SAM I Final Exam Material Flashcards
(173 cards)
1
Q
What are the signs of systemic distemper?
A
fever, nasal/ocular discharges, chorioretinitis, diarrhea, vomiting, pustular dermatitis, enamel hypoplasia, “hard pad”
2
Q
T/F: Occult heartworm infections are very rare in cats
A
False
Occult heartworm infections are very common in cats (up to 80%)
3
Q
What is the initial treatment protocol in a dehydrated dog with PU/PD?
A
IV Fluids
Large volumes of 0.9% NaCl delivered via a jugular catheter are ideal. Rapid administration of IV fluids restores blood volume and improves renal perfusion which decreases serum potassium concentration via dilution and promotion of renal potassium excretion.
4
Q
What should you be monitoring in any Lyme positive dog?
A
urine protein‐ creatinine ratio (UPC)
- Every Lyme positive dog, regardless of symptomatic or not, should be tested for proteinuria.*
- If urine protein‐ creatinine ratio (UPC) is elevated, treat for Lyme disease and monitor UPC.*
5
Q
Which of the following is found in the salivary gland of the tick: OspA or OspC
A
OspC
- OspA is outer surface protein expressed on borreliae in midgut of infected nymph ticks. This protein allows bacteria to ‘stick’ to gut epithelial cells.*
- When ticks ingest blood meal, the OspA expression is down‐regulated & OspC expression is up‐regulated. OspC allows bacteria to ‘stick’ to tick salivary glands. Borrelia migrate from midgut of tick to hemolymph to salivary glands. Thus reservoir host is infected via tick saliva.*
6
Q
Most thoracolumbar disc protrusions are between what spinal cord segments?
A
T11 and L2
7
Q
Crossed-extensor reflex in a dog in lateral recumbency is indicative of a ____ lesion
(UMN/LMN)
A
UMN
There are long spinal reflexes between limbs that are usually suppressed by UMNs. Damage to the UMNs releases this inhibition and flexion of one limb in response to a noxious stimulus is accompanied by extension of the contralateral limb.
8
Q
Sudden neurologic signs that result in death within 10 days in any dog or cat should make one suspicious of:
A
rabies!
9
Q
Without lifelong replacement therapy, dogs with hypoadrenocorticism invariably die. What are the 2 choices of long-term maintenance therapies?
A
(1) DOCP + Prednisolone or (2) Fludrocortisone
- Desoxycorticosterone pivalate (DOCP) is a mineralocorticoid therapy. DOCP has no glucocorticoid activity, so must be given with prednisolone
- Fludrocortisone does provide some glucocorticoid activity and therefore, additional prednisolone supplementation isn’t usually required except during periods of stress
10
Q
T/F: In the postictal phase of tonic-clonic seizures, animals very rapidly regain consciousness and soon appear normal
A
False
- This phase is a gradual return to consciousness with varying degrees of depression, fatigue, fright, dazed appearance, aimless pacing, thirst, or hunger. Occasionally, neurological deficits such as blindness, paresis and/or incoordination may occur during this period.*
- Postictal depression may last for seconds to days (average about 5 hours)*
11
Q
If a patient is undergoing treatment for leptospirosis and they are unable to tolerate doxycycline, what other anitibiotic may be used?
A
ampicillin or penicillin G
If doxycycline cannot be tolerated by the patient, ampicillin or penicillin G can be started. Follow with doxycycline 5 mg/mg bid to eradicate carrier state and the shedding of the bacteria in urine. Doxycycline is eliminated primarily in the feces, so is safe to use in dogs with renal insufficiency.
12
Q
What changes on a hemogram are observed in dogs with Babesia?
A
hemolytic anemia & thrombocytopenia
anemia, thrombocytopenia, fever and splenomegaly are all are fairly consistent findings, regardless of genotype, geographic region or host species
13
Q
T/F: Rocky Mountain Spotted Fever (RMSF) is clinically indistinguishable from acute ehrlichiosis
A
True
Clinical signs most frequently reported with Ehrlichia are depression, lethargy, anorexia, fever, lymphadenomegaly, splenomegaly and hemorrhages. More of a bleeding problem with E. canis than RMSF
14
Q
What is the drug of choice for treatment of Ehrlichia?
A
Doxycycline
15
Q
If a dog presents to your clinic with truncal alopecia, obesity, and lethargy, what might be at the top of your differential list?
A
Hypothyroidism
16
Q
An abnormal, sustained spasm of the facial muscles that appears to produce “grinning” is termed:
A
Risus sardonicus
- This is one of the main clinical signs associated with Tetanus*.
- Other signs of tetanus include sawhorse stance, erect ears, third eyelid protrusion, trismus (lock jaw), increased salivation, laryngeal spasm, dysphagia, opisthotonus, convulsions*
17
Q
T/F: Fibrocartilaginous emboli is associated with paresis or paralysis that is lateralizing and not painful
A
True
18
Q
At what age can you test a kitten for FeLV and not worry about maternal antibodies?
A
Any age
- We’re not concerned about antibodies with this disease. Test checks for antigen!*
- However, the ELISA assay cannot predict whether a cat is transiently or persistently infected. Therefore, any [+] ELISA needs to be retested after 8 to 12 weeks or a FeLV IFA needs to be done. ELISA [+], IFA negative cats should be retested in 2-3 months.*
19
Q
Identify the arrhythmia.
