RCVS Statutory Membership Examination (SME) · UK · Royal College of Veterinary Surgeons
Original practice questions written to the published syllabus · not past papersAntibacterial, antifungal, antiprotozoal, anthelmintic, ectoparasiticide and anticancer drugs, and the prudent use that slows antimicrobial resistance.
In the exams: ICAR AIEEA-PG 13 Unit IV (drug resistance); ICAR AICE-JRF core group 07; EAEVE Day One prescribing competences
How our questions for RCVS Statutory Membership Examination spread across the units of Veterinary Chemotherapy & Antimicrobial Stewardship. Difficulty: 7 easy, 23 medium, 2 hard.
| Anticancer drugs | 4 | |
| Prudent use of antimicrobials | 4 | |
| Macrolides | 3 | |
| Antiprotozoal drugs | 3 | |
| Anthelmintics | 3 | |
| Sulphonamides | 2 | |
| Beta-lactam antibiotics | 2 | |
| Aminoglycosides | 2 | |
| Antifungal drugs | 2 | |
| Ectoparasiticides | 2 | |
| Critically important antimicrobials | 2 | |
| Tetracyclines | 1 | |
| Fluoroquinolones | 1 | |
| Mechanisms and problems of drug resistance | 1 |
Choose an answer, then open the working. Each explanation says why the right answer is right and why the others are not.
A Doberman pinscher on trimethoprim-sulphonamide for ten days develops fever and shifting lameness with swollen joints. Which adverse reaction best fits?
C. Idiosyncratic sulphonamide hypersensitivity with polyarthritis
Dobermans are over-represented for immune-mediated sulphonamide reactions: fever, polyarthritis, skin eruptions, thrombocytopenia and hepatopathy. Cartilage erosion belongs to fluoroquinolones in growing animals.
Further reading: Riviere & Papich, Veterinary Pharmacology and Therapeutics, 10th ed.
Before and during a long course of a potentiated sulphonamide in a dog, which test is specifically recommended because of a known adverse effect?
D. Schirmer tear test
Sulphonamides are directly toxic to lacrimal acinar cells and can cause keratoconjunctivitis sicca, so tear production is monitored. Auditory testing relates to aminoglycoside ototoxicity.
Further reading: Riviere & Papich, Veterinary Pharmacology and Therapeutics, 10th ed.
A horse collapses with excitement and muscle tremors seconds after an intramuscular injection of procaine benzylpenicillin. The most likely cause is
C. inadvertent intravascular injection causing procaine toxicity
Procaine reaching the circulation causes CNS excitement in horses within seconds; aspirating before injecting reduces the risk. True penicillin anaphylaxis is possible but less typical of this immediate excitatory picture.
Further reading: Riviere & Papich, Veterinary Pharmacology and Therapeutics, 10th ed.
Why do many regulators discourage systemic gentamicin in cattle even where extra-label use is legal?
D. Kidney residues persist for many months, making withdrawal impractical
Aminoglycosides bind kidney tissue and are eliminated very slowly, so residues persist far beyond the plasma half-life. Carcinogenic residues are the nitrofuran and chloramphenicol concern.
Further reading: Giguère, Prescott & Dowling, Antimicrobial Therapy in Veterinary Medicine, 5th ed.
A cat becomes acutely blind with diffuse retinal degeneration after a high dose of an antimicrobial. Which drug is most likely?
B. Enrofloxacin
Enrofloxacin at high doses causes dose-related retinal degeneration in cats, linked to a defect in a retinal drug transporter; label limits for cats must be respected.
Further reading: Riviere & Papich, Veterinary Pharmacology and Therapeutics, 10th ed.
For cryptococcal meningoencephalitis in a cat, fluconazole is often preferred among the azoles because it
B. is water-soluble and penetrates cerebrospinal fluid well
Fluconazole is small, water-soluble, poorly protein-bound and reaches CSF and urine well. It is excreted renally, so kidney failure does matter; cortisol inhibition is a ketoconazole property and an adverse effect, not a benefit.
Further reading: Riviere & Papich, Veterinary Pharmacology and Therapeutics, 10th ed.
Several horses die with myocardial necrosis after being fed a cattle ration. Which feed additive is the most likely cause?
C. Monensin
Ionophores such as monensin are extremely toxic to horses, causing cardiac and skeletal muscle necrosis.
Further reading: Riviere & Papich, Veterinary Pharmacology and Therapeutics, 10th ed.
Sterile haemorrhagic cystitis is a characteristic adverse effect of
A. cyclophosphamide
The cyclophosphamide metabolite acrolein irritates the bladder urothelium; dosing in the morning and encouraging urination reduce contact time.
Further reading: Withrow & MacEwen's Small Animal Clinical Oncology
In a dairy herd, selective dry-cow therapy means
C. antimicrobial tubes only for infected cows or quarters, with teat sealant for the rest
Selective dry-cow therapy uses somatic cell counts, culture or history to identify infected cows or quarters for antimicrobial treatment and uses an internal teat sealant in uninfected ones, cutting antimicrobial use without raising new infections.
Further reading: National dairy guidance
Under Regulation (EU) 2019/6, how long is a veterinary prescription for an antimicrobial valid?
D. Five days from issue
Article 105 limits antimicrobial prescriptions to five days' validity, to stop prescriptions being stored and used later without fresh assessment.
Further reading: Regulation (EU) 2019/6
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