuse, non-septic lung disease). This can be determined because there are no signs of sepsis, he has an intermittent loud cough as opposed to a soft, painful, cough, and he has widespread crackles and wheezes without consolidation. Given this, fibrinous pleuropneumonia (shipping fever) can be ruled out. BRSV may have similar signs but there is a characteristic "honking" cough which this bull does not have, and usually is only this severe in young animals. Now you can rule out farmer's lung and silo filler's disease. This is where the history is especially important. With farmer's lung, the animal will have allergies, so his signs will be episodic. Usually, the animal will be housed indoors and be exposed to the allergen; going outside will improve his situation. With silo filler's disease (bronchiolitis obliterans) there is typically a history of the animal being housed close to the silo which often results in inhalation of toxic silo gases. Finally, there is the history of switching from a poor pasture to a lush pasture two weeks ago. This is classic for fog fever. The lush plants are high in tryptophan which is subsequently metabolized in the rumen to 3-methyl indole (toxic to the lungs).

Answer 82

Answer: **Electrical alternans and pulsus paradoxus** Explanation The correct answer is electrical alternans and pulsus paradoxus. Electrical alternans is an ECG finding in which the height of QRS complexes alternate due to the physical swinging of the heart as it contracts within the pericardial effusion. Pulsus paradoxus is an exaggerated decrease in arterial pulse quality during inspiration caused by increased right-sided filling at the expense of reduced left ventricular filling because the heart is constrained by the pericardial effusion. Third degree AV block does not occur with pericardial effusion. Obscuring of the cardiac/pulmonary parenchyma interface is usually due to pulmonary parenchyma changes or pleural effusion. Weak pulses and hepatomegaly are not specific to pericardial effusion, though are often present in dogs with severe pericardial effusion. Waterhammer pulses are palpated with PDAs or severe aortic regurgitation.

Answer 83

Answer: **The lesions can be internal and external, so dental radiographs should be taken to further investigate the extent of the lesions** Explanation The correct answer is the lesions can be internal and external, so dental radiographs should be taken to further investigate the extent of the lesions. FORL lesions are usually very painful and are more common now than before. Up to 67% of cats presenting for dental care may be affected. The exact etiology of FORL is not known, but studies have shown an association of FORL and diets low in calcium, magnesium, phosphorus, and potassium. Periodontal disease is also often found in association with FORL. Treatment should include addressing associated periodontal disease and possibly extraction of teeth affected by deep lesions. ***PowerLecture: Dentistry

Answer 84

Answer: **Change genetics for his next matings** Explanation The correct answer is to talk to the owner about changing his genetics for his next mating. The sudden rigor mortis of the pig as well as the soft pale muscle on a pig that just died is very suggestive of porcine stress syndrome (PSS). PSS is a simple recessive genetic myopathy. Pigs with heavy muscling and fast growth (desired characteristics in show pigs) can many times carry this gene. This condition can be eliminated from a herd through the selection of genetics. In this case at least one of the sows must be a carrier that was bred to a carrier boar. Antibiotics, water, and mycotoxins have no effect on the clinical presentation of the condition. This genetic condition often results in death of the pig when triggered by excitement, stress or placed under some anesthetics (especially halothane).

Answer 85

Answer: **Daily catheterization and lavage of the pouches** Explanation Irrigation should use saline or saline plus an appropriate and non-irritating antimicrobial drug. Systemic antimicrobial drugs are also used, but the hallmark of successful therapy is lavage and drainage. For inspissated pus or refractory cases, surgical drainage may be necessary.

Answer 86

Answer: **50% chance of long term survival, 50% chance of dying within 3 months** Explanation The case described is very consistent with acute cholangiohepatitis. This condition is usually seen in younger cats (mean age 3-3.5 years) and is more common in males than females. This is in contrast to chronic cholangiohepatitis which occurs in older cats (mean age 9 years). Acute cholangiohepatitis patients are more likely to be depressed, dehydrated and febrile. Bloodwork in cholangiohepatitis often shows a neutrophilia with or without a left shift. Mild increases in bilirubin and ALP are common, often with more severe elevations of ALT. The sonographic and biopsy findings are also consistent with the diagnosis of acute cholangiohepatitis and make other differentials such as hepatic lipidosis or lymphocytic portal hepatitis less likely. Treatment of choice for this disease includes antibiotics with aerobic and anaerobic coverage that are excreted unchanged in the bile. Examples of antibiotics excreted unchanged in the bile include tetracyclines, ampicillin, amoxicillin, erythromycin, chloramphenicol, and metronidazole. Usually erythromycin, tetracycline, and choloramphenicol are not the first choices unless they are indicated based on culture and sensitivity because erythromycin is not effective against gram negative bacteria, tetracycline is hepatotoxic, and chloramphenicol may cause anorexia. Ampicillin or amoxicillin with clavulanic acid are good choices and metronidazole may be used to expand the anaerobic coverage. Ursodeoxycholic acid (Actigall) is useful in all types of inflammatory liver disease because of its anti-inflammatory and anti-fibrotic properties on the liver. It also increases fluidity of biliary secretions. With treatment, it is thought that the response of acute and chronic cholangiohepatitis cases is similar with about half of animals dying or being euthanized within 90 days and half of them having prolonged survival.

Answer 87

Answer: **Optimal preventive treatment 2 to 3 months after major transmission season** Explanation The major transmission season differs by geographic area, being later in the north and also affected by irrigation of pasture in the west. Treating with a flukecide 2 to 3 months after major transmission season is effective at controlling flukes in most herds, but in some herds a second treatment to remove flukes acquired late in the season (such as on irrigated pasture) may be necessary. Vaccinating against Clostridium hemolyticum is also a good idea but will not control the fluke numbers.

Answer 88

Answer: **Corrective osteotomy** Explanation The correct answer is corrective osteotomy. Corrective osteotomies of the radius and ulna are often performed to relieve pain and the functional abnormalities induced by angular limb deformities.

Answer 89

Answer: **Tell the owner the dog has a guarded to poor prognosis and may need hemodialysis.** Explanation The correct answer is tell the owner the dog has a guarded to poor prognosis and may need hemodialysis. 4-MP and ethanol act by preventing alcohol dehydrogenase from converting ethylene glycol to its toxic metabolites. In animals where oliguric renal failure has already begun, most of the ethylene glycol will already have been metabolized, so there is no benefit to giving ethanol or 4-MP. Activated charcoal should only be given if the ethylene glycol was ingested within 2 hours. ***PowerPage: Toxins in the Garage (ethylene glycol, household cleaners)

Answer 90

Answer: **Surgical vasectomy** Explanation The correct answer is surgical vasectomy. The most reliable way to detect a sow in heat is if she stands for a boar trying to mount her. To prevent pregnancy of the sow, and to prevent injury to the herdsmen, the boar is vasectomized or epididymectomized. Castration would eliminate sex hormones that would motivate the boar to mount the sow.

Answer 91

Answer: **120mL/kg** Explanation The correct answer is 120 ml/kg day. This is considerably higher than a dog or cat.

Answer 92

Answer: **Leptospirosis** Explanation The correct answer is leptospirosis. Leptospirosis typically manifests as acute renal failure.

Answer 93

Answer: **Stertor is a gurgling noise usually generated in the nasal passages, while stridor is a high-pitched sound usually generated near the larynx** Explanation The correct answer is that stertor is a gurgling noise usually generated in the nasal passages while stridor is a high-pitched sound usually generated near the larynx. This is always a source of confusion for veterinary students. Both noises are audible without the aid of a stethoscope and indicate an extrathoracic problem.

Answer 94

Answer: **Non-steroidal anti-inflammatory therapy and strict rest** Explanation The most recent literature shows that 50% of dogs with clinical signs of intervertebral disc disease will improve with medical management alone. Medical management involves restricted activity and anti-inflammatory therapy. Prednisone, methyl-prednisolone sodium succinate, and non-steroidal anti-inflammatories are commonly used. Prednisone, if used, should be prescribed at an anti-inflammatory dose and not immunosuppressive. Dexamethasone sodium phosphate has only been shown to increase the likelihood of side effects and complications such as urinary tract infection and is therefore not recommended.

