Practice Flashcards
1
Q
Splintered QRS in what congenital heart disease?
A
Tricuspid valve dysplasia
2
Q
Dog with jugular pulses, ascites (signs of R CHF), no murmur?
A
Pulmonary hypertension
3
Q
Consensus statement on CHF for dogs (Stage A-D): CKCS with III/VI no clinical signs, cardiomegaly on thoracic radiographs.
A
CVD B2
4
Q
ECG from dog treated with doxorubicin. Wide QRS complex with deep S wave. P present for every QRS. What is the diagnosis?
A
Right bundle branch block
5
Q
Which of the following would be expected to be decreased in a patient with pulmonary hypertension? (this question is straight from CVT)
a) endothelin
b) angiotensin II
c) Nitric oxide
A
C. Nitric oxide
6
Q
Which of the following is inactivated in the lungs?
a) bradykinin
b) leukotrienes
c) angiotensin
d) prostaglandins
A
A. Bradykinins by ACE
7
Q
What electrolyte abnormality can cause increased Digoxin toxicity?
a) hyperkalemia
b) hypokalemia
c) hypernatremia
d) hyponatremia
A
B. Hypokalemia
8
Q
Which of the following tests is more sensitive for heartworm in the cat than the dog?
a) antigen test
b) antibody test
c) Echocardiogram
b) thoracic radiographs
A
B. Antibody test
9
Q
What heart rhythm is this?
A
A fib
Note: atrial flutter has a sawtooth appearance
10
Q
Which of the following would cause a hyperdynamic pulse?
a) aortic stenosis
b) aortic insufficiency
c) pulmonic stenosis
A
B. aortic insufficiency
Note: a PDA would also cause hyperdynamic pulses
11
Q
Be able to ID isovolumetric contraction on a pressure volume tracing.
A
12
Q
What predisposes to endocarditis?
A
Subaortic stenosis
13
Q
Describe the baroreceptor reflex.
A
Increased blood pressure/volume–>increased baroreceptor stretch–>increased vagal output–
>decreased CO
14
Q
What congential heart problem does a 5 month old cat with right sided heart murmur have?
A
Ventricular septal defect
15
Q
What is responsible for the S4 heart sound?
A
Atrial systole
16
Q
In a patient with a suspected drug reaction, which of the following would be the best to biopsy?
a) ulcer
b) pustule
c) erythematous skin
d) crust
A
B. Pustule
17
Q
Older dog with the following thyroid panel: TT4 – high, TSH – high. What is the diagnosis?
A
Immune mediated thyroiditis
18
Q
Older Saint Bernard with the following bloodwork: Baseline cortisol – low (1), ACTH – low, Cortisol following ACTH stimulation – low (1). What is the likely diagnosis?
A
Secondary hypoadrenocorticism
Note: With primary hypoadrenocorticism, ACTH should be high
19
Q
ACTH stim test: Baseline cortisol – high (92), 4 hr post stim – 25 (normal < 30), 8 hour post stim – 88 (normal < 30). What is the most likely diagnosis?
A
PDH - 8 hour consistent with HAC, and there was suppression indicating PDH
20
Q
Which of the following electrolyte abnormalities could result in hemolysis following treatment of a DKA patient?
a) hyperphosphatemia
b) hypophosphatemia
c) hyperkalemia
d) hypokalemia
A
B. Hypophosphatemia
21
Q
Given the following bloodwork: Ionized calcium of 1.8 - high, PTH – normal. What is the diagnosis?
A
Primary hyperparathyroidism
22
Q
Nutritional hyperparathyroidism would be associated with which of the following?
A. Diet high in calcium
B. Diet high in vitamin D
C. Increased renal excretion of phosphorus
D. High serum calcium levels
A
C. Increased renal excretion of phosphorus
Note: nutritional hyperparathyroidism results from a nutritional deficiency in calcium and vitamin D
23
Q
This thyroid hormone has shortest latency period and is quickest to reach maximum cellular activity?
A
T3
24
Q
Syndrome of inappropriate ADH secretion would cause which of the following?
A. Hypernatremia
B. Volume depletion
C. Normal GFR
A
C. Normal GFR - Renal blood flow increases, but the percent filtered is the same.
A. - would cause dilutional hyponatremia
B. - would cause volume retension
25
Bloodwork: pH: 7.2, HCO3: 10, PCO2: 50 – what is the acid base status?
Mixed respiratory and metabolic acidosis
26
Bloodwork showing low chloride (92), HCO3 (8), K (5.4) and Na (140) – what does this indicate?
A. Elevation in unmeasured anions
B. Hypoventilation
C. Metabolic acidosis
D. Anion gap of 20
A. Elevation in unmeasured anions
Note:
B. Hypoventilation - normal anion gap
C. Maybe true? don't have pH
D. AG = (Na + K) - (HCO3 + Cl) = (140+5.4) - (8+92) = 145-100 = 45 = high gap acidosis (addition of
unmeasured anions)
27
What are three causes of a normal anion gap acidosis?
Renal tubular acidosis, hypoventilation, and diarrhea (all of these are from loss of bicarb and typically are hyperchloremic).
28
What hormone is responsible for stimulating appetite and what counteracts that?
Ghrelin and leptin
29
You are testing goats for a disease. You test 100 goats and 60 are positive. On necropsy (gold standard), 50 of the positive goats have the disease, but the other 10 that tested positive do not. In addition, an additional 10 goats were found to have the disease that were not identified by the test. What is the sensitivity and specificity of this test?