A
Atrial fibrillation
Note the absence of P waves and the variable R-R intervals
20
Q
What percent of dogs exposed to Lyme do NOT DEVELOP signs?
A
90-95%
90‐95% dog exposed to B. burgdorferi remain asymptomatic. Organism probably does not invade connective tissues.
21
Q
If a dog presents with symmetric, ascending flaccid quadriparesis/quadriplegia, what should be at the top of your differential list?
A
Botulism
May also see CN signs: mydriasis, decreased gag reflex, megaesophagus
22
Q
Trismus is typically seen as a symptom of:
A
Tetanus
Trismus (lock jaw) is a spasm of the jaw muscles, causing the mouth to remain tightly closed
23
Q
Which virus causes cerebellar hypoplasia in dog?
A
canine herpesvirus
24
Q
What medications are included in Triple Therapy for treatment of Helicobacter?
A
Amoxicillin + Metronidazole + H2 blocker (famotidine, ranitidine, or omeprazole)
25
What clinical signs do *Ehrlichia/Anaplasma* have in common with *Borrelia*?
**lameness, fever, lethargy**
26
You finish vaccinating a puppy and on the way home, the owner calls you to tell you the puppy's face is swelling up. What type of vaccine reaction is this?
**Type I**
## Footnote
***IgE hypersensitivity***
27
T/F: ***Campylobacter*** is usually associated with signs of small intestinal diarrhea
**False**
*It usually shows large bowel diarrhea, which may be acute, intermittent, or chronic, but feces can be loose to watery to bloody & mucoid*
28
A small, lactating bitch presents 4 weeks after welping with tetany. What do you expect to see with regard to calcium levels?
**hy**_po_**calcemia**
29
T/F: Dogs with **parvovirus** are actually suffering from Gram‐negative sepsis
**True**
* Several studies have shown that the clinical signs associated with parvovirus infection is the result of bacteremia and the most likely source is bacterial translocation from the injured intestines.*
* Dogs with parvovirus are actually suffering from Gram‐negative sepsis*
30
Radiographically, what is the most consistent feature associated with **endocardiosis**?
**left atrial enlargement**
31
Between ***Hepatozoon americanum*** and ***Hepatozoon canis***, which one causes a more severe disease?
***Hepatozoon americanum***
*PCR testing can differentiate between H. canis and H. americanum*
32
T/F: In the dog: parvovirus, lyme, bordetella, and leptospirosis vaccines are **core vaccines**
**False**
*Lyme, bordetella, and leptospirosis vaccines are NOT core vaccines in the dog.*
_Distemper, parvovirus, rabies, and hepatitis are core vaccines in dogs_
33
T/F: The PCR test for ***Babesia canis*** is specific and will not detect other species.
**True**
*The PCR test for Babesia gibsoni, however, will detect a variety of species*
34
T/F: Cats found to be infected with **FIV** should be euthanised immediately as they have a very poor prognosis and because the virus is closely related to human immunodeficiency virus, it may be a zoonoses
No.
35
What diseases in the dog (that we have discussed in class) do we use **amoxicillin** to treat?
**salmonella, helicobacter, lyme**
36
Which of the following hormones does _not_ increase hepatic gluconeogenesis and glycogenolysis?
* Insulin
* Growth hormone
* Glucagon
* Cortisol
* Epinephrine
**Insulin**
37
Does the **FeLV ELISA** SNAP test check for antibodies or antigens to FeLV?
**antigen**
*which means you can test a kitten for FeLV at any age and not worry about maternal antibodies :)*
38
A 6-week-old MaltiPoo is diagnosed with hypoglycemia. What is the most likely diagnosis?
* Immature glycolytic and gluconeogenic enzymes
* PSS/MVD
* Hepatic carcinoma
* Insulinoma
**Immature glycolytic and gluconeogenic enzymes**
39
What is the most common systemic fungal disease in cats?
**Cryptococcosis**
40
For PCR determination of **leptospirosis**, what is the sample of choice during the first week of infection?
**blood**
* Blood is the sample of choice during the first week of infection since organism numbers are highest in blood at that time.*
* After 10 days of infection, organisms are found in greater numbers in _urine_.*
* If the time of infection is unknown, both blood and urine can be submitted to reduce the chance of false‐negative results.*
41
What is your initial treatment protocol for **severe heart failure**?
**O2 & Furosemide**
42
T/F: Botulism, tick paralysis, and coonhound paralysis all cause **flaccid paralysis** in the dog
**True**
43
What tick is responsible for transmission of ***Borrelia***?
**Ixodes spp.**
44
A 12 week old puppy presents with stiff rear limbs. Within 3 days, both are so rigid that you cannot flex the joints.
What is the likely cause of disease?
***Neospora caninum***
*multiple pups in litter may be affected; paraparesis that develops into extensor rigidity, limb atrophy; can progress to quadriparesis, CN signs, death*
45
You're performing a low dose dexamethasone suppression test (LDDST) and you observe a high basal cortisol sample. If 4 hours later the cortisol is less than 50% of baseline, what is your diagnosis?