Answer 95

Answer: **Chicken** Explanation The correct answer is chicken. Non-mammalian vertebrates (birds, reptiles, amphibians, and fish) have nucleated red blood cells (erythrocytes). The other answer choices are all mammals.

Answer 96

Answer: **Bartonella** Explanation Bartonella henselae is the bacterium that causes cat-scratch disease. In cat-scratch disease, the owner is infected with the bacteria from flea feces when the cat bites or scratches the owner. Commonly, the bacteria cause fever, malaise, weight loss and lymphadenopathy. Often, cats show no clinical signs. Dogs can be exposed via tick or flea vector and show signs similar to humans, including possible endocarditis. With the dog and cat being from a southern state, both animals were at risk of exposure from Bartonella species.

Answer 97

Answer: **Histomonas meleagridis. Turkeys** Explanation The correct answer is Histomonas meleagridis to turkeys. This protozoan parasite, also called blackhead or infectious enterohepatitis, is fatal to turkeys but less pathogenic to chickens. It causes extensive necrosis of the liver and cecum. For this reason, chickens and turkeys should not be housed together and turkeys should not be housed in areas where chickens were previously housed.

Answer 98

Answer: **An ionized calcium level** Explanation In some cases, during the immediate post-obstructive period, cats will develop hypocalcemic tetany. The mechanism is considered to be secondary to laws of mass action that drive down calcium as a result of existing hyperphosphatemia. Judicious use of calcium gluconate can quickly restore their electrolyte balance and prevent further complications such as hypocalcemic seizures.

Answer 99

Answer: **Discontinue meloxicam. Start an oral opioid-based pain medication for 5 days. Then start an anti-inflammatory dose of a steroid.** Explanation This dog has the classic two-engine gait characteristic of Wobbler's syndrome. The hematochezia noted on rectal exam, and the history of a tarry stool (suggesting upper Gl bleeding) is likely due to the meloxicam which should be discontinued immediately. Medical management for Wobbler's syndrome involves an anti-inflammatory dose of a steroid. A washout period is recommended after stopping meloxicam and before starting prednisone. Further diagnostics for Wobbler's syndrome involves imaging (cervical radiographs, myelogram, MRI or CT) and it can be helpful in ruling out neoplasia or traumatic injuries. The left forelimb lameness and abducted stance are likely due to a pinched nerve however further imaging would be needed for confirmation.

Answer 100

Answer: **Sodium EDTA** Explanation The correct answer is sodium EDTA. This is because the EDTA may bind up all the calcium and produce a hypocalcemia. Giving Ca EDTA will provide protection from that via the extra calcium.

Answer 101

Answer: **Infectious bursal disease** Explanation The correct answer is infectious bursal disease, also sometimes called gumboro disease. This disease is caused by a birna virus and is most readily isolated from the bursa of fabricius. It is highly contagious and difficult to eliminate from the environment. Subclinical infections commonly occur in chicks less than 3 weeks of age and are of most economic significance. In clinical infection, the signs and necropsy findings are as described. There is no effective treatment, but a vaccine is available. **Infectious Bursal Disease (IBD) in Poultry** Definitions and Causative Agent: • Infectious Bursal Disease (IBD): A highly contagious viral disease affecting young chickens, caused by the infectious bursal disease virus (IBDV), a birnavirus. Clinical Signs and Symptoms: • Acute Form: Depression, ruffled feathers, diarrhea, anorexia, trembling, prostration, and death. • Subclinical Form: Immunosuppression leading to increased susceptibility to other diseases and poor vaccine responses. Pathological Changes: • Bursa of Fabricius: Swollen, edematous, and hemorrhagic. • Histopathology: Lymphoid depletion in bursal follicles, necrosis, and inflammatory cell infiltration. Diagnosis: • Clinical Signs and Necropsy Findings: Characteristic lesions in the bursa. • Laboratory Tests: Virus isolation, serology (ELISA), RT-PCR. Treatment and Control: • No Specific Treatment: Supportive care. • Prevention: Vaccination with live or inactivated vaccines, biosecurity measures to prevent virus introduction. For more details, visit the Merck Veterinary Manual - [Infectious Bursal Disease in Poultry.](https://www.merckvetmanual.com/poultry/infectious-bursal-disease/infectious-bursal-disease-in-poultry?query=infectious%20bursal%20disease%20(ibd,%20gumboro))

Answer 102

Answer: **Collagenolytic granuloma** Explanation The image and description are most consistent with a collagenolytic granuloma. Feline eosinophilic granuloma complex consists of 3 separate clinical sydromes: 1) The collagenolytic granuloma (also known as eosinophilic granuloma or linear granuloma) usually occurs on the nose, chin, oral cavity (as in this case), or caudal thighs. The lesions are typically raised and ulcerative or nodular as seen here. 2) The eosinophilic plaque occurs most frequently on the abdomen and medial thighs but can appear other places. They appear as single or multiple, raised, red, often ulcerated lesions of varying size (0.5-7 cm). They frequently have a cobblestone appearance and unlike eosinophilic ulcers, these are often pruritic. This condition is histopathologically similar to miliary dermatitis and is usually associated with underlying allergy. 3) The eosinophilic ulcer (also known as indolent ulcer) typically occurs on the upper lip and may be unilateral or bilateral. They often have a characteristic central area of yellow to pink tissue with a slightly raised circumferential edge The underlying cause of eosinophilic ulcers and collagenolytic granulomas are unknown, although an underlying allergic cause such as arthropod bites and/or cutaneous hypersensitivity have been suggested. Treatment of collagenolytic granulomas is also controversial so it is unlikely that you would be asked about treatment of this disorder on a board exam aside from knowing that you should attempt to identify and remove/treat underlying allergy or biting arthropod problems. Some cases respond to antibiotic therapy but most require glucocorticoid therapy.

Answer 103

Answer: **Malignant catarrhal fever (MCF)** Explanation Malignant catarrhal fever (MCF) in North America is caused by sheep-associated ovine herpesvirus-2. A very high percentage of sheep and goats in North America are infected with OHV-2 and can transmit the virus to susceptible cattle, bison, deer, and other related species, even if only in close proximity and not in direct contact. The virus causes lymphocytic vasculitis and can be fatal. BVD does cause fever, but uncommonly results in corneal opacity. The marked lymphadenopathy and lymphocytic vasculitis are not consistent with BVD. ***PowerLecture: Malignant Catarrhal Fever - MCF

Answer 104

Answer: **Fecal centrifugation** Explanation The best answer to this question is to perform a fecal by centrifugation as the first step. Fecal centrifugation is the current standard and primary means for analysis of intestinal parasitism and should be performed several times on all pups during their first year of life and then every six months in adult dogs according to the Companion Animal Parasite Council (CAPC). The fecal centrifugation method has a much higher chance of egg retrieval and identification compared to passive fecal floats and fecal smears in saline, although the latter would be an appropriate secondary test to evaluate for motile Giardia trophozoites. However, because a negative fecal smear does not rule out giardiasis, a Giardia snap test is another secondary level test that could then be performed. A fecal examination via the Baermann technique is one of the least likely diagnostics to be utilized because it is time- and labor-intensive, requires a relatively large amount of fecal material, and is not very sensitive (a negative test does not rule out infection because fecal shedding of larvae is intermittent).

