RCVS Statutory Membership Examination (SME) · UK · Royal College of Veterinary Surgeons
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)
How our questions for RCVS Statutory Membership Examination spread across the units of Veterinary Clinical Biochemistry & Laboratory Diagnosis. Difficulty: 6 easy, 24 medium, 5 hard.
| Serum biochemistry panels | 7 | |
| Haematology | 6 | |
| Kidney function tests | 6 | |
| Urinalysis | 4 | |
| Liver function tests | 3 | |
| Sampling for microbiology | 3 | |
| Point-of-care testing | 3 | |
| Cytology | 2 | |
| Reference intervals and their interpretation | 1 |
Choose an answer, then open the working. Each explanation says why the right answer is right and why the others are not.
A dog treated with prednisolone for a week has a leukogram showing mature neutrophilia, lymphopenia, eosinopenia and monocytosis. What is this pattern?
D. Corticosteroid (stress) leukogram
Glucocorticoids reduce neutrophil margination and egress into tissues (mature neutrophilia), redistribute and lyse lymphocytes, sequester eosinophils, and in dogs often cause monocytosis. An adrenaline response includes lymphocytosis; a degenerative left shift has immature cells outnumbering mature ones.
Further reading: Stockham & Scott, Fundamentals of Veterinary Clinical Pathology (2nd ed.); Thrall et al., Veterinary Hematology, Clinical Chemistry, and Cytology (3rd ed.)
A 9-year-old dog has total calcium 3.6 mmol/L, high ionised calcium, low phosphorus and a mass at the anal sac. What is the most likely mechanism?
D. Parathyroid hormone-related protein from anal sac adenocarcinoma
Apocrine gland adenocarcinoma of the anal sac and lymphoma are the classic causes of humoral hypercalcaemia of malignancy, mediated by PTHrP, which also lowers phosphorus. Vitamin D toxicosis usually raises phosphorus; kidney disease typically has high phosphorus and normal or low ionised calcium.
Further reading: Stockham & Scott, Fundamentals of Veterinary Clinical Pathology (2nd ed.); Thrall et al., Veterinary Hematology, Clinical Chemistry, and Cytology (3rd ed.)
In dogs, which test is preferred for supporting a diagnosis of acute pancreatitis?
C. Species-specific pancreatic lipase immunoreactivity
Species-specific PLI is more sensitive and specific than amylase or total lipase, which come from other tissues and rise with azotaemia. TLI is the test for exocrine pancreatic insufficiency (low result); cobalamin assesses distal small intestinal disease and EPI.
Further reading: Stockham & Scott, Fundamentals of Veterinary Clinical Pathology (2nd ed.); Thrall et al., Veterinary Hematology, Clinical Chemistry, and Cytology (3rd ed.)
Which analyte is measured in dairy cows in the first two weeks after calving to detect subclinical ketosis?
B. Blood beta-hydroxybutyrate
Beta-hydroxybutyrate is the main circulating ketone and is measured after calving; thresholds in the literature are commonly 1.2-1.4 mmol/L. NEFA reflect fat mobilisation and are most useful before calving. GGT and fibrinogen do not diagnose ketosis.
Further reading: Stockham & Scott, Fundamentals of Veterinary Clinical Pathology (2nd ed.); Thrall et al., Veterinary Hematology, Clinical Chemistry, and Cytology (3rd ed.)
A clinically normal cat's serum shows K 9.0 mmol/L and total calcium 0.5 mmol/L. What is the most likely cause?
D. EDTA contamination of the serum sample
Potassium EDTA adds potassium and chelates calcium, so a well animal with extreme hyperkalaemia and near-zero calcium almost certainly has EDTA carry-over (wrong order of draw or decanting). Feline red cells are low in potassium, so haemolysis does not cause marked pseudohyperkalaemia in cats.
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.)
Which dipstick pad result is least reliable in cats?
A. Leukocyte esterase (often falsely positive)
The leukocyte pad gives frequent false positives in cats and false negatives in dogs; the sediment is used to assess pyuria. The glucose, blood and pH pads are generally usable in cats.
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.)
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.)
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.)
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