the veterinarian-client-patient relationship questions and answers

1. A young girl has brought in her pet cat, Crookshanks, who has been suffering from chronic renal failure. You know that Chronic renal failure will cause hypocalcemia. Which of the following options will cause the spasms and tremors in Crookshanks?

Neurotransmitter inhibition

Smooth muscle relaxation

Too much ATP

Excessive function of the lactate shuttle

Flooding of ACh into the synaptic cleft causing over-stimulation of the muscles

Chronic renal failure leads to hypocalcemia, which is a condition characterized by low levels of calcium in the blood. Calcium is necessary for proper muscle contractions and nerve function. The flooding of acetylcholine (ACh) into the synaptic cleft causes over-stimulation of the muscles. ACh is a neurotransmitter that is responsible for transmitting signals between nerve cells and muscle cells. When there is an excess of ACh, it can lead to muscle spasms and tremors. Therefore, in the case of Crookshanks, the flooding of ACh into the synaptic cleft is causing the spasms and tremors.

Explanation

Chronic renal failure leads to hypocalcemia, which is a condition characterized by low levels of calcium in the blood. Calcium is necessary for proper muscle contractions and nerve function. The flooding of acetylcholine (ACh) into the synaptic cleft causes over-stimulation of the muscles. ACh is a neurotransmitter that is responsible for transmitting signals between nerve cells and muscle cells. When there is an excess of ACh, it can lead to muscle spasms and tremors. Therefore, in the case of Crookshanks, the flooding of ACh into the synaptic cleft is causing the spasms and tremors.

2. After the lunch break, you feel drowsy and drink a Red Bull. Your 4th most loyal client walks in with his 2nd favorite dog, Demarcus. He tells you he believes Demarcus fought off a raccoon but has seen some changes over the last few days. Upon physical examination, you determine Demarcus has decreased reflexes, decreased muscle tone, and can lose muscle mass, weakness and paralysis, and depression of spinal reflexes. You inform your 4th most loyal client that these symptoms point to idiopathic polyradiculoneuritis (coonhound paralysis). Being the thorough professional you are, you pull out your whiteboard and colored Export markers to explain to him what is happening at the neuronal level to Demarcus. What would be the best summary of what is causing Demarcus's symptoms?

Demyelination of nerve fibers

Regular myelination of nerve fibers

Hyperkalemia

Hypokalemia

Milk fever (hypocalcemia)

The best summary of what is causing Demarcus's symptoms is demyelination of nerve fibers. This means that the protective covering around the nerves, called myelin, is being damaged or destroyed. This can lead to decreased reflexes, muscle weakness, and paralysis, which are all symptoms that Demarcus is experiencing.

Explanation

The best summary of what is causing Demarcus's symptoms is demyelination of nerve fibers. This means that the protective covering around the nerves, called myelin, is being damaged or destroyed. This can lead to decreased reflexes, muscle weakness, and paralysis, which are all symptoms that Demarcus is experiencing.

3. A client presents to clinic with her 18-year-old Bassett Hound mix named Todd. Patient reports that Todd is "sharp as a tack" due to his diet of a bowl of ice cream every evening after dinner. Calcium is important in neurotransmission at the synaptic level due to

Calcium is the primary component of lipofuscin which is an indicator of canine intelligence

It is necessary for the docking phase of neurotransmitter release

Calcium makes up the bulk of astrocytes which are necessary for cognitive function

Calcium is used by Nissl bodies in the neuron to synthesize acetylcholine

Calcium causes a conformational change of synapsin I releasing the neurotransmitter from the cytoskeleton

Calcium causes a conformational change of synapsin I, which leads to the release of neurotransmitters from the cytoskeleton. This process is crucial for neurotransmission at the synaptic level, allowing the transmission of signals between neurons. Therefore, calcium plays an important role in facilitating communication between neurons and is necessary for proper brain function.

Explanation

Calcium causes a conformational change of synapsin I, which leads to the release of neurotransmitters from the cytoskeleton. This process is crucial for neurotransmission at the synaptic level, allowing the transmission of signals between neurons. Therefore, calcium plays an important role in facilitating communication between neurons and is necessary for proper brain function.

