NAVLE Canine Internal Medicine Questions and Answers

Question 1

A 7-year-old female spayed Standard Poodle presents with a history of waxing and waning lethargy, vomiting, and anorexia. On physical examination, she is quiet but responsive, with a heart rate of 60 bpm and weak femoral pulses. Bloodwork reveals hyponatremia, hyperkalemia, and azotemia. Which of the following is the most definitive diagnostic test for this dog's suspected condition?

Accepted Answer

ACTH stimulation test

Answer

The clinical signs (lethargy, vomiting, anorexia), signalment (Standard Poodle), and classic electrolyte abnormalities (hyponatremia, hyperkalemia) are highly suggestive of hypoadrenocorticism (Addison's disease). The definitive diagnosis of hypoadrenocorticism is made by performing an ACTH stimulation test, which will show a low resting cortisol and a negligible response to ACTH administration.

Question 2

Which of the following is a primary therapeutic goal in the management of a dog with chronic kidney disease (CKD) and proteinuria?

Accepted Answer

Controlling systemic hypertension and reducing phosphorus intake

Answer

Management of canine CKD focuses on slowing disease progression and improving quality of life. Key goals include controlling systemic hypertension, which can exacerbate kidney damage, and reducing dietary phosphorus intake to manage renal secondary hyperparathyroidism. Protein restriction (not increase) is often indicated, and while diuretics have a role in specific situations, they don't increase GFR. Vitamin D supplementation must be done cautiously to avoid hypercalcemia.

Question 3

A 5-year-old Cocker Spaniel presents with acute lethargy, pale mucous membranes, and icterus. A complete blood count reveals a severe regenerative anemia (HCT 15%) with marked spherocytosis and autoagglutination. Which of the following is the most likely diagnosis?

Accepted Answer

Immune-Mediated Hemolytic Anemia (IMHA)

Answer

The combination of severe regenerative anemia, spherocytosis, and autoagglutination is pathognomonic for Immune-Mediated Hemolytic Anemia (IMHA). Spherocytes are red blood cells that have lost their biconcave shape due to partial phagocytosis, a hallmark of extravascular hemolysis in IMHA. Autoagglutination is the macroscopic clumping of red blood cells due to antibody coating. While other conditions can cause anemia, this specific combination of findings points strongly to an immune-mediated process.

Question 4

A 10-year-old Miniature Schnauzer with a history of hyperlipidemia presents with acute onset of vomiting, anorexia, and cranial abdominal pain. Physical examination reveals a 'praying posture.' Laboratory findings include neutrophilia, elevated amylase, and markedly elevated lipase. Which of the following is the most appropriate initial treatment?

Accepted Answer

Aggressive intravenous fluid therapy, analgesia, and antiemetics

Answer

The signalment, history, and clinical signs are classic for acute pancreatitis. The cornerstone of treatment is supportive care, which includes aggressive intravenous fluid therapy to correct dehydration and maintain pancreatic perfusion, potent analgesia to manage pain, and antiemetics to control vomiting. A low-fat diet is indicated once the patient can tolerate oral intake, and surgery is not typically the first-line treatment unless complications like an abscess or obstruction are present.

Question 5

A 4-year-old Soft Coated Wheaten Terrier is presented for chronic small bowel diarrhea, significant weight loss, and peripheral edema. Bloodwork reveals severe panhypoproteinemia (both albumin and globulin are low). Which of the following conditions is the most likely underlying cause?

Accepted Answer

Protein-losing enteropathy (PLE)

Answer

The combination of chronic diarrhea, weight loss, and panhypoproteinemia (low albumin and globulin) is characteristic of a protein-losing enteropathy (PLE). In PLE, proteins are lost through the gastrointestinal tract. While protein-losing nephropathy and chronic hepatitis cause hypoalbuminemia, globulins are typically normal or elevated. EPI causes weight loss and diarrhea but does not typically cause significant protein loss. Soft Coated Wheaten Terriers are also predisposed to PLE.

NAVLE - North American Veterinary Licensing Examination Practice Test

NAVLE - North American Veterinary Licensing Examination Practice Test

NAVLE Canine Internal Medicine Questions and Answers