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Australasian Veterinary Examination, formerly the National Veterinary Examination Veterinary Clinical Medicine II: Metabolic, Production and Deficiency Diseases: practice questions

Australasian Veterinary Examination (AVE), formerly the National Veterinary Examination (NVE) · Australia / New Zealand · Australasian Veterinary Boards Council (AVBC)

Original practice questions written to the published syllabus · not past papers
10worked here, free
51written to this exam in this subject
11syllabus units

What this subject covers

The production diseases of high-yielding animals and the mineral and vitamin deficiencies: milk fever, ketosis, grass tetany, downer cow and their relatives.

In the exams: ICAR AICE-JRF core group 07 (Medicine); China comprehensive paper cattle; a recurring topic across Indian PG, PhD and state PSC syllabi

Where the 51 questions fall

How our questions for Australasian Veterinary Examination, formerly the National Veterinary Examination spread across the units of Veterinary Clinical Medicine II: Metabolic, Production and Deficiency Diseases. Difficulty: 7 easy, 34 medium, 10 hard.

Ketosis7
Milk fever6
Hypomagnesaemia5
Trace mineral deficiencies5
Metabolic profile testing4
Downer cow syndrome4
Post-parturient haemoglobinuria4
Fatty liver syndrome4
Azoturia4
Rickets, osteomalacia and osteodystrophy4
Vitamin deficiencies4

10 practice questions, worked

Choose an answer, then open the working. Each explanation says why the right answer is right and why the others are not.

1 · Milk fever · medium

A 7-year-old Jersey cow calved 12 hours ago. She is in sternal recumbency with her head turned into her flank, cold ears, dilated pupils, a dry muzzle, ruminal stasis, a rectal temperature of 37.4 °C and a weak, rapid pulse. What is the most appropriate first treatment?

  1. An oral calcium chloride drench given immediately while she is still recumbent
  2. Intravenous magnesium sulfate given rapidly as a single large bolus
  3. Intravenous dextrose alone
  4. Calcium solution given slowly intravenously while auscultating the heart
Answer and working

D. Calcium solution given slowly intravenously while auscultating the heart

These are classic signs of stage 2 milk fever, and slow intravenous calcium is the treatment of choice; auscultation detects arrhythmias caused by too-fast infusion. A sternal cow with poor swallowing risks aspiration if drenched. Rapid IV magnesium is dangerous, and dextrose does not correct hypocalcaemia.

Further reading: Constable et al., Veterinary Medicine 11th ed.; Goff 2008; Oetzel 2004; Suttle, Mineral Nutrition of Livestock 4th ed.

2 · Ketosis · medium

Which description best fits type II ketosis in dairy cows?

  1. Onset 1 to 2 weeks after calving in over-conditioned cows, with insulin resistance and fatty liver
  2. Onset at 3 to 6 weeks after calving in thin cows that are underfed at peak milk yield
  3. Caused by feeding poorly fermented silage high in butyric acid, with no link to body condition or liver fat
  4. Occurs only in dry cows in the last month of pregnancy that are carrying twin calves
Answer and working

A. Onset 1 to 2 weeks after calving in over-conditioned cows, with insulin resistance and fatty liver

Type II ketosis is associated with fat cows, heavy fat mobilisation and fatty liver early in lactation, and responds less well to treatment. Type I (underfeeding) ketosis occurs at 3 to 6 weeks near peak yield. Butyric silage causes alimentary ketosis.

Further reading: Constable et al., Veterinary Medicine 11th ed.; Goff 2008; Oetzel 2004; Suttle, Mineral Nutrition of Livestock 4th ed.

3 · Ketosis · hard

A cow 10 days after calving has a reduced appetite, falling milk yield, strongly positive urine ketones, and a high-pitched ping on simultaneous percussion and auscultation over the left 9th to 13th ribs. What is the best interpretation?

  1. Primary ketosis only; the ping is normal rumen gas and needs no further investigation
  2. Right displaced abomasum with volvulus; immediate euthanasia without attempting surgery
  3. Traumatic reticuloperitonitis; give a magnet only and confine the cow for several weeks
  4. Left displaced abomasum with secondary ketosis; correct the LDA and support energy
Answer and working

D. Left displaced abomasum with secondary ketosis; correct the LDA and support energy

A ping over the left 9th to 13th ribs in an early-lactation cow is typical of left displaced abomasum. Reduced intake causes secondary ketosis, which will not resolve until the displacement is corrected. A rumen ping is usually lower and more dorsal and caudal; right displacement pings on the right.

Further reading: Constable et al., Veterinary Medicine 11th ed.; Goff 2008; Oetzel 2004; Suttle, Mineral Nutrition of Livestock 4th ed.

4 · Hypomagnesaemia · medium

A grazing cow with tetany has a serum magnesium of 1.1 mg/dL. Using a factor of 0.411, what is this in mmol/L and what does it indicate?

  1. 0.45 mmol/L; consistent with clinical hypomagnesaemic tetany
  2. 0.27 mmol/L; normal
  3. 2.7 mmol/L; hypermagnesaemia
  4. 0.45 mmol/L; normal for a lactating cow
Answer and working

A. 0.45 mmol/L; consistent with clinical hypomagnesaemic tetany

Working: 1.1 x 0.411 = 0.45 mmol/L. Clinical tetany is typical below about 0.5 mmol/L; normal values are commonly about 0.8 to 1.2 mmol/L (laboratory ranges vary). 0.2495 is the calcium factor (0.27), and dividing gives an impossible value (2.7).

