Multiple choice questions

1 In cases suspected of having regurgitation

a the pH of the food brought up is always acidic

b episodes always occur within an hour after eating

c the disorder is generally located in the oesophagus

d the food brought up usually contains bile

2 In a dog which is suspected of regurgitating, which of the follow­ing imaging procedures should be performed first to help confirm the diagnosis?

a CT of the thorax

b Fluoroscopy of the thorax

c Radiographs of the thorax

d Ultrasound of the thorax

3 Acquired myasthenia gravis in dogs is an

a idiopathic disorder with no known cause

b immune mediated disorder with antibodies against ACh molecules c immune mediated disorder with antibodies against ACh receptors d infectious disease caused by Bartonella spp.

4 The prognosis for a dog diagnosed with acquired myasthenia gravis is

a very poor with only 10% of dogs living for a year

b guarded as only about 50% of the dogs survive

c excellent with nearly 100% of dogs responding well

d unknown as insufficient case numbers have been examined

5 In cases of idiopathic megaoesophagus, the most common cause of death is

a starvation

b systemic infection

c oesophageal rupture

d aspiration pneumonia

6 Oesophageal strictures are usually best treated using

a balloon dilation, with repeated procedures if needed

b solely medical management with antacid drugs

c high dose oral corticosteroids to decrease inflammation

d surgical repair performed immediately

7 In a regurgitating 4-month-old puppy, a barium swallow shows abrupt discontinuation of the barium just cranial to the base of the heart with gross dilatation of the oesophagus cranial to that area. The most likely diagnosis is

a oesophageal foreign body

b idiopathic megaoesophagus

c oesophageal stricture

d persistent right aortic arch

8 What is the prognosis for dogs with persistent right aortic arch which have surgery?

a 80% have good swallowing function after the surgery

b The megaoesophagus will still be present but most dogs won’t re­gurgitate

c About half the dogs will continue to regurgitate

d Almost all of the dogs will still regurgitate

9 There is evidence that dysautonomia in cats

a may have an aetiology related to botulinum type C neurotoxin

b is likely to be caused by an autoimmune response

c may be related to a viral infection that is spread via faeces

d is due to a congenital disorder as it occurs mostly in related cats

10 Diagnoses of feline dysautonomia is based primarily on

a clinical signs

b imaging results

c a specific blood test

d the response to treatment

11 Treatment of feline dysautonomia

a is usually unrewarding as nearly all affected cats die

b includes use of interferon for the viral component of the disease

c is based on supportive, nutritional and nursing care

d is primarily based on antibiotics effective against anaerobic bac­teria

12 The pilocarpine test used to aid in a diagnosis of dysautonomia is based on

a mydriasis of the treated eye due to denervation supersensitivity b miosis of the treated eye due to denervation supersensitivity c mydriasis of the treated eye due to lack of sensitivity d miosis of the treated eye due to lack of sensitivity

13 Large rocks or bones can enter the small intestine of a dog from the stomach

a by moving through the pylorus with food particles

b by exerting pressure on the pylorus so that it opens

c due to ‘housekeeping waves’ which open the pylorus during fasting d by entering the duodenum with liquids during drinking

14 Dogs that chronically vomit bile in the early hours of the morn­ing are likely to have

a bilious vomiting syndrome and may respond to a late night snack b irritable bowel syndrome which will respond to probiotics c a motility disorder involving gastric emptying of food d alimentary lymphoma and need chemotherapy

15 Copper coloured irises in cats are nearly pathognomonic for

a food sensitivity

b persistent right aortic arch

c dysautonomia

d porto-systemic shunt

16 Metabolic alkalosis in a dog or cat which is vomiting is usually associated with

a a pyloric or duodenal foreign body

b gastrointestinal parasites

c Helicobacter infection

d pyometra

17 Barium impregnated polyethylene spheres (BIPS) are most use­ful for

a looking for intestinal mucosal disorders

b outlining the gastric shadow

c checking for an intestinal obstruction

d checking for megaoesophagus

18 The ‘organ of vomition’ is the

a oesophagus

b stomach

c duodenum

d colon

19 The chemoreceptor trigger zone is in

a the floor of the fourth ventricle

b the cerebrum

c the vestibular apparatus

d the duodenum

20 Endotoxic shock may occur in animals with intestinal obstruc­tion with a foreign body due to the

a presence of bacteria within the foreign body

b consequences of dehydration due to vomiting

c increased numbers of bacteria within the stagnant loop of intestine d body’s response to the dilated intestine distal to the foreign body

21 A gastrointestinal barium contrast study is performed in a 10-year-old dog that has been vomiting intermittently for four months.

