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Reverted edits by Bandrick (talk) to last revision by Bara
{{QuizCat|topic=Clinical|topicsubcategory=E|}}
{{toplink
|linkpage =WikiQuiz
|linktext = WikiQuiz
|pagetype=Quiz
|Review= '''Kirstie Pickles''' BVMS MSc Cert EM (Int Med) PhD Dip ECEIM MRCVS Lecturer in Equine Practice
}}{{QuizCat|topic=Clinical|topicsubcategory=E|}}
<WikiQuiz
questionnumber="1"
question="Which hypersensitivity condition is thought to be caused by an allergy to plant pollens and plant associated fungal spores?"
choice4="Summer pasture-associated recurrent airway obstruction (SPA-RAO)"
choice5="Recurrent Airway Obstruction (RAO)"
choice3="Extrinsic Allergic Bronchio-alveolitis"
choice1="Inflammatory airway disease (IAD)"
choice2="Diffuse fibrosing alveolitis"
correctchoice="4"
feedback4="'''Correct!''' SPA-RAO is a type III hypersensitivity seen in horses and is similar to the form seen in stabled horses, but this is seen when at summer pasture. [[:Category:Hypersensitivity|WikiVet Article: hypersensitivity ]]"
feedback5="'''Incorrect.''' RAO was formally known as Chronic obstructive pulmonary disease (COPD), it is a type III hypersensitivity which is encountered in adult horses and is a major cause of loss of performance. It is an asthma-like syndrome of the bronchioalveolar region, it is not fully understood, but is thought primarily to be a hypersensitivity response to inhaled allergens found in mouldy hay or bedding and in stable dust. The correct answer is summer pasture-associated recurrent airway obstruction (SPA-RAO), seen in horses and which is similar to the form seen when stabled, but this is seen when at summer pasture. [[:Category:Hypersensitivity|WikiVet Article: hypersensitivity ]]"
feedback3="'''Incorrect.''' Extrinsic Allergic Bronchio-alveolitis is a type III hypersensitivity which arises due to repeated inhalation of spores of thermophilic actinomycetes in mouldy hay. It is a disease primarily of housed cattle in winter. The correct answer is summer pasture-associated recurrent airway obstruction (SPA-RAO), seen in horses and is similar to the form seen when stabled, but this is seen when at summer pasture. [[:Category:Hypersensitivity|WikiVet Article: hypersensitivity ]]"
feedback1="'''Incorrect.''' The aetiology of inflammatory airway disease (IAD) is unknown. Proposed aetiologies include allergic airway disease, recurrent pulmonary stress, deep inhalation of dust, atmospheric pollutants, and/ or persistent respiratory viral infections. The correct answer is summer pasture-associated recurrent airway obstruction (SPA-RAO), seen in horses and is similar to the form seen when stabled, but this is seen when at summer pasture. [[:Category:Hypersensitivity|WikiVet Article: hypersensitivity ]]"
feedback2="'''Incorrect.''' Diffuse fibrosing alveolitis is a type III hypersensitivity. There is a diffuse inflammatory process characterised by thickening and fibrosis of the alveolar walls. The aetiology is not fully understood but it is likely to represent the end stage of a variety of initial insults. The correct answer is summer pasture-associated recurrent airway obstruction (SPA-RAO), seen in horses and is similar to the form seen when stabled, but this is seen when at summer pasture. [[:Category:Hypersensitivity|WikiVet Article: hypersensitivity ]]"
image="">
</WikiQuiz>
<WikiQuiz
questionnumber="2"
question="Which cranial nerves are in contact with the medial compartment of the guttural pouch?"
choice2="Cranial nerves IX, X, XI and XII"
choice4="Cranial nerves VIII, IX, X and XI"
choice3="Cranial nerves VII, VIII, IX and X"
choice5="Cranial nerves VI, VII, VIII, IX"
choice1="Cranial nerves V, VI, VII and VIII"
correctchoice="2"
feedback2="'''Correct!''' Cranial nerves IX, X, XI, and XII, the continuation of the sympathetic trunk beyond the cranial cervical ganglion and the internal carotid artery all run alonside the medial compartment of the guttural pouch. [[Ear - Anatomy & Physiology#Surrounding Gross Anatomy |WikiVet Article: guttural pouch.]]"