4.

A client brings in a heifer, which just so happened to have birthed a calf within the last couple days. We think the heifer is most likely experiencing symptoms of milk fever due to muscular weakness, and increased heart rate. Milk fever is mainly due to a lower level responsiveness of the cow's tissues to circulating parathyroid hormone. Which of the following describes the neurophysiology of this disease?

Hypocalcemia, decreased calcium levels and increased sodium influx

Hypercalcemia, increased calcium and reduced sodium influx

The cow is just tired and lacks energy reserves (glycogen depletion)

None of the above

All are accurate

Milk fever, also known as hypocalcemia, is a condition characterized by low levels of calcium in the blood. This leads to symptoms such as muscular weakness and increased heart rate. In this condition, there is a decreased calcium level and increased sodium influx in the cow's tissues. This imbalance in calcium and sodium levels affects the neurophysiology of the cow, leading to the symptoms observed. Hypercalcemia, increased calcium and reduced sodium influx, is not accurate in this case. The cow being tired and lacking energy reserves is not the cause of milk fever. Therefore, the correct answer is hypocalcemia, decreased calcium levels and increased sodium influx.

Explanation

Milk fever, also known as hypocalcemia, is a condition characterized by low levels of calcium in the blood. This leads to symptoms such as muscular weakness and increased heart rate. In this condition, there is a decreased calcium level and increased sodium influx in the cow's tissues. This imbalance in calcium and sodium levels affects the neurophysiology of the cow, leading to the symptoms observed. Hypercalcemia, increased calcium and reduced sodium influx, is not accurate in this case. The cow being tired and lacking energy reserves is not the cause of milk fever. Therefore, the correct answer is hypocalcemia, decreased calcium levels and increased sodium influx.

5. A client brings in a 4H steer named Jasper with a laceration on the right side of the neck. The client states that Jasper stuck his neck through the feeder and sliced it on the side of the feeder. You evaluate the laceration and conclude that Jasper needs stitches to close the wound up and get healed before he is shown in the local fair in a month. You must then block the area with a local anaesthetic so you can stitch Jasper up. Which of the following best describes the function of the anaesthetics given?

Blocks sodium membrane permeability and decreases action potential

Increases sodium

Increases action potential

Increase calcium

Increase potassium

The function of the anaesthetics given is to block sodium membrane permeability and decrease action potential. This means that the anaesthetics prevent the movement of sodium ions across the cell membrane, which helps to decrease the generation and transmission of nerve impulses. By blocking sodium membrane permeability and decreasing action potential, the anaesthetics can numb the area and provide pain relief, allowing for the stitching of the laceration on Jasper's neck.

Explanation

The function of the anaesthetics given is to block sodium membrane permeability and decrease action potential. This means that the anaesthetics prevent the movement of sodium ions across the cell membrane, which helps to decrease the generation and transmission of nerve impulses. By blocking sodium membrane permeability and decreasing action potential, the anaesthetics can numb the area and provide pain relief, allowing for the stitching of the laceration on Jasper's neck.

6. A 3 year old Great Dane Border Collie mix named Link is brought to your clinic with the following symptoms: hypersalivation, miosis, frequent urination, diarrhea, vomiting and dyspnea. After taking a detailed history, you strongly suspect tetraethyl pyrophosphate (organophosphate) poisoning, given the neighbor's obsession over his garden. Which one of the following best describes the way the organophosphates function?