Sensitivity = true positives/(true positives+false negatives) = a/(a+c) = 50/(50+10) = 85%
Specificity = true negative/(true negative+false positives) = d/(d+b) = 30/30+10 = 75%
30
If an animal was going to be euthanized if it tests positive for a disease, you want what type of test?
Highly specific
31
What is the source of Cryptosporidium hominis?
Humans
32
What approaches zero as prevalence of a disease declines?
Positive predictive value
33
What can bring about a hemolytic crisis in dogs with PFK deficiency?
Exercise
34
A 6 month old Irish setter with history of recurrent infections and elevated WBC count (I believe very high, 200,000?). What is the likely cause?
Canine leukocyte adhesion deficiency (CD18)
35
What percentage of equine and canine patients that are hospitalized in the ICU develop nosocomial infections?
16% (cats are 12%) - In general remember 15%, which is about right for all species
36
What is the most specific way to diagnose feline pancreatitis?
A. Abdo rads
B. Abdo AUS
C. Serum lipase
D. Serum amylase
Abdominal ultrasound (Bx even more specific)
Most specific BLOOD test for feline pancreatitis is fPLI
37
What is the diagnostic test for protein losing enteropathy?
Alpha 1 protease inhibitor
38
What would be the best treatment for acute exacerbation of hepatic encephalopathy?
Cleansing enema
39
Why is alkp more specific in cats?
Because they don't have a steroid induced isoenzyme.
40
How is alkp cleaved from the biliary membrane?
Bile salts
Note: ALP is anchored to cell membranes by glycophosphatidylinositol (GPI) proteins. Cleavage of these proteins by bile acids, phospholipase D, and proteases releases ALP from membranes, resulting in increased ALP levels in serum/plasma
41
In which scenario would post prandial bile acids be useful?
A. To differentiate intraheptatic from extrahepatic shunts
B. To determine the cause of hypoalbuminemia – liver disease versus PLE
C. To determine intrahepatic versus extrahepatic cholestasis (or bile duct obstruction)
B. To determine the cause of hypoalbuminemia, specifically liver disease vs PLE
Note: You would not run bile acids in a patient with cholestasis because you know they will be high
42
What are the mechanisms of neutrophil killing?
Respiratory burst using NADPH (oxidant generation)
Also release of lytic enzymes and antimicrobial peptides from granules - Lytic enzyme release: lysosomes fuse with phagosome --> phagolysosome
43
Where are NK cells formed?
In the bone marrow
44
Neutrophils bind to antibody coated organisms via what receptor?
CD 32
45
What do NK cells secrete large amounts of?
Interferon Gamma
46
What is the main clinical sign of systemic lupus erythematous?
Non-erosive polyarthritis
47
CpG and LPS are example of:
PAMPs
48
Which white blood cell has the shortest half-life in circulation?
A. neutrophil
B. eosinophil
C. platelet
D. lymphocyte
B. eosinophil
49
There are more BP substitutions in the coding versus non-coding region of MHC Class II receptor. This means that MHC II diversity is:
Selected for ie an advantage
50
What is the function of microRNA?
Decreased gene expression
51
What part of the cell does lupus attack?
The nucleus
- can diagnose by detection of anti-nuclear antibodies
52
IL-4, 10 and 13 cause macrophages to become:
A. M1
B. M2
C. NK cells
B. M2
M1 phenotype is stimulated by microbial products or pro-inflammatory cytokines [IFN-γ, TNF, or Toll-like receptor (TLR) ligands], and the typical characteristics of M1 macrophages include high antigen presentation, high production of IL-12 and IL-23, and high production of nitric oxide (NO) and reactive oxygen intermediates. In contrast, M2-type responses are the “resting” phenotype and are observed in healing-type circumstances without
infections. Such responses can also be further amplified by IL-4, IL-10, or IL-13
53
Vesiculobullous lesions of the mucus membranes in the mouth?
Pemphigus
54
Mutations in TLR-4 will _______ the risk of sepsis and _______ the risk of gram negative infections (know TLRs)
Increase, increase
TL3 - ds DNA (virus)
TL4 - LPS (bacteria)
TL5 - flagellin (bacteria)
TL 7, 8 - ss RNA (virus)
TL 9 - ds DNA, cpG DNA (virus)
55
Which immunoglobulin is present in the highest concentration in the blood?
IgG
Note:
IgM - Largest Ig, first produced in with antigenic stimulation
IgA - Found at mucosal surfaces (GI, lungs, etc)
IgE - smallest concentration
56
Something about kallikrein and what receptor it binds to.
The plasma kallikrein-kinin system counterbalances the renin-angiotensin system
When HK (high molecular weight kininogen)*PK (prekallikrein) binds to endothelial cells, PK is rapidly converted to kallikrein (K) by the enzyme prolylcarboxypeptidase (PRCP), which is constitutively active on endothelial cell membranes.Kallikrein autodigests its receptor, HK, to liberate bradykinin (BK), which can liberate tissue plasminogen activator (tPA), nitric oxide (NO), and prostacyclin (PGI2) from endothelial cells. Kallikrein also activates FXII, which binds to the same multiprotein receptor complex as HK in its absence
Kallikreins (tissue and plasma kallikrein) are serine proteases that liberate kinins (Bradykinin and Kallidin) from the kininogens, which are plasma proteins that are converted into vasoactive peptides. Prekallikrein is the precursor of plasma kallikrein. It can only activate kinins after being activated itself by factor XIIa or other stimuli. Bradykinin is released from high molecular weight kininogen. Kallidin is released from low molecular weight kininogen.
