BCSE Small Animal Internal Medicine 3 — Questions and Answers
Question 1: A 12-year-old cat presents with progressive dyspnea. Thoracocentesis yields a chylous effusion. Which underlying condition is most commonly associated with chylothorax in cats?
- Pulmonary thromboembolism
- Cardiac disease (especially cardiomyopathy) (Correct answer)
- Feline infectious peritonitis
- Mediastinal lymphoma
Correct answer: Cardiac disease (especially cardiomyopathy)
Cardiac disease, particularly hypertrophic cardiomyopathy, is the most common identifiable cause of chylothorax in cats due to elevated venous pressures.
Question 2: A dog with a known seizure disorder is presented for breakthrough seizures despite therapeutic phenobarbital levels. Which additional anticonvulsant is most commonly added as adjunctive therapy in dogs?
- Diazepam
- Potassium bromide (Correct answer)
- Gabapentin
- Levetiracetam
Correct answer: Potassium bromide
Potassium bromide is the most established second-line anticonvulsant in dogs, with a different mechanism than phenobarbital and well-documented efficacy.
Question 3: Which finding on a transtracheal wash or bronchoalveolar lavage is most consistent with eosinophilic bronchopneumopathy in a dog?
- Neutrophilic inflammation with intracellular bacteria
- Greater than 25% eosinophils on cytology (Correct answer)
- Predominance of lymphocytes
- Charcot-Leyden crystals with mast cell degranulation
Correct answer: Greater than 25% eosinophils on cytology
Eosinophilic bronchopneumopathy is characterized by eosinophilic airway inflammation, typically >25% eosinophils on BAL cytology.
Question 4: A 5-year-old Miniature Schnauzer presents with recurrent pancreatitis and marked hypertriglyceridemia. What is the most appropriate long-term dietary management?
- High-protein, low-carbohydrate diet
- Strict low-fat diet with less than 10% fat on dry matter basis (Correct answer)
- Omega-3 fatty acid supplementation alone
- High-fiber, moderate-fat diet
Correct answer: Strict low-fat diet with less than 10% fat on dry matter basis
A strict low-fat diet reduces dietary triglyceride absorption and decreases the risk of hyperlipidemia-induced pancreatitis in predisposed breeds.
Question 5: A 7-year-old DSH cat with chronic vomiting and weight loss has a PLI within normal limits but shows small intestinal wall thickening on ultrasound with loss of layering. The most likely diagnosis is:
- Chronic pancreatitis
- Alimentary lymphoma (Correct answer)
- Inflammatory bowel disease
- Tritrichomonas foetus infection
Correct answer: Alimentary lymphoma
Loss of normal intestinal wall layering on ultrasound in a middle-aged to older cat with chronic GI signs strongly suggests alimentary lymphoma.
Question 6: A dog presents with acute collapse, pale mucous membranes, and abdominal distension. Point-of-care ultrasound reveals free fluid in the abdomen. Abdominocentesis yields non-clotting hemorrhagic fluid. Which is the most common underlying cause?
- Coagulopathy secondary to rodenticide toxicosis
- Ruptured splenic mass (hemangiosarcoma) (Correct answer)
- Trauma-induced hepatic laceration
- Mesenteric vascular thrombosis
Correct answer: Ruptured splenic mass (hemangiosarcoma)
Splenic hemangiosarcoma is the most common cause of hemoabdomen in dogs and presents with acute collapse due to spontaneous tumor rupture.
Question 7: A puppy presents with regurgitation beginning at weaning. Thoracic radiographs show a dilated esophagus cranial to the heart base only. What is the most likely diagnosis?
- Generalized megaesophagus
- Persistent right aortic arch (vascular ring anomaly) (Correct answer)
- Myasthenia gravis
- Esophageal foreign body
Correct answer: Persistent right aortic arch (vascular ring anomaly)
Persistent right aortic arch traps the esophagus and causes focal dilation cranial to the heart base, distinguishable from generalized megaesophagus.
BCSE Small Animal Internal Medicine 3
A 12-year-old cat presents with progressive dyspnea.
Thoracocentesis yields a chylous effusion.
Which underlying condition is most commonly associated with chylothorax in cats?