a linear foreign body obstruction

b partial gastric dilatation and volvulus

c mucosal pyloric stenosis

d granulomatous inflammatory bowel disease

22 Which of the following drugs has a pro-motility intestinal effect at low doses in the fasting dog?

a Amoxicillin

b Clindamycin

c Erythromycin

d Enrofloxacin

23 Bradycardia is most likely to occur in dogs with hypoadreno­corticism due to

a hyperkalaemia

b hypocalcaemia c hyponatraemia d cortisol deficiency

24 A definitive diagnosis of hypoadrenocorticism should be made based on the results of which test(s)?

a Basal cortisol

b Electrolyte imbalance

c Low dose dexamethasone suppression test

d ACTH stimulation test

25 The intravenous fluid of choice for correcting dehydration in a patient with hypoadrenocorticism is

a 0.9% saline

b 0.18% saline with 4% glucose

c Lactated ringers

d hypertonic saline

26 Cats with pancreatitis may have low serum cobalamin concen­trations because

a ileal absorption is decreased due to ileus

b there is a dietary deficiency due to anorexia

c they lack the enzyme necessary for absorption

d they have decreased intrinsic factor

27 Folate is absorbed primarily in the

a stomach

b proximal intestine

c distal jejunum and ileum

d colon

28 Differentiating feline low grade small cell lymphoma from lymphocytic inflammatory bowel disease

a is based on the endoscopic appearance of the small intestine

b is based on ultrasonographic measurement of intestinal wall thick­ness

c is always possible based on cytology

d can be difficult even with histopathology

29 In a dog suspected of having eaten Gorilla glue, which is the best treatment?

a The initial treatment should be inducing emesis

b The dog should be treated with prokinetic drugs

c The dog should be treated with activated charcoal

d The glue mass should be removed surgically

30 Basophilic stippling of red blood cells on a haematoxylin and eosin stained blood smear from a dog

a can occur with any regenerative anaemia

b is suggestive of possible lead toxicity

c is suggestive of possible zinc toxicity

d is suggestive of porto-systemic shunting

31 Microcytosis (small red blood cells) can be found in the blood of normal healthy dogs of which breed?

a Akita

b Beagle

c Poodle

d Rottweiler

32 If ingested and absorbed, lead may be stored in the

a liver

b bone

c brain

d prostate

33 The potentially most serious side effect of treating lead toxicity with calcium edentate is reversible

a nephrotoxicity

b liver failure

c retinal damage

d osteoporosis

34 The most common gastric tumour in dogs is

a lymphoma

b leiomyosarcoma

c adenocarcinoma

d fibroma

35 The cat breed at highest risk for developing diabetes mellitus in the United Kingdom is the

a Burmese

b Persian

c Siamese

d Ragdoll

36 The most sensitive and specific test for diagnosis of pancreatitis in a cat which has been ill for a week is

a lipase

b amylase

c trypsin-like immunoreactivity

d feline pancreatic specific lipase

37 In cats, which is the most common sign of pancreatitis?

a Anorexia

b Vomiting

c Diarrhoea

d Fever

38 Compared to round (e.g. ball or rock) foreign bodies, linear in­testinal foreign bodies

a are less serious as they rarely cause obstruction

b cause more electrolyte imbalance

c are more likely to perforate the intestine

d are usually located within the stomach

39 The urinary crystal or urolith caused by porto-systemic shunts is

a calcium oxalate

b cystine

c struvite

d urate

40 The ductus venosus usually closes

a before birth

b within a week or two after birth

c at 4 months of age

d at 9 months of age

41 A breed commonly recognized to have congenital extrahepatic porto-systemic shunts is the

a Affenpinscher

b Beagle c Chow d Yorkshire terrier

42 Diets with a high meat protein content are contraindicated for dogs with porto-systemic shunting due to the increased risk of

a hepatic encephalopathy

b vomiting c diarrhoea d polydipsia

43 A good source of supplemental protein for a growing puppy with a porto-systemic shunt is

a cottage cheese

b turkey

c salmon d ham

44 Lactulose is used to treat patients with porto-systemic shunting because it

a has an antibiotic effect in the colon

b increases intestinal transit time

c acidifies colonic contents thereby trapping ammonia

d decreases bile acid concentration

45 A cat predisposed to hepatic lipidosis would be one which

a is fat and then becomes anorexic

b is thin and then becomes anorexic

c is on a high fat diet d is on a high protein diet

46 Which of the following abnormalities on serum chemistry would indicate that a cat may have hepatic lipidosis rather than cholangitis?

a Elevated AP and GGT

b Decreased AP and GGT

c Normal AP and increased GGT

d Elevated AP with normal GGT

47 Regarding gastrointestinal bleeding, which of the following is most correct?

a If the faeces colour is normal, there is no bleeding

b Dark faecal colour can only be caused by GI bleeding c Melaena in faeces is caused by oxidation of haemoglobin d Haematochezia is often caused by ingested blood

48 Acute haemorrhagic gastroenteritis usually differs from other forms of gastrointestinal bleeding in that

a the PCV increases

b the PCV decreases

c the PCV is not affected

d the albumin increases

49 Colonic vascular dysplasia is diagnosed

a based on haematology and serum chemistry

b by a typical appearance of the colon at colonoscopy

c on the typical cytology appearance

d on the typical histopathological appearance

50 Irritable bowel syndrome in dogs is diagnosed by the

a ultrasonographic appearance of the colon

b endoscopic appearance of the colon

c histopathology of the colon

d exclusion of other disorders and response to treatment

51 The most common colorectal tumours in the dog are

a adenoma/adenocarcinoma

b fibroma

c lymphoma

d sarcoma

52 In cats with Tritrichomonas foetus

a diagnosis is made by routine faecal examination

b diagnosis is made by zinc flotation of faeces

c the organisms are too small to be seen by light microscopy

d trophozoites can sometimes be seen in a fresh wet faecal prepara­tions

53 Histiocytic colitis in Boxer dogs responds to

a amoxicillin

b enrofloxacin

c clindamycin

d metronidazole

54 What is the most common cause of EPI in cats?

a Pancreatic acinar atrophy

b Exocrine pancreatic hypoplasia

c Chronic pancreatitis

d Pancreatic neoplasia