feedback4="'''Incorrect.''' Cranial nerves IX, X, XI, and XII, the continuation of the sympathetic trunk beyond the cranial cervical ganglion and the internal carotid artery all run alonside the medial compartment of the guttural pouch. [[Ear - Anatomy & Physiology#Surrounding Gross Anatomy |WikiVet Article: guttural pouch.]]"
feedback3="'''Incorrect.''' Cranial nerve VII, runs for a short distance over the caudodorsal aspect of the lateral, not the medial compartment of the guttural pouch. Cranial nerves IX, X, XI, and XII, the continuation of the sympathetic trunk beyond the cranial cervical ganglion and the internal carotid artery all run alonside the medial compartment of the guttural pouch. [[Ear - Anatomy & Physiology#Surrounding Gross Anatomy |WikiVet Article: guttural pouch.]]"
feedback5="'''Incorrect.''' Cranial nerve VII, runs for a short distance over the caudodorsal aspect of the lateral, not the medial compartment of the guttural pouch. Cranial nerves IX, X, XI, and XII, the continuation of the sympathetic trunk beyond the cranial cervical ganglion and the internal carotid artery all run alonside the medial compartment of the guttural pouch. [[Ear - Anatomy & Physiology#Surrounding Gross Anatomy |WikiVet Article: guttural pouch.]]"
feedback1="'''Incorrect.''' Cranial nerve VII, runs for a short distance over the caudodorsal aspect of the lateral, not the medial compartment of the guttural pouch. Cranial nerves IX, X, XI, and XII, the continuation of the sympathetic trunk beyond the cranial cervical ganglion and the internal carotid artery all run alonside the medial compartment of the guttural pouch. [[Ear - Anatomy & Physiology#Surrounding Gross Anatomy |WikiVet Article: guttural pouch.]]"
image="">
</WikiQuiz>
<WikiQuiz
questionnumber="3"
question="Which of the following is a valid treatment for tetanus in the horse in the early stages of infection?"
choice2="Wound debridement, IV antibiotics and tetanus antitoxin injections"
choice1="Sedatives and muscle relaxants"
choice4="Immediately bandaging the wound"
choice5="Tetanus vaccination followed by tetanus antitoxin"
choice3="Low dose short course antibiotics"
correctchoice="2"
feedback2="'''Correct!''' Opening up and debriding the wound will increase oxygen in the environment (Clostridium is an anaerobe). This in conjunction with high doses of IV penicillin to treat the infection, plus high doses of tetanus antitoxin to try and bind toxin not yet bound to neuromuscular junctions is an appropriate approach to treatment of tetanus in the early stages of infection. [[Clostridium tetani|WikiVet Article: Tetanus]]"
feedback1="'''Incorrect.''' At the early stage of infection the patient will not yet be exhibiting tetanic spasms which would require sedation and muscle relaxants. The correct answer is wound debridement, IV antibiotics and tetanus antitoxin injections. Opening up and debriding the wound will increase oxygen in the environment (Clostridium is an anaerobe). This in conjunction with high doses of IV penicillin to treat the infection, plus high doses of tetanus antitoxin to try and bind toxin not yet bound to neuromuscular junctions is an appropriate approach to treatment of tetanus in the early stages of infection. Link to WikiVet: Tetanus"
feedback4="'''Incorrect.''' The pathogenesis of tetanus is associated with penetration and germination of spores in a wound where there is an anaerobic environment. Bandaging the wound would exacerbate this by creating the optimum anaerobic environment for Clostridium. The correct answer is wound debridement, IV antibiotics and tetanus antitoxin injections. Opening up and debriding the wound will increase oxygen in the environment (Clostridium is an anaerobe). This in conjunction with high doses of IV penicillin to treat the infection, plus high doses of tetanus antitoxin to try and bind toxin not yet bound to neuromuscular junctions is an appropriate approach to treatment of tetanus in the early stages of infection. Link to WikiVet: Tetanus"
feedback5="'''Incorrect.''' Tetanus vaccination is an inappropriate treatment for a horse in the early stages of tetanus infection. The horse will either be dead or recovered by the time it has it has raised antibodies and if it were to survive it would have a strong immunity from natural exposure. Tetanus antitoxin however is an appropriate part of a treatment plan in this case. The correct answer is wound debridement, IV antibiotics and tetanus antitoxin injections. Opening up and debriding the wound will increase oxygen in the environment (Clostridium is an anaerobe). This in conjunction with high doses of IV penicillin to treat the infection, plus high doses of tetanus antitoxin to try and bind toxin not yet bound to neuromuscular junctions is an appropriate approach to treatment of tetanus in the early stages of infection. Link to WikiVet: Tetanus"
