MEMBERSHIP EXAMINATION
JUNE/JULY 2006
MEDICINE OF CATS
PAPER 1
Perusal time: 15 minutes
Time allowed: TWO (2) Hours after perusal
Answer FOUR (4) from the six questions ONLY.
All questions are of equal value
Subsections of Questions are of equal value unless stated otherwise
(Total marks available 120)
PAPER ONE –Medicine of Cats– 2006
Answer FOUR (4) from the six questions ONLY.
1.
a.
Describe the physiology of normal micturition in the cat.
b.
For a patient with a T3-L3 spinal cord lesion causing detrusor atony
and sphincter hypertonus:
i)
ii)
2.
c.
Thiamine deficiency.
Nutritional secondary hyperparathyroidism.
Devon rex myopathy.
Polycystic kidney disease.
Write short notes on ante-mortem diagnostic testing for THREE (3) of the
following:
a)
b)
c)
d)
5.
Discuss the physiology of potassium homeostasis.
Describe the potential causes and clinical consequences of
hypokalaemia.
Outline the management of hypokalaemia for TWO (2) of the causes
you have listed.
Write notes on the aetiology, pathophysiology and clinical findings associated
with THREE (3) of the following:
a.
b.
c.
d.
4.
Describe your management plan.
(10 marks)
List the mechanism of action and potential side effects of any
medications that you use.
(10 marks)
Potassium levels may become significantly altered in a variety of feline
disorders.
a.
b.
3.
(10 marks)
Feline leukaemia virus infection.
Feline immunodeficiency virus infection.
Feline infectious peritonitis.
Toxoplasmosis.
Describe the mechanisms of action, clinical indications for, and potential side
effects of THREE (3) of the following drugs:
a.
b.
c.
d.
e.
Chlorambucil.
Carbimazole.
Benazepril.
Terbutaline.
Amlodipine.
Continued over/Medicine of Cats/Paper 1
Continued/Medicine of Cats/Paper 1
6.
Discuss the indications, clinical significance and limitations of THREE (3) of
the following laboratory tests:
a.
b.
c.
d.
Urine protein-to-creatinine ratio.
Urine cortisol-to creatinine ratio.
Pre and postprandial serum bile acids.
Serum Vitamin B12 (Cobalamin) level.
END OF PAPER
MEMBERSHIP EXAMINATION
JUNE/JULY 2006
MEDICINE OF CATS
PAPER 2
Perusal time: 15 minutes
Time allowed: TWO (2) Hours after perusal
Candidates must answer FOUR (4) of 6 questions, which must include at least ONE
(1) question from SECTION B.
All questions are of equal value
Subsections of Questions are of equal value unless stated otherwise
(Total marks available 120)
PAPER TWO –MEDICINE OF CATS – 2006
Candidates must answer FOUR (4) of 6 questions, which must include at least ONE
(1) question from SECTION B.
SECTION A
1.
Outline common aetiologies for and diagnostic investigation of THREE (3) of
the following:
a)
b)
c)
d)
e)
2.
Write short notes on THREE (3) of the following:
a)
b)
c)
d)
e)
3.
4.
Hypercalcaemia
renomegaly
subcutaneous oedema
anisocoria
generalised weakness
Treatment of pyothorax.
Relevance of AB blood groups to cat breeding.
Aetiology, diagnosis and treatment of feline demodecosis.
Management of anorexia.
Clinical presentation, diagnosis and treatment of feline herpesvirus-1
dermatitis.
A 17 year-old desexed female domestic shorthair cat is presented with a
history of having had a single seizure-like episode the previous evening. The
owner is away and the carer has presented the cat. The cat has access to
outdoors and is perceived to be eating and drinking normally. On physical
examination the cat has a body condition score of 2/5, heart rate 220 bpm,
respiratory rate 42/min. No abnormalities are detected on a neurological
examination.
a)
List your differential diagnoses for seizures in this patient. Indicate
which you think are most likely.
(10 marks)
b)
Describe a logical, stepwise approach to the diagnostic investigation of
this case?
(20 marks)
a)
Outline the information that you would give to an owner who wishes to
feed their cat a vegetarian diet.
b)
Discuss dietary management considerations for EACH of the
following:
(i)
Diabetes mellitus.
(ii)
Chronic renal insufficiency.
(iii)
Inflammatory bowel disease.
Continued over/Medicine of Cats/Paper 2
Continued/Medicine of Cats/Paper 2
Candidates must answer at least ONE (1) question from SECTION B.
SECTION B
5.
A 4 year-old desexed male Burmese cat is presented with a three day history
of partial anorexia and lethargy. He is fed a commercial diet and has outdoor
access. On physical examination the cat is reluctant to stand, has a body
condition score of 4/5 a heart rate of 220 bpm, respiratory rate of 40 /min,
rectal temperature of 38.60C and pale mucous membranes.
a)
What is your assessment of the history and physical examination
findings in this case?
