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BCSE Veterinary Physiology I: Body Fluids, Blood, Circulation, Respiration and Excretion: practice questions

BCSE (Basic & Clinical Sciences Examination) · USA / Canada · ICVA; administered through CVMA-NEB and AVMA-ECFVG

Original practice questions written to the published syllabus · not past papers
8worked here, free
38written to this exam in this subject
12syllabus units

What this subject covers

How blood, heart, lungs and kidneys keep the internal environment stable in mammals and birds. Acid-base and fluid balance here underpin fluid therapy in the clinic.

In the exams: ICAR AICE-JRF core group 08; ICAR AIEEA-PG 14 (Physiology); PRC 10%; Nepal NLEV 6; China basic paper 13; AVE Paper 1 at least 5

What BCSE asks from it

BCSE, NAVLE, RCVS SME and the Australasian Veterinary Examination (Paper 1 physiology)

Applied physiology in cases: interpreting red cell indices and regeneration, coagulation panels in rodenticide poisoning, fluid deficit and distribution of crystalloids, hypoxaemia under anaesthesia, azotaemia and urine specific gravity, abomasal displacement alkalosis, and blood gas interpretation.

Where the 38 questions fall

How our questions for BCSE spread across the units of Veterinary Physiology I: Body Fluids, Blood, Circulation, Respiration and Excretion. Difficulty: 3 easy, 25 medium, 10 hard.

Acid-base balance6
Haemostasis and coagulation5
Cardiac cycle5
Blood composition and function4
Osmoregulation4
Body fluids3
Renal function3
Control of the cardiovascular system2
Control of respiration2
Gas exchange and transport2
Cellular basis of physiology1
High-altitude physiology1

8 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 · Blood composition and function · medium

An anaemic dog has PCV 20 per cent and 6 per cent reticulocytes. Taking 45 per cent as a normal PCV, what is the corrected reticulocyte percentage?

  1. About 1.2 per cent
  2. About 13.5 per cent
  3. About 2.7 per cent
  4. 6.0 per cent
Answer and working

C. About 2.7 per cent

Corrected % = observed % x patient PCV / normal PCV = 6 x 20 / 45 = 2.67 per cent. Multiplying by 45/20 instead inverts the correction and exaggerates regeneration (13.5 per cent); multiplying by the patient PCV as a fraction (6 x 0.20) without dividing by the normal PCV gives 1.2 per cent. The correction is needed because fewer mature red cells make the reticulocyte share look larger.

Further reading: Harvey JW, Veterinary Hematology: A Diagnostic Guide and Color Atlas.

2 · Blood composition and function · hard

A nervous Thoroughbred's PCV rises markedly between a sample taken calmly and one taken after it was frightened. The main reason is:

  1. Splenic contraction releasing stored red cells under sympathetic stimulation
  2. Erythropoietin-driven release of newly formed red cells from the bone marrow
  3. Acute dehydration from sweating during the few minutes of excitement
  4. Haemolysis of the second sample
Answer and working

A. Splenic contraction releasing stored red cells under sympathetic stimulation

The equine spleen stores a large red cell reserve that is expelled within minutes under adrenaline, so a single PCV in an excited horse can overstate the red cell mass. Dehydration and erythropoiesis cannot act that fast.

Further reading: Reece WO et al. (eds), Dukes' Physiology of Domestic Animals, 13th ed.

3 · Haemostasis and coagulation · medium

A dog ate an anticoagulant rodenticide 48 hours ago and shows no bleeding yet. Which test is expected to prolong first?

  1. Activated partial thromboplastin time (aPTT)
  2. Platelet count
  3. Prothrombin time (PT)
  4. Buccal mucosal bleeding time
Answer and working

C. Prothrombin time (PT)

The rodenticide blocks vitamin K recycling, and factor VII, measured by the PT, has the shortest half-life, so PT lengthens first; aPTT follows as IX, X and II fall. Bleeding time and platelet count test primary haemostasis, which is not affected.

Further reading: DiBartola SP (ed), Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice, 4th ed.