Further reading: Constable et al., Veterinary Medicine 11th ed.; Goff 2008; Oetzel 2004; Suttle, Mineral Nutrition of Livestock 4th ed.

5 · Fatty liver syndrome · easy

A donkey's serum triglyceride is reported as 620 mg/dL. Using a factor of 0.01129, what is it in mmol/L, and does it exceed the commonly used hyperlipaemia threshold of about 5.6 mmol/L?

  1. 7.0 mmol/L; yes
  2. 70 mmol/L; yes
  3. 16.1 mmol/L; yes
  4. 0.70 mmol/L; no
Answer and working

A. 7.0 mmol/L; yes

Working: 620 x 0.01129 = 7.00 mmol/L, above 5.6. The factor 0.0259 (16.1) applies to cholesterol, not triglyceride, and a misplaced decimal in the factor gives 70 or 0.70.

Further reading: Reed, Bayly & Sellon, Equine Internal Medicine 4th ed.; Constable et al. 11th ed.

6 · Azoturia · medium

A horse with stiff, painful hindquarters after exercise passes dark urine. The urine dipstick is strongly positive for blood, but no red cells are seen on microscopy of the sediment. This indicates:

  1. Myoglobinuria
  2. Haematuria from bladder stones
  3. Normal equine urine colour
  4. Bilirubinuria from liver failure
Answer and working

A. Myoglobinuria

Dipsticks react with the haem group of both haemoglobin and myoglobin. No red cells excludes haematuria, and the history of exercise-associated muscle pain points to myoglobin. The myoglobin comes from exercise-associated muscle damage.

Further reading: Reed, Bayly & Sellon, Equine Internal Medicine 4th ed.; Constable et al. 11th ed.

7 · Rickets, osteomalacia and osteodystrophy · medium

Beef cattle on phosphorus-deficient range are seen chewing bones of old carcasses. Which disease is this behaviour classically linked with?

  1. Tetanus
  2. Blackleg
  3. Botulism
  4. Anthrax
Answer and working

C. Botulism

Osteophagia (bone chewing) from phosphorus deficiency leads cattle to eat carcass material containing Clostridium botulinum toxin, as described in southern Africa (lamziekte). Phosphorus supplementation and vaccination are used for control.

Further reading: Constable et al., Veterinary Medicine 11th ed.; Goff 2008; Oetzel 2004; Suttle, Mineral Nutrition of Livestock 4th ed.

8 · Rickets, osteomalacia and osteodystrophy · medium

A horse is fed mostly wheat bran with grass hay; its total ration contains 0.25% calcium and 0.75% phosphorus of dry matter. What is the Ca:P ratio and the expected problem?

  1. 3:1; hypercalcaemia
  2. 0.33:1; nutritional secondary hyperparathyroidism (big head)
  3. 0.33:1; rickets from vitamin A excess (hypervitaminosis A)
  4. 3:1; normal ratio
Answer and working

B. 0.33:1; nutritional secondary hyperparathyroidism (big head)

Working: 0.25 / 0.75 = 0.33, so the ratio is about 0.33:1 (inverted, 1:3). With more phosphorus than calcium, PTH stays high and facial bones are replaced by fibrous tissue. Most species need about 1:1 to 2:1. Inverting gives 3:1, which describes the opposite ratio.

Further reading: Reed, Bayly & Sellon, Equine Internal Medicine 4th ed.; Constable et al. 11th ed.

9 · Rickets, osteomalacia and osteodystrophy · medium

A bone lesion shows reduced bone mass, but what bone is present is normally mineralised. This is:

  1. Osteomalacia
  2. Rickets
  3. Osteodystrophia fibrosa
  4. Osteoporosis
Answer and working

D. Osteoporosis

Osteoporosis is too little bone of normal composition (for example from starvation, copper deficiency or disuse). Osteomalacia and rickets are failures of mineralisation, and osteodystrophia fibrosa is fibrous replacement under PTH.

Further reading: Constable et al., Veterinary Medicine 11th ed.; Goff 2008; Oetzel 2004; Suttle, Mineral Nutrition of Livestock 4th ed.

10 · Vitamin deficiencies · medium

Cattle fed mouldy sweet clover hay bleed excessively after dehorning. The correct specific treatment is:

  1. Vitamin K1 (phytonadione)
  2. Vitamin K3 (menadione) intravenously as the preferred treatment
  3. Vitamin E
  4. Calcium borogluconate
Answer and working

A. Vitamin K1 (phytonadione)

Mouldy sweet clover contains dicoumarol, a vitamin K antagonist that prevents activation of clotting factors II, VII, IX and X. Vitamin K1 is the effective antidote; vitamin K3 is much less effective as treatment. Blood transfusion may be needed in severe cases.

Further reading: Constable et al., Veterinary Medicine 11th ed.; Goff 2008; Oetzel 2004; Suttle, Mineral Nutrition of Livestock 4th ed.

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Veterinary Clinical Medicine II: Metabolic, Production and Deficiency DiseasesThe full study manual, free Australasian Veterinary Examination, formerly the National Veterinary ExaminationFormat, sections and how it has changed

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Veterinary Clinical Medicine II: Metabolic, Production and Deficiency Diseases for other exams

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