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 papersLesions organ system by organ system, plus the pathology of nutritional and production diseases.
In the exams: ICAR AICE-JRF core group 06; ICAR AIEEA-PG 13 (Pathology)
NAVLE, BCSE, PAVE QSE, RCVS SME and the Australasian Veterinary Examination
Clinical-pathological reasoning: interpret a necropsy or biopsy description in a case, such as a cat with saddle thrombus, a dog with hypercalcaemia and an anal sac mass, a feedlot steer with haemoptysis, a cow down after calving, or an old horse with a long coat and laminitis.
How our questions for NAVLE spread across the units of Systemic Veterinary Pathology. Difficulty: 1 easy, 11 medium, 3 hard.
| Pathology of the cardiovascular system | 2 | |
| Pathology of the respiratory system | 2 | |
| Pathology of the urinary system | 2 | |
| Pathology of the gastrointestinal tract | 1 | |
| Pathology of the liver | 1 | |
| Pathology of the nervous system | 1 | |
| Pathology of the musculoskeletal system | 1 | |
| Pathology of the skin | 1 | |
| Pathology of the reproductive system | 1 | |
| Pathology of the endocrine system | 1 | |
| Nutritional pathology | 1 | |
| Production pathology | 1 |
Choose an answer, then open the working. Each explanation says why the right answer is right and why the others are not.
A 9-year-old cat is found with sudden painful paralysis of both hind limbs, cold pads and absent femoral pulses. At necropsy the left atrium is dilated and contains a thrombus. What is the most likely underlying heart disease?
B. Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy is the commonest feline heart disease; left atrial dilation and stasis produce a thrombus that embolises to the aortic bifurcation (saddle thrombus). Myxomatous mitral degeneration is the classic disease of old small-breed dogs, and ARVC is a disease of Boxers affecting the right ventricle.
Further reading: Zachary JF, Pathologic Basis of Veterinary Disease, 7th ed.
At necropsy of a 7-year-old dog from a heartworm-endemic area, the laboratory's reference ratio of left ventricular free wall thickness to right ventricular free wall thickness is about 3:1. The measured left ventricular free wall is 12 mm and the right ventricular free wall is 8 mm. What do the ratio and the likely cause indicate?
D. Ratio 1.5:1, right ventricular hypertrophy from pulmonary hypertension due to Dirofilaria immitis
12 mm / 8 mm = 1.5, so the ratio is 1.5:1, well below the reference of about 3:1: the right wall is relatively thick. Heartworms cause villous endarteritis of the pulmonary arteries, pulmonary hypertension and right ventricular pressure overload. Dividing the right wall by the left (8/12 = 0.67) inverts the ratio and hides the change; left ventricular hypertrophy would raise the ratio above 3:1 (as in the 4:1 option), not lower it.
Further reading: Maxie MG, Jubb, Kennedy and Palmer's Pathology of Domestic Animals, 6th ed.
A lung that is heavy, rubbery, fails to collapse when the chest is opened and bears rib impressions most likely has:
C. Interstitial pneumonia
Diffuse damage to alveolar walls in interstitial pneumonia makes the lung firm and elastic so it does not collapse and takes rib impressions. Bronchopneumonia is cranioventral and consolidated, embolic pneumonia is multifocal, and atelectatic lung is collapsed and sunken.
Further reading: Zachary JF, Pathologic Basis of Veterinary Disease, 7th ed.
A sheep dies suddenly with jaundice, dark red urine and gunmetal-blue kidneys after being moved and handled. The ration contained supplementary minerals formulated for cattle. The most likely diagnosis is:
A. Chronic copper poisoning with haemolytic crisis
Sheep store copper in the liver; stress triggers release, intravascular haemolysis and haemoglobinuric nephrosis that colours the kidneys dark blue-black. Cattle minerals are often too rich in copper for sheep. Acute fasciolosis causes haemorrhagic liver tracks and anaemia, not haemoglobinuria.
Further reading: Zachary JF, Pathologic Basis of Veterinary Disease, 7th ed.
A ewe fed poor-quality silage circles to one side, has a drooping ear and lip on one side, and dies. Microabscesses in the brainstem are found on histology. The cause is:
A. Listeria monocytogenes
Listeria enters via the trigeminal nerve and produces brainstem microabscesses with cranial nerve deficits and circling. Histophilus somni causes thrombotic haemorrhagic infarcts in cattle; Coenurus forms a cyst that compresses the cerebrum; type D epsilon toxin causes symmetrical malacia.
Further reading: Zachary JF, Pathologic Basis of Veterinary Disease, 7th ed.
A 1-year-old dog has a solitary, hairless, red, button-like dome on the pinna that appeared within weeks. Cytology shows round cells with moderate cytoplasm and many lymphocytes. The most likely diagnosis and outlook are:
C. Cutaneous histiocytoma, likely to regress spontaneously
Histiocytoma is a benign Langerhans cell tumour of young dogs and regresses as lymphocytes infiltrate it. Mast cell tumours have metachromatic granules on cytology and occur in older dogs; squamous cell carcinoma arises in sun-damaged, unpigmented skin.
Further reading: Zachary JF, Pathologic Basis of Veterinary Disease, 7th ed.
An 8-year-old intact bitch, 6 weeks after oestrus, is lethargic and polydipsic with a vulval discharge. The uterus is distended with pus. The hormonal state that predisposes to this condition is:
D. Prolonged progesterone dominance in dioestrus
Repeated progesterone exposure causes cystic endometrial hyperplasia, closes the cervix and suppresses uterine immunity, allowing bacteria such as E. coli to cause pyometra. Oestrogen alone in the normal cycle does not produce this complex, though exogenous oestrogen given during dioestrus can increase the risk.
Further reading: Zachary JF, Pathologic Basis of Veterinary Disease, 7th ed.
Ten here, 15 in the app. The Laisha app has every practice question we have written to NAVLE in this subject, marked as you go, with timed papers, a jump-to-unanswered list and a certificate when you pass at 70 per cent.
Free for ten days, then one subscription of US$10 a month. We would rather say so here than have you find it later.
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