Spring 2025

Question 1

A dog is identified as having persistent hypertension (systolic BP 165 mm Hg) without

evidence of target organ damage. Abdominal ultrasound reveals an adrenal tumor with

evidence of invasion into the vena cava. What class of anti-hypertensive drug would be

the best “first-line” therapy to address this dog’s hypertension?

a. Angiotensin converting enzyme inhibitor

b. Calcium channel blocker

c. Beta-blocker

d. Aldosterone agonist

Answer 1

c. Beta-blocker

Question 2

A cat presents with acute blindness and is found to have retinal detachment. Evaluation

reveals a systolic blood pressure of 206 mm Hg. The most appropriate plan to lower this

patient’s blood pressure is:

a. Normalize the blood pressure within six hours

b. Decrease the BP by 10% over about one hour and then by 15% over the

next six hours

c. Decrease the BP by 20% over 1-2 hours and then normal range within 24 hours

d. Normalize the BP within 24 hours

Answer 2

b. Decrease the BP by 10% over about one hour and then by 15% over the

next six hours

Question 3

Aldosterone synthase is secreted from which portion of the hypothalamic-pituitary axis?

a. zona glomerulosa of the adrenal gland

b. zona fasciculata of the adrenal gland

c. zona reticularis of the adrenal gland

d. the pituitary gland

Answer 3

a. zona glomerulosa of the adrenal gland

Question 4

Which test can be used to differentiate primary from secondary hypoadrenocorticism? 

a. ACTH stimulation test

b. Low Dose Dexamethasone Suppression Test

c. Endogenous ACTH concentration

d. Endogenous Aldosterone concentration

Answer 4

c. Endogenous ACTH concentration

Question 5

Which of the following is not a stimulus for promoting pancreatic secretion?

a. Acetylcholine

b. Enterokinase

c. Cholecystokinin

d. Secretin

Answer 5

b. Enterokinase

Question 6

The liver has ______ blood flow and ______vascular resistance

a. High blood flow and high vascular resistance

b. High blood flow and low vascular resistance

c. Low blood flow and high vascular resistance

d. Low blood flow and low vascular resistance

Answer 6

b. High blood flow and low vascular resistance

Question 7

What is the proposed mechanism for hypomagnesemia secondary to chronic PPI use in humans?

a. Inhibition of Transient Receptor Potential Melastatin 6 (TRPM6) and 7 ion channels

b. Hypochlorhydria resulting in decreased Mg solubility

c. Inhibition of H+K+ ATPase enzyme

d. PPI induced SIADH

Answer 7

a. Inhibition of Transient Receptor Potential Melastatin 6 (TRPM6) and 7 ion channels

Question 8

Which mechanism best describes the development of hypophosphatemia secondary to Salicylate

toxicity?

a. Alkalosis àrapid diffusion of CO2 from intracellular space to extracellular space à increased

intracellular pH àactivation of phosphofructokinase and glycolysis à phosphorus shifting

intracellularly

b. Excessive insulin release à intracellular uptake of phosphate and glucose for glycolysis à

intracellular uptake of phosphate and glucose for glycolysis à transcellular shifting à

hypophosphatemia

c. B-adrenergic receptor-mediated cellular uptake of phosphate

d. Uncoupling of oxidative phosphorylation and inhibition of the Krebs Cycle initially causes

hyperphosphatemia (from transcellular shifts from the intracellular to extracellular

compartment) then rapidly (30 to 60 min) hypophosphatemia, caused by excessive urinary

excretion, results

Answer 8

. Uncoupling of oxidative phosphorylation and inhibition of the Krebs Cycle initially causes

hyperphosphatemia (from transcellular shifts from the intracellular to extracellular

compartment) then rapidly (30 to 60 min) hypophosphatemia, caused by excessive urinary

excretion, results

Question 9

What percentage of the filtered phosphate load is reabsorbed by the renal tubules?