Answer 105

Answer: **Deep digital flexor tenotomy** Explanation The case descriptions and radiographs are consistent with chronic laminitis. The dorsal hoof wall is much thicker distally due to P3 rotation. Gas tracks under the dorsal hoof wall are evident and there is a round lucent defect in the cranial medial aspect of the sole. There is P3 osteopenia and remodeling of the distal aspect of P3. Although the optimal treatment for chronic laminitis remains controversial, the best answer is clearly deep digital flexor tenotomy. Deep digital flexor tenotomy is reported in several studies to be useful in the management of chronic laminitis, particularly when the distal phalanx is rotated or pedal bone penetration is present. Unfortunately, chronic laminitis is sometimes refractory to this therapy as well. Other reported options include dorsal hoof wall resection, curettage of regions of septic osteitis, and many types of corrective shoes. Again, all of these options may be ineffective. The options of arthrodesis and surgical exploration of the joint are poor choices as this is not a joint disease. Palmar digital neurectomy is a procedure used to manage navicular disease and results in desensitization of the heel.

Answer 106

Answer: **Dysfunction of the esophageal groove** Explanation This is a typical description of esophageal groove dysfunction in a calf resulting in rumen acidosis. To review normal physiology, the esophageal groove (also known as reticular groove) is a specialized part of the ruminant stomach that closes in response to drinking milk, directing it directly to the abomasum. When dysfunctional, milk goes to the rumen where it is fermented by rumen microbes and converted to volatile fatty acids and lactic acid. The resulting rumen acidosis leads to the clinical signs described in this case. For this reason, this phenomenon is sometimes referred to as rumen drinking. For this reason, this phenomenon is sometimes referred to as rumen drinking.

Answer 107

Answer: **Notify the state and federal authorities** Explanation The correct answer is notify the state and federal authorities. Vesicular stomatitis is a disease that must be reported to state and federal authorities. There is no specific treatment for the disease. Secondary infections should be treated symptomatically.

Answer 108

Answer: **Traumatic reticuloperitonitis** Explanation The correct answer is hardware disease (traumatic reticuloperitonitis). Cattle ingest wires which then perforate the reticulum and migrate into the pericardium and cause an infection. In small ruminants, Clostridium perfringens will cause pericarditis. In swine, pericarditis may be caused by haemophilus, streptococcus, and Stephanurus edentatus. ***PowerLecture: Traumatic Reticuloperitonitis

Answer 109

Answer: **A diet that is low in protein and alkalinizing** Explanation Based on the dog's breed and the fact that the stones are not radiopaque, you feel confident that this dog has urate stones. Urate uroliths may be dissolved and prevented with a diet that is alkalinizing and low in protein, with the addition of allopurinol. Allopurinol decreases uric acid, thus decreasing the likelihood of urate crystals which, over time, turn into stones. Avoiding high protein, calcium, and vitamin D in the diet aids in the prevention of calcium oxalate stones. A low phosphate and magnesium diet will help to prevent struvite stone development. Sodium restriction (in conjunction with 2-MPG supplementation) is used to prevent cystine stones.

Answer 110

Answer: **First premolar** Explanation The first premolar may cause problems with the bit, and is thus often electively removed by veterinarians. ***PowerLecture: Dentistry

Answer 111

Answer: **Lawsonia intracellularis infection** Explanation Although not as commonly as in pigs, L. intracellularis can infect horses (and other species). Similar to pigs, the infection usually involves weanling age horses and causes thickening of the small intestine and hypoproteinemia. The low protein is commonly observed as ventral edema clinically. Both Clostridioides and Salmonella can cause diarrhea at any age but are not as commonly associated with ventral edema. Intussusceptions do occur but also typically result in colic. ***PowerLecture: Foal Diarrhea

Answer 112

Answer: **Infectious bovine keratoconjunctivitis (IBK)** Explanation The most common bacteria causing this is Moraxella bovis, although other organisms including Neisseria species and Moraxella ovis can also induce similar lesions in cattle. Also, IBR and mycoplasma seem to be risk factors that may increase the risk of developing IBK.

Answer 113

Answer: **Regeneraive anemia** Explanation The correct answer is regenerative anemia. Polychromasia indicates that less mature red blood cells are being released into circulation as is seen in a regenerative response.

Answer 114

Answer: **Osteochondrosis** Explanation The correct answer is osteochondrosis. Rickets and nutritional secondary hyperparathyroidism are caused by calcium deficiency or excess phosphorus. Goiter is caused by insufficient or excess iodine.

Answer 115

Answer: **The pharyngeoesophageal sphincter fails to relax** Explanation The correct answer is the pharyngeoesophageal sphincter fails to relax. This is a rare congenital condition which is usually diagnosed in dogs at weaning. Treatment involves a cricopharyngeal myectomy.

Answer 116

Answer: **Dystocia** Explanation This case describes the presentation of a cow with metritis. Metritis typically occurs within 2 weeks of calving and is characterized by cows that are off-feed, depressed, and have decreased milk production. They often have fetid reddish-brown discharge and may have failure to pass the placenta. The risk factors associated with development of metritis in cows include retained fetal membranes, dystocia, stillbirth, and twinning. Lesser risk factors are uterine prolapse, milk fever, dirty calving environments and ketosis. Taylorella equigenitalis is a cause of venereal disease in horses but not cows. Tritrichomonas foetus typically causes infertility in the first half of gestation. Brucella abortus causes late gestation abortions and may cause placentitis. Contaminated milking equipment may be associated with certain types of mastitis but not metritis.

Answer 117

Answer: ** Inject all pigs with ceftiofur** Explanation The correct answer is to inject all pigs with ceftiofur, which is approved for use in treatment and control swine respiratory disease associated with several common pathogens. The photo shows the classical lesions of polyserositis associated with Glaesserella parasuis (Glasser's disease). Although Streptococcus suis is also known to cause polyserositis in this age pigs it is easily grown on blood agar plates. Glasserella parasuis requires blood agar supplementation with NAD. Your in-house blood agar culture did not show any growth suggesting no live bacteria, or some other organism requiring special growing conditions. Glaesserella parasuis causes a severe vasculitis leading to polyserositis (photo). Most pigs carry G. parasuis in their tonsils with no clinical signs. The bacteria then become systemic and cause acute death. It is unknown what causes the bacteria to go systemic and cause acute death, but stress and concurrent PRRS viral infection are known to be associated with clinical outbreaks. Because the disease is so quick acting (peracute), it is impossible to know which pigs are early in the disease. Therefore, the only option is to go through and systematically inject all pigs with a long acting ceftiofur. Most, if not all, S. suis and G. parasuis isolates are susceptible to ceftiofur. Immediate response is necessary to minimize future mortalities. It is important to note, that injecting pigs with any antibiotic will only stop the current outbreak and not eliminate the bacteria from that group of pigs. Although you may want to submit samples from some of the dead pigs to a diagnostic laboratory for official confirmation, this is not the top priority at this time as the pigs require immediate attention (it will take 2 - 3 days to get results back from the diagnostic lab). With no apparent clinical signs, there is no way to identify which pigs to select for euthanasia and submission to a diagnostic lab. From the clinical history, there are no indications that vaccinations for PCV2 or APP are necessary at this time.

Answer 118

Answer: **Serum creatinine** Explanation The correct answer is serum creatinine. A rise in serum creatinine is proportional to a fall in GFR. A 4-fold increase in creatinine corresponds to a 4-fold decrease in GFR.

Answer 119

Answer: **2(13/3 C1/1P4/4 2/3)** Explanation The correct answer is 2(13/3 C1/1 P4/4 M2/3). Remember the dog has 42 teeth total.

Answer 120

Answer: **Connell pattern** Explanation The correct answer is Connell pattern. Both the Connell and Cushing patterns are used to close hollow viscera because they are very effective at inverting tissue and creating a watertight seal. The difference between these two patterns is that Cushing pattern only goes through the submucosa and does not enter the lumen. The Ford interlocking and horizontal mattress patterns are not used for closing hollow viscera.

Answer 121

Answer: **7-9 months** Explanation The correct answer is 7-9 months. Ligaments heal in a similar fashion as tendons; it is a gradual process involving production, replacement, and reorganization of collagen. About 55% of horses with suspensory ligament desmitis return to their normal use so the prognosis is guarded.

