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ENADE Veterinary Clinical Biochemistry & Laboratory Diagnosis: practice questions

ENADE: Medicina Veterinária · Brazil · INEP

Original practice questions written to the published syllabus · not past papers
10worked here, free
102written to this exam in this subject
10syllabus units

What this subject covers

Using the laboratory well: haematology, biochemistry panels, organ function tests, urinalysis, cytology, sampling for microbiology, reference intervals and quality control.

In the exams: NAVLE data gathering and interpretation 35%; BCSE diagnostics 22-25 items; PAVE QSE diagnostics 23% (to Sep 2026)

Where the 102 questions fall

How our questions for ENADE spread across the units of Veterinary Clinical Biochemistry & Laboratory Diagnosis. Difficulty: 31 easy, 62 medium, 9 hard.

Haematology19
Serum biochemistry panels17
Kidney function tests11
Urinalysis11
Reference intervals and their interpretation10
Liver function tests9
Sampling for microbiology8
Cytology7
Point-of-care testing5
Laboratory quality control5

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 · Haematology · medium

An excited, healthy young cat has a mature neutrophilia and a lymphocytosis on a sample taken after a struggle. What is the best interpretation?

  1. Corticosteroid (stress) leukogram from chronic disease
  2. Acute inflammation with a regenerative left shift
  3. Physiological (adrenaline-mediated) leukocytosis
  4. Lymphoid leukaemia with secondary neutrophilia
Answer and working

C. Physiological (adrenaline-mediated) leukocytosis

Adrenaline mobilises the marginal neutrophil pool and, especially in cats and young animals, lymphocytes, within minutes. A stress leukogram causes lymphopenia, not lymphocytosis. There is no left shift to indicate inflammation, and the transient lymphocytosis does not suggest leukaemia.

Further reading: Stockham & Scott, Fundamentals of Veterinary Clinical Pathology (2nd ed.); Thrall et al., Veterinary Hematology, Clinical Chemistry, and Cytology (3rd ed.)

2 · Liver function tests · medium

An obese, anorexic cat is icteric with markedly increased ALP and only mildly increased GGT. Which condition fits best?

  1. Extrahepatic bile duct obstruction
  2. Hepatic lipidosis
  3. Neutrophilic cholangitis
  4. Corticosteroid hepatopathy
Answer and working

B. Hepatic lipidosis

In feline hepatic lipidosis ALP rises markedly while GGT rises relatively little; cholangitis and bile duct obstruction usually raise GGT more. Cats have no corticosteroid-induced ALP isoenzyme.

Further reading: Stockham & Scott, Fundamentals of Veterinary Clinical Pathology (2nd ed.); Thrall et al., Veterinary Hematology, Clinical Chemistry, and Cytology (3rd ed.)

3 · Liver function tests · medium

A 6-month-old Yorkshire Terrier has microcytosis, low urea, low albumin, ammonium urate crystals in urine and markedly increased post-prandial bile acids. What is the most likely diagnosis?

  1. Congenital portosystemic shunt
  2. Primary hepatocellular carcinoma
  3. Acute hepatic necrosis from a toxin
  4. Extrahepatic bile duct obstruction
Answer and working

A. Congenital portosystemic shunt

This is the classic shunt profile: portal blood bypasses the liver, so bile acids and ammonia rise, synthesis of urea and albumin falls, ammonium urate crystals form, and microcytosis is common. Toxic necrosis would show large ALT rises; obstruction would cause icterus.

Further reading: Stockham & Scott, Fundamentals of Veterinary Clinical Pathology (2nd ed.); Thrall et al., Veterinary Hematology, Clinical Chemistry, and Cytology (3rd ed.)

4 · Urinalysis · easy

Ammonium urate crystals in the urine of a young Yorkshire Terrier most likely indicate which condition?

  1. Normal urine for the breed
  2. A portosystemic shunt
  3. Ethylene glycol toxicosis
  4. Struvite urolithiasis
Answer and working

B. A portosystemic shunt

Ammonium urate crystals form when ammonia and uric acid are not converted by the liver, as with shunts or liver failure. They are expected in Dalmatians and some English Bulldogs because of an inherited urate transport defect, but not in Yorkshire Terriers.

Further reading: Stockham & Scott, Fundamentals of Veterinary Clinical Pathology (2nd ed.); Thrall et al., Veterinary Hematology, Clinical Chemistry, and Cytology (3rd ed.)

5 · Cytology · medium

A dog's skin mass aspirate stained with a rapid aqueous stain shows round cells with few visible granules, many eosinophils and a background of pale material. Why might a mast cell tumour be missed?

  1. Mast cell granules may stain poorly with some aqueous rapid stains
  2. Mast cells never exfoliate into needle aspirates of skin
  3. Eosinophils usually prove the mass is purely inflammatory
  4. Mast cells are only identifiable on histopathology
Answer and working

A. Mast cell granules may stain poorly with some aqueous rapid stains

Some aqueous rapid Romanowsky-type stains fail to stain mast cell granules, so cells may look like other round cells; eosinophils are a clue. A full Romanowsky stain such as Wright-Giemsa or a methanol-fixed preparation helps. Mast cells exfoliate readily.