57
What is the major protein involved in breakdown of clots?
Plasmin
58
In addition to doxycycline, what drug do you need to treat a patient with Neorickettsia helminthoeca?
Praziquantel (for Nanophyetus salmincola trematode)
59
Which of the following tests would be most specific for diagnosis of T. gondii in a cat with clinical signs? (check CVT)
A. Oocysts in feces
B. IgM >1:64 in CSF
C. IgG > 1:64 in blood
D. Blood culture
B. IgM>1:64 in CSF
60
Young cat with acute, hemolytic anemia with epicellular RBC parasites? How would you treat this cat?
Doxycycline.
This is likely mycoplasma haemophelis. Remember that mycoplasma doesn’t have a cell wall so can’t cell wall inhibitors like penicillins or cephalosporins.
61
Dog with pleural effusion, elevated temperature (104.5). On cytology of pleural fluid, you see non-acid fast filamentous organism. Aerobic culture is negative. What is the most likely cause?
Actinomyces
62
Most common cause of pyothorax in a cat?
Pasteurella
62
What is the most common infectious causes of discospondylitis?
Staph aureus
63
3 year old dog with large bowel diarrhea. On rectal scrapings you see small (2-4 um) organisms inside macrophages. What is the diagnosis?
Histoplasmosis
64
You have a cat that has tested positive for FIV. Four weeks ago, she gave birth to kittens, who subsequently tested positive for FIV. What would you do?
Isolate kittens and retest in 6 months*
- Tests for Ab, have to wait for maternal Ab to leave (FeLV tests for Ag rather than Ab)
65
Horses and dogs are a reservoir for humans for which of the following?
A. Pythium
B. Blasto
C. Staph aureus
D. Staph pseudintermedius
C. Staph aureus
66
What tick carries Anaplasma phagocytophilum?
Ixodes (co-transmitted with Borrelia)
67
Which of the following cause myocarditis in dogs, cerebellar hypoplasia in cats and diarrhea in pigs?
Parvovirus
68
How do you diagnose rabies?
IFA on brainstem, cerebellum
69
What is the ideal test for cryptococcus diagnosis
Latax agglutination test
70
How to diagnosis Hepatozoon americanum?
Muscle biopsy
71
Where is CSF reabsorbed?
Arachnoid villi
72
What is the long term treatment of myasthenia gravis?
A. Pyridostigmine bromide
B. Steroids
C. Mycophenolate
D. Edrophonium bromide
A. Pyridostigmine bromide - long acting Acetylcholinesterase inhibitor
Note: Edrophonium bromide - Short acting acetylcholinesterase inhibitor (too short acting for Tx; tensilon test)
73
Dog that is circling to the left and has the following cranial nerve abnormalities:
Menace: L normal R decreased
PLR: L Normal R normal
Nasal sensation: L Normal R absent
Thoracic limb CP: L normal R decreased
Pelvic limb CP: L normal R decreased
Left cortex or thalamus (circle to the side of the lesion, deficits on contralateral side)
74
What nerve innervates the external urethral sphincter?
Pudendal
75
What % of animals that have cerebral-vascular events are hypertensive?
30%
76
What are signs of an UMN lesion?
A. Hyperreflexia
B. Flaccid paralysis
C. Muscle atrophy
A. Hyperreflexia
77
You have a boxer with signs consistent with steroid responsive meningitis. How could you definitively diagnosis this?
IgA levels in serum and CSF
78
You have a patient with a dropped jaw and otherwise normal neurologic examination. Which will be affected?
Trigeminal nerve – mandibular branch
79
Which of the following drugs could you use for a dog with urinary incontinence?
A. Oxybutynin
B. Ephedrine
C. Pseudephedrine
B. Ephedrine - nonselective sympathomimetic, similar to PPA but less effective
Note: Oxybutynin - parasympatholytic, decreases detrusor overactivity (opposite bethanechol)
80
Alpaca with dilated left pupil. Menace is intact but the left pupil does not constrict when light is shone in left or right eye. Right eye is normal. Where is the lesion?
Left oculomotor
81
Bulldog that has head horizontal head tremors that last about 30 seconds. The tremors can be stopped by giving him a treat. What is the diagnosis?
Idiopathic
82
9 year old dog with coombs negative hemolytic anemia, hypoalbuminemia, hypocholesterolemia, mildly elevated bilirubin. What is the most likely diagnosis?
A. Primary IMHA
B. Histiocytic neoplasia
C. Erythroblastic anemia
B. Histiocytic neoplasia
83
What are 4 chemotherapy drugs that cross the blood-brain barrier?
Cytosar, procarbazine, hydroxyurea, CCNU
84
You are treating a Collie with chemotherapy while awaiting MDR mutation testing. Which of the drugs would be the safest to use while you await the results?
A. vincristine
B. doxorubicin
C. cytoxan
d. mitoxantrone
C. Cytoxan
85
What would be your first line treatment for dog with splenic mass, Hct: 35%, Plt: 95,000, mildly elevated PT/PTT?
A. Heparin
B. Packed RBC transfusion to increase oxygen carrying capacity.
C. Fluid therapy/ volume expansion
D. Plasma transfusion
C
86
What is the mechanism of action of mitoxantrone?
Inhibits topoisomerase II and also causes intercalation of DNA
87
What is the most common skin tumor in cats?
