Australian College of Veterinary Scientists Membership Examination June/July 2009 Medicine of Cats Paper 1 Perusal time: fifteen (15) minutes Time allowed: two (2) hours after perusal Answer four (4) from the six (6) questions only All questions are of equal value Subsections of questions are of equal value unless stated otherwise Medicine of Cats Paper 1 Page 1 of 3 Paper 1: Medicine of cats Answer four (4) from the following six (6) questions only. 1. Discuss the pathophysiology of two (2) of the following: a) peritoneal effusions b) pre-hepatic, hepatic and post-hepatic jaundice c) myocardial hypertrophy due to both primary cardiac disease and secondary to other disorders d) feline bronchial disease (asthma). 2. Write brief notes on the mechanism of action, clinical indications and potential side effects of three (3) of the following drugs: a) meloxicam b) omeprazole c) clindamycin d) metronidazole e) cyproheptadine. 3. Discuss hypercalcaemia in cats. In your answer include all of the following: a) clinical signs b) the causes of hypercalcaemia, indicating the three (3) most common aetiologies c) your ideal plan for diagnostic investigation in a cat with increased serum total calcium. Continued over page Medicine of Cats Paper 1 Page 2 of 3 4. Describe and illustrate using diagrams, the neuroanatomical pathways involved in both of the following: a) the pupillary light reflex (PLR) b) Horner’s syndrome. 5. Write notes on the pathophysiology, clinical and laboratory findings associated with three (3) of the following: a) paracetamol toxicity b) lily toxicity c) thiamine deficiency d) vitamin K antagonists e) permethrin toxicity. 6. Systemic hypertension is a common clinical disorder in older cats. Answer all of the following: a) Outline the physiological mechanisms that control blood pressure in the cat. b) List the causes of hypertension in the cat. c) Explain the clinical consequences of uncontrolled hypertension in the feline patient. End of paper Medicine of Cats Paper 1 Page 3 of 3 Australian College of Veterinary Scientists Membership Examination June/July 2009 Medicine of Cats Paper 2 Perusal time: fifteen (15) minutes Time allowed: two (2) hours after perusal Answer four (4) from the six (6) questions only At least one (1) question must be from Section B All questions are of equal value Subsections of questions are of equal value unless stated otherwise Medicine of Cats Paper 2 Page 1 of 7 Paper 2: Medicine of cats Answer four (4) from the following six (6) questions only. At least one (1) question must be from Section B. Section A 1. Discuss the clinical presentation, diagnosis and management of two (2) of the following clinical problems: a) uncomplicated diabetes mellitus b) pancreatitis c) hyperaldosteronism d) idiopathic hepatic lipidosis. 2. Write notes on the diagnosis, limitations of diagnostic tests, and treatment of two (2) of the following: a) dermatophytosis due to Microsporum canis b) corneal ulceration due to feline herpesvirus type I c) flea allergy dermatitis d) tritrichomoniasis e) Mycoplasma haemofelis. Continued over page Medicine of Cats Paper 2 Page 2 of 7 3. For three (3) of the following conditions outline the differential diagnosis and discuss your diagnostic approach: a) coughing in a six-year-old Burmese cat living in Brisbane b) renomegaly in a 15-year-old Persian cat c) anaemia in a four-year-old Devon rex cat d) chronic sneezing in a two-year-old exotic shorthair cat e) haematuria in a three-year-old Abyssinian cat. 4. Inflammatory bowel disease (IBD) is frequently a problem in cats. Write notes on all of the following: a) the typical historical and clinical features of this disorder b) the ideal diagnostic approach to a cat with suspected IBD c) histological classification of IBD d) your treatment plan in a cat diagnosed with lymphocytic plasmacytic IBD. End of Section A Medicine of Cats Paper 2 Page 3 of 7 Section B Answer at least one (1) question from this section. 