Cholesterol desmolase converts cholesterol into what hormone in the rate limiting step common to the synthesis of all adrenal steroid hormones?
Pregnenolone
Progesterone
17-Hydroxypregnenolone
11-Dexoycorticosterone
Pregnenolone
With regards to patients with septic shock, the 2008 CORTICUS trial found that low-dose hydrocortisone therapy, compared to placebo, was associated with
improved survival.
more rapid pressor weaning regardless of ACTH results.
no change in incidence of superinfection.
shorter ICU stays.
more rapid pressor weaning regardless of ACTH results
Physiologic functions of thyroid hormone include:
an increase in cellular metabolic activity by increasing the number and size of golgi complexes in the cell.
an increase concentration of cholesterol and triglycerides and a decrease concentration of free fatty acids.
an increase in the activity of the Na-K-ATPase and an increase in permeability of the cell membrane to K+ ions.
increased pulse pressure from increased systolic pressure and decreased diastolic pressure.
increased pulse pressure from increased systolic pressure and decreased diastolic pressure.
What is the mechanism of action of albuterol for the treatment of hyperkalemia?
Activation of the beta-2 receptor lowers the threshold membrane potential restoring normal membrane excitability.
Beta-agonist drugs stimulate the Na+-K+-2Cl- cotransporter on the luminal surface of the thick ascending limb of the loop of Henle.
Beta-agonists drugs stimulate the Na+-K+-ATPase pump promoting translocation of extracellular K+ into the cell.
Beta-adrenergic stimulation increases the activity of the Na+-Cl- cotransporter, increasing water reabsorption and diluting extracellular K+.
Beta-agonists drugs stimulate the Na+-K+-ATPase pump promoting translocation of extracellular K+ into the cell.
Which of the following statements correctly describes the mechanism of action for β-adrenergic agonists used for the treatment of airway bronchoconstriction?
Stimulation of beta receptors on the neutrophil cell membrane inhibit the release of pro-inflammatory cytokines.
Stimulation of the β2 receptors increase intracellular cAMP concentrations resulting in bronchial smooth muscle relaxation.
Inhibition of phosphodiesterase-3 and -4 increases intracellular cAMP concentrations resulting in reduction in pro-inflammatory cytokine release.
Inhibition of vagal-mediated cholinergic smooth muscle tone in the respiratory tract.
Stimulation of the β2 receptors increase intracellular cAMP concentrations resulting in bronchial smooth muscle relaxation.
Which statement best describes the management of allergic airway disease?
Oral prednisone, prednisolone, and methylprednisolone acetate are commonly used medications for the maintenance of allergic airway disease.
Use of inhaled fluticasone has been shown to decrease airway inflammatory cells, prostaglandins, and inflammatory cytokines.
Administration of enteral bronchodilators prior to inhalant bronchodilator therapy increases the overall efficacy of treatment.
Treatment with anthelminthic medication is only recommended after diagnosis of parasitic allergic airway disease.
Use of inhaled fluticasone has been shown to decrease airway inflammatory cells, prostaglandins, and inflammatory cytokines.
Which of the following statements best characterizes frozen plasma?
Frozen plasma is plasma which was frozen by 4 hours after collection/separation and can be stored for up to 5 years.
Frozen plasma is plasma which was frozen more than 8 hours after collection/separation and has lower concentrations of factors V and VIII.
Frozen plasma is plasma has been stored up to 12 months and has lower concentrations of factors V, VII, and vWF.
Frozen plasma is plasma which was frozen more than 8 hours after collection/separation and is deficient in factors II, VII, IX and XI.
Frozen plasma is plasma which was frozen more than 8 hours after collection/separation and has lower concentrations of factors V and VIII.
Albumin is a highly charged molecule in the blood, which is responsible for 80% of colloidal osmotic pressure (COP or oncotic pressure) in healthy animals. Albumin’s large contribution to COP is mostly due to Van’t Hoff’s law, which states
the negative charge attracts sodium ions, which then attracts water across the vascular endothelium.
the negative charge attracts red blood cells, which then attracts water across the vascular endothelium.
the COP generated by a particle is indirectly proportional to its molecular weight.
the COP generated by a particle is directly proportional to its concentration in the blood.
the COP generated by a particle is indirectly proportional to its molecular weight.
Human intravenous immunoglobulin (hIVIG) has been used in human medicine for years to treat conditions such as HIV, Guillain-Barre syndrome, and Kawasaki disease. It has been studied with variable success in veterinary medicine. Which of the following is a proposed mechanism of action for IVIG?
Inhibition of T-cell receptor-activated transduction pathway
Suppress lymphocyte proliferation and decrease antibody synthesis by B cells
Inhibit the release of IL-1, TNF-ɑ, and prostaglandins from leukocytes
Inhibition of complement, decreasing circulating cytokines
Inhibition of complement, decreasing circulating cytokines
Uveitis is a condition that occurs secondary to primary ocular conditions or extraocular conditions. The following are findings on a physical and ophthalmologic exam that are consistent with the diagnosis of uveitis:
aqueous flair and decreased intraocular pressure.
aqueous flair and increased intraocular pressure.
buphthalmos and aqueous flair.
buphthalmos and decreased intraocular pressure.
aqueous flair and decreased intraocular pressure.
