NAVLE Feline Internal Medicine 3

Question 1

A cat with chronic vomiting undergoes endoscopic biopsy showing diffuse infiltration of small lymphocytes in the lamina propria. PARR testing confirms clonality. Which diagnosis is confirmed?

Accepted Answer

Small cell lymphoma

Answer

Clonal small lymphocyte infiltration confirmed by PCR for antigen receptor rearrangement (PARR) distinguishes small cell lymphoma from IBD, which is polyclonal.

Question 2

Which urine specific gravity value is most consistent with isosthenuria in a cat with suspected chronic kidney disease?

Accepted Answer

1.012

Answer

Isosthenuria (USG 1.008–1.012) indicates the kidneys cannot concentrate or dilute urine beyond plasma osmolality, a hallmark of significant tubular dysfunction.

Question 3

A cat on long-term methimazole therapy for hyperthyroidism develops facial excoriation, pruritus, and jaundice. Which complication is most likely?

Accepted Answer

Hepatotoxicity and immune-mediated dermatitis

Answer

Methimazole can cause hepatotoxicity and facial pruritus/excoriation due to immune-mediated dermatitis, both reasons to consider alternative therapy such as radioiodine or surgery.

Question 4

A 9-year-old cat presents with hypercalcemia (total Ca 14.2 mg/dL), weight loss, and peripheral lymphadenopathy. Which condition is most likely?

Accepted Answer

Lymphoma

Answer

Lymphoma is the most common cause of hypercalcemia of malignancy in cats, mediated by PTHrP secretion.

Question 5

Which finding on echocardiography best differentiates hypertrophic cardiomyopathy (HCM) from physiologic cardiac hypertrophy secondary to hyperthyroidism in a cat?

Accepted Answer

Systolic anterior motion (SAM) of the mitral valve

Answer

SAM of the mitral valve causing dynamic left ventricular outflow tract obstruction is characteristic of primary HCM and is not a feature of hyperthyroid-induced hypertrophy.

NAVLE - North American Veterinary Licensing Examination Practice Test

NAVLE - North American Veterinary Licensing Examination Practice Test

NAVLE Feline Internal Medicine 3