**Pituitary-dependent hy**_per_**adrenocorticism**
46
What infectious organisms can cause acute **hemorrhagic** diarrhea?
**parvovirus, salmonella, salmon poisoning, giardia, ICH**
47
What cells in a dog’s body does **parvovirus** like to ‘mess with’?
**rapidly dividing cells**
*intestinal crypts, lymphoid tissue, and bone marrow*
48
T/F: 90-95% of dogs exposed to *Borrelia burgdorferi* do not develop clinical signs
**True**
*God damned mystery*
49
What is the best stand alone hormone assay (accuracy) to diagnose **hy**_po_**thyroidism**?
**fT4**
*Excellent but expensive because must be determined by equilibrium dialysis; Not affected by circulating antiT4 autoantibodies; not as affected by concurrent illness or drugs as T4*
50
T/F: In the dog: distemper, parvovirus, parainfluenza, and hepatitis vaccines are **core vaccines**
**False**
*Parainfluenza is NOT a core vaccine in the dog.*
*_Distemper, parvovirus, rabies, and hepatitis are core vaccines_.*
51
The insulin and dosing schedule of choice in a cat associated with an 80% induction of remission:
* Vetsulin/Lente BID
* PZI SID
* Glargine BID
* Glipizides
* Alpha glucosidase inhibitors
**Glargine BID**
52
The insulin and dosing schedule of choice in a dog is:
* Lente (Vetsulin) BID
* Lente insulin SID
* PZI SID
* Glargine SID
**Lente (Vetsulin) BID**
53
Why is blood PCR not considered a good test for diagnosing **Lyme disease**?
**Lyme 'hides' in joints**
*PCR on blood is likely to be negative as spirochetemia in dogs is rare. However in experimentally induced infections, PCR on punch biopsy skin samples taken at inoculation site showed a peak in spirochete numbers at day 60 post infection; this was same time that clinical signs of arthritis developed. Synovial tissue biopsy is preferred over joint fluid for PCR.*
54
What drug should be given to a dog in an **Addisonian crisis** for glucocorticoid replacement therapy?
**dexamethasone**
*Dexamethasone preferred as it will not interfere with the ACTH stimulation assay; in addition, a single dose of short-acting corticosteroid will not suppress the hypothalamic pituitary adrenal axis.*
55
T/F: **Endocardiosis** is characterized by decreased contractility of the heart
**False!**
*In patients with endocardiosis, there is thickening and contraction of the AV valve, resulting in valve incompetence. The heart compensates by increasing sympathetic tone, which **increases contractility***
56
T/F: **ACE Inhibitors** block myocardial remodeling induced by RAAS in CHF
**True**
*ACE inhibitors slow the progression of heart failure, block remodeling and fibrosis due to Angiotensin II and aldosterone, enable up to 50% reduction in furosemide dosage, & prolong and improve quality of life*
57
Will a Lyme vaccine give you a false positive result with the **Idexx C6 Antibody SNAP test**?
**No.**
*C6 protein is not expressed in the tick, in tissue culture, or in Lyme vaccines, so _C6 test can differentiate between natural infection and vaccine‐induced antibodies_*
58
What is **"triple therapy"** and which infectious agent is it used for?
**Amoxicillin + Metronidazole + H2 blocker (famotidine, ranitidine, or omeprazole)**
*Used to treat _Helicobacter_*
59
What is the adulticide drug of choice for treatment of heartworm in dogs?
**Melarsomine**
60
T/F: A positive isolation from the feces can confirm that **Salmonella** is the cause of disease
**False**
*A positive isolation from the feces does not mean that Salmonella is the cause of disease, because it can be isolated from healthy animals*
61
At what age can a dog be vaccinated against **Lyme disease**?
Are boosters needed and if so, when?
**as early as 12 weeks of age**
*Vaccines are initially given as a series of 2 vaccines, 2‐4 weeks apart. Lyme vaccine should be re‐administered (boostered) annually*
62
The treatment for hyperthyroidism with the best outcome (longest survival) is:
**Radioactive iodine (I131)**
*Hyperthyroidism is typically cured with one dose of radioactive iodine (\>95% of cases with only carcinoma cats requiring a second higher dose). Considered gold standard therapy by many especially for cases with thyroid adenocarinoma and metastasis (treated with a higher dose).*
63
T/F: Strabismus is commonly associated with **Horner's Syndrome**
**False**
*Horner's Syndrome is marked by miosis most commonly, but there can also be ptosis, enophthalmos and protrusion of the membrana nictitans.*
* *_miosis_: constriction of the pupil*
* *_ptosis_: drooping of the eyelid*
* *_enophthalmos_: posterior displacement of the eyeball*
64
T/F: In KITTENS: Rhinotracheitis, Panleukopenia, Calicivirus, and FeLV vaccines are **core vaccines**
**True**
In kittens: Rhinotracheitis, Panleukopenia, Calicivirus, and FeLV vaccines are core vaccines. Rabies is also a core vaccine in felines
65
What is the most specific test for diagnosing **hy**_po_**thyroidism** in the dog?
**TT4/TSH**
66
A Great Dane presents with LMN signs in all 4 limbs, tetraparesis and decreased tone in all 4 limbs; and its reflexes are reduced to absent. What is your most likely diagnosis?
