Follow up exam.

for 5th year veterinary student Internal Medicine

Group ( ) Time allowed: 1hr
___________________________________________________________
Identify the correct answer (s) in the following.
2-Propyle glycol is indicated in combination with I.V. glucose therapy for treatment of:
 Pregnancy toxemia
 Bovine ketosis.
 Abom. Displacement
 None of the above

3-To avoid Pregnancy toxemia, pregnant ewes should be:

 In a good nutritional status at late of pregnancy
 Limited nutritional status at late of pregnancy.
 Never of the above.
4-Lipomobilization is a condition usually associate:
 Bovine ketosis.
 Pregnancy toxemia
 Fat cow syndrome.
 All of the above.
5- Milk fever occurs in dairy cows as a results of:
• Drop of Ionized Ca in blood and tissues beyond the capability of PTH to withstand
such drop.
• Brain ischemia and anemia may have a role after parturition
• Decreased feed intake directly after parturition.
• All of the above.
6- Mik fever should be differentially diagnosed from:
 Acute coliforme Toxic mastitis.
 Hypomagnesemia.
 Bovine ketosis.
7- Signs of response to IV calcium infusion in milk fever are:
• Tremors are seen as neuromuscular function returns,
• Stronger heart sounds and decreased heart rate
• eructation, defecation, and urination once the cow rises
8- One of the following aren’t encountered in right sided heart failure:
 Overexertion,
 Lung edema,
 Anasarca,
 Ascitis,
9- The Initial dose of Cardiac Glycosides for horse is:
 1.5-2.2 mg/100 kg,
 0.6-1.2 mg/dl
 3.0-4.4 mg/dl
 None of the above.

10- Prepheral circulatory failure occurs when

 Reduced cardiac output due to failure of venous return to the heart.
 Increased cardiac output due to hypervoulemia
 Two quickly given i.v. injection.
  Cardiac tamponade
Filling the missing answers 1 Marke/each
11- Cows those at risk of ketosis are:
………………………………………………………………………………….
………………………………………………………………………………….
…………………………………………………………………………………………………
……………….………………………………………………………………………………….
………………………………
12- Restablishing of normoglycemia in bovine ketosis could be achieved via:
………………………………………………………………………………….
………………………………………………………………………………….
…………………………………………………………………………………………………
……………….………………………………………………………………………………….
………………………………
13- Signs of left sided heart failure are:
- …………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………
14- The cause (s) of death in equine azoturia may occurs from:
- …………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………
15- The main Laboratory diagnosis of Postparturient hemoglobinuria depends on:
- …………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………
6- Mik fever should be differentially diagnosed from:
 Acute coliforme Toxic mastitis.
 Hypomagnesemia.
 Bovine ketosis.

15- The cause (s) of death in equine azoturia may occurs from:
 Myoglobinemic nephrosis.
 Uraemia.
 Myocardial degeneration.
 Septicemia.

16-An adult draught horse was brought to your clinic with a history of Profuse
sweating, hyperpnoea, Stiffness,, swinging of the hind legs appeared within one hour
after beginning of the exercise. What is your suggestion
 Paralytic myoglobinuria ,
 Black water Disease,
 Rhabdomyolysis
 Tying Up Syndrome,
 Setfast disease

17-In Azoturia, Feeding of highly concentrated ration to draft horses at rest resulted in
Formation of large stores of glycogen in muscles.
The rate of removal of lactic acid from the blood stream does not equal to its production
and the disease ensues.

18-Paralytic equine myoglobinuria may occurred as a result of:

 Feeding of highly concentrated ration to draft horses at rest resulted in
 Ration deficient in vitamins A, B,C. and E
 Ration rich in Ca, P, Na, CU, Mg, Mn, Fe, Co and I)
 All of the above

The following are the main laboratory findings in cases of equine azoturia except:
 Increased levels of sugars, lactic and pyurvic acids,
 Increased levels of N.P.N. and phosphorus.
 Decreased levels of alkaline reserve, protein, calcium, vitamins A, B, and C.
 Decreased levels of CPK and SGOT in blood indicating muscle destruction.

Cases of azoturia could be managed medically by:

• Analgesics (i.v. Novalgin or Chloral hydrate 30 gm orally)
• Antacids (i.v. of 200-400 ml Na bicarbonate 2-5 %).
• Normal saline.
• Vitamin B1 (0.5 gm i.m daily of Thaimine )
• Insulin 200-300 IU im.
• Cortisone.
• Antibiotics.

