NAVLE ASSESSMENT EXAM (ACTUAL EXAM) WITH CORRECT ANSWERS

NAVLE ASSESSMENT EXAM (ACTUAL EXAM) WITH CORRECT ANSWERS This is Sacrococcygeal dysgenesis, an inherited trait in Manx cats. Look for dysgenesis, agenesis of sacrum or other spinal column abnormalities. May present asymptomatic or with palpable lumbosacral abnormalities and LMN hind limb signs. (Hopping or crouched gait). May see nonprogressive urinary or fecal incontinence, chronic constipation. Sequelae include recurrent urinary tract infections, megacolon. NO treatment. Follow this link to see the original Merck image. Refs: Pasquini's, Tschauner's Guide to Small Animal Clinics, vol 1, 2nd ed. p. 537, and the Merck Veterinary Manual online edition. What is wrong with this picture? A - Pelvic fracture B - Tail root avulsion C - Left acetabular fracture D - Megacolon E - Sacrococcygeal dysgenesis This is the clinical picture of Pericardial effusion. Note the spherical "Balloon heart". Follow this link to see a DV view of pericardial effusion. RX of choice is pericardiocentesis. Ascites, distended jugulars suggests RIGHT congestive heart failure (CHF), more than left CHF (pulmonary edema, crackles, wheezes, cough). Cor pulmonale is just another name for right CHF due to pulmonary hypertension. Dilated cardiomyopathy (DCM) should be on your DDX. More likely to hear systolic murmur, arrhytmias, less likely to be muffled heart sounds. ECHOCARDIOGRAPHY resolves DDX between pericardial effusion, DCM and Peritoneopericardial hernia. Refs: Blackwell's 5-Minute Vet Consult Canine Feline, 4th ed. pp. 288-9, 1052-3, Tschauner/Pasquini's Guide to Sm An Clinics, 2nd ed. pp. 230-32 and the Merck Veterinary Manual online edition. An 8-year old German shepherd is presented with a 1-month history of cough, labored breathing and lethargy. He has fainted a few times after exertion. Upon physical exam pallor and a slow capillary refill time is noted. The dog has jugular distension, diminished, quiet heart sounds, ascites and weak, variable femoral pulses. T=102.0 F (38.9 C)..[N=99.5-102.5 F] HR=140 bpm...........[N=80-120] RR=24 brpm...........[N=15-34] A thoracic radiograph reveals the following. What is the clinical diagnosis? A - Peritoneopericardial hernia B - Dilated cardiomyopathy C - Congestive heart failure (left) D - Pericardial effusion E - Cor pulmonale These are ventricular premature complexes (VPCs). You had better be thinking the dog is in early stages of Dilated Cardiomyopathy (DCM). According to Merck, 9th ed. "...ventricular premature contractions on a routine ECG in a presumed healthy DOBERMAN Pinscher or BOXER is HIGHLY SUGGESTIVE of CARDIOMYOPATHY". Echocardiography is the test of choice for definitive diagnosis of DCM. Remember this mnemonic for DCM breed predispositions: "DCM in a BOX" (ie: "D_obes, C_ockers, M_assive dogs (giant breeds), in a BOX_er" ALWAYS FATAL. Death usually in 6 to 24 months after Dx. WORSE Prognosis in DOBES, generally survive less than 6 months from Dx. Ref: Blackwell's 5-Minute Vet Consult Canine Feline, 4th ed. pp. 210-1 and the Merck Veterinary Manual online edition. During a routine dental cleaning under isoflurane anesthesia on an 8-year old male neutered Doberman, the ECG monitor shows the following pattern. The dog is stable and doing fine. What is this pattern? A - Atrial fibrillation B - Ventricular premature complexes C - Atrioventricular (AV) block D - Accelerated idioventricular rhythm E - Sinus arrhythmia