Further reading: Stockham & Scott, Fundamentals of Veterinary Clinical Pathology (2nd ed.); Thrall et al., Veterinary Hematology, Clinical Chemistry, and Cytology (3rd ed.)

6 · Cytology · easy

Why should cytology slides not be packaged with formalin-fixed biopsy specimens?

  1. Formalin fumes damage cell staining irreversibly
  2. Formalin dissolves the glass of the slides in transit
  3. Formalin makes cells take up stain far too intensely
  4. Formalin fumes cause the cells to multiply on the slide
Answer and working

A. Formalin fumes damage cell staining irreversibly

Even fumes from formalin alter cell staining so that cytology becomes uninterpretable. Ship slides in separate sealed packaging.

Further reading: Stockham & Scott, Fundamentals of Veterinary Clinical Pathology (2nd ed.); Thrall et al., Veterinary Hematology, Clinical Chemistry, and Cytology (3rd ed.)

7 · Sampling for microbiology · medium

Cattle on a pasture die suddenly with dark unclotted blood from the nostrils. What should the veterinarian do?

  1. Perform a full necropsy at once to look for splenic enlargement
  2. Open the abdomen and send the whole spleen in formalin by post
  3. Not open the carcass; take a peripheral blood smear and notify authorities
  4. Bury the carcass immediately without collecting any sample
Answer and working

C. Not open the carcass; take a peripheral blood smear and notify authorities

These signs suggest anthrax. Opening the carcass exposes Bacillus anthracis to air, allowing sporulation and long-lasting contamination. A peripheral (e.g. ear vein) blood smear stained with polychrome methylene blue (McFadyean reaction) shows capsulated rods. Anthrax is notifiable in most countries.

Further reading: Stockham & Scott, Fundamentals of Veterinary Clinical Pathology (2nd ed.); Thrall et al., Veterinary Hematology, Clinical Chemistry, and Cytology (3rd ed.)

8 · Point-of-care testing · easy

Why should a blood smear be reviewed alongside every in-clinic analyser CBC?

  1. Analysers miss agglutination, platelet clumps, parasites and abnormal cells
  2. The analyser cannot count red cells without the smear first
  3. Smears are only needed when the analyser is out of order
  4. The smear replaces the need for quality control on the analyser
Answer and working

A. Analysers miss agglutination, platelet clumps, parasites and abnormal cells

Automated counts are fast but cannot reliably detect agglutination, Heinz bodies, haemoparasites, platelet clumps, toxic change or atypical cells. Smear review is a quality check and a diagnostic step, not a substitute for QC.

Further reading: Stockham & Scott, Fundamentals of Veterinary Clinical Pathology (2nd ed.); Thrall et al., Veterinary Hematology, Clinical Chemistry, and Cytology (3rd ed.)

9 · Point-of-care testing · easy

Which problem is typical of impedance haematology analysers when used with feline blood?

  1. Feline red cells are often too large to be counted by impedance
  2. Large feline platelets may be counted as red cells, lowering the platelet count
  3. Feline white cells are destroyed by the analyser's diluent
  4. Feline blood cannot be anticoagulated with EDTA for analysers
Answer and working

B. Large feline platelets may be counted as red cells, lowering the platelet count

Cat platelets are large and overlap with small feline red cells in volume, so impedance counters may misclassify them, causing falsely low platelet counts. Feline red cells are small, not large.

Further reading: Stockham & Scott, Fundamentals of Veterinary Clinical Pathology (2nd ed.); Thrall et al., Veterinary Hematology, Clinical Chemistry, and Cytology (3rd ed.)

10 · Haematology · medium

A dog with chronic gastrointestinal bleeding has microcytic, hypochromic red cells, keratocytes and a high platelet count. What is the most likely cause of the anaemia?

  1. Anaemia of inflammation with iron sequestration
  2. Immune-mediated haemolytic anaemia with spherocytes
  3. Acute haemorrhage within the last 24 hours
  4. Iron deficiency from chronic external blood loss
Answer and working

D. Iron deficiency from chronic external blood loss

Chronic external blood loss depletes iron, giving microcytic hypochromic cells, keratocytes and often thrombocytosis. Anaemia of inflammation is normocytic and mild; IMHA shows spherocytes; acute haemorrhage is normocytic and pre-regenerative.

Further reading: Stockham & Scott, Fundamentals of Veterinary Clinical Pathology (2nd ed.); Thrall et al., Veterinary Hematology, Clinical Chemistry, and Cytology (3rd ed.)

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Read the subject

Veterinary Clinical Biochemistry & Laboratory DiagnosisThe full study manual, free ENADEFormat, sections and how it has changed

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Veterinary Clinical Biochemistry & Laboratory Diagnosis for other exams

National Veterinary Examination · JapanNAVLE · USA / CanadaBCSE · USA / CanadaPAVE and its QSE · USAAustralasian Veterinary Examination, formerly the National Veterinary Examination · Australia / New ZealandRCVS Statutory Membership Examination · UK

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