Spring 2023

Question 1

Which of the following is increased in primary hypoparathyroidism?

a. serum phosphorus

b. parathyroid hormone

c. 1-25-diydroxyvitamin D (calcitriol)

d. 25 hydroxyvitamin D (calcifediol)

Answer 1

a. serum phosphorus

Question 2

Which of the following is decreased in cholecalciferol ingestion?

a. serum phosphorus

b. parathyroid hormone

c. 1-25-diydroxyvitamin D (calcitriol)

d. 25 hydroxyvitamin D (calcifediol)

Answer 2

parathyroid hormone

Question 3

Acute “sharp” pain is transmitted by _______________ fibers which are _______________.

a. C fibers; unmyelinated

b. A-δ fibers: unmyelinated

c. C fibers; myelinated

d. A-δ fibers; myelinated

Answer 3

A-δ fibers; myelinated

Question 4

Nociception involves four phases. In order, beginning at the site of injury, they are:

a. sensation, transmission, modulation, perception

b. transduction, transmission, modulation, perception

c. transduction, modulation, transmission, perception

d. sensation, modulation, transmission, perception

Answer 4

b. transduction, transmission, modulation, perception

Question 5

Vascular spasm immediately following injury occurs prior to platelet plug formation.  Much of the

vasoconstriction in small vessels is due to _______ release from platelets.  

a. Adenosine diphosphate

b. von Willebrand factor

c. Thromboxane A2

d. Platelet activating factor

Answer 5

c. Thromboxane A2

Question 6

von Willebrands factor (vWF) serves as an adhesion bridge between exposed subendothelial collagen

and _________ receptors on the platelet membrane. 

a. P2 purinergic receptors

b. Thromboxane A2 receptors

c. Phosphatidylerine receptors

d. Glycoprotein 1b receptors

Answer 6

Glycoprotein 1b receptors

Question 7

Which organ system is the most vulnerable to oxygen toxicity resulting from prolonged high inspired

oxygen concentration?

a. Respiratory

b. Cardiovascular

c. Central Nervous System

d. Gastrointestinal system

Answer 7

a. Respiratory

Question 8

Which of the following is incorrect in describing the cardiovascular effects of high positive pressure

ventilation (PEEP)?

a. Increased right ventricular afterload due to elevated pulmonary vascular resistance

b. Shift interventricular septum to the left, preventing adequate diastolic filling of left ventricle

c. Decreased left ventricular afterload due to increased transmural left ventricular pressure

d. Decreased venous return and right atrial filling due to elevated intrathoracic pressure

Answer 8

. Decreased left ventricular afterload due to increased transmural left ventricular pressure

Question 9

In refeeding syndrome, the most common two electrolyte imbalances encountered are as follows:

a. Hypokalemia and hypophosphatemia

b. Hypokalemia and hyperphosphatemia

c. Hyperkalemia and hypophosphatemia

d. Hyperkalemia and hyperphosphatemia

Answer 9

Hypokalemia and hypophosphatemia

Question 10

The following vitamin, which is an important cofactor in carbohydrate metabolism, can become

depleted in a state of starvation.

a. Ascorbic Acid (Vitamin C)

b. Thiamine (Vitamin B1)

c. Folate (Vitamin B9)

d. Alpha-Tocopherol (Vitamin E)

Answer 10

b. Thiamine (Vitamin B1)

Question 11

What is the major pathologic mechanism behind ventilator associated pneumonia?

a. Impaired respiratory defenses to infection including cough and mucous clearance due to sedation and

the presence of an endotracheal tube

b. Microaspiration past the cuff of the endotracheal tube and biofilm development within the

endotracheal tube

c. Neutrophil dysfunction with a reduced phagocytic capability and elevation in neutrophil proteases in

the alveolar space

d. Change in oral and gastric flora due to lack of oral hygiene due to impaired swallowing, antimicrobial

pressures and gastric colonization due to antacid administration

Answer 11

Microaspiration past the cuff of the endotracheal tube and biofilm development within the endotracheal tube

Question 12

Which of the following measures may decrease the incidence of ventilator associated

pneumonia?

a. Increasing gastric pH prophylactically

b. Routine changing of the ventilator circuit

c. Maintenance of endotracheal cuff pressure  20 cm H2O

d. Aspiration of subglottic secretions

Answer 12

Aspiration of subglottic secretions

Question 13

Which of the following preferentially vasoconstricts efferent arterioles in the kidneys to help

preserve normal GFR in the face of hypotension or hypovolemia?

a. Endothelial derived Nitric oxide

b. Prostaglandin E2

c. Angiotensin II

d. Epinephrine

Answer 13

c. Angiotensin II

Question 14

Recall that clearance of a substance from the kidneys depends on glomerular filtration, tubular

reabsorption and tubular secretion. Under normal circumstances which substance is freely

filtered and has no tubular reabsorption?

