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National Veterinary Examination Veterinary Orthopaedics & Lameness: practice questions

National Veterinary Examination (獣医師国家試験) · Japan · Ministry of Agriculture, Forestry and Fisheries (MAFF), with the Veterinary Affairs Council

Original practice questions written to the published syllabus · not past papers
10worked here, free
62written to this exam in this subject
9syllabus units

What this subject covers

Fractures and their fixation, joint, tendon and ligament disease, lameness examination in horses and cattle, hoof and claw disorders, diagnostic nerve blocks and rehabilitation.

In the exams: ICAR AIEEA-PG 13 (Surgery & Radiology); NAVLE equine 14.7% and bovine 13.3% species weighting

Where the 62 questions fall

How our questions for National Veterinary Examination spread across the units of Veterinary Orthopaedics & Lameness. Difficulty: 17 easy, 35 medium, 10 hard.

Joint diseases10
Hoof and claw disorders10
Fractures8
Tendon and ligament injuries7
Equine lameness examination6
Bovine lameness examination6
Fracture fixation5
Diagnostic nerve blocks5
Physiotherapy and rehabilitation5

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 · Fractures · easy

Which Salter-Harris fracture is usually recognised only weeks later, when premature physeal closure produces limb shortening or angular deformity?

  1. Type I, a clean separation through the hypertrophic zone of the growth plate
  2. Type II, a physeal fracture that exits through a corner of the metaphysis
  3. Type IV, an articular fracture crossing epiphysis, physis and metaphysis
  4. Type V, a compression injury that crushes the germinal layer of the physis
Answer and working

D. Type V, a compression injury that crushes the germinal layer of the physis

The type V crush injury is often invisible on the first radiograph and is diagnosed when growth stops. Types I, II and IV show displacement or fracture lines on the initial films.

2 · Fractures · medium

A 5-month-old Labrador has a displaced fracture that passes through the distal femoral epiphysis into the stifle joint and continues across the physis and metaphysis. What is the most appropriate management principle?

  1. A modified Robert Jones bandage for four weeks, because physeal fractures in young dogs always heal quickly
  2. Anatomical reduction and rigid internal fixation, as it is an articular Salter-Harris type IV fracture
  3. Cage rest and analgesia only, because the remaining growth will remodel the joint surface in time
  4. A single intramedullary pin alone, because it controls rotation and collapse in the distal femur
Answer and working

B. Anatomical reduction and rigid internal fixation, as it is an articular Salter-Harris type IV fracture

A fracture crossing epiphysis, physis and metaphysis is Salter-Harris type IV and involves the joint, so the joint surface must be reconstructed exactly and fixed rigidly. A bandage cannot immobilise the femur. Rest alone leaves an incongruent joint. An IM pin alone does not control rotation or collapse.

3 · Fractures · medium

A cat hit by a car has a mid-shaft femoral fracture. Which temporary support is most appropriate while it is stabilised for surgery?

  1. A modified Robert Jones bandage from the toes to mid-thigh to immobilise the femur
  2. A short distal limb cast ending just below the stifle to rest the limb in partial extension
  3. Strict cage rest with analgesia, because a distal limb bandage cannot immobilise the femur
  4. A spica splint over the shoulder with the forelimb strapped to the body wall
Answer and working

C. Strict cage rest with analgesia, because a distal limb bandage cannot immobilise the femur

A Robert Jones bandage only immobilises fractures at or below the stifle and elbow; ending at mid-thigh it acts as a weight on a lever and worsens the femoral fracture. A short cast does not reach the fracture. A spica splint over the shoulder is used for humeral fractures, not the femur.

4 · Joint diseases · hard

During examination under sedation, a 6-month-old dog's hip is pushed dorsally with the limb adducted, then abducted, and a clunk is felt as the femoral head drops into the acetabulum. This finding is:

  1. A positive cranial drawer sign of the stifle
  2. A normal finding in a puppy with tight hips
  3. A positive Ortolani sign, indicating hip laxity
  4. A craniodorsal hip luxation needing a sling
Answer and working

C. A positive Ortolani sign, indicating hip laxity

The clunk of reduction as the subluxated femoral head re-enters the acetabulum is the Ortolani sign of hip laxity. The drawer test is a stifle test, a normal hip does not subluxate, and a luxated hip does not reduce and re-luxate with this manoeuvre.