feedback3="'''Incorrect.''' Antibiotics would be used in the early stages of infection but you want to use very high dose and extended courses to have any effect on the infection. The correct answer is wound debridement, IV antibiotics and tetanus antitoxin injections. Opening up and debriding the wound will increase oxygen in the environment (Clostridium is an anaerobe). This in conjunction with high doses of IV penicillin to treat the infection, plus high doses of tetanus antitoxin to try and bind toxin not yet bound to neuromuscular junctions is an appropriate approach to treatment of tetanus in the early stages of infection. Link to WikiVet: Tetanus"
image="">
</WikiQuiz>
<WikiQuiz
questionnumber="4"
question="Corynebacterium pseudotuberculosis causes what type of disease in horses?"
choice5="Ulcerative lymphangitis"
choice4="Pyelonephritis"
choice3="Caseous lymphadenitis"
choice1="Mastitis"
choice2="Granulomatous lymphadenitis"
correctchoice="5"
feedback5="'''Correct!''' Corynebacterium pseudotuberculosis causes ulcerative lymphangitis in the horse. The infection results in lymphangitis of lower limbs or abscessation in pectoral region. This is a rare disease in the UK, but is relatively common in southwestern USA, where infection in horses is seasonal, with a peak incidence in late summer and autumn. In the UK, the same organism is more commonly found in sheep and goats, where it causes caseous lymphadenitis. Link to WikiVet: Corynebacterium"
feedback4="'''Incorrect.''' Corynebacterium pseudotuberculosis does not cause pyelonephritis in the horse. The correct answer is that C. pseudotuberculosis causes ulcerative lymphangitis in the horse. The infection results in lymphangitis of lower limbs or abscessation in pectoral region. This is a rare disease in the UK, but is relatively common in southwestern USA, where infection in horses is seasonal, with a peak incidence in late summer and autumn. In the UK, the same organism is more commonly found in sheep and goats, where it causes caseous lymphadenitis. Link to WikiVet: Corynebacterium"
feedback3="'''Incorrect.''' Corynebacterium pseudotuberculosis does not cause caseous lymphadenitis in the horse. However in the UK, this organism is most commonly found in sheep and goats, where it does cause caseous lymphadenitisThe correct answer is that C. pseudotuberculosis causes ulcerative lymphangitis in the horse. The infection results in lymphangitis of lower limbs or abscessation in pectoral region. This is a rare disease in the UK, but is relatively common in southwestern USA, where infection in horses is seasonal, with a peak incidence in late summer and autumn. Link to WikiVet: Corynebacterium"
feedback1="'''Incorrect.''' Corynebacterium pseudotuberculosis does not cause mastitis in the horse. The correct answer is that C. pseudotuberculosis causes ulcerative lymphangitis in the horse. The infection results in lymphangitis of lower limbs or abscessation in pectoral region. This is a rare disease in the UK, but is relatively common in southwestern USA, where infection in horses is seasonal, with a peak incidence in late summer and autumn. In the UK, the same organism is more commonly found in sheep and goats, where it causes caseous lymphadenitis. Link to WikiVet: Corynebacterium"
feedback2="'''Incorrect.''' Corynebacterium pseudotuberculosis does not cause granulomatous lymphadenitis in the horse. The correct answer is that C. pseudotuberculosis causes ulcerative lymphangitis in the horse. The infection results in lymphangitis of lower limbs or abscessation in pectoral region. This is a rare disease in the UK, but is relatively common in southwestern USA, where infection in horses is seasonal, with a peak incidence in late summer and autumn. In the UK, the same organism is more commonly found in sheep and goats, where it causes caseous lymphadenitis. Link to WikiVet: Corynebacterium"
image="">
</WikiQuiz>
<WikiQuiz
questionnumber="5"
question="Which peripheral nerve disease of horses involves degeneration of the ventral horn motor neurons?"