Answer 122

Answer: **Uterine inertia** Explanation The correct answer is uterine inertia. Studies show that this the most common cause of dystocia followed by malpresentations, fetal oversize, narrow canal, and malformations.

Answer 123

Answer: **Herpes virus** Explanation The correct answer is herpesvirus. Infectious laryngotracheitis is an acute infection which results in dyspnea, coughing, rales, and bloody tracheal discharge. Mortality is variable but can reach up to 50%. Diagnosis is based on clinical signs but is confirmed by demonstration of intranuclear inclusion bodies in the tracheal epithelium or by isolation of the virus through tissue samples. Treatment is aimed at prevention and supportive care if cost effective. Vaccination is recommended. ***PowerPage: Poultry: Infectious Laryngotracheitis

Answer 124

Answer: **Milkweed** Explanation The correct answer is milkweed. Milkweed is a cardiac glycoside which can cause acute clinical signs and death. Bracken fern toxicity causes bone marrow depression in ruminants and can take up to 3 months to show clinical signs. Moldy sweet clover leads to coagulopathy via vitamin K antagonism after consumption over long periods of time. Ragwort is a pyrrolizidine alkaloid which causes liver disease after several months of consumption. ***PowerPage: Poisonous Plants

Answer 125

Answer: **Calcium carbonate** Explanation The correct answer is calcium carbonate. Equine urine contains high amounts of calcium carbonate. Magnesium ammonium phosphate (aka struvite crystals) is also occasionally noted in horse urine. 2 more common: calcium carbonate and calcium phosphate. Although ureteroliths and uroliths are not terribly common in the horse, these are the stones you would expect to encounter.

Answer 126

Answer: **Progressive Retinal Atrophy (PRA)** Explanation The correct answer is PRA. Progressive retinal atrophy, sometimes called progressive retinal degeneration is an inherited retinal disease seen in several breeds but most notably Toy and Miniature Poodles. Age of onset is variable, but signs are usually night blindness progressing to complete blindness due to loss of rods prior to cones. Retinal lesions are classically the ones described in this case. It is differentiated from SARDS by the clinical course and the fact that there are no retinal lesions in acute SARDS. You could see similar retinal lesions from glaucoma but would expect more clinical signs and you wouldn't have night blindness progressing. Taurine deficiency causes retinal lesions in cats not dogs, and they have a different appearance.

Answer 127

Answer: **Metabolic acidosis** Explanation The correct answer is metabolic acidosis. Ruminant saliva contains a large amount of bicarbonate to help neutralize fatty acids being produced in the rumen. ***PowerLecture: Vagal Indigestion

Answer 128

Answer: **Make sure Max is eating every day** Explanation In an obese cat such as Max, hepatic lipidosis can develop quickly in the case of inappetence. Therefore, it is very important for Max's owner to make sure that he is eating every day. While additional fiber may ensure the cat feels full, it is not the most important piece of advice here. It is not good advice to restrict water intake. Dietary supplements are not necessary if Max is eating a well-balanced diet for weight loss.

Answer 129

Answer: **Calicivirus** Explanation Typically, feline calicivirus is an upper respiratory pathogen that may cause oral ulcerations +/- conjunctival chemosis. However, outbreaks of highly virulent and often lethal feline calicivirus infections have been seen. This is frequently referred to as "Virulent systemic feline calicivirus (VS-FCV)." These infections are characterized by the signs described above; typically cats develop a severe acute upper respiratory tract disease first, followed by characteristic signs of cutaneous edema and ulcerative lesions on the skin and paws. Edema is located mainly on the head and limbs. Some cats may be jaundiced due to hepatic necrosis and/or pancreatitis. Thromboembolism and coagulopathy caused by DIC may be observed including petechiae, ecchymoses, epistaxis or hematochezia. Feline viral rhinotracheitis is a herpesvirus and causes respiratory symptoms but not the more severe signs described here. Panleukopenia selectively damages rapidly dividing tissues, namely the bone marrow and gastrointestinal tract. Neither FeLV nor FIV alone can cause the severe respiratory and ulcerative/edematous lesions described in this case.

Answer 130

Answer: **Abdominal radiograph** Explanation The correct answer is abdominal radiograph. Based on the description, you should suspect a renal mass (carcinoma) causing progressive compression of the ischiatic nerve. A radiograph would be the best test of these choices to confirm that diagnosis. Radiographs of the right leg would rule out orthopedic disease, but would not show the primary mass. Urinalysis would most likely not show evidence of neoplastic cells.

Answer 131

Answer: **Paired antibody titer for RMS and doxycycline** Explanation The clinical signs and laboratory results with the presence of Dermacentor ticks make Rocky Mountain Spotted Fever the top differential in this case. There is no in-house laboratory test for RMSF, so that is not a logical next step. A single antibody titer for RMS is not diagnostic of RMS even with clinical disease as this only indicates antibodies to the RMS, not active infection. Treatment with doxycycline is considered the treatment of choice and should be started immediately, even without a definitive diagnosis, because patients can decline rapidly without treatment. A paired antibody titer with a 4-fold increase plus clinical disease is considered diagnostic for RMSF and treatment with doxycycline should be started immediately making this the best answer for this question.

Answer 132

Answer: **Evaluation of creatine kinase (CK) and aspartate aminotransferase (AST) to rule-out myopathy** Explanation Based on the clinical signs, the most likely cause is recurrent exertional rhabdomyolysis, commonly observed in racing Thoroughbreds. Typical clinical signs include muscle cramping of the major muscle groups; the cramping is painful and consequently causes the tachycardia, tachypnea, and profuse swelling. The muscle pain can be exacerbated upon physical examination by firm palpation of the larger muscle groups. The most sensitive serum enzyme to evaluate myositis is creatine kinase, a muscle specific enzyme with a short half-life. AST is not muscle specific but does become elevated at a slower pace, as compared to CK. Thus CK will rise and fall quickly whereas AST will increase and decrease slower once the myositis has resolved.

Answer 133

Answer: **Treat with 7-day course of prednisolone BID, then taper** Explanation Eosinophili plaques, Indolent ulcers, and Eosinophilic granulomas are all components of Eosinophilic Granuloma Complex (EGC) which is a hypersensitivity reaction in cats. The presence of eosinophils in the impression smear and the noted eosinophilia on the CBC lead to one of these components as the diagnosis. This cat's presentation as severely pruritic, the location of the lesions, and the presence of eosinophilia makes the eosinophilic plaque the most likely diagnosis. The appropriate initial treatment for this condition is a course of glucocorticoids. Based solely on the description of the lesions, a mast cell tumor or cutaneous lymphoma are valid options/differentials for this patient, but the bloodwork and impression smear results rule them out. Thus, biopsy, staging, or bone marrow aspirates are not indicated at this time. Lime sulfur dips would be indicated with a diagnosis of dermatophytosis.

Answer 134

Answer: **It is a whipworm that causes mucohemorrhagic diarrhea in pigs of all ages** Explanation The correct answer is it is a whipworm that causes mucohemorrhagic diarrhea in pigs of all ages. Trichuris suis occurs most commonly in pigs less than 6 months of age but can affect any age group. Clinical signs include dehydration, anorexia, mucohemorrhagic diarrhea, and sometimes death. The worms are found in the cecum and colon. Controlling the disease includes treating sows with anthelmintics a week or two before farrowing and moving them to a clean pasture. Raising swine off soil also helps control the disease.