All of the following treatments can be used to help reduce an acute increase in intraocular pressure in a patient with glaucoma:
Prednisolone acetate, latanaprost, and dorzolamide
Dorzolamide, timolol, or latanaprost
Timolol, prednisolone acetate, or dorzolamide
Latanaprost, tropicamide, or timolol
Dorzolamide, timolol, or latanaprost
Which of the following are the most common bacteria isolated from “melting” corneal ulcers?
Staphylococcus sp. and Pseudomonas sp.
E. coli and Staphylococcus sp.
E. coli and Beta-hemolytic streptococcus
Beta-hemolytic streptococcus and Pseudomonas sp.
Beta-hemolytic streptococcus and Pseudomonas sp.
Which of the following continuous renal replacement therapies is a purely convective modality?
Continuous venovenous hemofiltration (CVVH)
Continuous venovenous hemodialysis (CVVHD)
Continuous venovenous charcoal hemodialysis (CVVCHD)
Continuous venovenous hemodiafiltration (CVVHDF)
Continuous venovenous hemofiltration (CVVH)
Aminoglycoside toxicity leads to acute renal failure as a result of injury to the
glomerulus.
proximal tubule.
loop of Henle.
distal tubule.
proximal tubule.
The following biomarker has been found to be able to detect acute kidney injury prior to elevations in creatinine concentrations:
Neutrophil gelatinase associated lipocalin
Procalcitonin
C-reactive protein
Soluble urokinase-type plasminogen receptor
Neutrophil gelatinase associated lipocalin
High-flow nasal oxygen therapy is an option for animals with moderate hypoxemia. Flow rates up to 60 L/min can be tolerated by most patients. Which of the following statements best describes why these flow rates are tolerated?
The variable FiO2 can be chosen for patient need.
Soft silicone nasal prongs allow a more diffuse jet.
The oxygen is delivered in heated and humidified air.
Most animals are receiving some degree of sedation.
The oxygen is delivered in heated and humidified air.
Which of the following causes of hypoxemia will have a normal A – a oxygen gradient on room air and will be responsive to oxygen?
Diffusion impairment
Hypoventilation
Right to left shunting
Low V/Q regions
Hypoventilation
When assessing platelet function, platelet aggregometry
using the weak agonist collagen will help promote adherence and platelet granule release.
using the strong agonist epinephrine will help promote adherence and platelet granule release.
may use a collagen/ADP test to confirm an abnormal collagen/epinephrine test.
reporting a normal closure time indicates normal platelet function.
may use a collagen/ADP test to confirm an abnormal collagen/epinephrine test.
Platelets have two types of organelles, 𝜶 granules and dense-core granules. Which statement differentiates dense-core granules from 𝜶 granules?
The dense-core granules are more abundant than 𝜶 granules.
Dense granules contain a high amount of fibrinogen
The dense-core granules store von Willebrand factor and clotting factor V.
The dense-core granules store ATP, ADP, serotonin, and calcium.
The dense-core granules store ATP, ADP, serotonin, and calcium.
Which of the following statements best describes the interaction between platelets and the vascular endothelium?
The negative charge on platelets and heparan sulfate in endothelial cells may help prevent platelet adhesion under normal conditions.
Platelet adhesion is mediated by glycoproteins receptors in the platelet membrane that are known as ligands.
Endothelial damage exposes ligands including collagen which binds to glycoprotein Gp1b/1a in the platelet membrane.
Nitric oxide inhibits platelet adhesion to endothelium and aggregation mediated via cAMP and its transduction mechanism.
The negative charge on platelets and heparan sulfate in endothelial cells may help prevent platelet adhesion under normal conditions.
According to the modified Starling hypothesis, the development of interstitial edema is predominately dependent on the
microvascular hydrostatic pressure.
oncotic pressure of the endothelial surface layer.
interstitial oncotic pressure.
filtration coefficient of the tissue bed.
microvascular hydrostatic pressure.
In acute hypervolemia induced by crystalloid and/or colloid fluid resuscitation, what mediator causes deterioration of the endothelial surface layer?
Nitric oxide synthase
Atrial natriuretic peptide
Tumor necrosis factor-⍺
C-reactive protein
Atrial natriuretic peptide
Given the emerging understanding of the importance of the endothelial glycocalyx in the pathophysiology of critical illness, it is a logical therapeutic target. How is doxycycline postulated to preserve the endothelial glycocalyx?
Anti-inflammatory properties
Antioxidant properties
Inhibition of heparanase
Inhibition of matrix metalloproteinase
Inhibition of matrix metalloproteinase
Magnesium deficit can result in
hypokalemia due to impaired renal reabsorption across the Na-K-Cl cotransporter.
decreased neuronal excitability and decreased neuromuscular transmission.
vascular smooth muscle dilation resulting in systemic hypotension.
intracellular sodium deficit due to impairment of the Na-K-ATPase pump.
hypokalemia due to impaired renal reabsorption across the Na-K-Cl cotransporter.