4 · Haemostasis and coagulation · medium

A young male dog has bleeding into joints. Its aPTT is prolonged and its PT and platelet count are normal. The most likely diagnosis is:

  1. Von Willebrand disease
  2. Anticoagulant rodenticide (vitamin K antagonist) poisoning
  3. Haemophilia A
  4. Immune-mediated thrombocytopenia
Answer and working

C. Haemophilia A

Haemophilia A is X-linked, so affected animals are usually male, and factor VIII sits in the intrinsic pathway, lengthening aPTT but not PT. Rodenticide prolongs PT first; thrombocytopenia lowers the count; von Willebrand disease causes mucosal bleeding with a prolonged bleeding time. Haemophilia A is factor VIII deficiency.

Further reading: Reece WO et al. (eds), Dukes' Physiology of Domestic Animals, 13th ed.

5 · Cardiac cycle · medium

Echocardiography of a dog gives an end-diastolic volume of 60 mL and an end-systolic volume of 20 mL. What is the ejection fraction?

  1. 40 per cent
  2. 300 per cent
  3. About 33 per cent
  4. About 67 per cent
Answer and working

D. About 67 per cent

Stroke volume = 60 - 20 = 40 mL; EF = SV / EDV = 40 / 60 = 66.7 per cent. 33 per cent is ESV/EDV; 300 per cent inverts the ratio (EDV/ESV); 40 is the stroke volume in mL, not a percentage.

Further reading: Reece WO et al. (eds), Dukes' Physiology of Domestic Animals, 13th ed.

6 · Cardiac cycle · easy

On an ECG recorded at 25 mm/s, the R-R interval is 15 mm. What is the heart rate?

  1. 200 beats per minute
  2. 4 beats per minute
  3. 100 beats per minute
  4. 36 beats per minute
Answer and working

C. 100 beats per minute

R-R time = 15 / 25 = 0.6 s; HR = 60 / 0.6 = 100/min. 200 comes from assuming 50 mm/s; 4 comes from dividing 60 by the millimetres; 36 comes from multiplying 0.6 s by 60 instead of dividing.

Further reading: Reece WO et al. (eds), Dukes' Physiology of Domestic Animals, 13th ed.

7 · Osmoregulation · hard

A dog with a calculated osmolality of 308 mOsm/kg has a measured osmolality of 340 mOsm/kg and was found near spilled radiator fluid. What is the osmolal gap and its meaning?

  1. 648 mOsm/kg, suggesting ethylene glycol
  2. -32 mOsm/kg, suggesting laboratory error
  3. 32 mOsm/kg, suggesting an unmeasured osmole such as ethylene glycol
  4. 32 mOsm/kg, which is within normal limits
Answer and working

C. 32 mOsm/kg, suggesting an unmeasured osmole such as ethylene glycol

Osmolal gap = measured - calculated = 340 - 308 = 32 mOsm/kg; adding the two gives 648. A gap this large means an unmeasured solute; ethylene glycol raises it early, before its metabolites cause a high anion gap acidosis. Typical gaps are small, though the reference depends on the laboratory.

Further reading: DiBartola SP (ed), Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice, 4th ed.

8 · Acid-base balance · medium

An anaesthetised dog has pH 7.08, PCO2 70 mmHg and bicarbonate 20 mmol/L. The primary disorder is:

  1. Metabolic alkalosis
  2. Respiratory alkalosis
  3. Metabolic acidosis
  4. Respiratory acidosis
Answer and working

D. Respiratory acidosis

Acidaemia with a high PCO2 points to hypoventilation (6.1 + log10(20 / 2.1) = 7.08). Bicarbonate has not yet risen because renal compensation takes days; a bicarbonate this close to normal does not explain the pH.

Further reading: DiBartola SP (ed), Fluid, Electrolyte, and Acid-Base Disorders in Small Animal Practice, 4th ed.

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Read the subject

Veterinary Physiology I: Body Fluids, Blood, Circulation, Respiration and ExcretionThe full study manual, free BCSEFormat, sections and how it has changed

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Veterinary Physiology I: Body Fluids, Blood, Circulation, Respiration and Excretion for other exams

ENADE · BrazilNational Veterinary Examination · JapanICAR AIEEA · IndiaAustralasian Veterinary Examination, formerly the National Veterinary Examination · Australia / New ZealandNAVLE · USA / CanadaRCVS Statutory Membership Examination · UKNational Practising Veterinarian Qualification Examination · ChinaNational Licensure Examination for Veterinarians · NepalVeterinarian Licensure Examination · Philippines

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