ICVA Canine Internal Medicine 2 — Questions and Answers
Question 1: A 7-year-old Labrador presents with polyuria, polydipsia, and a pendulous abdomen. Bloodwork shows elevated ALP and a stress leukogram. Which test best differentiates pituitary-dependent hyperadrenocorticism from adrenal-dependent hyperadrenocorticism?
- Low-dose dexamethasone suppression test
- High-dose dexamethasone suppression test (Correct answer)
- ACTH stimulation test
- Urine cortisol:creatinine ratio
Correct answer: High-dose dexamethasone suppression test
The high-dose dexamethasone suppression test differentiates PDH (suppresses) from ADH (fails to suppress) in dogs with confirmed hyperadrenocorticism.
Question 2: A dog with immune-mediated hemolytic anemia (IMHA) has a PCV of 14%. Which finding on blood smear is most consistent with regenerative anemia?
- Hypersegmented neutrophils
- Polychromasia and reticulocytosis (Correct answer)
- Spherocytes only
- Heinz bodies
Correct answer: Polychromasia and reticulocytosis
Polychromasia and reticulocytosis indicate active bone marrow regeneration in response to anemia.
Question 3: Which electrocardiographic finding is most characteristic of hyperkalemia in a dog?
- Prolonged QT interval
- Sinus tachycardia with ST elevation
- Peaked T waves and widened QRS complexes (Correct answer)
- Atrial fibrillation
Correct answer: Peaked T waves and widened QRS complexes
Hyperkalemia causes peaked T waves, widened QRS, and eventually sinoventricular rhythm as potassium rises.
Question 4: A 5-year-old Golden Retriever presents with ascites. Abdominal fluid analysis shows a total protein of 1.8 g/dL and cell count of 300 cells/µL. This fluid is best classified as:
- Exudate
- Modified transudate
- Pure transudate (Correct answer)
- Chylous effusion
Correct answer: Pure transudate
A pure transudate has low protein (<2.5 g/dL) and low cell count (<1500 cells/µL), typically caused by hypoalbuminemia or portal hypertension.
Question 5: Which hepatic enzyme is most specific for hepatocellular damage (rather than cholestasis) in dogs?
- Alkaline phosphatase (ALP)
- Gamma-glutamyltransferase (GGT)
- Alanine aminotransferase (ALT) (Correct answer)
- Aspartate aminotransferase (AST)
Correct answer: Alanine aminotransferase (ALT)
ALT is a cytosolic enzyme most specific for hepatocyte damage in dogs, while ALP and GGT primarily reflect cholestasis or induction.
Question 6: A dog with protein-losing nephropathy (PLN) has a urine protein:creatinine ratio of 6.2. Which breed is most predisposed to glomerulonephritis due to a primary genetic defect in collagen IV?
- Labrador Retriever
- English Cocker Spaniel
- Soft Coated Wheaten Terrier
- Samoyed (Correct answer)
Correct answer: Samoyed
Samoyeds have an X-linked hereditary nephritis caused by a mutation in the COL4A5 gene encoding type IV collagen.
Question 7: In a dog with diabetic ketoacidosis (DKA), which electrolyte abnormality is most critical to monitor and replace during insulin therapy?
- Sodium
- Potassium (Correct answer)
- Calcium
- Magnesium
Correct answer: Potassium
Insulin drives potassium into cells, so serum potassium must be closely monitored and supplemented to prevent life-threatening hypokalemia during DKA treatment.
ICVA Canine Internal Medicine 2
A 7-year-old Labrador presents with polyuria, polydipsia, and a pendulous abdomen.
Bloodwork shows elevated ALP and a stress leukogram.
Which test best differentiates pituitary-dependent hyperadrenocorticism from adrenal-dependent hyperadrenocorticism?