a. Creatinine

b. Bicarbonate

c. Amino acids

d. Urea

Answer 14

a. Creatinine

Question 15

Physiologic effects of opioids include:

a. Indirect depression of the pontine and medullary centers in the brain leading to

decreased respiratory rate and tidal volume

b. Inhibitory responses linked to the indirect stimulation of dopaminergic receptors

c. Release of antidiuretic hormone

d. Decreased responsiveness of afferent nerve endings to noxious stimuli

Answer 15

c. Release of antidiuretic hormone

Question 16

The following characterizes remifentanil:

a. Remifentanil is considered a cardiac sparing drug

b. Elimination of remifentanil is ultrashort and is metabolized by renal esterases

c. Administration of remifentanil results in profound respiratory depression, and

elimination time is prolonged after long term IV infusion

d. Remifentanil is an appropriate agent for patients with severe hepatic disease

Answer 16

Remifentanil is an appropriate agent for patients with severe hepatic disease

Question 17

What is the primary mechanism by which administration of 0.9% NaCl causes a metabolic acidosis?

a. Erythrocyte chloride shift (Hamburger Phenomenon)

b. Chloride induced renal vasodilation

c. Increase in ATOT

d. Decrease in SID

Answer 17

Decrease in SID

Question 18

According to a JAVMA 2020 article regarding mortality and prognostic indicators with severe

anaphylaxis, hyperphosphatemia was significantly associated with death. Which is a proposed

mechanism of hyperphosphatemia due to anaphylaxis?

a. Release of intracellular components from histamine induced cascade resulting in hepatocellular

necrosis

b. Increased activity of ATP on hepatocytes causing increased phosphorus update and decreased

utilization of phosphates

c. Rhabdomyolysis resulting in decreased reuptake of released phosphates from ruptured myocytes

d. Histamine and vasoactive inflammatory mediators causing impaired phosphate utilization

Answer 18

Release of intracellular components from histamine induced cascade resulting in hepatocellular

necrosis

Question 19

Which of the following aspects of the early phase of anaphylaxis results in the progression of the

cellular mechanisms?

a. Cross-linked IgE to mast cells FcR transduces intracellular tyrosine kinase signaling activating phospholipase C.

b. IP3 acts as a primary messenger system moving intracellular calcium levels into secretory granules.

c. Histamine 3 receptor binding increases norepinephrine release from effector nerves, inhibiting sympathetic responses.

d. Heparin modulates tryptase including increasing complement activity and inhibiting coagulation.

Answer 19

Cross-linked IgE to mast cells FcR transduces intracellular tyrosine kinase signaling activating phospholipase C.

Question 20

Which electrolyte abnormality can increase renal ammoniagenesis, worsening clinical

signs associated with hepatic encephalopathy?

a. Ionized hypocalcemia

b. Hypomagnesemia

c. Hypokalemia

d. Hyponatremia

Answer 20

c. Hypokalemia

Question 21

Based on the lipid sink theory, which of the following toxins has the most therapeutic response to

intravenous lipid emulsion?

a. Toxin A with Log P of 2.56

b. Toxin B with Log P of 1.01

c. Toxin D with Log P of 3.51

d. Toxin C with Log P of 0.22

Answer 21

Toxin D with Log P of 3.51

Question 22

Which of following is the theoretical mechanism of intravenous lipid emulsion (ILE) therapy for

bupivacaine toxicity?

a. ILE increases the mitochondrial oxidation of free fatty acids and improves the neurological function of

central nervous system.

b. ILE sequesters bupivacaine within the plasma and inhibits free radical formation in the central nervous

system.

c. ILE sequesters bupivacaine within the adipose tissue and inhibits free radical formation in the

myocardial tissues.

d. ILE increases the mitochondrial oxidation of free fatty acids and improves the positive inotropic effect.

Answer 22

ILE increases the mitochondrial oxidation of free fatty acids and improves the positive inotropic effect.

