National Licensure Examination for Veterinarians (NLEV) · Nepal · Nepal Veterinary Council (NVC Act 2055 BS)
Original practice questions written to the published syllabus · not past papersThe production diseases of high-yielding animals and the mineral and vitamin deficiencies: milk fever, ketosis, grass tetany, downer cow and their relatives.
In the exams: ICAR AICE-JRF core group 07 (Medicine); China comprehensive paper cattle; a recurring topic across Indian PG, PhD and state PSC syllabi
How our questions for National Licensure Examination for Veterinarians spread across the units of Veterinary Clinical Medicine II: Metabolic, Production and Deficiency Diseases. Difficulty: 6 easy, 29 medium, 8 hard.
| Ketosis | 7 | |
| Milk fever | 6 | |
| Hypomagnesaemia | 5 | |
| Trace mineral deficiencies | 5 | |
| Metabolic profile testing | 4 | |
| Downer cow syndrome | 4 | |
| Post-parturient haemoglobinuria | 4 | |
| Vitamin deficiencies | 4 | |
| Fatty liver syndrome | 2 | |
| Rickets, osteomalacia and osteodystrophy | 2 |
Choose an answer, then open the working. Each explanation says why the right answer is right and why the others are not.
A 7-year-old Jersey cow calved 12 hours ago. She is in sternal recumbency with her head turned into her flank, cold ears, dilated pupils, a dry muzzle, ruminal stasis, a rectal temperature of 37.4 °C and a weak, rapid pulse. What is the most appropriate first treatment?
D. Calcium solution given slowly intravenously while auscultating the heart
These are classic signs of stage 2 milk fever, and slow intravenous calcium is the treatment of choice; auscultation detects arrhythmias caused by too-fast infusion. A sternal cow with poor swallowing risks aspiration if drenched. Rapid IV magnesium is dangerous, and dextrose does not correct hypocalcaemia.
Further reading: Constable et al., Veterinary Medicine 11th ed.; Goff 2008; Oetzel 2004; Suttle, Mineral Nutrition of Livestock 4th ed.
A heifer was delivered of an oversized calf by forced traction. Next day she cannot rise; when lifted, her hind legs slide outwards and she cannot bring them together. Which nerve is most likely injured?
D. Obturator nerve
The obturator nerve runs along the medial pelvic wall and can be compressed by the calf during delivery. It supplies the adductor muscles, so injury lets the hind legs splay outwards. Femoral nerve damage causes quadriceps weakness and inability to fix the stifle, while radial and suprascapular nerves supply the forelimb.
Further reading: Constable et al., Veterinary Medicine 11th ed.; Goff 2008; Oetzel 2004; Suttle, Mineral Nutrition of Livestock 4th ed.
When examining a cow that remains recumbent after treatment for milk fever, which examination is essential to detect pelvic fractures or sacroiliac luxation?
A. Rectal palpation of the pelvic bones while the cow is moved
Rectal palpation of the pelvis, ideally while the limbs are moved or the cow is rocked, can reveal fractures, crepitus and luxations that make the prognosis hopeless. The other examinations are useful for other conditions but do not assess the pelvis.
Further reading: Constable et al., Veterinary Medicine 11th ed.; Goff 2008; Oetzel 2004; Suttle, Mineral Nutrition of Livestock 4th ed.
Which description best fits type II ketosis in dairy cows?
A. Onset 1 to 2 weeks after calving in over-conditioned cows, with insulin resistance and fatty liver
Type II ketosis is associated with fat cows, heavy fat mobilisation and fatty liver early in lactation, and responds less well to treatment. Type I (underfeeding) ketosis occurs at 3 to 6 weeks near peak yield. Butyric silage causes alimentary ketosis.
Further reading: Constable et al., Veterinary Medicine 11th ed.; Goff 2008; Oetzel 2004; Suttle, Mineral Nutrition of Livestock 4th ed.
A cow 10 days after calving has a reduced appetite, falling milk yield, strongly positive urine ketones, and a high-pitched ping on simultaneous percussion and auscultation over the left 9th to 13th ribs. What is the best interpretation?
D. Left displaced abomasum with secondary ketosis; correct the LDA and support energy
A ping over the left 9th to 13th ribs in an early-lactation cow is typical of left displaced abomasum. Reduced intake causes secondary ketosis, which will not resolve until the displacement is corrected. A rumen ping is usually lower and more dorsal and caudal; right displacement pings on the right.
Further reading: Constable et al., Veterinary Medicine 11th ed.; Goff 2008; Oetzel 2004; Suttle, Mineral Nutrition of Livestock 4th ed.
A grazing cow with tetany has a serum magnesium of 1.1 mg/dL. Using a factor of 0.411, what is this in mmol/L and what does it indicate?
A. 0.45 mmol/L; consistent with clinical hypomagnesaemic tetany
Working: 1.1 x 0.411 = 0.45 mmol/L. Clinical tetany is typical below about 0.5 mmol/L; normal values are commonly about 0.8 to 1.2 mmol/L (laboratory ranges vary). 0.2495 is the calcium factor (0.27), and dividing gives an impossible value (2.7).
Further reading: Constable et al., Veterinary Medicine 11th ed.; Goff 2008; Oetzel 2004; Suttle, Mineral Nutrition of Livestock 4th ed.
Beef cattle on phosphorus-deficient range are seen chewing bones of old carcasses. Which disease is this behaviour classically linked with?
C. Botulism
Osteophagia (bone chewing) from phosphorus deficiency leads cattle to eat carcass material containing Clostridium botulinum toxin, as described in southern Africa (lamziekte). Phosphorus supplementation and vaccination are used for control.
Further reading: Constable et al., Veterinary Medicine 11th ed.; Goff 2008; Oetzel 2004; Suttle, Mineral Nutrition of Livestock 4th ed.
A bone lesion shows reduced bone mass, but what bone is present is normally mineralised. This is:
D. Osteoporosis
Osteoporosis is too little bone of normal composition (for example from starvation, copper deficiency or disuse). Osteomalacia and rickets are failures of mineralisation, and osteodystrophia fibrosa is fibrous replacement under PTH.
Further reading: Constable et al., Veterinary Medicine 11th ed.; Goff 2008; Oetzel 2004; Suttle, Mineral Nutrition of Livestock 4th ed.
Cattle on a pasture with adequate copper content show loss of coat colour and scouring. Pasture molybdenum and sulfur are high. What is the mechanism?
B. Molybdenum and sulfur form thiomolybdates in the rumen that bind copper and reduce its uptake
This is secondary (conditioned) copper deficiency. Thiomolybdates form insoluble complexes with copper in the rumen and can also affect systemic copper metabolism; high iron is another antagonist. The teart pastures of England are the classic example.
Further reading: Constable et al., Veterinary Medicine 11th ed.; Goff 2008; Oetzel 2004; Suttle, Mineral Nutrition of Livestock 4th ed.
Cattle fed mouldy sweet clover hay bleed excessively after dehorning. The correct specific treatment is:
A. Vitamin K1 (phytonadione)
Mouldy sweet clover contains dicoumarol, a vitamin K antagonist that prevents activation of clotting factors II, VII, IX and X. Vitamin K1 is the effective antidote; vitamin K3 is much less effective as treatment. Blood transfusion may be needed in severe cases.
Further reading: Constable et al., Veterinary Medicine 11th ed.; Goff 2008; Oetzel 2004; Suttle, Mineral Nutrition of Livestock 4th ed.
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