Basal cell tumor
88
You have a patient with a suspected mast cell tumor that does not stain with aqueous quick stains. What would be the next stain to use?
Wright-Geimsa
89
Feline blood typing. Type A is:
A. Rare in siamese
B. Dominant to B
C. Recessive to AB
B. Dominant to B
90
What is the most antigenic blood type in dogs?
DEA 1.1+
91
Where is most of the body's iron?
Bound to hemoglobin
92
If a patient has hemolysis of RBCs following a transfusion, which type of HS reaction is involved?
Type II hypersensitivity- Ab mediated destruction
Note:
Type 1 IgE mediated
Type 2: Ab mediated cytoxic
Type 3: Immune complex
Type 4: delayed
93
Which of the following conditions would result in a high serum iron?
A. Hemolysis
B. Iron deficiency anemia
C. Anemia of chronic disease
A. Hemolysis
94
In which of the following conditions would you see microcytosis before hypochromia?
A. B12 deficiency
B. folate deficiency
C. iron deficiency anemia
C. iron deficiency anemia
95
Gompertzian growth; smaller tumors grow _____ as compared to larger tumors and are _____ susceptible to chemotherapy.
Faster, more
96
What is the most consistent finding for patients with a stress leukogram?
Lymphopenia
97
What is a target for mTOR
Sirolimus/Rapamycin
98
Question about PARR – multiple bands present in dog with lymphadenopathy. What is the diagnosis?
Inflammatory disease
99
What determines the specificity of PCR?
Primers
100
Where does oxygen bind on RBC?
Fe2+ (iron atom on the heme group)
101
What is the most common secondary brain tumor?
Hemangiosarcoma
102
Adult beagle with 1 month history of vomiting and inappetance. Physical exam is unremarkable. Bloodwork shows hypoglycemia with no other abnormalities. Staging shows mass in stomach. What is the diagnosis?
Leiomyosarcoma
103
What is the mechanism of action of Doxycycline?
bind to 30s ribosomal subunit of bacteria
104
What is the mechanism of action of cisipride?
5HT-4 agonist
105
What is the mechanism of action of gabapentin
inhibits voltage gated calcium channels
106
What is the mechanism of action of ondansetron?
5HT-3 antagonist
107
What is the mechanism of action of cyclosporine?
Binds and forms complex with cyclophilin which inhibits calcineurin/NFAT (nuclear factor of activated T
cells), which decreases T-cell inflammatory cytokine production (IL-2)
108
What is the mechanism of action of enrofloxacin?
DNA gyrase inhibitor
109
What is the mechanism of action of derlapitide?
Slentrol - accumulation of lipids in enterocytes
110
What is the location for nephrotoxicity for gentamycin?
PCT
111
What is the mechanism of action of aspirin?
Irreversible COX inhibition
112
What drug decreases CSF production?
Omeprazole
113
What is the mechanism of action of the following drugs and where do they work?
1. Furosemide
2. Thiazide diuretics
3. Spironolactone
Furosemide - loop diuretic, it works by inhibiting electrolyte reabsorption from the kidneys and enhancing the excretion of water from the body
Thiazide diuretics - distal convoluted tubule, decrease sodium reabsorption and therefore decreased fluid reabsorption
Spironolactone - distal convoluted tubule and collecting ducts, interfere with sodium reabsorption in distal renal tubules by competitively inhibiting the action of aldosterone
114
What is a side effect of misoprostal
Abortion in humans
115
You give a boxer Diazepam and it starts having neurologic signs. What drug do you give it?
flumazenil (reversible)
116
Name three antibiotics that penetrate the prostate
TMPS, enrofloxacin, chloramphenicol
117
What do you need to determine drug dose in an animal?
Volume of distribution
118
What drug can cause clinical signs of hypothyroidism?
TMPS
119
If given concurrently with theophylline, what drug has to be dose reduced?
Enrofloxacin
120
Essential amino acids for cats only
Argenine and taurine
121
What is the mechanism of uptake of peptides in the GI tract?
Small peptides are absorbed into the small intestinal epithelial cell by cotransport with H+ ions via a transporter called PepT1. Once inside the enterocyte, the vast bulk of absorbed di- and tripeptides are digested into amino acids by cytoplasmic peptidases and exported from the cell into blood
122
What is the mechanism of uptake of sodium in the GI tract?
Electrical and chemical gradients
123
What percentage of sodium is absorbed in the proximal convoluted tubule?
65%
124
Which of the following is most important for protecting the gastric mucosa?
PGE2 or PGI2
PGE2
125
Resting membrane potential is determined by:
A. Passive diffusion of K
B. Active transport of K
C. Passive diffusion of Na
D. Active transport of Na
A. Passive diffusion of K
126
Which cell in the lung produces surfactant?
Type 2 pneumocytes
127
Which of the following is present in the gastric fluid of a fasting dog or horse?
A. Calcium
B. Phosphorus
C. Gastrin
D. Intrinsic factor
D. Intrinsic factor
128
Where are J receptors located?
In the alveoli in the lungs
129
What increases cardiac contractility?
Increased extracellular calcium
130
In excitation contraction coupling, which of the following is responsible for spread of the action potential?
T tubules
131
Where are bile acids conjugated?
In the hepatocytes
132
A patient is still lipemic after a 24 hour fast. This is due to elevation of which of the following?
A. HDL
B. LDL
C. VLDL
D. Cholesterol
C. VLDL
133
What causes release of ach?