Question 23

Activated charcoal administration should be administered every _____________ hours

for those toxicities that undergo enterohepatic recycling.

a. 1 – 2

b. 2 – 4

c. 4 – 8

d. 6 – 8

Answer 23

c. 4 – 8

Question 24

What is the correct classification of the post-synaptic acetylcholine receptor at the neuromuscular

junction of skeletal muscle?

a. Inotropic, muscarinic

b. Inotropic, nicotinic

c. Metabotropic, muscarininc

d. Metabotropic, nicotinic

Answer 24

b. Inotropic, nicotinic

Question 25

The function of soluble N-ethylmaleimide-sensitive factor activating protein receptor (SNARE) proteins is to: a. Re-uptake choline from the synaptic cleft to be recycled into acetylcholine b. Act as a cofactor for choline acetyltransferase to resynthesizes acetylcholine c. Provide a scaffold for axonal transport of neuronal vesicles toward synaptic terminals d. Aid in fusion of synaptic vesicles with the pre-synaptic membrane

Answer 25

Aid in fusion of synaptic vesicles with the pre-synaptic membrane

Question 26

Which of the following is the most common mechanism by which acquired myasthenia gravis results in muscle weakness? a. Antibodies against acetylcholine receptors b. Antibodies against muscle specific kinase c. Defective acetylcholine synthesis d. Acetylcholinesterase deficiency

Answer 26

a. Antibodies against acetylcholine receptors

Question 27

According to the randomized, double-blinded, placebo-controlled trial, ATHOS-3, which evaluated the use of Angiotensin II as compared to placebo in patients who have failed standard therapies for vasodilatory shock: a. Inclusion criteria dictated that patients had to have remained in vasodilatory shock with norepinephrine at 0.5mcg/kg/min +/- vasopressin. b. The primary end point evaluated was achievement of a MAP >=65 OR an increase in MAP of > =10. c. The percentage of patients who met the primary end point with respect to mean arterial pressure at 3 hours was significantly greater in the angiotensin II group than in the placebo group. d. Patients in the angiotensin II group had a higher frequency of cardiovascular and other adverse events compared to the placebo group, but, did not have a higher mortality rate.

Answer 27

c. The percentage of patients who met the primary end point with respect to mean arterial pressure at 3 hours was significantly greater in the angiotensin II group than in the placebo group.

Question 28

Regarding discontinuation of antithrombotic therapy, the Consensus on the Rational Use of Antithrombotics in Veterinary Critical Care (CURATIVE) guidelines a. recommend discontinuing single agent antiplatelet therapy 48 hours prior to planned or elective procedure for high risk patients. b. recommend weaning of low molecular weight heparin (LMWH) agents prior to discontinuing. c. recommend that LMWH agents not be discontinued prior to a planned or elective procedure for high risk patients. d. recommend restarting antithrombotic therapy one week post-surgery in low/moderate risk patients.

Answer 28

c. recommend that LMWH agents not be discontinued prior to a planned or elective procedure for high risk patients.

Question 29

According to the 2017 JAVMA article titled Multicenter evaluation of signalment and comorbid conditions associated with aortic thrombotic disease in dogs, of 99 dogs with documented aortic thrombotic disease, what were the top 2 most commonly recorded concurrent conditions? a. IMHA and PLN. b. PLN and neoplasia. c. IMHA and severe pancreatitis. d. PLN and hyperadrenocorticism.

Answer 29

b. PLN and neoplasia.

Question 30

Which of the following statements is most correct regarding fluid therapy in the cat with a urethral obstruction? a. Use of 0.9% saline has been associated with a worse outcome (survival, length of stay) when compared to a balanced electrolyte solution. b. Use of 0.9% saline leads to a faster reduction in potassium levels when compared to a balanced electrolyte solution. c. Use of a balanced electrolyte solution leads to more rapid correction of acid-base abnormalities when compared to 0.9% saline. d. Use of a balanced electrolyte solution leads to more rapid correction of renal values when compared to 0.9% saline.

Answer 30

Use of a balanced electrolyte solution leads to more rapid correction of acid-base abnormalities when compared to 0.9% saline.

Question 31

34. Which statement about the use of indwelling urinary catheters is most correct once a urethral obstruction has been relieved? a. Polypropylene catheters are no more irritating than polyvinyl chloride catheters and either are suitable for use as indwelling catheters. b. Polyurethane catheters have been shown to be less irritating to urethral tissues than any other material and are preferred. c. 5 French catheters have been shown to have an increased incidence of reobstruction within 24 hours of removal compared with 3.5 French catheters. d. The length of time an indwelling catheter is left in place has no impact on the risk of reobstruction.

Answer 31

5 French catheters have been shown to have an increased incidence of reobstruction within 24 hours of removal compared with 3.5 French catheters.

Question 32

Which of the following statements is most correct regarding the dispensing of antimicrobials in a cat with a urethral obstruction? a. Urinary tract infections are common at the time of presentation and antimicrobials should be uniformly dispensed. b. Submitting the catheter tip for culture at the time of removal will yield accurate culture results. c. A culture ideally should be obtained at the time of catheter removal via cystocentesis but should not be taken via the catheter. d. A cystocentesis should be obtained 3 days after catheter removal to evaluate for a possible urinary tract infection.

Answer 32

A cystocentesis should be obtained 3 days after catheter removal to evaluate for a possible urinary tract infection.