Cases of azoturia could be managed medically by:

- …………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………

Postparturient hemoglobinuria occurred in dairy cow as a results of:

 Severe drop in serum P levels as a result of its secretion in milk
 Heavy feeding on hemolytic or oxidative plant toxins and plants low in P
 Stress of heavy lactation
 All of the above

The cause(s) of death in Postparturient hemoglobinuria of cows are:

- …………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………

The main Laboratory diagnosis of Postparturient hemoglobinuria depends on:

- Serum P < 4 mg/dl.,
- Low RBCs, Hb, PCV.
- Excess urine Urobilinogin
- All of the above

The main Laboratory diagnosis of Postparturient hemoglobinuria depends on:

- …………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………

Cases of Postparturient hemoglobinuria should be differentially diagnosed from:

- …………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………
Cases of Postparturient hemoglobinuria could be treated by:
• I.V. injection of 60 gm Na hypophosphate in 300 ml DW, repeated s.c. for next 3
days
• Tonophosphan 50 ml, I/M Twice/24 hr
• Copper glycinate (120 mg copper) may halt hemolysis.
• Supportive fluid therapy and Anti-oxidants (Vit. E, C)
• Bone meal should be added to the ration of cows.
• Blood transfusion should be attempted in severe anemia (PCV < 16 %) 4- 10
liter/cow

Cases of Postparturient hemoglobinuria could be treated by:

- …………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………
12- Milk fever can be avoided by the following regimen:
………………………………………………………………………………….
………………………………………………………………………………….
…………………………………………………………………………………………………
……………….………………………………………………………………………………….
………………………………

Prognosis of Postparturient hemoglobinuria is considered unfavourable if:

- Cow is severely dehydrated anemic and weak
- Cows are being recumbent since 3 days
- PCV is being < 16 %
- All of the above.

Blood transfusion should be attempted in cows with Postparturient hemoglobinuria if:

- Cow is severely dehydrated and weak
- PCV is being > 16 %
- PCV is being < 16 %
- All of the above.
9- The DCAD approach in milk fever could be achieved by
1- Use the dietary cation-anion difference (DCAD), which decreases the blood pH of
cows prior and just afetr calving.
2- Adding excess anions to the diet is believed to enhance calcium resorption from bone
and absorption from the GI tract-
3- Reducing the K content of the diet: by feeding corn silage as a major portion of the
dry cow’s diet to decrease bl. pH

10-Grass Staggers occurs mostly in:

• Adult lactating cows are most susceptible due to the loss of Mg in milk.
• It is rare in non lactating cattle but may occurred when undernourished cattle were
turned to green cereal crops.
• It occurs mainly when animals are grazed on lush grass pastures or green cereal crops,
but can occur in lactating beef cows fed silage indoors.

11- Signs of left sided heart failure are:

- …………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………
-…………………………………………………………………………………

12- Causes of Congestive heart failure are:

• Defect in filling
• Conduction defect
• Overloading heart
• All of the above.
13- One of the following aren’t encountered in right sided heart failure:
 Overexertion,
 Lung edema,
 anasarca,
 ascitis,
14- One of the following aren’t encountered in right sided Herat failure
 Polyuria,
 hepatomegaly,
 proteinuria,
 Diarrhea.
15-14- One of the following aren’t encountered in left sided Herat failure
 Ascitis,
 Dyspnea,
 Sneezing,
 Cyanosis.
16-Heart tonics as Cardiac Glycosides (digitalis and quabain) .The Initial dose for horse
is:
 1.5-2.2 mg/100 kg,
 0.6-1.2 mg/dl
 3.0-4.4 mg/dl
 None of the above.
17- The main causes of Acute heart failure are:
 • Cardiac tamponade (cardiac sac is suddenly filled with fluid.)
• In excessive tachycardia or ventricular fibrillation as that occurs in falling
disease of cattle and enzootic muscular dystrophy.
• Two quickly given i.v. injection.
• In lighting stroke.
• In excessive bradycardia either due to occurrence of heart block or to I.V.
injection of calcium preparations.
• Occlusion of the coronary blood vessels but it is rarely to occur in animals

18- The maintenance dose of Cardiac Glycosides for horse is:

 0.8-1.1 mg/100 kg after 4 hrs, and each 24 hrs.
 1.6-2.2 mg/100 kg after 4 hrs, and each 24 hrs.
 2.2-4.2 mg/100 kg after 4 hrs, and each 24 hrs.
 None of the above.

19- Prepheral circulatory failure occurs when

 Reduced cardiac output due to failure of venous return to the heart
 Increased cardiac output due to hypervoulemia
 Two quickly given i.v. injection.
 Cardiac tamponade
20-

14-Grass tetany is a complex metabolic disturbance ch. by

 Drop of serum and CSF Mg which lead to
 hyperexcitability,
 muscular spasms,
 convulsions,
 respiratory distress,
 collapse, and death.

15-The diagnostic lab. Findings in hypomagnesemia ar:

• Drop in Mg and Ca levels in blood and CSF.
• Mild decrease in serum P, increase in serum K.
• Decreased Mg in urine.
• All of the above.