**Coonhound paralysis**
67
Difficulty breathing while lying down is termed:
**orthopnea**
68
A dog has a [BG] \> 300 mg/dL several hours each day (within 10 hours of dosing), fructosamine \> 500 umol/L, persistent clinical signs with a [BG] nadir of 80 mg/dL.
What is the problem?
**Duration of action too short**
69
Regarding titers for **toxoplasmosis**: how is diagnosis of this disease made?
**High IgM titer or 4x increase in IgG titer over 2‐4 wks**
70
Identify the arrhythmia.
**Sinus Arrhythmia**
## Footnote
*There is a normal P wave for every normal QRS complex, but the _R-R intervals vary_*
71
What is an important prognosticator in **adrenal tumors**?
* Post ACTH [cortisol]
* Location (right worse than left)
* Presence of metastasis
**Presence of metastasis**
*About 50% of the adrenal tumors are benign (adenomas) and 50% malignant (adenocarcinomas). The malignant tumors tend to be larger, more invasive, and metastasize to the lungs and liver. These tumors episodically secrete large amounts of cortisol and cause atrophy of the contralateral adrenal gland.*
72
What is the drug of choice for treatment of **Lyme disease**?
**Doxycycline**
73
You start a 5-year-old miniature snauzer on **Desoxycortisone pivilate (DOCP)**. How would you determine if the dose administered is appropriate?
**measure serum electrolytes**
*To assess the dose, check electrolytes on day 12 to 13 post injection for the first 1-2 months. Potassium (K) should be towards the low end of the normal range and sodium (Na) toward the high end. If K is high, then increase the next dose by 10%*
74
The ideal range of [BG] in a diabetic dog on insulin therapy is:
**100-250 mg/dL**
75
What metabolic problems should you anticipate occurring with canine parvovirus (think about what you might find on a chemistry profile or hemogram)?
**hypoglycemia, hypokalemia, anemia, leukopenia**
76
What drugs do you use to treat **toxoplasmosis** in dogs?
**Clindamycin** or **Pyrimethamine-sulfa**
## Footnote
* Clindamycin 10‐20 mg/kg (dog); 10‐12.5 mg/kg (cat); PO BID x 2 – 4 weeks*
* or*
* Or sulfadiazine 30 mg/kg PO BID with pyrimethamine 0.25 to 0.5 mg/kg PO BID x 4 weeks*
77
What infectious disease is known for causing **acute renal failure**?
What infectious disease is known for causing **acute hepatic failure**?
What infectious disease is known for causing both **acute renal & hepatic failure**?
* Acute _renal_ failure: **Lyme disease**
* Acute _hepatic_ failure: **Infectious canine hepatitis**
* Acute _renal & hepatic_ failure: **Leptospirosis**
78
T/F: **Lyme nephropathy** is believed to be caused by an inflammatory response to renal invasion of organisms
**False**
*The exact causative mechanism has not been proven, but it is NOT caused by an inflammatory response to renal invasion of organisms*
79
T/F: **Fibrocartilaginous embolus** is typically not associated with pain
**True**
80
What has been the standard method of diagnosing **leptospirosis**?
**Microscopic agglutination test (MAT)**
81
T/F: Prednisolone can be used instead of cage rest in dogs that are mildly effected by **thoracolumbar intervertebral disc disease**
**False**
*Corticosteroids given without cage rest often results in temporary improvement and then relapse with far more severe signs*
82
In dogs with dilated cardiomyopathy (DCM), **atrial fibrillation** is best controlled with:
**β-blockers**
*In dogs with DCM, atrial fibrillation is best controlled with β-blockers such as atenolol or metoprolol.*
83
If an older cat presents to your clinic with weight loss and a good appetite, what should be at the top of your differential list?
**Hy**_per_**thyroidism**
84
A **parvovirus** dog that continues to vomit despite in hospitalization antiemetics and proper treatment should be evaluated for what?
**foreign bodies, intussusception, pancreatitis**
85
What are the expected hormone changes with true **early clinical primary hy**_po_**thyroidism** from **lymphocytic thyroiditis**?
**↑ TGAA, ↓ TT4, ↓fT4, ↑TSH**
86
A 4-month-old cat tested FIV [+] on your in-house ELISA snap test. What is the most likely cause?
**Maternal antibodies**
* Maternally derived antibodies to FIV in kittens younger than 6 months of age may result in [+] ELISA and [+] Western Blot test results.*
* Kittens born to infected queens may test [+], yet most will not be infected. To clarify infection status, any [+] result in a kitten \< 6 months old should be re-tested at 60-day intervals. A [+] test result in a cat older than 6 months of age is considered positive (i.e. infected). Even kittens that initially test [+] yet become seronegative prior to 6 months of age have likely been exposed, and consideration should be given to re-testing a minimum of 60 days after the last potential exposure*
87
T/F: The leptospirosis vaccine is a **core vaccine**
**False**
88
Name the **Cushing's** screening test with the highest sensitivity:
**Urine cortisol:creatinine**
*In dogs with nonadrenal illness, false positive results are highest for the urine cortisol:creatinine ratio, then the LDDST, and then the ACTH stimulation test.*
89
T/F: The same drug is used in treatment of **Ehrlichia** and **Borrelia**
**True - Doxycycline**
90
T/F: Cats infected with **FeLV** will inevitably develop clinical signs
**False**
91
What is a good screening test for young dogs that have signs of **hepatozoonosis** in North America?