Organophosphates inhibit cholinesterase, an enzyme that breaks down acetylcholine, a neurotransmitter that carries signals between nerves and muscles

Organophosphates increase cholinesterase production, an enzyme that breaks down acetylcholine, a neurotransmitter that carries signals between nerves and muscles

Organophosphates inhibit the release of epinephrine which breaks down acetylcholine, a neurotransmitter that carries signals between nerves and muscles

Organophosphates inhibit cholinesterase, an enzyme that breaks down acetylcholine, a neurotransmitter that inhibits signal transduction between nerves and muscles

Organophosphates function by inhibiting cholinesterase, an enzyme that breaks down acetylcholine. Acetylcholine is a neurotransmitter that carries signals between nerves and muscles. When cholinesterase is inhibited, acetylcholine accumulates, leading to excessive stimulation of the nervous system. This can result in symptoms such as hypersalivation, miosis (constriction of the pupils), frequent urination, diarrhea, vomiting, and dyspnea. The history of the neighbor's obsession with his garden suggests that Link may have been exposed to organophosphates, which are commonly used as pesticides in gardens.

Explanation

Organophosphates function by inhibiting cholinesterase, an enzyme that breaks down acetylcholine. Acetylcholine is a neurotransmitter that carries signals between nerves and muscles. When cholinesterase is inhibited, acetylcholine accumulates, leading to excessive stimulation of the nervous system. This can result in symptoms such as hypersalivation, miosis (constriction of the pupils), frequent urination, diarrhea, vomiting, and dyspnea. The history of the neighbor's obsession with his garden suggests that Link may have been exposed to organophosphates, which are commonly used as pesticides in gardens.

7. A client brings in her 8 year old bitch name Lauren who was just hit by a car. Upon examination of the animal, you notice Lauren has shortness of breath, fatigue, and a fast heartbeat. You decide to take x-rays to see if there is any internal damage and notice the femur is broken and the femoral artery maybe obstructed. What condition can this activity induced muscle injury lead to?

Hyperoxia leading to an excess supply of oxygen in tissues and organs

Ischemia from blood vessels becoming blocked and reduced blood flow

Rigor Mortis from persistent muscle contractions and failure to relax

Lactate shuttle due to glucose being absorbed in the blood

None of the above

The correct answer is "Ischemia from blood vessels becoming blocked and reduced blood flow." In this scenario, the client's 8-year-old bitch, Lauren, has experienced a broken femur and a possible obstruction of the femoral artery. These injuries can lead to ischemia, which is the condition where blood vessels become blocked or narrowed, resulting in reduced blood flow to the affected area. This can cause symptoms such as shortness of breath, fatigue, and a fast heartbeat. The other options listed in the question do not accurately describe the potential consequences of the muscle injury in this case.

Explanation

The correct answer is "Ischemia from blood vessels becoming blocked and reduced blood flow." In this scenario, the client's 8-year-old bitch, Lauren, has experienced a broken femur and a possible obstruction of the femoral artery. These injuries can lead to ischemia, which is the condition where blood vessels become blocked or narrowed, resulting in reduced blood flow to the affected area. This can cause symptoms such as shortness of breath, fatigue, and a fast heartbeat. The other options listed in the question do not accurately describe the potential consequences of the muscle injury in this case.

8. Othello the cat's neurons can send impulses to their target organs only at specific intervals. The initial stimulation is followed by a period where no further stimuli can initiate another impulse no matter how strong the stimulus is. During repolarization, there is a phase where a strong enough stimulus would trigger a neuron to initiate another impulse. What is this phase called and what is the consequence to its occurrence?

Absolute refractory period with a consequence of tetany

Relative refractory period with a consequence of a longer absolute refractory period

Absolute refractory period with a consequence of a longer relative refractory period

Relative refractory period with a consequence of a compound action potential

Absolute refractory period with a consequence of a supernormal phase

During the relative refractory period, a neuron can initiate another impulse if the stimulus is strong enough. The consequence of this phase is that it leads to a longer absolute refractory period, which is the period where no further stimuli can initiate another impulse regardless of their strength. This means that during the relative refractory period, the neuron is less responsive and requires a stronger stimulus to generate another impulse, resulting in a longer period of time where the neuron is unable to respond to any stimulus.

Explanation

During the relative refractory period, a neuron can initiate another impulse if the stimulus is strong enough. The consequence of this phase is that it leads to a longer absolute refractory period, which is the period where no further stimuli can initiate another impulse regardless of their strength. This means that during the relative refractory period, the neuron is less responsive and requires a stronger stimulus to generate another impulse, resulting in a longer period of time where the neuron is unable to respond to any stimulus.