Answer 135

Answer: **Keep necropsying dead pigs until you see a pattern** Explanation The correct answer is to keep necropsying dead pigs until you see a general pattern of what system(s) may be affected. Although untreated, acutely affected, euthanized pigs are the best for diagnostic sampling, since decomposition can distort or make difficult to identify some gross pathology, many times recently dead pigs can still provide enough information to help guide in figuring out what is causing the mortalities. When dealing with large populations of animals you must be able to differentiate individual pig problems from population problems, therefore you need to necropsy more than one dead pig. It is not efficient to necropsy all pigs or even just select 30 head. Doing only 10 head may or may not provide you with a true picture of what is going on in the whole herd. Diagnostic sampling (including correct animals to sample) and live pig evaluation will also be important in helping you figure out what may be causing the high mortality on this farm.

Answer 136

Answer: **Psoroptes** Explanation The correct answer is Psoroptes. Psoroptic mange is a reportable disease. Clinical signs may or may not be present. When they are present, pruritus of the ear is commonly observed. A definitive diagnosis is based on skin scrapings and otoscopic examination.

Answer 137

Answer: **Ileum** Explanation The correct answer is ileum. Disease affecting the ileum will commonly lead to Cobalamin deficiency.

Answer 138

Answer: **Feline immunodeficiency virus** Explanation The correct answer is feline immunodeficiency virus. FeLV is a retrovirus in the oncornaviridae subfamily. Panleukopenia is a parvovirus, and rabies is in the rhabdoviridae family.

Answer 139

Answer: **Lead poisoning** Explanation Used motor oil contains tetraethyl lead when leaded gasoline was used. Cattle are sometimes curious and will actually drink used motor oil, resulting in acute lead poisoning. Treatment involves chelation therapy with calcium disodium EDTA. Thiamine has also proven useful, as well as several other adjunct therapies. Removal of the oil from the rumen and Gl tract may also prove beneficial. ***PowerLecture: Central Nervous System

Answer 140

Answer: **Amoxicillin** Explanation Amoxicillin is effective against Gram-positive bacteria, especially Staphylococcus. It is absorbed orally and can be administered in water to birds with susceptible bacterial infections. Metronidazole is useful in birds against anaerobic infections such as Clostridium and some motile protozoa such as Trichomonas, Giardia and Cochlosoma. Ketoconazole is an antifungal sometimes used for Candida infections. Terbinafine is an antifungal used to treat Aspergillus and dermatophytes. Gentamicin is toxic to birds. Oxytetracycline is poorly absorbed orally and is given intramuscularly although it can cause irritation/necrosis at injection sites.

Answer 141

Answer: **Drug Enforcement Agency** Explanation The Drug Enforcement Agency, or DEA, has the sole authority over drugs distributed between states.

Answer 142

Answer: **Pituitary adenoma** Explanation The correct answer is pituitary adenoma. Pituitary adenomas are rare causes of hypothyroidism although they can cause Cushing's disease. However, they usually occur in old horses (average age is about 20 years). In a foal, an iodine deficiency can lead to hypothyroidism because iodine is required in thyroid hormone. lodine excess can also cause hypothyroidism due to damage to the thyroid. This is referred to as the Wolff-Chaikoff effect, although you don't need to know that name. lodine deficiency or excess can come from the mare or from the foal's diet. Hypothyroidism in foals can be life-threatening and can cause abnormalities including physeal dysgenesis, incoordination, limb deformities, tendon ruptures, stillbirths, weakness, and death.

Answer 143

Answer: **Seizures** Explanation The answer is seizures. Clinical signs of bluetongue result from generalized vasculitis and generally include fever, edema, nasal discharge, crusting around the nose, hyperemic mucous membranes, oral ulcers, pulmonary edema, lameness (from coronitis and myositis), diarrhea, leukopenia, and teratogenesis. Cyanosis of the tongue is how the disease got its name. ***PowerLecture: Blue Tongue

Answer 144

Answer: **Distal check desmotomy and proximal check desmotomy** Explanation The correct answer is distal check desmotomy and proximal check desmotomy. The distal check desmotomy relieves the deep digital flexor contracture while proximal check desmotomy relieves superficial digital flexor contracture. If the contracture is severe, it may recur 2-4 months after surgery. At such time, a suspensory desmotomy is an option but subluxation at the proximal interphalangeal joint is a common consequence. ***PowerPage: Top 9 Equine Lameness

Answer 145

Answer: **Observation of the site for recurrence** Explanation Basal cell tumors are common in older cats and most (greater than 90%) display benign behavior, even when histologically malignant with a high mitotic rate. If the tumor is diagnosed by cytology or histopathology without surgical removal, many veterinarians will recommend monitoring without surgical removal although these masses can ulcerate or get fairly large.

Answer 146

Answer: **Proventricular dilatation syndrome** Explanation Proventricular dilatation syndrome, also known as PDS, PDD or Macaw wasting disease, can affect many species of birds in addition to macaws. Clinical signs of regurgitation, weight loss despite a good appetite, polyuria, and passage of undigested seeds are characteristic, but may also include neurologic signs. The histopathologic lesion is a lymphoplasmacytic ganglioneuritis. Pacheco's disease causes acute liver necrosis and associated clinical signs, including sudden death. Hypovitaminosis A generally causes oral plaques and other types of squamous metaplasia. Capillaria is an intestinal parasite and may cause diarrhea or weight loss. Candidiasis is an overgrowth of yeast in the crop and may cause regurgitation but not the other signs. ***PowerPage: Psittacine Viral Diseases

Answer 147

Answer: **Fine needle aspirate, prognosis likely good** Explanation In young dogs small localized masses along the head, ears, and limbs are often histiocytomas, a benign collection of histiocytes with a few other inflammatory cells present. They can occur in younger dogs and often resolve after a few months. A few histiocytomas can ulcerate, and multiple histiocytomas can be found on one animal. Those that do not regress on their own can be surgically excised. Differentials should include mast cell tumors, which need grading and staging to determine prognosis, sebaceous adenomas, papillomas, and infection. Fine needle aspirates will often give a conclusive diagnosis.

Answer 148

Answer: **Nasal aspergillosis** Explanation The correct answer is nasal aspergillosis. This dog is undergoing a clotrimazole infusion treatment which involves the administration of clotrimazole into the nasal cavity under anesthesia for long periods of contact time, in order to kill the fungus.

Answer 149

Answer: **Cutaneous adverse food reaction** Explanation The correct answer is cutaneous adverse food reaction (CAFR). While atopic dermatitis is pruritic, it tends to respond to steroids. It presents initially as a seasonal phenomenon, usually with involvement of the feet and often with pustules, crusts, and other secondary lesions consistent with bacterial or yeast infection. Otitis is also commonly seen (rather than just pinnal lesions). Moreover, pruritus caused by CAFR is more common than atopic dermatitis in dogs <6 months of age. While non-seasonal in presentation, demodicosis is not pruritic, and a course of steroids would likely have resulted in a worsening of clinical signs. If the trunk is affected, the lateral and dorsal aspects are more likely to be affected than the ventrum. Dermatophytosis is not pruritic and would also have likely worsened in the face of steroid administration. The gold standard for diagnosis of a cutaneous adverse food reaction is the abatement of clinical signs with a food trial involving a restricted or novel diet, followed by recurrence of clinical signs when the patient is challenged with the previous food.

Answer 150

Answer: **Surgical removal of the mandibular and sublingual salivary glands** Explanation This is a case of a salivary mucocele. Surgical removal of the mandibular and sublingual salivary glands is the gold standard for treatment. The glands are removed together because the duct of the mandibular gland travels through the sublingual gland and removal of one gland would unavoidably traumatize the other. Simply lancing and draining the gland with penrose placement will not be curative. There have been rare case reports of the use of a CO2 laser as a cutting and dissecting tool in this surgery, but simply severing the duct of the mandibular gland is insufficient treatment.

Answer 151

Answer: **Cantharidin** Explanation The correct answer is cantharidin. The blister beetle is the organism known to make this toxin. The toxin commonly gets incorporated into alfalfa, and the beetles get killed when the hay is processed. Other toxic causes of colic include oleander, rhododendron, and nightshades.

