NAVLE Equine Surgery and Lameness 4

Question 1

A 2-year-old Thoroughbred colt has bilateral forelimb angular limb deformity (valgus) at the carpus identified at 4 months of age. Radiographs show the deformity originates at the distal radial physis. The foal is now presenting at 6 months without improvement. What surgical option should be considered?

Accepted Answer

Transphyseal bridging (screw and wire or staple) on the convex side

Answer

Transphyseal bridging on the convex (lateral) side of a carpal valgus deformity slows growth on that side, allowing the concave side to 'catch up' and correct the angular deformity.

Question 2

A horse presents with chronic forelimb lameness localized to the coffin joint. Radiographs show marked osteolysis and periarticular new bone formation. Synoviocentesis yields thick, turbid fluid with 85,000 WBC/μL (>90% neutrophils) and a glucose concentration much lower than serum. What is the next most critical step?

Accepted Answer

Perform through-and-through joint lavage and systemic antimicrobials

Answer

Septic arthritis requires immediate joint lavage (through-and-through or arthroscopic) combined with systemic and intra-articular antimicrobials to remove bacteria and inflammatory mediators.

Question 3

A 15-year-old Quarter Horse gelding has a chronic, non-healing wound over the lateral aspect of the pastern with a fistulous tract. Probing reveals contact with bone. Radiographs show cortical lysis of the lateral proximal phalanx. What is the definitive treatment?

Accepted Answer

Surgical debridement and sequestrum removal

Answer

Sequestrum formation requires surgical removal of the devitalized bone fragment combined with debridement of the surrounding infected tissue to allow healing.

Question 4

Which of the following is the most accurate description of a 'chip fracture' at the dorsal aspect of the proximal interphalangeal joint in a performance horse?

Accepted Answer

An osteochondral fragment typically arising from the dorsal proximal rim of the middle phalanx

Answer

Dorsal chip fractures at the pastern joint are osteochondral fragments typically arising from the dorsal proximal rim of the middle phalanx, removed arthroscopically.

Question 5

A 12-year-old Hanoverian mare develops acute severe lameness 48 hours after a routine intra-articular corticosteroid injection in the stifle. The joint is severely swollen, warm, and painful. Synoviocentesis is performed. Which synovial fluid finding would most strongly indicate post-injection septic arthritis rather than a corticosteroid flare?

Accepted Answer

WBC of 60,000/μL with 95% neutrophils and positive bacterial culture

Answer

Post-injection septic arthritis is confirmed by markedly elevated WBC (>30,000/μL) with predominantly neutrophils and positive bacterial culture, distinguishing it from a transient corticosteroid flare.

NAVLE - North American Veterinary Licensing Examination Practice Test

NAVLE - North American Veterinary Licensing Examination Practice Test

NAVLE Equine Surgery and Lameness 4