5 · Tendon and ligament injuries · easy

Which test detects cranial cruciate ligament insufficiency in a dog by flexing the hock while holding the stifle at a standing angle?

  1. Ortolani test
  2. Cranial drawer of the hock
  3. Patellar push test
  4. Tibial compression test
Answer and working

D. Tibial compression test

In the tibial compression test, flexing the hock tightens the gastrocnemius and pushes the tibia cranially if the cranial cruciate ligament is deficient. The Ortolani test is for hip laxity, and the other names are not standard tests for the CrCL.

6 · Diagnostic nerve blocks · easy

Which local anaesthetic is favoured by many equine clinicians for diagnostic blocks because it causes less tissue irritation?

  1. Procaine with adrenaline
  2. Tetracaine
  3. Benzocaine
  4. Mepivacaine
Answer and working

D. Mepivacaine

Mepivacaine is widely preferred for diagnostic blocks because of low tissue irritation and reliable action. Procaine with adrenaline, tetracaine and benzocaine are not standard choices for perineural diagnostic anaesthesia.

7 · Bovine lameness examination · hard

Using a 0 to 3 mobility score in a 200-cow herd, 30 cows score 2 and 10 score 3. What proportion of the herd is lame (score 2 or 3), and which cows need urgent attention?

  1. 15 per cent; only cows scoring 2 need any treatment
  2. 20 per cent; the 10 cows scoring 3 need urgent treatment
  3. 5 per cent; only cows scoring 3 count as lame at all
  4. 40 per cent; all cows scoring 1 or more need urgent treatment
Answer and working

B. 20 per cent; the 10 cows scoring 3 need urgent treatment

(30 + 10) / 200 = 20%. Score 2 cows need prompt treatment and score 3 cows urgent treatment. 15% counts only score 2, 5% only score 3, and score 1 indicates imperfect mobility, not urgent lameness.

8 · Hoof and claw disorders · medium

What is the purpose of step three of the Dutch five-step method, dishing out the sole?

  1. To make the dorsal wall of each claw exactly the same angle
  2. To remove all the horn of the sole down to the corium
  3. To move load from the typical sole ulcer site to the wall and heel
  4. To lower the heel of the healthy claw so the cow tips forward
Answer and working

C. To move load from the typical sole ulcer site to the wall and heel

Shaping the sole on the axial side at the typical ulcer site transfers load away from it. Wall angle is set in steps one and two, cutting to the corium is over-trimming, and the healthy claw's heel is not lowered.

9 · Hoof and claw disorders · easy

Which form of equine laminitis is now considered the most common?

  1. Endocrinopathic laminitis associated with insulin dysregulation or PPID
  2. Supporting-limb laminitis following a fracture of the opposite limb
  3. Laminitis caused by walking on hard roads after a long journey
  4. Laminitis caused by retained fetal membranes in mares after foaling
Answer and working

A. Endocrinopathic laminitis associated with insulin dysregulation or PPID

Endocrinopathic laminitis linked to equine metabolic syndrome or pituitary pars intermedia dysfunction is now regarded as the commonest form. Supporting-limb, road and sepsis-related causes occur but are less common.

10 · Physiotherapy and rehabilitation · medium

After TPLO in a dog, which instruction is most appropriate in the first weeks?

  1. Unrestricted off-lead exercise from the day after surgery to strengthen the quadriceps quickly
  2. Complete immobilisation of the limb in a full-length cast for eight weeks after the osteotomy
  3. No weight bearing on the limb at all until the implant is removed after six months
  4. Short controlled lead walks and home exercises; no off-lead running until the bone has healed
Answer and working

D. Short controlled lead walks and home exercises; no off-lead running until the bone has healed

Controlled lead walking and progressive exercises protect the osteotomy while preventing stiffness and muscle loss. Unrestricted activity risks implant failure, a cast causes fracture disease, and prolonged non-weight-bearing is unnecessary.

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Read the subject

Veterinary Orthopaedics & LamenessThe full study manual, free National Veterinary ExaminationFormat, sections and how it has changed

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Veterinary Orthopaedics & Lameness for other exams

ENADE · BrazilRCVS Statutory Membership Examination · UKAustralasian Veterinary Examination, formerly the National Veterinary Examination · Australia / New ZealandBCSE · USA / CanadaNAVLE · USA / CanadaNational Licensure Examination for Veterinarians · NepalICAR AIEEA · India

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