Answer 152

Answer: **Entropion** Explanation The correct answer is entropion. It is also commonly seen in pigs. Usually, the lower eyelid will be affected.

Answer 153

Answer: **Amprolium** Explanation Amprolium has zero withdrawal time Sulfaquinoxoline has a 10 day withdrawal time Sulfadimethoxine has a 5 day withdrawal period Nicarbazin has a 4 day withdrawal Robenidine has a 5 day withdrawal period

Answer 154

Answer: **Cheyletiella** Explanation The correct answer is Cheyletiella. This is the fur mite of rabbits and typically causes clinical signs as described in this question.

Answer 155

Answer: **Adenomatous hyperplasia** Explanation The correct answer is adenomatous hyperplasia. Adenomatous hyperplasia is the cause for about 70-75% of cases of feline hyperthyroidism. Lymphocytic thyroiditis is responsible for primary hypothyroidism in dogs. Thyroid carcinoma occurs in about 1-3% of cases. Goiter is defined as an enlargement of the thyroid gland, and can be secondary to adenomatous hyperplasia, adenoma, or carcinoma.

Answer 156

Answer: **No treatment is necessary** Explanation The correct answer is no treatment is necessary. It is normal for horses to have a slower heart rate, especially race horses, and not uncommon to observe a second degree block. ***PowerLecture: Cardiology

Answer 157

Answer: **Fecal sand test** Explanation The horse's clinical signs suggest that the most likely diagnosis is sand enterocolopathy. Horses eating off the ground in sandy environments can ingest large amounts of sand, causing weight loss and mild diarrhea. In severe cases, large amounts of sand can cause impactions and intestinal rupture. The Fecal Sand Test is an easy horse-side, used to assess the presence and amount of sand. Two to four fecal balls are placed in a rectal sleeve or plastic bag with water and then mixed. After standing undisturbed for 15 minutes, sand will settle to the bottom of the sleeve. A fecal occult blood test can be used if hind gut ulcers are suspected. The fecal egg count will give you an estimate of the parasite load. A fecal culture can test for bacterial causes of diarrhea.

Answer 158

Answer: **Normal** Explanation The correct answer is normal. There may be no menace in a calf for its first 2 weeks of life, but the calf should demonstrate normal vision when allowed to move.

Answer 159

Answer: **Test the foal's DNA for severe combined immunodeficiency** Explanation The signalment and signs of multiple infections suggest that this foal has severe combined immunodeficiency (SCID), a lethal autosomal recessive genetic disease of Arabians. A DNA test is available for antemortem diagnosis and for diagnosis of the heterozygous carrier state. Affected foals have lymphoid hypoplasia, pronounced lymphopenia, and the absence of serum IgM. These foals typically either die of infection or are euthanized before 5 months of age. When SCID's mode of inheritance was initially determined, recommendations were made to remove mares and stallions from the breeding program on the basis of a SCID foal. The availability of genetic testing, however, allows the detection of carriers; sound breeding decisions can then be made based on these results and carriers can still remain a part of a breeding program. Lavender foal syndrome (also called coat color dilution lethal or CCDL) is a lethal autosomal recessive neurologic disease, which typically leads to euthanasia within days of birth due to significant neurologic signs.

Answer 160

Answer: **Pupillary dilation and slit lamp evaluation** Explanation The best way to differentiate cataracts from lenticular sclerosis in dogs is to dilate the pupils and perform a slit lamp evaluation, also called retroillumination. This will allow you to identify the fundic reflection. In the animal without cataracts, the full fundic reflection should be visible. In an animal with cataracts, there will be obstruction of reflected light to some degree. Tonometry is a test for intraocular pressure to diagnose glaucoma. Electroretinography assesses the electrical activity of the retina for retinal function and to diagnose retinal degeneration.

Answer 161

Answer: **Increase dietary magnesium or inject Copper glycinate** Explanation When excess molybdenum causes secondary copper deficiency, it can be overcome by increasing dietary copper or by injecting Copper glycinate. Copper glycinate must be prescribed by the attending veterinarian and dispensed by the compounding pharmacy, as no commercial over the counter products are currently available. Injectable copper glycinate containing 30% copper by weight is given to adult cattle at the rate of 400 mg (120 mg copper) subcutaneously. Calves are given 100-200 mg of copper glycinate (30 to 60 mg copper), depending on their age. One injection may be effective as a treatment followed by dietary supplementation for up to 4 to 6 months in cases of primary copper deficiency. In cases of excess molybdenum, repeat injections may be necessary.

Answer 162

Answer: **Praziquantel** Explanation The correct answer is praziquantel. Pyrantel, fenbendazole, and ivermectin are not known to be effective against Dipylidium caninum infections.

Answer 163

Answer: **Less than 200,000 cells/ml** Explanation The correct answer is less than 200,000 cells/ml. The goal is to have a SCC of less than 200,000 cells/ml.

Answer 164

Answer: **Clostridium perfringens type C enteritis** Explanation The correct answer is Clostridium perfringens type C enteritis. C. perfringens type C causes acute hemorrhagic diarrhea and death in piglets 1-7 days old. Enteric colibacillosis (enterotoxogenic E. coli) causes diarrhea in piglets up to 2 weeks of age, but does not usually cause hemorrhagic diarrhea or death. Rotavirus enteritis does not usually cause hemorrhagic diarrhea or death. TGE (a coronavirus) affects all age groups and causes nearly 100% mortality in piglets less than 2 weeks of age. It also sometimes causes vomiting but does not cause hemorrhagic diarrhea. Swine dysentery (Brachyspira hyodysenteriae) causes bloody diarrhea and death typically in grower and finisher pigs.

Answer 165

Answer: **Equine** Explanation The correct answer is equine. A fasting or anorectic horse can become clinically icteric and develop bilirubin values of up to 8 mg/dL within a few days of fasting due to reduced hepatic uptake, conjugation, and secretion of bilirubin.

Answer 166

Answer: **Spider lamb syndrome** Explanation The condition is a severe chondrodysplasia of Suffolk and Suffolk cross sheep, caused by an autosomal recessive trait. It is also called Ovine Hereditary Chondrodysplasia.

Answer 167

Answer: **Polymerase chain reaction (PCR)** Explanation The correct answer is PCR. This is a classic presentation for feline hemotropic mycoplasmosis (FHM). Mycoplasma haemofelis (formerly known as Haemobartonella felis) is a bacterium that attaches itself to host red blood cell (RBC) membranes. This bacterium does not have a cell wall. Because it resides inside living host cells, it cannot be cultured in a lab. A cat becomes infected from the bite of an infected flea. Soon the cat's red blood cells are covered with mycoplasma organisms. The cat's immune system eventually detects foreign proteins on RBCs and begins to mount an attack in the form of antibodies. These antibodies bind to the mycoplasma organisms, which serve to mark the infected RBC for removal and destruction by the spleen. To complicate matters, the number of organisms present on RBC membranes changes rapidly, making it easy to miss infected cells on a blood smear even in a grossly infected cat. You got lucky with this cat because the organism was detected on your smear. IFA and Western blot are incorrect; those methods are not used to detect FHM infection.