choice4="Equine motor neuron disease"
choice2="Stringhalt"
choice1="Cauda equina neuritis"
choice3="Sweeney"
choice5="Distal denervating disease"
correctchoice="4"
feedback4="'''Correct!''' Equine motor neuron disease is a generalised lower motor neuron disorder of particularly postural muscles of the body limbs, neck and sacrocaudalis medialis leading to diffuse weakness and a raised tail head. There is degeneration of ventral horn motor neurons, chromatolysis, neurofilament accumulation, gliosis, Wallerian degeneration and denervation changes in the muscle. [[Peripheral Nervous System Pathology Overview|WikiVet Article: PNS ]]"
feedback2="'''Incorrect.''' Stringhalt is a distal axonopathy especially of large diameter fibres, but its causes are poorly understood. The correct answer is equine motor neuron disease, which is a generalised lower motor neuron disorder. There is degeneration of ventral horn motor neurons, chromatolysis, neurofilament accumulation, gliosis, Wallerian degeneration and denervation changes in the muscle. [[Peripheral Nervous System Pathology Overview|WikiVet Article: PNS ]]"
feedback1="'''Incorrect.''' Cauda equina neuritis is the equine version of idiopathic polyradiculoneuritis. Extradural nerve roots of cauda equina are thickened and discoloured and there is an inflammatory infiltrate, extensive axonal damage and demyelination. The aetiology unknown. The correct answer is equine motor neuron disease, which is a generalised lower motor neuron disorder. There is degeneration of ventral horn motor neurons, chromatolysis, neurofilament accumulation, gliosis, Wallerian degeneration and denervation changes in the muscle. [[Peripheral Nervous System Pathology Overview|WikiVet Article: PNS ]]"
feedback3="'''Incorrect.''' Suprascapular nerve injury or 'Sweeney' is caused by the horse colliding into an object. There is fibrous entrapment as the nerve is reflected around the wing of the scapula, resulting in atrophy of supra- and infra- spinatous muscles. The correct answer is equine motor neuron disease, which is a generalised lower motor neuron disorder. There is degeneration of ventral horn motor neurons, chromatolysis, neurofilament accumulation, gliosis, Wallerian degeneration and denervation changes in the muscle. [[Peripheral Nervous System Pathology Overview|WikiVet Article: PNS ]]"
feedback5="'''Incorrect.''' Distal denervating disease is a distal axonopathy, possibly of toxic origin. It is a condition of small animals, not large animals. The correct answer is equine motor neuron disease, which is a generalised lower motor neuron disorder. There is degeneration of ventral horn motor neurons, chromatolysis, neurofilament accumulation, gliosis, Wallerian degeneration and denervation changes in the muscle. [[Peripheral Nervous System Pathology Overview|WikiVet Article: PNS ]]"
image="">
</WikiQuiz>
<WikiQuiz
questionnumber="6"
question="What is a potential sequel to guttural pouch empyema in the horse?"