a. 20-30%

b. 50-60%

c. 80-90%

d. 10-20%

Answer 9

c. 80-90%

Question 10

The following statement describes the mechanism of action of Ketamine:

a. Ketamine inhibits the GABA receptors in the brain

b. Ketamine competitively inhibits NMDA receptors in the brain

c. Ketamine directly agonizes the GABA receptors in the spinal cord

d. Ketamine non-competitively inhibits NMDA receptors in the spinal cord

Answer 10

d. Ketamine non-competitively inhibits NMDA receptors in the spinal cord

Question 11

The following is the mechanism of action of Buprenorphine

a. Buprenorphine antagonizes the kappa-opioid receptor and partially agonizes-

antagonizes the mu-opioid receptor

b. Buprenorphine agonizes the kappa-opioid receptor and partially agonizes-antagonizes

the mu-opioid receptor

c. Buprenorphine partially agonizes-antagonizes the kappa-opioid receptor and

antagonizes the mu-opioid receptor

d. Buprenorphine antagonizes the kappa-opioid receptor and agonizes the mu-opioid

receptor

Answer 11

a. Buprenorphine antagonizes the kappa-opioid receptor and partially agonizes-

antagonizes the mu-opioid receptor

Question 12

Alfaxalone produces unconsciousness in dogs and cats by what mechanism?

a. By agonizing the gamma aminobutyric acid subtype B (GABAB) receptors in the

central nervous system (CNS)

b. By antagonizing the gamma aminobutyric acid subtype A (GABAA) receptors in the

central nervous system (CNS)

c. By agonizing the gamma aminobutyric acid subtype A (GABAA) receptors in the

central nervous system (CNS)

d. By antagonizing the gamma aminobutyric acid subtype B (GABAB) receptors in the

central nervous system (CNS)

Answer 12

c. By agonizing the gamma aminobutyric acid subtype A (GABAA) receptors in the

central nervous system (CNS)

Question 13

The primary stimulus for calcitonin secretion is:

a. Increased extracellular fluid PO42- concentration

b. Decreased extracellular fluid PO42- concentration

c. Increased extracellular fluid Ca2+ concentration

d. Decreased extracellular fluid Ca2+ concentration

Answer 13

c. Increased extracellular fluid Ca2+ concentration

Question 14

The active form of vitamin D (1,25-dihydroxycholecalciferol) ________ intestinal

calcium absorption and ___________renal calcium and phosphorous excretion

a. Increases, decreases

b. Increases, increases

c. Decreases, decreases

d. Decreases, increases

Answer 14

a. Increases, decreases

Question 15

What is the recommended time-frame for surgical intervention in cases of necrotizing fasciitis?

a. 2 – 4 hours

b. 4 – 6 hours

c. 6 – 12 hours

d. Within 24 hours

Answer 15

b. 4 – 6 hours

Question 16

What is the most common clinical sign associated with thiamine deficiency?

a. Polyneuropathy and muscle weakness

b. Polyphagia

c. Pathologic fracture

d. Polyuria/Polydipsia

Answer 16

a. Polyneuropathy and muscle weakness

Question 17

What is the correct equation to calculate the free water deficit?

a. FWD = 0.6 x lean body weight kg x (patient serum Na / 140 -1)

*another acceptable answer is FWD = 0.6 x patient weight (kg) x [(patient Na/normal Na) – 1]

b. FWD = lean body weight x (desired hydration % + current hydration %)

c. FWD = 0.6 x lean body weight x (patient serum Na / 140)

d. FWD = 0.6 x lean body weight x (desired hydration % - current hydration %)

Answer 17

FWD = 0.6 x lean body weight kg x (patient serum Na / 140 -1)

*another acceptable answer is FWD = 0.6 x patient weight (kg) x [(patient Na/normal Na) – 1]

Question 18

A 15 kg dog presents with hypernatremia and a serum sodium level of 160 mEq/L.  What is the free water deficit for this dog?

a. 0.8 L

b. 1.0 L

c. 1.2 L

d. 1.5 L

Answer 18

c. 1.2 L

Question 19

A 2024 study by Echeir et al evaluated the use of the respiratory rate-oxygenation index

(ROX) to predict failure of high flow nasal canula oxygen. Based on the findings of that

study, which of the following patient is most likely to fail high flow nasal canula oxygen

and require mechanical ventilation?

a. A 6 week old MI 5 kg mix breed puppy with non-cardiogenic pulmonary edema,

respiratory rate 50, FIO2 40%, SPO2 92%

b. A 13 yo 8 kg MC Chihuahua with congestive heart failure, respiratory rate 48, FIO2 60%, SPO2 93%
*ROX= (SpO2/FiO2)/RR x 100
*ROX =3.23

c. A 6yo 25 kg Golden Retriever with aspiration pneumonia, respiratory rate 36, FIO2

