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EQUINE

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Welcome to the Equine NAVLE Notes: Cardiorespiratory section.

 

Here, veterinarians preparing for the NAVLE test will find comprehensive notes on respiratory and cardiovascular issues in horses. Explore key topics such as equine asthma, exercise-induced pulmonary hemorrhage (EIPH), atrial fibrillation, and valvular heart disease. These notes are designed to help you prepare thoroughly and confidently for the exam, ensuring you're ready to pass with flying colors.

Notes:

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Test your knowledge with our sample questions!

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Eq CR Sample Questions

NAVLE test sample questions

Equine: Cardiorespiratory

Question 1:
Which of the following is the most reliable diagnostic method for confirming Rhodococcus equi infection in foals?

A) Serologic testing
B) Fecal flotation
C) Thoracic radiography
D) Nasopharyngeal swab culture

Question 2:
When treating a foal diagnosed with severe Rhodococcus equi pneumonia, which combination of drugs is considered the standard therapy?

A) Doxycycline and gentamicin
B) Amoxicillin and clavulanic acid
C) Azithromycin and rifampin
D) Tetracycline and metronidazole

​Question 3:

A 10-year-old Thoroughbred gelding presents with intermittent poor performance. On auscultation, an irregularly irregular rhythm is noted. An ECG reveals absence of P waves and irregular R-R intervals. What is the most likely diagnosis?


A. Second-degree AV block
B. Atrial fibrillation
C. Sinus arrhythmia
D. Ventricular tachycardia

Question 4:

Which of the following best describes the pathophysiology of atrial fibrillation in horses and the standard treatment to restore sinus rhythm?


A. Delayed ventricular repolarization; treat with lidocaine
B. Atrioventricular nodal reentry; treat with beta-blockers
C. Disorganized atrial electrical activity; treat with quinidine sulfate
D. Atrial inflammation; treat with corticosteroids

Question 5:

A 2-month-old foal presents with failure to thrive and poor exercise tolerance. On auscultation, a loud, holosystolic murmur is heard over the right cranial thorax. Echocardiography reveals a left-to-right shunting defect in the membranous portion of the interventricular septum. What is the most likely diagnosis?

A. Patent ductus arteriosus (PDA)
B. Ventricular septal defect (VSD)
C. Atrial septal defect (ASD)
D. Tetralogy of Fallot

Question 6:

Which of the following statements is correct regarding the pathophysiology and clinical relevance of congenital heart disease in foals?

A. All PDAs in foals are pathological and should be surgically corrected immediately
B. A small atrial septal defect (ASD) always leads to cyanosis due to right-to-left shunting
C. A large VSD causes volume overload of the right ventricle and pulmonary overcirculation
D. Tetralogy of Fallot typically presents with a left-to-right shunt and normal oxygenation

Scroll down to discover the answers and detailed explanations for the sample questions.

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Answers & Explanations

Question 1:​

Answer: C) Thoracic radiography

Explanation: Thoracic radiography is a key diagnostic tool for Rhodococcus equi in foals, particularly for identifying perihilar alveolar patterns indicative of pulmonary consolidation and abscess formation. Serologic testing is not recommended due to its poor correlation with disease severity, and fecal flotation and nasopharyngeal swabs are not effective diagnostic methods for this disease​

Question 2:

Answer: C) Azithromycin and rifampin

Explanation: The standard treatment for severe Rhodococcus equi pneumonia in foals is a combination of a macrolide antibiotic (such as azithromycin) and rifampin. This combination is highly effective due to its synergistic activity and ability to penetrate abscesses, which are common in this disease. Alternatives like doxycycline and gentamicin are considered in cases of resistance, but they are not the first-line treatment​

Question 3:

Answer: B) Atrial fibrillation

Explanation: Atrial fibrillation is the most common pathological arrhythmia in horses, especially athletic animals. It is characterized on ECG by the absence of P waves and an irregularly irregular ventricular rhythm. It often presents with poor performance and irregular heartbeat on auscultation.

Question 4:

Answer: C) Disorganized atrial electrical activity; treat with quinidine sulfate

Explanation: Atrial fibrillation in horses results from disorganized atrial electrical activity leading to loss of coordinated atrial contraction. Quinidine sulfate, a Class IA antiarrhythmic, is commonly used for chemical cardioversion in horses.

Question 5:

Answer: B) Ventricular septal defect (VSD)

Explanation: VSD is the most common congenital heart defect in horses. It typically involves the membranous portion of the septum, resulting in a left-to-right shunt. A loud, holosystolic murmur is best heard over the right heart base. Clinical signs include poor performance, growth delay, and in large defects, congestive heart failure.

Question 6:

Answer: C) A large VSD causes volume overload of the right ventricle and pulmonary overcirculation

Explanation: In large VSDs, left-to-right shunting leads to excessive blood flow into the right ventricle and pulmonary circulation, resulting in volume overload, pulmonary hypertension, and possible left-sided heart failure. PDAs may be physiologic in foals <1 week old. ASDs usually result in left-to-right shunting. Tetralogy of Fallot includes a right-to-left shunt with cyanosis due to pulmonary stenosis and overriding aorta.

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