choice2="Chondroids"
choice5="Epistaxis"
choice1="Laryngeal hemiplegia"
choice4="Retropharyngeal abscesses"
choice3="Distension of the guttural pouch with air"
correctchoice="2"
feedback2="'''Correct!''' Chondroids are formed from inspissated pus. Empyema is caused by upper respiratory tract infections, especially the pathogenic Streptococcus equi var. equi, the cause of Strangles. [[Guttural Pouch Empyema |WikiVet Article: Guttural pouch ]]"
feedback5="'''Incorrect.''' Epistaxis is associated with guttural pouch mycosis, a fibrinous necrotising diphtheritic inflammatory process, most often caused by Aspergillus spp. The fungus grows adjacent to the internal carotid artery and can lead to necrosis of the arterial wall and (sometimes fatal) haemorrhage. The correct answer is chondroids, which are concretions of inspissated pus. Empyema is caused by upper respiratory tract infections, especially the pathogenic Streptococcus equi var. equi, the cause of Strangles. [[Guttural Pouch Mycosis |WikiVet Article: Guttural pouch ]]"
feedback1="'''Incorrect.''' Laryngeal hemiplegia is associated with guttural pouch mycosis, a fibrinous necrotising diphtheritic inflammatory process most often caused by Aspergillus spp. There is invasion of neighbouring structures such as nerves, causing the hemiplegia. Cranial nerves IX, X, XI, XII and the sympathetic trunk cross the dorsocaudal aspect of the medial compartment, and cranial nerve VII is in contact with the lateral compartment.The correct answer is chondroids. These consist of inspissated pus. Empyema is caused by upper respiratory tract infections, especially the pathogenic Streptococcus equi var. equi. [[Guttural Pouch Mycosis |WikiVet Article: Guttural pouch ]]"
feedback4="'''Incorrect.''' Retropharyngeal abscess is a possible cause of guttural pouch empyema not a consequence of it. The correct answer is chondroids. These consist of inspissated pus. Empyema is caused by upper respiratory tract infections, especially the pathogenic Streptococcus equi var. equi. [[Guttural Pouch Empyema |WikiVet Article: Guttural pouch ]]"
feedback3="'''Incorrect.''' Distention of the guttural pouch is seen in guttural pouch tympany, a congenital defect of the guttural pouch ostia. Although it is potentially secondary to inflammation it is not itself an inflammatory condition. The abnormal distention of pouch with air causes a marked retropharyngeal swelling. The correct answer is chondroids. These consist of inspissated pus. Empyema is caused by upper respiratory tract infections, especially the pathogenic Streptococcus equi var. equi. [[Guttural Pouch Tympany |WikiVet Article: Guttural pouch ]]"
image="">
</WikiQuiz>
<WikiQuiz
questionnumber="7"
question="Which of the following is a predisposing factor for a pedunculated lipoma in the horse?"
choice5="Obesity"
choice3="Post partum mare"
choice2="Crib-biting"
choice1="Non steroidal anti-inflammatories (NSAIDs)"
choice4="Tapeworms"
correctchoice="5"
feedback5="'''Correct!''' Overweight horses, particularly Arabian horses and Morgan ponies are predisposed to pedunculated lipomas. These are a common cause of a strangulating obstruction of the small intestine, which needs to be surgically resected. Link to WikiVet: Equine Intestinal Conditions"
feedback3="'''Incorrect.''' Post partum mares are predisposed to large colon vovulus, not pedunculated lipomas. Overweight horses, particularly Arabian horses and Morgan ponies are predisposed to pedunculated lipomas. These are a common cause of a strangulating obstruction of the small intestine, which needs to be surgically resected. Link to WikiVet: Equine Intestinal Conditions; Large colon torsion"
feedback2="'''Incorrect.''' Horses that crib bite are predisposed to epiploic foramen entrapment, not pedunculated lipomas. Overweight horses, particularly Arabian horses and Morgan ponies are predisposed to pedunculated lipomas. These are a common cause of a strangulating obstruction of the small intestine, which needs to be surgically resected. Link to WikiVet: Equine Intestinal Conditions; Epiploic Foramen Entrapment"
feedback1="'''Incorrect.''' Administration of NSAIDs predisposes horses to gastric and colonic ulceration and colitis, but not pedunculated lipomas. Overweight horses, particularly Arabian horses and Morgan ponies are predisposed to pedunculated lipomas. These are a common cause of a strangulating obstruction of the small intestine, which needs to be surgically resected. Link to WikiVet: Equine Intestinal Conditions; Gastric Ulceration"
feedback4="'''Incorrect.''' Anoplocephala perfoliata tapeworm infestation can predispose spasmodic colic and ileal impaction in the horse, but do not predispose pedunculated lipomas. Overweight horses, particularly Arabian horses and Morgan ponies are predisposed to pedunculated lipomas. These are a common cause of a strangulating obstruction of the small intestine, which needs to be surgically resected. Link to WikiVet: Equine Intestinal Conditions; Impaction"
image="">
</WikiQuiz>
<WikiQuiz
questionnumber="8"
question="Which of the following parameters may suggest that an equine colic patient can be managed medically?"