**Radiographs**
* Look for normal or periosteal bone proliferation near muscle attachments (more common in dogs less than 1 year old). Good screening test for the disease.*
* Auburn has developed a _Quantitative PCR_ detects the 18S rRNA gene of this organism. Capable of diagnosing American canine hepatozoonosis with high sensitivity (as few as 7 organisms per ml blood) and specificity. Discriminates H. americanum from other similar protozoa such as H. canis, Babesia gibsoni, and Babesia canis.*
92
T/F: Since many **Greyhounds** are subclinical carriers of *Babesia*, using them as blood donors is acceptable as long as they are asymptomatic
**False**
*Severe hemolytic anemia, thrombocytopenia & life‐threatening disease have been reported in young dogs, heavily parasitized dogs, & _dogs transfused with infected blood_*
93
What is the most common cause of vaccine failure in young pets?
**persistent maternal antibodies**
*Maternal Ab block vaccine from inciting immune response. Young pets susceptible to disease until vaccine series is done.*
94
If you start an Addison's patient on **Desoxycorticosterone pivalate (DOCP),** how do you assess the dosing?
**check electrolytes**
*To assess the dose, check electrolytes on day 12 to 13 post injection for the first 1-2 months. Potassium (K) should be towards the low end of the normal range and sodium (Na) toward the high end. If K is high, then increase the next dose by 10%.*
95
What is the most important dietary component in **diabetic cat** diets?
**High protein (\>45% ME)**
96
**OspA** is an outer surface protein expressed on borreliae in __________ of infected nymph ticks
**midgut**
*OspA is outer surface protein expressed on borreliae in _midgut_ of infected nymph ticks. This protein allows bacteria to ‘stick’ to gut epithelial cells.*
97
What is the most frequent cause of **myoclonus** in dogs?
**Canine distemper**
98
What species of *Babesia* is most commonly found in **Pit Bulls**?
***Babesia gibsoni***
99
You can diagnose **giardia** by finding cysts or trophozoites in samples from the GI tract or in feces.
T/F: A negative result is a reliable way to rule out giardiasis
**False**
*A negative result never rules out giardiasis because it is an _intermittent shedder_*
100
What drug is used to treat cryptococcosis _if there are CNS signs or if the cribiform plate is involved_??
**Fluconazole**
*Itraconazole if no CNS signs. If CNS signs or if cribiform plate is involved, use fluconazole because it crosses blood brain barrier. Treatment is long term (go 2 months beyond a negative antigen test): \>6 months and sometimes for years.*
101
How are **rabies** and **pseudorabies** alike? Different?
**They have similar clinical signs (seizures, behavioral changes, pruritus, self mutilation, rubbing, salivation), but _pseudorabies only occurs in places where the disease is endemic in swine_**
102
Does the **FIV ELISA** snap test check for _antibodies_ or _antigen_? Why is this question important?
**antibodies**
* Testing for FIV infection has relied almost exclusively on antibody detection, as viral load, and thus ability to detect antigen is often low, especially in the early stages of infection.*
* When we get a positive FIV test in a kitten younger than 6 months, we don’t know if it is maternally derived antibody (most common senario) or antibody made by the kitten because it has a FIV infection (from mother or from fighting with another FIV + cat), or if kitten was previously vaccinated for FIV*
103
**Hy**_per_**thyroidism** is typically a disease of the cat caused by the excessive production and secretion of ________ and \_\_\_\_\_\_\_\_.
**T3 & T4**
*Hyperthyroidism is typically a disease of the cat caused by the excessive production and secretion of _thyroxine (T4)_ and _triiodothyronine (T3)_. These hormones influence cellular metabolism in multiple organs by increasing the metabolic rate.*
104
Which screening test has better sensitivity in screening for Cushing's:
ACTH stimulation test or LDDS?
**LDDS**
* LDDST: more sensitive (\>95%) but less specific (44-73%)
* ACTH stim: less sensitive (80%) but more specific (85%)
105
If a dog with **distemper** is *only* showing neurological signs, is it shedding the virus?
**No.**
106
T/F: Most dogs infected with ***Babesia canis vogeli*** in the United States are subclinical carriers
**True**
107
T/F: Adult heartworms usually die within a few hours after treatment with **Melarsomine**
**False**
*Worms mostly die between 3 and 21 days after therapy is completed*
108
Briefly describe the pathophysiology of **rickettsial organisms**:
**Rickettsiae enter circulation and replicate in endothelial cells of capillaries & small blood vessels, causing direct damage (vasculitis & necrosis).**
**Vasculitis leads to extravasation of fluid & RBCs into extravascular space creating edema, hemorrhage, hypotension, and potentially shock.**
109
T/F: About 1/3 of **leishmaniasis** patients have fever and splenomegaly
**True**
110
In your diabetic patient, when insulin administration results in hypoglycemia (which may or may not be clinically evident) and subsequent rebound hyperglycemia, this is referred to as:
**Somogyi effect** (insulin-induced hyperglycemia)
## Footnote
*The Somogyi effect is demonstrated by documenting a BG \< 65 mg/dl followed by a BG \>300 mg/dl within one 24 hour period of time. Morning BG values are usually high (400 - 450 mg/dl) in these patients.*
111
What dogs should be vaccinated for Lyme disease?