9. You administer lidocaine to a dog, called Samantha, as a part of your pre-anaesthesia routine. A student asks you "I know it has to block something but what does it block?" Which of the following will you tell them?

Sodium Channels on the presynaptic neuron

Potassium Channels on the presynaptic neuron

Calcium Channels on the presynaptic neuron

Nicotinic Receptors on the postsynaptic neuron

Cholinergic Receptorson the postsynaptic neuron

Lidocaine blocks sodium channels on the presynaptic neuron.

Explanation

Lidocaine blocks sodium channels on the presynaptic neuron.

10. Merlin, the 10-year-old Havanese, presents for his first dental cleaning. He has grade IV gingival disease and will need extensive scaling with multiple extractions. You perform preanesthetic blood chemistries and find his values to be within normal range with exception of an elevated neutrophil count. Before beginning, you decide to perform a local anesthetic nerve block on his mouth with a combined injection of Lidocaine and Bupivacaine. What is the neuronal effect taking place?

Lidocaine and bupivacaine act to block Ach receptors causing loss in muscle fiber sensation.

In order to ensure proper pain management, you give lidocaine and bupivacaine as they are powerful painkillers.

The correct answer is that the injection of lidocaine and bupivacaine will decrease sodium membrane permeability, resulting in a decrease of action potential and causing a loss of sensory neuron activity. Lidocaine and bupivacaine are local anesthetics that work by blocking sodium channels, preventing the generation and conduction of nerve impulses. This leads to a loss of sensation in the area where the anesthetic is applied.

Explanation

The correct answer is that the injection of lidocaine and bupivacaine will decrease sodium membrane permeability, resulting in a decrease of action potential and causing a loss of sensory neuron activity. Lidocaine and bupivacaine are local anesthetics that work by blocking sodium channels, preventing the generation and conduction of nerve impulses. This leads to a loss of sensation in the area where the anesthetic is applied.

11. A client presents to clinic with her 8 year old Vizsla, Boze, for his annual vaccines. Client requests that after administering the vaccine staff rub the area while stating "epicritic." What is she hoping to achieve with this action?

Stimulation of the type A gamma nerve fibers to compete with the arriving afferent information of the needle stick

Stimulation of the type C fibers to compete with the arriving afferent information of the needle stick

Stimulation of the type A alpha fibers to compete with the arriving afferent information of the needle stick

Temporal summation to compete with the arriving afferent information of the needle stick

Nothing, the client is clearly insane

The client is hoping to achieve stimulation of the type A alpha fibers to compete with the arriving afferent information of the needle stick. This is likely to provide some relief or distraction from the pain caused by the needle stick.

Explanation

The client is hoping to achieve stimulation of the type A alpha fibers to compete with the arriving afferent information of the needle stick. This is likely to provide some relief or distraction from the pain caused by the needle stick.

12. Lina is a 6-year-old Karakachan dog who has been experiencing chronic pain for the last few months. Her owner mentioned that along with the chronic pain, Lina has started to have increased anxiety as the 4th of July is nearing and her neighbors have started with the fireworks already. The owner wants a medication that can work to divert and alleviate the pain associated with this condition. You decide to prescribe an inhibitory neurotransmitter, which will work to manage pain and alleviates anxiety. This specific inhibitory neurotransmitter works by increasing the amount of Ca and Cl entry, leading to hyperpolarization of the cell. What is the name of this inhibitory neurotransmitter and what is happening to the cells in terms of excitability?

Glutamate, the cell is becoming hyperpolarized, decreasing excitability, leading to no sensory input

Epinephrine, the cell is becoming hyperpolarized, increasing excitability, leading to sensory input

Glutamate, the cell is becoming hyperpolarized, increasing excitability, leading to no sensory input

Norepinephrine, the cell is becoming hyperpolarized, increasing excitability, leading to sensory input

Benzodiazepine, the cell is becoming hyperpolarized, decreasing excitability, leading to no sensory input

The correct answer is Benzodiazepine. Benzodiazepine is an inhibitory neurotransmitter that works by increasing the amount of Ca and Cl entry into the cell, which leads to hyperpolarization. Hyperpolarization decreases the excitability of the cell, resulting in a decrease in sensory input. This medication can help alleviate both the chronic pain and anxiety that Lina is experiencing.

