BCSE - Basic and Clinical Sciences Examination Small Animal Internal Medicine Questions and Answers — Questions and Answers
Question 1: An 8-year-old miniature Schnauzer is presented with a 24-hour history of acute vomiting, anorexia, and cranial abdominal pain. The owner reports the dog may have ingested fatty table scraps the previous evening. The veterinarian suspects acute pancreatitis. Which of the following blood tests is the most specific for diagnosing pancreatitis in dogs?
- Canine pancreatic lipase immunoreactivity (cPLI) (Correct answer)
- Serum amylase
- Alanine aminotransferase (ALT)
- Serum lipase
Correct answer: Canine pancreatic lipase immunoreactivity (cPLI)
Canine pancreatic lipase immunoreactivity (cPLI) is the most specific non-invasive test for diagnosing canine pancreatitis. Traditional enzymes like amylase and lipase can be elevated due to other conditions (e.g., renal disease, gastrointestinal disease, corticosteroid administration) and are not specific to the pancreas. The cPLI assay measures only lipase of pancreatic origin, making it highly specific and sensitive for pancreatic inflammation.
Question 2: A 7-year-old male neutered Maine Coon cat presents for an annual wellness examination. A new grade III/VI systolic heart murmur is auscultated. The cat is otherwise asymptomatic. Which of the following diagnostic tests is considered the gold standard for definitively diagnosing hypertrophic cardiomyopathy (HCM)?
- Thoracic radiography
- Echocardiography (Correct answer)
- Serum NT-proBNP measurement
- Electrocardiography (ECG)
Correct answer: Echocardiography
Echocardiography is the definitive, gold-standard method for diagnosing feline HCM. It allows for direct visualization and measurement of the left ventricular wall thickness, confirming the presence of concentric hypertrophy which is the hallmark of the disease. While other tests like radiography, ECG, and NT-proBNP are useful for screening and assessing the consequences of HCM, only echocardiography provides a definitive diagnosis.
Question 3: A young German Shepherd is presented with a history of chronic diarrhea and significant weight loss despite a ravenous appetite. Which of the following clinical signs is most characteristic of exocrine pancreatic insufficiency (EPI)?
- Melena and intermittent vomiting
- Jaundice and ascites
- Steatorrhea and polyphagia (Correct answer)
- Polyuria and polydipsia
Correct answer: Steatorrhea and polyphagia
Exocrine pancreatic insufficiency (EPI) is a condition of maldigestion caused by insufficient production of digestive enzymes by the pancreas. The classic clinical signs include polyphagia (ravenous appetite), significant weight loss, and steatorrhea (large volumes of pale, fatty, malodorous feces) due to the inability to digest fats.
Question 4: A 4-year-old female spayed Standard Poodle presents with a history of intermittent lethargy, anorexia, and vomiting for several weeks. On physical examination, she is weak and has a slow, regular heart rate. A baseline chemistry panel is performed. Which of the following sets of electrolyte abnormalities is most pathognomonic for typical hypoadrenocorticism in this dog?
- Hypernatremia and hypokalemia
- Hypocalcemia and hyperphosphatemia
- Hyperglycemia and hypochloremia
- Hyponatremia and hyperkalemia (Correct answer)
Correct answer: Hyponatremia and hyperkalemia
Typical hypoadrenocorticism (Addison's disease) involves a deficiency of both glucocorticoids and mineralocorticoids (aldosterone). Aldosterone deficiency impairs the kidneys' ability to conserve sodium and excrete potassium, leading to the classic findings of hyponatremia (low sodium) and hyperkalemia (high potassium). This combination, often resulting in a sodium-to-potassium ratio of less than 27:1, is highly suggestive of the disease.
Question 5: A 10-year-old, obese West Highland White Terrier is presented for a chronic, harsh cough that has been present for over two months. Physical examination is unremarkable except for the cough elicited on tracheal palpation. Thoracic radiographs are taken. Which of the following radiographic findings would be most consistent with a diagnosis of chronic bronchitis?
- A diffuse, unstructured interstitial pattern
- A lobar alveolar pattern with air bronchograms
- Pleural effusion and cardiomegaly
- A prominent bronchial pattern (doughnuts and tram lines) (Correct answer)
Correct answer: A prominent bronchial pattern (doughnuts and tram lines)
The classic radiographic finding in canine chronic bronchitis is a prominent bronchial pattern. This is caused by inflammation and thickening of the bronchial walls, which appear as 'doughnuts' when viewed on-end and 'tram lines' when viewed in parallel with the x-ray beam. While other patterns can coexist, the bronchial pattern is the most characteristic feature.
Question 6: A 6-month-old Yorkshire Terrier is presented for evaluation of episodic bizarre behavior, including head pressing and aimless wandering, which are most pronounced after eating a high-protein meal. Bloodwork reveals microcytosis, low BUN, and mildly elevated liver enzymes. Which of the following conditions is the most likely cause of these clinical signs?
- Idiopathic epilepsy
- Portosystemic shunt (PSS) (Correct answer)
- Canine distemper virus
- Granulomatous meningoencephalitis (GME)
Correct answer: Portosystemic shunt (PSS)
A portosystemic shunt (PSS) is a vascular anomaly that allows portal blood to bypass the liver, preventing detoxification of substances from the GI tract like ammonia. The resulting hyperammonemia leads to hepatic encephalopathy, causing post-prandial neurological signs. The combination of a young, small-breed dog with neurological signs worsening after meals, along with classic lab findings like microcytosis and low BUN, is highly suggestive of a PSS.