A. Influx of Na
B. Efflux of Na
C. Influx of Ca
D. Efflux of Ca
C. Influx of calcium
134
What inhibits glucagon secretion?
Somatostatin
135
What is the primary constituent of chylomicrons?
Triglycerides
136
What amino acid stimulates insulin release?
Alanine
Actual question was which of the following stimulates insulin release
137
An increase in which of the following would result in an decrease in GFR?
A. Glomerular capillary hydrostatic pressure
B. Glomerular capillary oncotic pressure
A. Glomerular capillary oncotic pressure
Glomerular capillary Hydrostatic pressure favours filtration, while glomerular oncotic pressure opposes filtration. So an increase in hydrostatic pressure would increase GFR while an increase in oncotic pressure would decrease GFR.
138
Does growth hormone increase or decrease the utilization of carbohydrates?
Decrease (so it can be stored and used for growth)
139
What is the main stimulus for GI motility?
Myenteric plexus
140
An abnormality of the ornithine cycle would result in an elevation of what?
AKA urea cycle which converts highly toxic ammonia to urea for excretion.
Elevation in ammonia
141
What is the most potent stimulus for H+ secretion by the kidney?
Histamine (and Ach)
142
What is responsible for the automaticity of cardiac pacemaker cells?
Slow Na and Ca channels
143
Osmosis due to protein is related to which of the following properties?
A. Charge
B. Number
C. Mass
D. Shape
B. Number
144
What activates pepsin in the stomach?
HCl
145
What percentage of total body water is extracellular fluid?
What is the 60-40-20 rule?
1/3
60% of body weight is water, 40% of body weight is ICF, and 20% of body weight is ECF
146
Which of the following would increase cerebral blood flow?
A. Increased CO2
B. Decreased CO2
C. Increased pH
A. Increased CO2
147
Know what shifts O2-hemoglobin dissociation curve to the right and left.
Right is at offloading O2 at tissues, Left is onloading O2 at Lung
Right - increased temperature, increased CO2, increased H+(decreased pH), 2,3-DPG
Left - opposite
148
Bicarbonate secretion into the pancreatic duct results in which of the following?
Diffusion of water into the duct.
149
What is the treatment for oselerus osleri?
Fendbendazole
150
You have a puppy with respiratory signs and nodules seen in trachea on radiographs. Most likely diagnosis?
Oselerus osleri
151
What is an example of something that will not respond to oxygen supplementation?
Cyanide toxicity
Shunt
152
What is the treatment for acetominephin toxicity?
SamE
153
MOA of strichnine toxicity
Inhibits glycine, which makes it easier for neurons to fire action potentials leading to tetanus
154
Poodle with 24 history of vomiting, anorexia, lethargy. Bloodwork shows elevated ALT, ALP, GGT, Tbil, low albumin, NORMAL BG and BUN. What is the most likely diagnosis?
Afalotoxin
155
MofA of Cyanide toxicity
Inhibits ATP production in the mitochondria - not responsive to O2 supplementation
156
MofA carbon monoxide toxicity
Binds Hb with high affinity, preventing O2 from binding
157
Which of the following would increase osmolarity?
a. Ethylene glycol
i. Osmolar gap = calculated - measured
1. difference indicated unmeasured osmoles
158
MofA of botulinin toxin
inhibits ACh from axon terminal causing flaccid paralysis
159
Dog with lower urinary signs is diagnosed with a UTI based on culture and susceptibility (susceptible to many antibiotics). Dog is treated with appropriate antibiotics and infection resolves. Two weeks following completion of antibiotics, lower urinary signs return. Urine is culture and has same organism and susceptibility profile as first culture. This is an example of what? (This from CVT)
a. Reinfection
b. Relapse
c. Resistant infection
d. Superinfection
B. Relapse
160
Adult female spayed dog with a 2 week history of blood vulvar discharge. Vaginal cytology shows degenerative and non-generative neutrophils with extracellular bacteria and non-cornified epithelial cells. What is the diagnosis?
Stump pyometra
Note: I think absence of cornified epithelial cells is important for ruling out ovarian remnant syndrome,
which would secrete estrogen and result in cornification of epithelial cells.
161
You have a cat with a creatinine of 3.0 and a UPC of 0.3. What IRIS stage is this cat?
Stage 3, borderline proteinuric
162
Urinary sodium excretion of <1% is most consistent with?
Severe volume depletion
163
What is the mechanism of action for PUPD for dogs with pyometra?
E Coli toxin interferes with ADH on the distal tubule/collecting ducts - causes a nephrogenic DI
164
What is the mechanism of action for PUPD with CKD?
a. Increased blood flow to existing nephrons due to decreased renal function
b. Select damage to distal tubule and collecting ducts
c. Increased solute load resulting in osmotic diuresis
C. Increased solute load resulting in osmotic diuresis
165
Dog with a USG of 1.005. Dog fails to respond to water deprivation or vasopressin. What is the diagnosis?
a. Nephrogenic diabetes insipidus
b. Central diabetes insipidus
c. Chronic kidney disease
A. Nephrogenic diabetes insipidus
Note: Central (neurogenic, pituitary, or neurohypophyseal) DI, characterized by decreased secretion of antidiuretic hormone (ADH); Nephrogenic DI, characterized by decreased ability to concentrate urine because of resistance to ADH action in the kidney. So nephrogenic will not respond to vasopressin.
166
Eosinophils are associated with what type of response?