Answer 168

Answer: **There is no effective treatment against the adults** Explanation The correct answer is there is no effective treatment against the adults. Treatment with ivermectin is only effective against the microfilariae of Onchocerca. Other drugs are ineffective against the adult helminths. **Onchocerciasis in Animals** Definitions and Etiology: • Onchocerciasis: A parasitic dermatitis caused by Onchocerca species, primarily affecting equines and ruminants. • Causative Agents: Onchocerca cervicalis in horses, found in the ligamentum nuchae; transmitted by Culicoides spp. in equines, and Simulium spp. in ruminants. Pathophysiology: • Adult Worms: Located in connective tissues such as the ligamentum nuchae in horses, causing inflammation ranging from acute necrosis to chronic granulomatous changes, resulting in fibrosis and mineralization. • Microfilariae: Found in the dermis and occasionally in peripheral blood, accumulating in the ventral midline, face, neck, chest, withers, forelegs, and abdomen. They may trigger immunologic reactions leading to dermatitis. Clinical Signs: • Dermatitis: Pruritic lesions on the ventral midline and other regions, including scaling, crusting, ulceration, alopecia, and depigmentation. • Ocular Involvement: Microfilariae may also accumulate in the eyes, though their direct association with uveitis remains debated. Diagnosis: • Histology and Skin Scraping: Identification of microfilariae is done through full-thickness skin biopsy (>6 mm), with tissue being minced, macerated, and stained with methylene blue for microscopic differentiation. • PCR Testing: Can be performed on tissue sections to confirm the species of Onchocerca. Treatment: • Macrocyclic Lactones: Effective against microfilariae but not adult worms. • Ivermectin: 200 mcg/kg dosage, >99% efficacy. • Moxidectin: 400 mcg/kg dosage, similarly efficacious. • Post-Treatment Reactions: Some horses may develop marked ventral midline swelling post-treatment, which usually resolves spontaneously but may require symptomatic management. Prevention: • Vector Control: Application of topical repellents to prevent bites from Culicoides spp. and other vectors. [onchocerciasis in Animals](https://www.merckvetmanual.com/integumentary-system/helminths-of-the-skin/onchocerciasis-in-animals?query=onchocerca%20microfilariae)

Answer 169

Answer: **Potassium** Explanation The correct answer is potassium. Animals with uroperitoneum are usually hyperkalemic and additional potassium in intravenous fluids would be contraindicated. ***PowerLecture: Foal Uroperitoneum

Answer 170

Answer: **Increase in the rate of cardiac arrhythmias** Explanation Barbiturates are often used to induce anesthesia and to control seizures when all other anti-epileptic drugs are not effective. They can cause cardiac arrhythmias (ventricular bigeminy is the most common), tachycardia, dose dependent hypotension, apnea, and a decrease in CNS activity.

Answer 171

Answer: **Ottis media/interma, middle ear trauma, listeriosis** Explanation The calf's signs are most consistent with dysfunction of the peripheral vestibular system (although one cannot rule out central vestibular) and facial nerve dysfunction. Middle/inner ear infection or trauma are likely and listeria is a reasonable differential as well. Most of the other choices listed are not typically associated with vestibular signs as described in this case.

Answer 172

Answer: **Methicillin-resistant Staphylococcus aureus** Explanation S. aureus is host-adapted to humans. Methicillin-sensitive S. aureus persistently colonizes approximately 30% of humans and intermittently colonizes another 30%. Methicillin-resistant strains are increasing in prevalence in the human population. The isolation of Staphylococcus aureus on dogs may not represent persistent colonization, but owners should be warned to practice careful hand hygiene if the family dog is diagnosed with a methicillin-resistent strain of S. aureus. Staphylococcus pseudintermedius is host-adapted to dogs. Human infections with S. pseudintermedius have been reported, but are rare; thus methicillin-resistant S. pseudintermedius does not present as great a zoonotic risk as methicillin-resistant S. aureus.

Answer 173

Answer: **To slow down the heart in the case of supraventricular tachycardia** Explanation The correct answer is to slow down the heart in the case of supraventricular tachycardia. Atenolol is a beta adrenergic antagonist used for slowing down the heart for hypertrophic cardiomyopathy and certain cardiac arrhythmias such as supraventricular tachycardias.

Answer 174

Answer: **Inguinal hernias in pigs is heritable** Explanation The correct answer is inguinal hernias in pigs is heritable. Both inguinal and umbilical hernias occur commonly in pigs. Inguinal hernias occur more commonly in males than females, particularly after castration. They can be unilateral or bilateral and occur more commonly on the left side. Umbilical hernias occur in both sexes but are slightly more common in females.

Answer 175

Answer: **Administer oxytocin (IM or IV) and lavage the uterus to facilitate removal** Explanation Most texts state that the placenta in a mare is retained after greater than 3 hours post-parturition; therefore, this would be considered a retained placenta. Oxytocin, along with uterine lavage, will cause the uterus to contract and facilitate expulsion of the placenta. Strong physical traction on the retained placenta is generally considered contraindicated, as you may tear the placenta and leave remnants of it within the uterus, resulting in possible complications. Broad-spectrum antimicrobials are often administered to decrease the incidence of metritis but alone would not be appropriate.

Answer 176

Answer: **Guaifenesin** Explanation The correct answer is guaifenesin. Unfortunately, the exact mechanism is unknown; however, we do know that guaifenesin acts centrally by blocking nerve impulse transmission at the internuncial neuron level in the subcortical brain, brain stem, and spinal cord. Veterinarians should be careful not to give too much guaifenesin because early signs of toxicity are in the form of increased rigidity. So what does the vet do? Give more guaifenesin, causing respiratory and cardiac arrest. Ketamine is a dissociative agent and is known for its ability to cause hypertonia. Atracurium is a non-depolarizing neuromuscular blocking agent that acts by competitively binding to cholinergic receptors at the motor endplate. Succinylcholine is a depolarizing neuromuscular blocking agent.

Answer 177

Answer: **Ears back** Explanation The correct answer is ears back. During anestrus, a mare will typically reject a stallion's romantic interest. Other signs of reiection by a mare include striking and avoidance of a stallion. The other choices are all signs of estrus.

Answer 178

Answer: **Gentamicin** Explanation The correct answer is gentamicin. It is important to remember that reptiles have a renal-portal system in which blood from the caudal half of the body passes through the kidneys before returning to the heart. Therefore, administration of a potentially nephrotoxic drug, as are all aminoglycosides, would be contraindicated in the caudal half.

Answer 179

Answer: **Borrelia burgdorferi** Explanation The correct answer is Borrelia burgdorferi. Rickettsia rickettsii is the causative agent of Rocky Mountain Spotted Fever.

Answer 180

Answer: **Tendonitis** Explanation The correct answer is tendonitis. Pedal osteitis is inflammation of the structures of the feet associated with demineralization of P3. Pedal osteitis commonly occurs in performance horses and is associated with working on hard surfaces. Both forelimbs may be affected. Treatment consists of prolonged rest, NSAIDs and corrective shoeing.

Answer 181

Answer: **This tick is uncommonly associated with muscle tremors** Explanation The only soft bodied tick of horses is Otobius megnini (spinose ear tick), which is typically found in the ear canal. These ticks are associated with generalized muscle tremors in some affected horses, although the mechanism is unknown. These tremors resolve with treatment of the ticks. The ticks do not carry bacterial infections like the hard bodied ticks. They do cause severe pain and pruritus locally in the ear canal. Horses may present with head shaking or the owner may describe having difficulty bridling. These signs may be interpreted to be neurologic, however, they are simply due to pain and irritation caused by the ticks.

Answer 182

Answer: **Every 365 days** Explanation The ideal length of lactation for a typical dairy cow is 305 days with approximately 60 days of dry period. This allows the cow to calve every 12 months so they can consistently produce milk with a short dry period. This has been determined to result in the greatest milk output with the greatest feed efficiency.