16-Hypomagnesimai should be differentially diagnosed from:

 Acute lead poisoning
(Blindness and frenzy)
  2- BSE
(Frenzy signs have no relation to Mg)
 3-Rabies
(down paralysis, Dog biting, No convulsions).
 4-Nervous from of ketosis (Ketonemia, ketonuria)

17-The prominannt signs of whole milk tetany in calves are:

• Hyperesthesia.
• Tachycardia and normal body temp.
• Deviation of head and opisothonus.
• Ataxia, dropping of ears.
• Difficulty drinking of water, inability to reach water pucket.
• Muscle tremors esp. with kinking abdomen.
• Convulsions, foot pushing, jaw movement, frothiness.

18-Grass staggers is a complex metabolic disorder at peak of lactation ch. by :

1- Drop of serum and CSF Mg.
2- Drop of serum and soil K
3- Drop of serum glucose
4- None of the above

19- Grass staggers of lactating cows is usually charct. By:

1- Hyperexcitability, muscular spasm
2- Respiratory distress,
3- Convulsions, collapse, and death.
4- All of the above.
5- None of the above.
20- To obtain a good response in Grass stager cows, it preferable to give them:
1- I.V or S.C injection of 200-300 ml of 5 % Mg gluconate.
2- I.V or S.C injection of 200-300 ml of 10 % Mg gluconate.
3- I.V or S.C injection of 200-300 ml of 15 % Mg gluconate.
4- I.V or S.C injection of 200-300 ml of 25 % Mg gluconate.

21- 23: High lact. cow observed with signs of red urine for 5 days 6 weaks after
parturition, 38 C body temp., PCV 12 %, Total Bilirubin 3 mg/dl and 3+ve urobilinogin
and recumbency. This cow may suffer from:
1- Hemolytic anemia.
2- Hemmorrhagic anemia.
3- Postpartutrient Hypophosphatemia.
3- Bacillary Hb uria
4- None of the above.

22- To treat this condition it is advised to:

1- Increase resistance of RBCs cell membrane by giving Sod. Diabasic phosphate.
2- Administration of hematinics.
3- Blood transfusion.
4- All of the above.

23- The same cow is advised to be treated with.

1- Na monobasic phosphate.
 2- Blood transfusion.
3- Plasma infusion.

24- The most important laboratory findings in Grass staggers are:

• Drop in Mg and Ca levels in blood and CSF.
• Signs of muscl. tremors observed when Mg < 0.7 mg/dl., Ca < 5-8 mg/dl
• Mild decrease in serum P, increase in serum K.
• Decreased Mg in urine.

25- Grass staggers should be differentially diagnosed from:

1- Acute lead poisoning (Blindness and frenzy)
2- BSE (Frenzy signs have no relation to Mg)
3- Rabies
(down paralysis, Dog biting, No convulsions).
4-Nervous from of ketosis (Ketonemia, ketonuria)

26- Treatment of grass staggers

• It can be successful if given early and without excessive handling of the affected
animal
• 200 ml of Mg sulfate 50% injected under the skin increased the level of Mg in the
blood in 15 min. or
• IV inj of 500 ml. of (Ca Borogluconate 25 %, + Hypophosphate Mg 5 %), 50 ml
for ewe. or
• Mg lactate 3.3 % iv or sc. or
• Mg gluconate 15 % (200-300 ml iv).
• Avoid heart & respiration abnormalities during IV injection

27- How to avoid Hypomagnesemia Mg should be given as feed additive:

1. Daily oral supplements of Mg oxide 60 g to cattle and 10 g to sheep should be
given in the danger period.
2. Mg Oxide 7-8 % mixed with Mollas or water and sprayed over hay and dry food.
3. Let pastures to complete its growth and decrease its K supply.
4. Avoid parturition of cows at winter season and delay it to the end of winter.
5. Avoid stress factors of transport, weather etc.
6. Adequate Soil Phosphorus decreases the Grass Tetany Potential of Tall Fescue
Pasture
7. Feeding free-choice mineral that supplies 13-15 g of Mg / head / day for 30 days
prior to and 30 days after turnout will control most grass tetany problems.
28- Cows those at risk of ketosis are:
8. High lact. cows at ist 6 wk of lactation are at risk of ketosis with incidence of 5-
16%,
9. It occurs in all parities & less common in primiparous animals)
10. It appear to have no genetic predisposition,
11. Cows with excessive adipose stores (BCS ≥3.75 out of 5.0) at calving are at
increased risk of ketosis.
12. Lactating cows with hyperketonemia (subclinical ketosis—serum BHB
concentrations >12 mg/dL) are at increased risk of developing clinical ketosis

29- Ketosis frequently occurs concurrently with other peripartum diseases as:
• Displaced abomasum,
 • retained fetal membranes, and
• metritis.
• Fatty liver.