**dogs in Lyme-endemic areas**
* In endemic areas, vaccinating young pups before tick‐borne exposure to B. burgdorferi may give the best protection against Lyme disease,*
* Vaccines are initially given as a series of 2 vaccines, 2‐4 weeks apart. Lyme vaccine should be re‐administered (boostered) annually.*
112
With which canine infectious disease do we observe **periosteal bone proliferation** near muscle attachments?
**Hepatozoonosis & Valley Fever (*Coccidioides*)**
113
Why do vets that are examining a dog or cat with diarrhea, often empirically treat it for **Giardia**?
**to rule it out**
*To diagnose giardia, you may find cysts or trophozoites in samples from the GI tract or in feces. A negative result never rules out giardiasis because it is an intermittent shedder, so it is recommended to “treat for it” even if cysts or trophozoites can not be found in samples*
114
T/F: Every dog that tests positive for **Lyme disease** should be tested for proteinuria, regardless of whether they're symptomatic or not
**True**
115
What is the diagnostic test of choice for screening a cat with suspected hy**_per_**thyroidism?
**TT4**
116
T/F: The **leptospirosis** vaccination protects against all pathogenic serovars of the organism
**False**
*Response to vaccine is fairly serovar‐specific, so clinical infections may still occur with serovars that are not included in the vaccine*
117
What infectious diseases can be spread via **urine**?
****_h_**erpesvirus, **_i_**nfectious canine hepatitis [ICH], **_l_**eptospirosis, **_b_**rucellosis**
118
How is ***Brucella*** most commonly transmitted?
**Sexually**
* Most common transmission: reproductive*
* Other means of transmission: oral, conjunctiva*
119
What are the main signs associated with **vestibular disease**?
**head tilt, circling (to the affected side), and nystagmus**
120
What is the most common endocrinopathy of older cats?
**Hy**_per_**thyroidism**
* Mean age = 12 years*
* Caused by excessive production of T4 and T3. 70% of cats with hyperthyroidism have bilateral tumors*
121
A dog presents with a BG reading of 62 mg/dl.
T/F: This dog is normoglycemic.
**False**
*This dog is hypoglycemic.*
122
A lactating bitch presents with **muscle fasciculations** and **tetany**. What value would you expect to be low in this patient?
**calcium**
*Clinical signs of hypocalcemia (especially muscle fasciculations, tetany, and seizures) usually only occur with severe hypocalcemia (Ca \< 6 mg/dl).*
*_For treatment_: Administer 10% calcium gluconate at a dose of 0.5 - 1.5 ml/kg IV SLOW to effect (up to 20 mls over 10 -- 30 minutes). Monitor patient with continuous ECG and discontinue IV bolus push if vomiting or bradycardia occurs. Treatment with IV bolus is continued until resolution of tetany is noted (usually note response within minutes).*
123
Regarding IgG titers for **leptospirosis**: how is diagnosis of this disease made?
**4x MAT increase over 2‐4 weeks confirms active disease**
*Since titers may be negative during the first 7‐ 10 days, demonstration of a four‐fold increase in MAT over 2‐4 weeks confirms active disease. Titers \< 1:300 are often post‐vaccinal. Titers \> 1:800 may indicate active disease. A single titer \> 1:3200 is also considered a positive diagnosis unless dog was vaccinated within last month.*
124
Anytime **insulin therapy** is initiated or changed, how soon should the animal be rechecked?
**7 days**
*Anytime insulin therapy is initiated or changed, the animal should be allowed to "equilibrate" at home for 7 days before response to insulin therapy is assessed (with the exception that we may monitor for hypoglycemia in the initial treatment period). Cats should be checked weekly during first month as may stop needing insulin.*
125
What is the vector for ***Ehrlichia canis*** and ***Ehrlichia chaffeenis***?
***Rhipicephalus***
*The brown dog tick*
126
What is considered the best diagnostic test to test for current infection with *Borrelia*?
**C6 antibody ELISA snap test**
127
T/F: **Canine wobblers** occurs most commonly in younger Great Danes and older Dobermans
**True**
*Cervical spondylomyelopathy (Canine wobblers) is most often seen in Great Danes (3-18 months) and Dobermans (5-8 years)*
128
T/F: **Pimobendan** is a vasodilator and a negative ionotrope
**False**
*Pimobendan is a vasodilator and a **positive** ionotrope*
129
What species of *Babesia* is most commonly found in **Greyhounds**?
***Babesia canis***
130
Which test do we use to monitor therapeutic response in a patient with **hy**_per_**adrenocorticism**?
* ACTH stim test
* LDDS
* [ACTH]
**ACTH stim test**
131
What drug is used to treat cryptococcosis if there are _no CNS signs_?