Answer 183

Answer: **Onchocerca** Explanation The correct answer is Onchocerca. Onchocerca can cause dermatitis in the horse due to hypersensitivity to dying microfilariae. Lesions include alopecia and scaling of the ventral midline, face, and pectoral region. Often lesions are diamond shaped and there may be a "bull's eye" lesion on top of the head. Onchocerca is nonseasonal, in contrast to culicoides hypersensitivity and variably pruritic. Ocular lesions can also occur with onchocerca including uveitis, conjunctivitis, and keratitis. Culicoides hypersensitivity, also referred to as sweet itch, occurs due to allergy to the saliva of the gnat. It recurs seasonally in the warmer months and tends to worsen with age. Typically, horses are pruritic and develop lesions on the poll, mane, and tail from self trauma, although ventral midline dermatitis can occur as well. More chronically, scarring can occur. Treatment is to decrease exposure to the gnat and to treat with steroids. Habronemiasis is a condition where the larvae of the stomach worm migrate and emerge creating granulomatous lesions, usually around the eye, male genitalia, or lower extremities. Inside the granulomas, you can find dead larvae. Haematobia irritans is a bigger problem in cattle than horses (they reproduce in cow feces) but can affect horses, especially ones that are near cattle. It typically causes ventral midline dermatitis with wheals with a central crust that progress to alopecia and ulceration with fairly focal lesions, rather than more diffuse lesions caused by culicoides. Lastly, Hypoderma is a bigger problem in cattle but can occur in horses and typically creates nodules on the back that have a pore on top.

Answer 184

Answer: **Improper humidity** Explanation Especially in climates with very low ambient humidity, reptiles kept in an improper humidity range will often have difficulties with normal ecdysis. Owners may need to provide a "humidity box" to give these animals an area with increased humidity to help with shedding. Excessive dietary phosphorus supplementation may sometimes cause bone resorption, but rarely is a direct cause of dysecdysis. Improper UVB lighting may affect normal calcium metabolism but does not directly relate to normal shedding. Signs of hypervitaminosis A include epidermal necrosis and sloughing. Generally, there are other skin lesions present in addition to dysecdysis (if present).

Answer 185

Answer: **Dogs with malignant mammary tumors greater than 3 cm in size are considered to have a worse prognosis than those with tumors 2 cm in size** Explanation Generally, dogs with malignant mammary tumors greater than 3 cm are thought to have a worse prognosis than those with tumors smaller than 3 cm. The tumor size cut off in cats is 2 cm; cats with mammary tumors greater than 2 cm have a poorer prognosis than those with tumors smaller than 2 cm. Mammary tumors more frequently develop in the caudal glands (4th and 5th). Like in dogs, the risk for development of mammary tumors in cats is greatly reduced if they are spayed early in life; there is a strong hormonal influence associated with development of mammary tumors later in life.

Answer 186

Answer: **Physiologic leukogram** Explanation A "physiologic leukogram" is from an epinephrine-mediated excitation response and is commonly seen in cats who get excited upon entering a veterinary clinic. You can see the classic mild neutrophilia along with normal to increased lymphocytes and no monocytosis. Although there are bands present in the blood work this is a normal amount according to reference levels provided, and is thereby not considered a left shift.

Answer 187

Answer: **These are chondroids and are a source of persistent bacterial shedding** Explanation These objects are chondroids, which are concretions of pus and bacteria. They most commonly occur when horses develop guttural pouch empyema, an accumulation of purulent exudate in the guttural pouch due to mucosal infection or drainage from the retropharyngeal lymph nodes with Streptococcus equi subsp. equi (Strangles). This inspissated guttural pouch exudate provides a refuge for the bacteria and allows for continued bacterial shedding. When exudate persists, it can become increasingly dense (inspissated), forming solidified concretions that are difficult to extract and serve as a nidus for prolonged shedding of the organism. To reduce shedding and transmission, these chondroids should be removed and the guttural pouch should be flushed and infused with 5 million units of penicillin G in 3% gelatin. In addition, these horses should be treated with penicillin G intramuscularly for 7 days, isolated for 30 days, and then retested with 3 consecutive series of nasopharyngeal swabs and culture. Animals that remain positive should go through a repeat treatment and culture cycle.

Answer 188

Answer: **Calcium oxalate urolithiasis** Explanation The correct answer is calcium oxalate urolithiasis. Struvites are soluble at low pH. Acidifying diets have resulted in an increased prevalence of calcium oxalate urolithiasis.

Answer 189

Answer: **12 hours post-partum** Explanation The correct answer is after 12 hours. Usually, the fetal membranes are passed in 2 to 8 hours; after 12 hours, it is considered retained. Retained placenta appears to occur more commonly in dairy than beef cattle. The rates are reported to be in the range of 8 to 12% of all single births in dairy cows.

Answer 190

Answer: **Bovine viral diarrhea** Explanation The correct answer is bovine viral diarrhea. Calves born with BVD are persistently infected and should be culled

Answer 191

Answer: **Gossypol** Explanation The correct answer is gossypol (found in cotton seed in varying amounts) toxicity. Gossypol is a cardiotoxin and can kill calves less than 4 months of age. In adults, if fed at high levels, it usually causes sterility in bulls and decreased conception in cows. Moldy sweet clover inhibits vitamin K and causes a coagulopathy. St. John's-wort contains hypericin and results in photosensitivity. Tansy ragwort is a pyrrolizidine alkaloid and causes liver disease. Larkspur causes general nonspecific signs such as salivation, bloat, muscle fasciculation, collapse, staggering, and death.

Answer 192

Answer: **6** Explanation The correct answer is 6. The 3-rooted permanent teeth in the maxilla of a dog are P4, M1, and M2. There are no 3-rooted permanent mandibular teeth in the dog.

Answer 193

Answer: **68 days** Explanation The correct answer is 68 days. A dog's RBC lives for 110 days. A human's RBC lives for 120 days.

Answer 194

Answer: **Western Equine Encephalitis** Explanation The keys to this question are that the horse is unvaccinated for WEE, has a progression of central nervous system signs over several days and characteristic CSF changes. Another reasonable differential would be rabies, particularly if the horse had not been vaccinated for it. Equine protozoal myeloencephalitis (or myelitis) can be seen at any age and is caused by Sarcocystis neurona. It should be suspected when a horse has asymmetric neurological signs as it is a multifocal disease of the central nervous system. Cervical vertebral malformations (Wobbler Syndrome) and degenerative myeloencephalopathy are diseases seen primarily in horses under a year of age. Degenerative myelopathy causes a symmetrical ataxia. Cerebellar abiotrophy is usually observed in foals which are less than one year of age, particularly 1-6 months of age. It is mostly seen in Arabian, Oldenburg, and Gotland breeds. There is no treatment and signs may be progressive. Diagnosis is based on a good history and clinical signs such as intention tremors, lack of a menace, hypermetria, and ataxia. Thiamine deficiency in horses usually occurs from ingestion of thiaminase-containing plants (bracken fern) and results in loss of condition and slight uncoordinated movements. If not treated, the disease may progress to cause twitching, tremors and seizures.

Answer 195

Answer: **Closing the wound with skin sutures** Explanation Suturing the wound closed after a grass awn removal is contraindicated. It is important to leave the wound open to drain. If it is closed, the infection will remain trapped in the tissues and likely create an abscess. Using alligator forceps to remove the plant material is advisable - this instrument is very helpful when it comes to foxtail removal! Following the tract from the wound entrance is also advisable - this indicates where the foreign body has migrated and the tract should be followed. Flushing with chlorhexidine solution is recommended.

Answer 196

Answer: **6 months** Explanation The correct answer is 6 months. Kittens may have maternal antibodies circulating within them and not be infected. Therefore, it is recommended that cats which tested positive to be re-tested after they are 6 months of age. For the PowerPage'™ on this topic, view Feline Retroviral Diseases (FELV and FIV)

Answer 197

Answer: **Vitamin K1** Explanation The correct answer is vitamin K1. Brodifacoum is a vitamin K antagonist commonly used in rodenticides. Ingestion of this compound causes hemorrhaging. Treatment for this condition requires vitamin K1 administration for 4-6 weeks. For the PowerPage™ on this topic, view Rodenticide Toxicity

Answer 198

Answer: **Monensin** Explanation The correct answer is monensin. Amprolium is a false thiamine analog and bracken fern contains thiaminase. Excess grain consumption results in increased production of thiaminases by rumen bacteria. High sulfur concentrations may also induce polio. Dietary levels of sulfur greater than 33mg/kg of body weight are toxic.