Explanation

The correct answer is Benzodiazepine. Benzodiazepine is an inhibitory neurotransmitter that works by increasing the amount of Ca and Cl entry into the cell, which leads to hyperpolarization. Hyperpolarization decreases the excitability of the cell, resulting in a decrease in sensory input. This medication can help alleviate both the chronic pain and anxiety that Lina is experiencing.

13. You have a new client, Laddoo, a 13-year-old Chihuaha who just moved down from Southern California with his family. The family forgot to bring his medical records, so you call his prior veterinarian for his records. Upon recieving his records, you see that Laddoo has been diagnosed with Idiopathic polyradiculoneuritis. This makes sense because, during your examination, you noticed he had decreased reflexes, decreased muscle tone, and depression of spinal reflexes, indicating demyelination of the nerve. Laddoo's parents are both scientists and want to know what is happening in regards to the membrane. How do you explain this?

You explain that this disease increases the resistance to membrane ion inflow and therefore increases the electrocurrent speed.

You explain that this disease decreases the resistance to membrane ion inflow and therefore decreases the electrocurrent speed.

You explain that this disease decreases the resistance to membrane ion inflow and therefore increases the electrocurrent speed.

You explain that this disease doesn’t change the resistance to membrane ion inflow and therefore increases the electrocurrent speed

not-available-via-ai

Explanation

not-available-via-ai

14. A man brings in his horse called Shadowfax into your clinic. As you are examining Shadowfax she becomes tense, his eyes dilate and you are preparing to jump out the way as you expect her to bolt. Which part of the CNS is this response associated with?

Cervicosacral

Craniosacral

Lumbosacral

Craniothoracic

Thoracolumbar

This response is associated with the thoracolumbar part of the central nervous system. This is because the symptoms described, such as tenseness, dilated eyes, and the expectation of the horse bolting, indicate a fight-or-flight response. The thoracolumbar part of the CNS is responsible for this response, as it controls the sympathetic nervous system, which activates the body's stress response.

Explanation

This response is associated with the thoracolumbar part of the central nervous system. This is because the symptoms described, such as tenseness, dilated eyes, and the expectation of the horse bolting, indicate a fight-or-flight response. The thoracolumbar part of the CNS is responsible for this response, as it controls the sympathetic nervous system, which activates the body's stress response.

15. A hunting dog, Cooper, is brought into your clinic experiencing symptoms of coonhound paralysis. We know that coonhound paralysis consists of decreased reflexes, decreased muscle tone, loss of muscle mass, weakness and paralysis, as well as depression of spinal reflexes. What might be the neurological effect at the level of the action potential?

Decreased potassium which makes the axon more hyperpolarized

Decreased potassium which makes the axon more depolarized

Increased potassium which makes the axon more hyperpolarized

Increased potassium which makes the axon more depolarized

None of the above

In coonhound paralysis, the neurological effect at the level of the action potential is increased potassium which makes the axon more hyperpolarized. Hyperpolarization refers to an increase in the membrane potential, making it more negative than the resting potential. This can lead to decreased excitability of the axon and impaired transmission of signals. Increased potassium levels can disrupt the balance of ions involved in generating action potentials, leading to the symptoms observed in coonhound paralysis such as decreased reflexes, muscle weakness, and paralysis.

Explanation

In coonhound paralysis, the neurological effect at the level of the action potential is increased potassium which makes the axon more hyperpolarized. Hyperpolarization refers to an increase in the membrane potential, making it more negative than the resting potential. This can lead to decreased excitability of the axon and impaired transmission of signals. Increased potassium levels can disrupt the balance of ions involved in generating action potentials, leading to the symptoms observed in coonhound paralysis such as decreased reflexes, muscle weakness, and paralysis.