5. A 14-year-old female, neutered, domestic longhair cat presents with lethargy and chronic weight loss. The cat has had a normal to increased appetite for three to four months, but in the past week has become inappetent and has been vomiting. Physical examination reveals a bodyweight of 2.9 kg and a body condition score of 3/9. There is a palpable 3 x 4 cm mid-abdominal mass. The remainder of the physical examination is unremarkable. Haematology and serum biochemistry and urinalysis results are listed below. Haematology Parameter Value Reference range 0.25 0.30–0.45 L/L MCV 51 43–55 fL MCH 16 13–17 pg MCHC 330 282–333 g/dL Platelets 573 300–800 x 109/L Reticulocyte % 1.9 <0.5% Reticulocyte count 91 <61 x 109/L WBC 15.5 5.5–19.0 x 109/L Neutrophils 12.6 2.0–13.0 x 109/L Lymphocytes 0.6 0.9–7.0 x 109/L Monocytes 1.4 <0.7 x 109/L Eosinophils 0.8 <1.1 x 109/L PCV Blood smear: platelets clumped Continued over page Medicine of Cats Paper 2 Page 4 of 7 Serum biochemistry Parameter Value Reference range Sodium 154 144–158 mmol/L Potassium 5.1 3.7–5.4 mmol/L Chloride 121 106–123 mmol/L Urea 18.7 5.0–15.0 mmol/L Creatinine 0.14 0.08–0.20 mmol/L 7.4 3.2–7.5 mmol/L 4 <10 µmol/L AST 30 2–62 U/L ALT 46 19–100 U/L ALP 48 5–50 U/L Total protein 58 60–84 g/L Albumin 24 25–38 g/L Globulin 34 31–52 g/L Total calcium 2.2 2.1–2.8 mmol/L Phosphate 1.3 1.0–2.3 mmol/L Cholesterol 3.5 2.2–5.5 mmol/L Glucose Bilirubin Urinalysis Parameter Value Specific gravity 1.042 Protein 2+ Glucose negative Ketones negative Bilirubin negative Blood trace pH 6.5 Answer all of the following: a) What is your assessment of the clinical and clinicopathological findings? b) Discuss your diagnostic approach to this case. c) If the diagnosis was high-grade alimentary lymphoma, outline your advice to the owner regarding treatment options and prognosis. If the cat were retrovirus positive (either FIV or FeLV) would this influence your advice? Continued over page Medicine of Cats Paper 2 Page 5 of 7 6. A four-year-old, male neutered, domestic shorthair cat presents with acute lethargy and inappetence. Physical examination reveals a bodyweight of 4.1 kg and body condition score of 5/9. The respiratory rate is 60 breaths per minute and there is a moderate inspiratory dyspnoea. Rectal temperature is 40.1°C. You estimate that the cat is approximately 10% dehydrated. Blood and urine were subsequently collected for analysis. The results are presented below: Haematology Parameter Value Reference range PCV 0.28 0.30–0.45 L/L Platelets 349 300–800 x 109/L Reticulocyte % 0.2 <0.5% Reticulocyte count 11 <61 x 109/L WBC 22.0 5.5–19.0 x 109/L Neutrophils 19.0 2.0–13.0 x 109/L Band neutrophils 1.5 <0.3 x 109/L Lymphocytes 0.7 0.9–7.0 x 109/L Monocytes 0.8 <0.7 x 109/L Eosinophils <0.1 <1.1 x 109/L Blood smear: platelets clumped. Slight toxic change. Serum biochemistry Parameter Value Reference range Sodium 145 144–158 mmol/L Potassium 4.2 3.7–5.4 mmol/L Chloride 115 106–123 mmol/L Urea 5.6 5.0–15.0 mmol/L 0.10 0.08–0.20 mmol/L Glucose 5.1 3.2–7.5 mmol/L Bicarbonate 15 12–24 mmol/L 19.2 15.0–30.0 mmol/L Bilirubin 14 <10 µmol/L AST 64 <66 U/L ALT 71 <91 U/L ALP 12 <51 U/L Total protein 90 60–84 g/L Albumin 32 25–38 g/L Globulin 58 31–52 g/L Total calcium 2.2 2.1–2.8 mmol/L Phosphate 1.6 1.0–2.3 mmol/L Cholesterol 3.5 2.2–5.5 mmol/L Creatinine Anion gap Medicine of Cats Paper 2 Page 6 of 7 Urinalysis Parameter Value Specific gravity 1.060 Protein 2+ Glucose negative Ketones negative Bilirubin negative Blood trace pH 7.0 Answer all of the following: a) i) What is your initial assessment of the history and clinical examination findings? Justify your answer. ii) What would be the first diagnostic test you would choose after examining the cat, and why? b) What is your assessment of the clinicopathological findings? c) Outline your diagnostic plan given these findings. d) Discuss the optimal management of one (1) of the most likely differential diagnoses. End of paper Medicine of Cats Paper 2 Page 7 of 7