NAVLE (North American Veterinary Licensing Examination) · USA / Canada · International Council for Veterinary Assessment (ICVA); scored by NBME, delivered by Prometric
Original practice questions written to the published syllabus · not past papersUsing 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)
NAVLE (data gathering and interpretation, about 35%)
Case-based interpretation of CBC, biochemistry and urinalysis across dogs, cats, horses and cattle: classifying azotaemia with USG, stress vs inflammatory leukograms, regenerative vs non-regenerative anaemia, hypoadrenocorticism electrolyte patterns, effusion analysis and which test to order next.
How our questions for NAVLE spread across the units of Veterinary Clinical Biochemistry & Laboratory Diagnosis. Difficulty: 31 easy, 62 medium, 9 hard.
| Haematology | 19 | |
| Serum biochemistry panels | 17 | |
| Kidney function tests | 11 | |
| Urinalysis | 11 | |
| Reference intervals and their interpretation | 10 | |
| Liver function tests | 9 | |
| Sampling for microbiology | 8 | |
| Cytology | 7 | |
| Point-of-care testing | 5 | |
| Laboratory quality control | 5 |
Choose an answer, then open the working. Each explanation says why the right answer is right and why the others are not.
An excited, healthy young cat has a mature neutrophilia and a lymphocytosis on a sample taken after a struggle. What is the best interpretation?
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.)
An obese, anorexic cat is icteric with markedly increased ALP and only mildly increased GGT. Which condition fits best?
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.)
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?
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.)
Ammonium urate crystals in the urine of a young Yorkshire Terrier most likely indicate which condition?
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.)
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?
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.)
Why should cytology slides not be packaged with formalin-fixed biopsy specimens?
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.)
Cattle on a pasture die suddenly with dark unclotted blood from the nostrils. What should the veterinarian do?
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.)
Why should a blood smear be reviewed alongside every in-clinic analyser CBC?
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.)
Which problem is typical of impedance haematology analysers when used with feline blood?
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.)
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?
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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