**Itraconazole**
* Itraconazole if no CNS signs.*
* If CNS signs or if cribiform plate is involved, use fluconazole because it crosses blood brain barrier. Treatment is long term (go 2 months beyond a negative antigen test): \>6 months and sometimes for years.*
132
Insulin with the longest duration of effect is:
* Crystalline insulin
* Human recombinant insulin/Vetsulin-Lente
* Protamine Zinc (PZI) - Ultralente
* Glargine
**Glargine**
133
In cats, **DCM** is also characterized by ventricular dilatation, apparent thinning of the ventricular walls and decreased contractility. The majority of cases in cats, however, are due to a deficiency of \_\_\_\_\_\_\_\_\_\_
**taurine**
*Unlike in dogs, this is an essential amino acid in cats as they have a limited ability to synthesize taurine. The disease is now very rare as commercial cat food makers have increased the levels of taurine in their products.*
134
Name the steroid induced isoenzyme that increases in cases of **hy**_po_**adrenocortism**?
**alkaline phosphatase (ALP)**
*Alk Phos bone isoenzyme is elevated due to increased bone turnover*
135
Vast majority of **hy**_per_**thyroid** cats have T4 concentrations greater than _____ nmol/l and this is considered to be diagnostic
**\> 60 nmol/L**
*Vast majority of hyperthyroid cats have T4 concentrations greater than **_60 nmol/l_** and this is considered to be diagnostic*
136
Which test is NOT a test used to differentiate PDH from ADH?
* ACTH stimulation test
* [ACTH]
* LDDS
* Abdominal US
* CT of the head
**ACTH stimulation test**
*Dogs with both PDH and ADH will hyper-respond to ACTH and exhibit abnormally high post-cortisol values and animals with iatrogenic Cushing's syndrome will exhibit suppressed post-cortisol levels (looks Cushingoid but stims hypoadrenocorticoid). Normal levels may be because of poor drug or drug administration or because dog is normal or false negative.*
137
Why might you perform a urinalysis on an animal with **hy**_per_**adrenocorticism**?
**urinary tract infection**
*Urine samples in animals with HAC should be routinely cultured due to the high incidence of UTI's (50%) that are typically silent*
138
How long does a tick have to be attached to a dog or human in order to transmit Borrelia?
**48-50 hours**
139
A dog presents with DKA. What investigation would you NOT recommend?
* ACTH time & US
* LDDS & US
* UA and C&S (Culture & Sensitivity)
* CPL (Canine Pancreatic Lipase) and US
**LDDS & US**
*High number of false positives, especially if the dog is concurrently sick. Even though this would be the best option in normal dogs, you would want to use ACTH stim in this case since it isn't affected by the illness*
140
What electrolyte may need to be supplemented in IV fluids during parvo treatment?
**Potassium**
141
An older male cat presents with dyspnea. You note retinal degeneration and a large cardiac sillhouette on radiographs. The cat's owner cooks the cat's meals for him.
What is your top differential?
**Dilated Cardiomyopathy (DCM)**
*With DCM, dyspnea is usually present. The retinal degeneration is suggestive of taurine deficiency (backed up by the fact that his owner cooks for him). The cardiac sillhouette on radiographs is to due to pleural effusion*
142
T/F: Clinical signs associated with **Lyme Disease** may develop 2-5 months post-exposure
**True**
143
When we talk about titers, are we usually referring to antibodies or antigens?
**antibodies**
The antibody titer is a test that detects the presence and measures the amount of antibodies within the blood. The amount and diversity of antibodies correlates to the strength of the body's immune response.
144
What is the vector for *Hepatozoon americanum*?
***Amblyomma maculatum***
145
T/F: Kittens under a year of age are at greater risk of **FeLV** infection than adults.
**True**
*There is strong age-acquired natural resistance to FeLV infection in adult cats. **Kittens under a year of age are at greater risk of infection than adults**. The risk of infection in adult FeLV-negative cats is approximately 10% to 15% if they have lived with a viremic cat for several months. Studies in cluster households have shown that virus-neutralizing antibodies do not persist life-long, so that a previously negative cat may become viremic.*
***So if owners refuse to separate housemates, the uninfected cats should receive FeLV vaccination to attempt to enhance their natural level of immunity in this environment of high viral exposure.***
146
What is the treatment of choice for **leptospirosis**?
**Doxycycline**
*Doxycycline PO or IV for 2 weeks*
147
A cat with diabetes mellitus has now developed severe electrolyte loss as well as ketonuria.
How should you treat this animal?
**SLOWLY return the patient to normal glucose, fluids, and electrolytes**
* The cat has diabetic ketoacidosis (DKA)*
* Proper therapy does not imply forcing as rapid a return to normal as possible. Because osmotic and biochemical problems can be created by overly aggressive therapy, as well as by the disease process itself (whether DKA or HHS), rapid changes in various vital parameters can be as harmful as or more harmful than no change. If all abnormal parameters can be slowly moved toward normal (i.e., over 36 to 48 hours), the likelihood of successful therapy is greater.*
148
T/F: With regard to **canine parvovirus**, there are good vaccines against the disease but vaccination failures may occur if there is interference from maternal antibodies.
**True**
149
What is the typical signalment & history associated with **feline hy**_per_**thyroidism**?
**12 year old DSH with polyphagia and vomiting**
* HyperT is the most common endocrinopathy affecting cats \> 8 years. The mean age of affected cats is _12 years_, with a range of 4 to 22 years old.*
* Classic presentation: weight loss with ravenous appetite and hyperactivity*
150
The continual or recurrent inclination to evacuate the bowels is termed:
**tenesmus**
151
What are the neurological signs of **distemper**?