Results of a complete blood count and serum biochemical profile were as follows:
Analyte
PCV
TPP
Hb
Erythrocytes
MCV
MCHC
MCH
Patient Value
0.11 L/L
53g/L
36g/L
2.25 x 1012/L
48.9 fl
327 g/L
16.0 pg
Normal Range
0.30-0.45
59-78
80-140
6-10 x 1012
40-45
310-350
13-17
White cell count
Segmented neutrophils
Bands
Lymphocytes
Monocytes
Eosinophils
Platelet Count
Reticulocyte (uncorrected)
Total Reticulocytes
9.3 x 109/ L
8.0 x 109/ L
0.00 x 109/ L
1.1 x 109/ L
0.2 x 109/ L
0.2 x 109/L
180
2.6 %
0.084 x 1012/L
8-14
4-11
0-0.40
1.6-7.0
0.05-0.6
0-1
300-700 x10^9/L
0-1.0
Abnormal Smear Morphology: Poikilocytosis-Moderate, Polychromasia-Moderate
Sodium
153
mmol/L
147-156
Potassium
3.5
mmol/L
4.0-4.6
Chloride
115
mmol/L
115-130
Calcium
2.1
mmol/L
2.0-2.8
Phosphate
1.4
mmol/L
0.9-2.3
ALT
331
U/L
<60
ALP
37
U/L
0-50
Bilirubin (total)
2.2
mol/L
2-3
Urea
17
mmol/L
5-14
Creatinine
215
mol/L
90-180
Glucose
7.26 mmol/L
3.6-6.6
Protein
53
g/L
54-73
Albumin
22
g/L
19-38
Globulin
31
g/L
26-51
Creatine Kinase
301
mol/L
0-360
Urine specific gravity > 1.050
Continued over Medicine of Cats/Paper 2 – Question 5
Continued Medicine of Cats/Paper 2 – Question 5
6.
b)
What is your assessment of these results?
c)
List your differential diagnoses.
d)
What further diagnostic and/or treatment options would you offer to
the owner at this stage? Justify your recommendations.
Rastus, an 8 year-old desexed male domestic shorthair, is presented with acute
inappetence and lethargy. He has been eating less over the past few days and
has been quite thirsty during this time. Rastus is an indoor/outdoor cat. He has
otherwise been in good health and is up to date with parasite control and
routine vaccinations. He was found to be FIV-seropositive on a screening test
last year. His owner reports that he is urinating and defecating normally.
Physical examination reveals that Rastus is 6.6kg with a body condition score
of 4/5. He is slightly tachycardic (180 BPM) and tachypnoeic (RR 40).
However he has no overt dyspnoea. You estimate he is about 10% dehydrated.
He is lethargic and quiet, preferring to lie in sternal recumbency on the
examination table. He has pink mucous membranes that have a tacky feel
when you perform a capillary refill time (< 2 sec). His abdomen is difficult to
palpate because he has a lot of intra-abdominal fat.
You admit Rastus for further investigation. You collect blood and urine for
routine analysis (results below) and start him on intravenous fluids.
Analyte
PCV
TPP
Hb
Erythrocytes
MCV
MCHC
MCH
Patient Value
0.40 L/L
70g/L
130g/L
8.5 x 1012/L
42 fl
327 g/L
16.0 pg
Normal Range
0.30-0.45
59-78
80-140
6-10 x 1012
40-45
310-350
13-17
White cell count
Segmented neutrophils
Bands
Lymphocytes
Monocytes
Eosinophils
Reticulocyte (uncorrected)
9.5 x 109/ L
7.6 x 109/ L
0.00 x 109/ L
0.8 x 109/ L
0.4 x 109/ L
0.8 x 109/L
0.5 %
8-14
4-11
0-0.40
1.6-7.0
0.05-0.6
0-1
0-1.0
Continued over Medicine of Cats/Paper 2 – Question 6
Continued Medicine of Cats/Paper 2 – Question 6
Abnormal Smear Morphology: Red blood cell morphology is normal. Platelets are
clumped and adequate.
Sodium
Potassium
Chloride
Calcium
Phosphate
ALT
ALP
Bilirubin (total)
Urea
Creatinine
Glucose
Protein
Albumin
Globulin
Creatine Kinase
151
5.6
111
2.8
6.6
60
37
2.3
65
850
7.26
65
39
31
301
mmol/L
mmol/L
mmol/L
mmol/L
mmol/L
U/L
U/L
mol/L
mmol/L
mol/L
mmol/L
g/L
g/L
g/L
mol/L
147-156
4.0-4.6
115-130
2.0-2.8
0.9-2.3
<60
0-50
2-3
5-14
90-180
3.6-6.6
54-73
19-38
26-51
0-360
Urinalysis:
Urine specific gravity 1.020
Urine chemistry (“dipstick”)
Glucose: negative
Protein: 2+
Bilirubin: negative
Ketones: negative
Haemoglobin: negative
Urine pH: 6.0
Microscopic:
RBC/HPF: < 1
WBC/HPF: <1
Casts: negative
Bacteria: negative
Crystals: negative
(a)
Outline your interpretation of the clinicopathological findings in this case.
Explain the criteria you would use to differentiate an acute versus a chronic
process.
(b)
List your differential diagnoses.
(c)
Explain how you would investigate this case further.
(d)
If the diagnosis was renal lymphosarcoma, outline treatment options. Does the
cat’s FIV-status and/or the degree of azotaemia influence your advice with
regards to prognosis?
END OF PAPER