TH2
Produce IL-5 which increases eosinophil release from BM and activates them at site of interest
167
What stage of Cytauxzoon felis is associated with vascular obstruction?
Schizont
Note: Stage that causes clinical signs
168
Most common reported side effect of oclacitinib?
Diarrhea
Note: Apoquel, JAK inhibitor for atopic dermatitis
169
Stage of life cycle of toxoplasma associated with transplacental or transmammary transmission
Tachyzoites
170
Test that requires live organisms for diagnosis within first 1-2 weeks
Lepto - MAT
171
Most potent stimulator for aldosterone secretion?
Hyperkalemia
172
Stimulator for ADH secretion
Osmoreceptors in the supraoptic nuclei
173
Goat with neurological signs: circline to the right, left sided CP deficits
Right forebrain
174
Question about sensitive diagnosis of masticatory myositis 6 weeks after dog had swollen head
2M antibody
175
Question about dropped jaw – which nerve?
Mandibular branch of trigeminal nerve
176
Dog with 2nd degree AV block that responds to atropine response test, how to treat?
Propantheline
177
Dog with decreased menace and nasal sensation on the left, circling to the right, left CP deficits
Right forebrain/thalamus
178
MofA for cyclosporine
Inhibits pathway that ends up activating NFAT
Note: affinity for calcineurin, causing an inhibition of calcium-stimulated phosphatase in calcineurin. This inhibited dephosphorylation step does not allow for activation of NFAT (nuclear factor of activated T-cells) which is needed for the nuclear transcription of genes coding for several important cytokines.
179
Dog with HCT 75%, which chemo to treat?
Hydroxyurea
(for polycythemia vera)
180
How much sodium is reabsorbed in the PCT?
65%
181
How much more potent is dexamethasone compared to prednisone?
7 times
182
Most sensitive test for Bartonella in dogs?
PCR
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Most sensitive diagnosis of toxoplasma in cats with clinical signs?
IgM in CSF
184
Dog with really high TT4, high TSH?
Idiopathic thyroiditis
B/C Antibodies against T4 cause TT4 to be elevated
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Dog with chronic weight loss/diarrhea, low cobalamin, normal TLI/folate/PLI?
Inflammatory bowel disease
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Dog with acute vomiting, nervous tremoring, abdominal pain. CBC: mild anemia with 50 nRBCs
Lead toxicity
187
Drugs to treat lead/mercury toxicity?
CaEDTA
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Most common secondary malignancy to brain?
Hemangiosarcoma
189
Mechanism of action of diazoxide?
Inhibition of closure of ATP-dependent K+ channels in beta cell (inhibits depolarization, inhibiting insulin)
190
Most common cause for migrating necrotizing dermatitis?
Glucagonoma
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Old beagle with mild abdominal pain, history of inappetence, hypoglycemic on bloodwork and stomach mass?
Leiomyosarcoma
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Acid base: low pH, low HCO3-, high pCO2
Mixed respiratory/metabolic acidosis
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Cause of S3 heart sound
Ventricular filling
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English bulldog with intermittent horizontal head tremors that can be distracted out of them by a treat
Idiopathic head tremors
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Mechanism of action of phenylpropanolamine?
Alpha agonist at the urethral sphincters
196
Which nerve innervates skeletal muscle at the external urethral sphincter?
Pudendal
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Young boxer with neck pain and suspect SRMA. What is needed to support your diagnosis?
Elevated IgA on CSF
198
What is a cause for low ionized calcium?
Metabolic alkalosis
Note: because a portion of both hydrogen ions and calcium are bound to serum albumin,
when blood becomes alkalotic, the bound hydrogen ions dissociate from albumin, freeing up the albumin to bind with more calcium and thereby decreasing the freely ionized portion of total serum calcium
199
Collie with lymphoma pending ABCB1 mutation test; which chemo should you start with?
Cyclophosphamide
200
ECG with rapid complexes that are narrow and tall, irregular rhythm, no obvious P waves (flat baseline)
Afib
Atrial standstill would have a regular bradycardic rhythm with no obvious P waves, while Atrial flutter has a typical sawtooth appearance.
201
Which of the following is least likely to respond to oxygen therapy?
A. Cyanide toxicity
B. V/Q mismatch
C. Hypoventilation
A. Cyanide toxicity
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Dog that is mydriatic, bradycardic, ataxic and dribbling urine
THC toxicity
203
Most common clin path abnormality with Hepatozoon americanum?
Neutrophilia
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Mechanism of orlistat?
Decreased absorption of lipids from intestinal tract and increased satiety.
205
Zoonotic disease from both dogs and horses
Staph aureus
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Most common community acquired cause of pneumonia in cats
Mycoplasma
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Most common cause of discospondylitis in dogs
Staphylococcus
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Drug that can cause clinically significant hypothyroidism AND cross blood prostate barrier
TMPS
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Carrier for copper in the blood
Cerruloplasmin
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What would support an iron deficiency anemia?
Decreased saturation of serum transferrin levels
211
Cavalier King Charles Spaniel comes in for dietary indiscretion and acute vomiting and estimated to be 10% dehydrated. On CBC has 25,000 platelets. How to treat first?
Fluid therapy
Note: Congenital macrothrombocytopenia is normal in this breed
212
Old cat with DKA. Give bloodwork showing severe acidosis, mild hypokalemia, severe hypochloridemia, severe hyperglycemia, ketonuria and glucosuria. How to treat first?