If dog is showing only neurological signs, is it shedding the virus?
**behavioral changes, seizures, vestibular or cerebellar signs, weakness, paralysis, myoclonus**
*If dog is showing only neurological signs, it is _NOT_ shedding the virus*
152
What is the oral drug of choice for treatment of **hy**_per_**thyroidism**?
**Methimazole**
153
What is the most sensitive test for detecting active infection with ***Leishmania***?
**PCR**
*Confirmed cases of leishmaniasis in the U.S. must be reported to the Center for Disease Control (CDC)*
154
T/F: Amphotericin B can be used to treat **cryptococcosis**
**True**
\*\*Remember it can be nephrotoxic!\*\*
155
T/F: In some cases of **hypercalcemia,** trial chemotherapy can be used to rule out neoplasia
**True**
*Trial chemotherapy with L-asparaginase can be used to rule out lymphosarcoma. A return of serum calcium to normal levels \<72 hours is suggestive of LSA*
156
T/F: Most fungal infections have lower respiratory signs (lung involvement)
**True**
157
What infectious disease can be spread via the reproductive tract?
**Brucellosis**
158
What surface protein does the Idexx **C6 Antibody SNAP test** check for?
**VlsE**
* C6 Antibody test measures antibodies against the C6 protein which is expressed by Borrelia burgdorferi as part of the VlsE surface lipoprotein, & which helps the organism to escape host immune responses.*
* C6 protein is not expressed in the tick, in tissue culture, or in Lyme vaccines, so C6 test can differentiate between natural infection and vaccine‐induced antibodies*
* However, a positive test does not predict clinical disease, only exposure and infection*
159
A cat is in hospital for a blood glucose curve. The nadir is \<80 mg/dL. The most likely cause is:
* Insulin overdose
* Lack of food intake
* Strenuous exercise
* Overlap of insulin effect - duration too long
* All of the above
**All of the above**
160
T/F: UMN and LMN lesions both result in paralysis or paresis
**True**
161
What is the most common clinical sign associated with **lyme disease** in dogs?
**Nonerosive polyarthritis**
*Acute onset of lameness or joint swelling of one or more joints are the most common signs*. *The lameness is said to begin near the site of infection*
162
What is the most common adverse effect of **Thyroid ablation**?
**Laryngeal Paralysis**
163
Which is not a common sign of **Brucellosis**?
* Epididymitis
* Infertility
* Abortions
* Diskospondylitis
* Vomiting
Vomiting
164
What **laboratory changes** occur with *Ehrlichia/Anaplasma* but NOT with *Borrelia*?
**↓ platelets, ↓ neutrophils, ↑ lymphocytes**
165
How does a dog get **salmon poisoning**?
**ingestion of metacercariae in infected fish**
*Adult flukes develop in dog’s intestine in 6 days, Rickettsiae are inoculated presumably into villus epithelial and intestinal lymphoid cells; Rickettsemia develops; organisms are disseminated to other organs.*
166
What is the drug of choice for seizure control in cats?
**Phenobarbital**
*Liver toxicity has not been reported in cats and there is no liver induction (no elevation of ALP, no acceleration of the phenobarbital hepatic metabolism during the first months of therapy)*
167
T/F: In dogs with masticatory myositis there is usually a good response to antibiotic therapy
**False**
*In dogs with masticatory myositis there is usually a good response to _steroid_ therapy*
168
Normal or increased insulin levels in the face of hypoglycemia (\<60mg/dL) is very suggestive of:
**Insulinoma!**
169
Clicker Q: All these dogs have low [T4]. Select the typical signalment and history for canine hypothyroidism:
* 3 yo female Poodle with reduced appetite and PuPd
* 12 yo Miniature Schnauzer with a pot-belly, alopecia and calcinosis cutis
* 6 yo Beagle with hypotrichosis and reduced activity
* 3 yo Greyhound with bradycardia
**6 yo Beagle with hypotrichosis and reduced activity**
170
Clicker Q: Which is a screening test for **hy**_po_**thyroidism**?
* TT4
* fT4
* TT3
* fT3
* TSH
**TT4**
171
A 6 year old Bouvier, has weight gain and facial paralysis. TT4 and fT4 are low, TSH is high, TSH stim. test, the TT4 remains unchanged. What is the diagnosis?
* Primary hypoT
* Secondary hypoT
* Tertiary hypoT
* Euthyroid sick syndrome
**Primary hypoT**
172
A tentative diagnosis of **hy**_per_**thyroidism** can be made on palpation of the neck along with supportive historical and exam findings. What would you expect to find upon palpation of the neck in a hyperthyroid patient?
**palpable goiter**
* (palpable in 90%+)*
* Goiter: palpate from behind, lift neck and turn 45 ̊opposite to side of interest*
173
What is the most common type of functional **thyroid tumor** in the cat, responsible for feline **hy**_per_**thyroidism**?
**Bilateral thyroid adenoma**
*Adenoma (or adenomatous hyperplasia) is the most common type of functional thyroid tumor in the cat with most being bilateral (70%). Causative etiology of adenomatous hyperplasia is unknown. Speculation includes canned diet and exposure to cat litter.*