30- Ketosis diagnosis depends on:

• Cow-side tests for the presence of ketone bodies in urine or milk .
• Due to the large surge in plasma NEFA at calving, a positive test for ketones is
very common during this period.
• Urine ketone body conc. are always higher than milk ketone body concentrations
• Mild ketones in urine & milk without signs indicate suclinical ketosis.

31- Ketosis diagnosis depends on:

• Milk tests for acetone and acetoacetate are more specific than urine tests.
• Positive milk tests for acetoacetate and/or acetone usually indicate clinical ketosis
• A dipstick to detect BHB in milk, available in Japan and Europe, is more
sensitive than milk tests for acetone and acetoacetate and may be useful for
monitoring incidence of subclinical ketosis.

32- Ketosis should be differentiated from:

1- Milk fever.
2- Ruminal acidosis
3- LDA, RDA
4- Hypomagnesemia
5- BSE (Mad cow sydm)
6- Rabies.
7- Lead poisoning

33- Restablishing normoglycemia in ketosis could be achieved via:

1- I.V. admin. of ½-1 L of 50% dextrose/ or glucose which is very hyperosmotic
and, if admin. perivascularly, results in severe tissue swelling and irritation, so
care should be taken to assure that it is given I.V.

34-Propylene glycol (250-400 g/dose, PO, [~8-14 oz]) twice d. acts as a glucose precursor
in combination with other therapy avoiding overdosing.

35- The serum ketone bodies are :

• Acetone, Acetoacetate, and β-hydroxybutyrate (BHB).
•

36-Cattle with hyperketonemia

1- Have concurrent acidemia in contrary to other spp.
2- Haven't concurrent acidemia in contrary to other spp

37- Cases of ketosis in very early lactation are usually associated with fatty liver.
- Cases occurring closer to peak milk prod., may be assoc. with underfed cattle
experiencing a metabolic shortage of gluconeogenic precursors than with excessive fat
mobilization.
Exam 2:
Dept. of animal Medicine Date: / /2009
Faculty of Veterinary Medicine Time allowed: 1 hr.
Assiut University Group:
Midterm exam. For 5th year veterinary student (Followup exam)

1- You are invited to examin a recently parturated dairy cow with signs of depression,
flaccid paralysis, and sternal recumbency.
To reach a diagnosis you have to:
a. Ask the owner about the ration offered to this cow before parturition.
b. Examine the locomotor system of this cow.
c. Giving it IV calcium infusion.
d. Measure the blood serum Ca, ph and Mg

This could may be suffer from:

a. Postparturient pariesis.
b. Bovine ketosis
c. Fat cow syndrome.
d. Acute coliform mastitis.

1-A high lactating cow admitted to your clinic with signs of anorexia, emaciation,
hyperasethesia, nervous signs and muscle tremors, this case may suscpected as:
- Postparturient hypophosphatemia
- Nervous form of ketosis.
- Acid- indigestion.
- Grass staggers.

- Postparturient hypophosphatemia
- Nervous form of ketosis.
- Acid- indigestion.
- Grass staggers.

Fill the missed sentences:

1-Normal values of blood serum Ca P: Mg in a cow.

2-The main cause of death in pregnancy toxemia:

- ……………………………………………………………………………..
-……………………………………………………………………………..- -
……………………………………………………………………………..- -
……………………………………………………………………………..

3- Mik fever should be differentially diagnosed from:

1.
2.
3.
4.
4- To treat this condition it is advised to:
5- Increase resistance of RBCs cell membrane by giving Sod. Diabasic phosphate.
6- Administration of hematinics.
7- Blood transfusion.
 8- All of the above.

4-Bovine ketosis are :

- Usually observed in high lactating cows at peak of lactation.
- Seldom observed before parturition.
- Never observed at dry period.
- All of the above.

4-Bovine ketosis are:

- Usually associated with metabolic acidosis.
- Seldom associated with metabolic acidosis.
- Never associated with metabolic Acidosis.

12- Causes of Congestive heart failure are:

• Defect in filling
• Conduction defect
• Overloading heart
• All of the above.

13- Feeding low-calcium diets during the dry period of cows is important because:
 It stimulate intestinal absorption of dietary Ca.
 Enhance skeletal resorption prior to the sudden onset of lactation.
 It is essential regime to avoid Milk fever.
 None of the above.

Tremors seen during IV Ca injection of Milk fever cows indicate:

 Returns of neuromuscular function,
 Favorable signs of response.
 Unfavorable signs of response.
 Ca toxixcity.

A dministration of ½-1 L of 50% dextrose/ or glucose for bovine ketosis is:

 It is a very hyperosmotic and should be given intravenously
 It should be never given Intravenously.
 It could be given subcutaneously
 It results in severe tissue swelling and irritation, if given perivascularly