NAVLE Feline Internal Medicine Questions and Answers

Question 1

A 12-year-old female spayed Domestic Shorthair cat is presented with a 2-month history of progressive weight loss despite a ravenous appetite (polyphagia). The owner also reports occasional vomiting and restlessness. On physical examination, you note a heart rate of 230 bpm, a thin body condition, and an unkempt haircoat. Which of the following is the most likely diagnosis?

Accepted Answer

Hyperthyroidism

Answer

The combination of weight loss with polyphagia, tachycardia, and hyperactivity in an older cat is classic for hyperthyroidism. Diabetes mellitus can cause weight loss and polyphagia but is not typically associated with tachycardia or hyperactivity. Chronic kidney disease usually presents with weight loss and polyuria/polydipsia, but often with a decreased appetite. Inflammatory bowel disease typically involves weight loss, vomiting, and/or diarrhea, but not the other clinical signs noted.

Question 2

Which dietary modification is considered most critical in slowing the progression of chronic kidney disease (CKD) in cats?

Accepted Answer

Restricted phosphorus

Answer

Restricting dietary phosphorus is a cornerstone of managing feline CKD and has been shown to slow the progression of the disease. While moderate protein restriction is also part of therapeutic renal diets, phosphorus restriction is considered more critical for slowing progression. Excessive sodium restriction is not recommended, and increasing protein is contraindicated in later stages. Grain-free formulations have no proven benefit for CKD.

Question 3

A 9-year-old, obese, male neutered domestic shorthair is diagnosed with diabetes mellitus. Which insulin type, when combined with a low-carbohydrate diet, offers the highest probability of achieving diabetic remission in a newly diagnosed cat?

Accepted Answer

Glargine

Answer

Glargine insulin, a long-acting insulin analog, has been shown to result in better glycemic control and a higher probability of remission in newly diagnosed diabetic cats compared to other insulins like PZI or Lente (Vetsulin). NPH has a short duration of action in cats, and regular insulin is used for emergencies like DKA, not long-term management.

Question 4

A 7-year-old cat presents with a history of chronic vomiting, diarrhea, and weight loss. Bloodwork reveals a low serum cobalamin (Vitamin B12) level. Concurrent inflammation of the intestine, pancreas, and biliary tract is suspected. What is this condition called?

Accepted Answer

Triaditis

Answer

Feline triaditis is the concurrent inflammation of the pancreas (pancreatitis), biliary tract (cholangitis), and small intestine (inflammatory bowel disease). This combination of conditions is common in cats and often leads to malabsorption, resulting in clinical signs like vomiting, weight loss, and hypocobalaminemia due to impaired intestinal absorption. While the other conditions can cause similar signs, 'triaditis' specifically refers to the inflammation of these three associated organs.

Question 5

A 1-year-old male cat from a multi-cat household presents with a distended abdomen, fever, and lethargy. Abdominocentesis yields a viscous, straw-colored fluid with a high protein content. Which simple, in-house test can be performed on the fluid to strongly support a diagnosis of effusive Feline Infectious Peritonitis (FIP)?

Accepted Answer

Rivalta's test

Answer

The Rivalta's test is a simple and affordable test that involves adding a drop of the effusion fluid to a tube of distilled water and acetic acid. A positive result (the drop retains its shape) is caused by the high protein and fibrin content typical of FIP effusions and has a high positive predictive value for FIP. While not definitive, it is a strong supportive indicator. Coronavirus titers are often non-diagnostic as many cats are exposed to feline coronavirus without developing FIP. Cytology typically shows non-specific pyogranulomatous inflammation, and bacterial culture will be negative.

NAVLE - North American Veterinary Licensing Examination Practice Test

NAVLE - North American Veterinary Licensing Examination Practice Test

NAVLE Feline Internal Medicine Questions and Answers