40%, SPO2 89%

d. An 8 yo SF Standard Poodle with pulmonary contusions, respiratory rate 24, FIO2

60%, SPO2 92%

Answer 19

b. A 13 yo 8 kg MC Chihuahua with congestive heart failure, respiratory rate 48, FIO2 60%, SPO2 93%
*ROX= (SpO2/FiO2)/RR x 100
*ROX =3.23

Question 20

Which of the following options is appropriate for maintaining humidification of the

airway during mechanical ventilation?

a. Heat and moister exchanger (HME) installed between the endotracheal tube

and the Y-piece

b. Intermittent nebulization with sterile saline q4-8h as needed

c. Maintaining adequate levels of distilled water in expiratory limb water trap

d. Creation of a water seal within the inspiratory limb of the ventilator tubing

Answer 20

a. Heat and moister exchanger (HME) installed between the endotracheal tube

and the Y-piece

Question 21

What is the maximum recommended duration of airway suctioning during mechanical

ventilation?

a. 1-2 seconds

b. 3-5 seconds

c. 10-15 seconds

d. 20-30 seconds

Answer 21

c. 10-15 seconds

Question 22

What is the primary site of magnesium absorption in the GI tract?

a. Jejunum

b. Duodenum

c. Ileum

d. Colon

Answer 22

c. Ileum

Question 23

What segment of the nephron is responsible for a majority of magnesium absorption?

a. Distal convoluted tubule

b. Proximal tubule

c. Loop of Henle

d. Collecting Ducts

Answer 23

c. Loop of Henle

Question 24

Per the rule of nines, what is the estimated total body surface area burned in a dog that presents

with burns on the dorsal trunk following general anesthesia?

a. 9%

b. 18%

c. 27%

d. 36%

Answer 24

18

Question 25

Which of the following statements regarding complications of burn wounds is correct? a. Since the superficial appearance of burn wounds can be misleading, the use of systemic inflammatory response syndrome (SIRS) criteria can be helpful in determining if a burn wound infection is present. b. Intra-abdominal hypertension occurs in 36-70% of people with burn wounds, but only 30-50% of veterinary patients. c. In people with both severe burn injury and smoke inhalation, 30-50% of patients will develop pneumonia. d. Systemic antimicrobials are routinely administered prophylactically in the management of burn wounds.

Answer 25

c. In people with both severe burn injury and smoke inhalation, 30-50% of patients will develop pneumonia.

Question 26

7. Recall that DAMPs (damage associated molecular pathogens) and PAMPS (pathogen associated molecular pattern molecules) can both stimulate local inflammation and upregulate the immune system. Where do these originate from? a. PAMPS are exogenously derived, DAMPS are endogenously derived b. DAMPS are exogenously derived, PAMPS are endogenous derived c. PAMPS and DAMPS are both exogenously derived d. PAMPS and DAMPS are both endogenously produced

Answer 26

a. PAMPS are exogenously derived, DAMPS are endogenously derived

Question 27

Which white blood cell is primarily involved in the response to PAMPS and DAMPS? a. Neutrophil b. Eosinophil c. Macrophage d. Monocytes

Answer 27

c. Macrophage

Question 28

A common PAMP is LPS. LPS is able to initiate the cascade for production of cytokine via which toll like receptor (TLR)? a. 4 b. 2 c. 3 d. 9

Answer 28

4

Question 29

A recent study by Zoia et al. evaluated the use of human IVIg in dogs with immune-mediated thrombocytopenia. By 2.5 days after infusion, what percentage of patients were determined to be “responders” (i.e. absent clinical signs of bleeding and a platelet count ≥40 × 10 9 /L [40,000/μL])? a. 10% b. 30% c. 50% d. 70%

Answer 29

70

Question 30

What is the proposed major mechanism of action of IVIg? a. Down-regulation of inflammatory cytokine production, including IL-1, IL-6, and TNFα b. Fc receptor blockade on the cell membranes of mononuclear phagocytes c. Redirection of immune system response to production of antibodies against foreign proteins rather than self-antigens d. Mediating Fas-Fas ligand interactions that initiate plasma cell apoptosis

Answer 30

b. Fc receptor blockade on the cell membranes of mononuclear phagocytes

Question 31

The 2024 RECOVER Guidelines recommend optimizing CPR to maximize ETCO 2 to no less than ____mmHg in dogs and cats undergoing CPR. a. 12 b. 15 c. 18 d. 21

Answer 31

18