Fluid therapy
If there is a choice choose plasmalyte or norm R over saline
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Inappetant cat for 10 days. Bloodwork showing ALT 200s, ALP 600s, GGT 7, Tbili 4. Most likely diagnosis?
Hepatic lipidosis
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Poodle with elevated ALT 600s, ALP 200s, mild hypoalbuminemia, elevated Tbili, normal BUN/Creat. Most likely diagnosis?
Afaloxtoxicosis
215
Old Labrador with moderate anemia that is NOT Coombs positive, hyperbilirubinemia, hypoalbuminemia,
hypocholesterolemia. What is the most likely diagnosis?
Hemophagocytic histiocytic sarcoma
216
Cat with thoracic effusion. Effusion is light gold and has non-degenerative neutrophils, protein 8 g/dL, WBC 5000/uL. What’s the most likely diagnosis?
FIP
217
Mechanism of action of ascites with FIP?
Virus triggering VEGF leading to leakage of fluid.
Note: Production of vascular endothelial growth factor by infected monocytes may be lead to increased vascular permeability and contribute to cavitary effusion
218
2 YO dog with hemothorax – PT more elevated than PTT with 80,000 platelets. Most likely diagnosis?
Vitamin K antagonist toxicity
219
What cell type is lost causing lymphopenia in cats with FeLV/FIV?
CD4+
220
What is the mechanism of PU/PD in hypercalcemia of malignancy?
Inhibition of effect of ADH
221
Primary hyperparathyroidism
Give an elevated ionized calcium and normal PTH, what’s the diagnosis?
222
Mechanism of PU/PD in chronic renal disease?
Solute overload due to loss of nephrons which leads to osmotic diuresis
223
Cat with IRIS Stage 3 CKD, UPC 0.5 repeated 3 times, with a negative urine culture. How to treat?
Enalapril
224
What electrolyte abnormality worsens digoxin toxicity?
Hypokalemia – Digoxin competitively binds at K binding site on Na/K ATPase, so with less K, more
digoxin binds which worsens toxicity
225
Vaginal cytology of an intact female dog: no blood, no neutrophils, but angular epithelial cells with small nuclei
Estrus
226
What effect does stimulation of the baroreceptors have?
Activation of the vagal center
227
Mechanism for neutrophil killing?
Respiratory burst via NADPH oxidase
228
What would IV lipid emulsion therapy be useful in treating?
Ivermectin toxicity
229
What should one of the goals be within 6 hours when following the goal of directed sepsis therapy?
Attain MAP of at least 65 mmHg
230
What is the most common action by the liver in phase II drug metabolism?
Glucoronidation
231
Calculate an odds ratio given a table of numbers.
Calculate sensitivity and specificity (kind of tricky; given % sensitivity and supposed to calculate how many do NOT have the disease in that study, so you need to be able to fill out the table.
232
Calculate anion gap and try to predict what more is going on given a blood gas
This patient has REALLY high bicarbonate; answer might have been paradoxical aciduria
233
What is one mechanism of Pimobendan?
Enhanced sensitivity to calcium
234
What drug is MESNA used for?
Ifosfamide -- Mesna used to decrease risk of hemorrhagic cystitis with cyclophosphamide or ifosfamide
235
Interpret a low dose dexamethasone suppression test that shows no suppression at 4 or 8 hours.
Consistent with hyperadrenocorticism but can’t identify which type
236
What is the ideal diet for a cat with diabetes?
High protein, low carb
237
Dog with lipemic sample 12 hours after a meal. What causes it?
VLDL
238
What enzyme in the adrenal cortex is stimulated by ACTH?
Cholesterol desmolase
239
Markers that could be found on B cells?
CD21, CD45, CD79
240
What is HCO3- secretion in the pancreas associated with?
Osmotically draws water into secretion
241
What is responsible for automaticity in the SA node?
Slow Na and Ca channels
242
What is the most important in regulating intestinal motility?
Myenteric plexus
243
What has the greatest effect on resistance?
Vessel radius
244
If you have alveoli that are getting low oxygen, what happens in the tissues immediately adjacent to them?
Constriction of capillaries, moving blood to parts of the lung that are better aerated
245
What is the mechanism of action of botulinum toxin?
Inhibition of acetylcholine release from the presynaptic membrane
246
When should you treat Salmonella?
When clinically necessary due to clinical signs
247
What does cisplatin do to cats?
Pulmonary edema
248
Most specific test for feline asthma?
>25% eosinophils in bronchoalveolar lavage
249
What is the definition of functional residual capacity?
The volume of air left in the lungs at the end of a normal expiration
250
Immune molecule most commonly associated with IMHA?
IgG
251
Treatment of choice for Boxer histiocytic ulcerative colitis?
Enrofloxacin
252
What is contra-indicated in head trauma?
Methylprednisolone
253
What first line treatment has the highest initial response rate for perianal fistulas?
Cyclosporine
254
What does TLR-4 recognize?
LPS
255
What is stimulated with acid in the duodenum, fatty acids/amino acids and something else?
Acetylcholine -- released in response to H+, FAs, AAs in duodenum
256
What causes increased contractility?
Increased extracellular calcium
257
What is typical of presentation of hypoadrenocorticism?
Chronic vague GI signs due to low cortisol
258
What does RDW represent on a CBC
Anisocytosis
259
Cause of hyperkinetic pulse?
Aortic insufficiency and PDA
260
Most common clinical signs of hepatic encephalopathy in cats?
Aggression, hypersalivation, seizures
261
What disease process could worsen hepatic encephalopathy?
Metabolic alkalosis -- More NH4+ is converted to NH3 which can cross BBB making signs worse
262
What is the toxic mechanism behind the glycoside plants (foxglove, kalanchoe, etc)?
Inhibition of Na/K/ATPase pump
263
Which of the following could be used as a prokinetic thanks to its acetylcholinesterase inhibitor activity?
Neostigmine
264
Mechanism of action of the antiemetic maropitant citrate?
NK-1 antagonist
265
Essential fatty acid in dogs and cats?
Linoleic or linolenic – also arachidonic acid in cats
266
What makes glargine long-acting?
Formation of crystals in the SQ
Note: Slowly reversible binding to albuminàdetemir insulin
267
What would be decreased in pulmonary hypertension?
Prostacyclin
268
Which of the following inhibits platelet aggregation?
Nitric oxide
269
What is the most potent chemokine produced in the arachidonic acid cascade?
Leukotriene B4
270
What detects glycoproteins? Can’t quite remember the question.
CD40 – receptor for TNFa
271
Mechanism of action of clopidogrel?
Irreversible binding of ADP-receptor on platelets
272
What do microRNAs do?
Supress gene expression
273
What inhibits glucagon release?
Somatostatin
274
What does hyperthyroidism decrease in order to cause increased glomerular filtration rate?
Total peripheral resistance
275
What heartworm test is more sensitive in cats than in dogs?
Heartworm antibody -- Such small worm burden, antigen levels will likely not be identified
276
Mechanism of action of doxycycline?
Inhibition of 30s ribosomal unit
277
Cause of pre-hepatic portal hypertension?
Portal vein atresia
278
What are serum bile acids useful in determining?
a. Hepatic versus post-hepatic cholestasis
b. Hypoalbuminemia due to PLE versus liver dysfunction
c. Intrahepatic versus extrahepatic portosystemic shunts
B. Hypoalbuminemia due to PLE versus liver dysfunction
279
Which respiratory parasite would you diagnose via Baermann?
Aelurostrongylus
280
What does cranial nerve III innervate?
Pupillary muscle
281
What is the most common cause of megaesophagus in dogs?
Myesthenia gravis
282
Where are apotransferrin and apoferritin located?
Apotransferrin is transferrin before it is bound to Fe3+ which moves through circulation to BM or Liver. Apoferritin is before iron binds it and is located in the cell for iron storage.
283
What is the cause of elevated triglycerides in a fasted blood sample
VLDL (if ask for a second option then LDL)
284
What infectious disease can cause hypercalcemia?
Granulomatous infections ie blasto
285
When does ventricular filling occur?
Prior to/at third heart sound after isovolumetric relaxation
286
What CBC change would you see in cats that have diabetes, hyperthyroidism, or lymphoma?
Heinz bodies
287
Mechanism of action of omeprazole
H/K/ATP pump inhibitor
288
How is cobalamin absorbed?
The Cobalamin- intrinsic factor complex is absorbed by receptors in the ileum to mid-jejunum in dogs, and in cats (and humans) only in the ileum. This membrane-bound receptor is called the Cubam receptor
289
Where is CSF made and stored?
choroid plexus epithelium and ependymal cells of the ventricles and flows into interconnecting chambers; namely, the cisterns and the subarachnoid spaces.
290
Most common bacteria in canine pyoderma
Staph pseudintermedius
291
What does fetal hemoglobin do?
Is O2 affinity greater for fetal hemoglobin or adult hemoglobin? Would fetal hemoglobin shift hemoglobin oxygen curve to left or right?
Hb F evolved to potentiate the transfer of oxygen (O2) from maternal blood to fetal tissues, a goal achieved by the higher O2 affinity of Hb F compared with adult Hb A. This is largely due to the insensitivity of Hb F to 2,3 BPG (sometimes called 2,3 DPG), the major modulator of hemoglobin-O2 affinity.J
Shift curve to R
291
How do you prevent the regrowth of a polyp after removal from a cat ear
bulla osteotomy
291
On PARR, leukemia vs lymphoma?
CD34?
292
What is an early sign of nsaid acute cortical nephrotoxicity
urine tubular casts
293
How to diagnose uroabdomen in the dog
a diagnosis of uroabdomen can be made if the creatinine ratio is ≥2:1
294
How to diagnose chylous effusion in dog - what lipid molecule do you measure?
Chyle is made primarily of chylomicrons, an aggregate of long-chain triglycerides, cholesterol esters, and phospholipids. It is also rich in lymphocytes,
295
How is chlostridium teteni transmitted?
by the direct transfer of C. tetani spores from soil and excreta of animals and humans to wounds and cuts
296
6 week old GSD is regurgitating and not gaining weight. It was recently weaned. What is the most likely cause?
PRAA causing megaesophagus
297
What organism would you diagnose if you saw morulae in a neutrophil in the southwestern USA?
Anaplasma
298
What endothelial derived factor is reduced in pulmonary hypertension?
Prostacyclin
299
What hormones acts on the small intestine to inhibit peristalsis?
glucagon
300
Is conjugated bilirubin bound to protein in order to travel though body?
No, but unconjugated is bound to albumin
301
What are some disease processes that cause hypokalemia?
Hyperaldosteronism, metabolic alkylosis (or respiratory?), renal tubular disease, loop diuretics, vomiting/diarrhea, endotoxemia, and due to insulin release
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