choice2="1.5 litres nasogastric reflux"
choice3="Heart rate of 64 bpm"
choice1="Ileus"
choice5="Serosanguineous peritoneal fluid sample"
choice4="Depression"
correctchoice="2"
feedback2="'''Correct!''' Less than 2 litres nasogastric reflux usually suggests a medical colic. More than 5 litres of fluid, and rapid reaccumulation usually indicates that surgery is necessary. Remember, it is important that any findings are considered in the context of the history, full clinical examination and results of other ancillary diagnostic procedures. Signs that indicate that a colic is surgical include depression, unrelenting and progressive pain that is unresponsive to analgesia, ileus, abnormalities per rectum, heart rate > 60 bpm, prolonged capillary refill time, injected mucous membranes and moderate to severe haemoconcentration. Link to WikiVet: Equine Colic Diagnosis"
feedback3="'''Incorrect.''' A heart rate of > 60 bpm is one parameter that may indicate that a colic is surgical. Remember, it is important that any findings are considered in the context of the history, clinical examination and results of other ancillary diagnostic procedures. Signs that indicate that a colic is surgical include depression, unrelenting and progressive pain that is unresponsive to analgesia, ileus, > 5 litres nasogastric reflux abnormalities per rectum, heart rate > 60 bpm, prolonged capillary refill time, injected mucous membranes and moderate to severe haemoconcentration. Link to WikiVet: Equine Colic Diagnosis"
feedback1="'''Incorrect.''' Ileus and lack of faecal output can be a sign that a colic is surgical. Remember, it is important that any findings are considered in the context of the history, clinical examination and results of other ancillary diagnostic procedures. Signs that indicate that a colic is surgical include depression, unrelenting and progressive pain that is unresponsive to analgesia, ileus, > 5 litres nasogastric reflux abnormalities per rectum, heart rate > 60 bpm, prolonged capillary refill time, injected mucous membranes and moderate to severe haemoconcentration. Link to WikiVet: Equine Colic Diagnosis"
feedback5="'''Incorrect.''' If the gut is compromised it becomes leaky and so cells can pass through into the peritoneal cavity, and produce a serosanguineous peritoneal fluid sample, which can therefore be a sign that a colic is surgical. Remember, it is important that any findings are considered in the context of the history, clinical examination and results of other ancillary diagnostic procedures. Signs that indicate that a colic is surgical include depression, unrelenting and progressive pain that is unresponsive to analgesia, ileus, > 5 litres nasogastric reflux abnormalities per rectum, heart rate > 60 bpm, prolonged capillary refill time, injected mucous membranes and moderate to severe haemoconcentration. Link to WikiVet: Equine Colic Diagnosis"
feedback4="'''Incorrect.''' A depressed and unresponsive horse is more likely to have a surgical colic. Horses that are alert and responsive may be medically managed. Remember, it is important that any findings are considered in the context of the history, clinical examination and results of other ancillary diagnostic procedures. Signs that indicate that a colic is surgical include depression, unrelenting and progressive pain that is unresponsive to analgesia, ileus, > 5 litres nasogastric reflux abnormalities per rectum, heart rate > 60 bpm, prolonged capillary refill time, injected mucous membranes and moderate to severe haemoconcentration. Link to WikiVet: Equine Colic Diagnosis"
image="">
</WikiQuiz>
<WikiQuiz
questionnumber="9"
question="Which of the following is true with regard inflammatory airway disease (IAD) in the horse?"
choice5="Often seen in young racehorses"
choice2="It always leads to recurrent airway obstruction (RAO)"
choice3="It is a life-long condition"
choice4="It can not be differentiated from recurrent airway obstruction by bronchoalveolar lavage (BAL)"
choice1="It is associated with Equine Herpes Virus"
correctchoice="5"
feedback5="'''Correct!''' Inflammatory airway disease (IAD) is seen in young racehorses with a prevalence of 20-65%. It is characterised by excessive mucus in the airways and coughing and/ or reduced performance. It may also be subclinical. Link to WikiVet:"
feedback2="'''Incorrect.''' Whilst inflammatory airway disease (IAD) may possibly progress to RAO, it does not always do so, The correct answer is that IAD is seen in young racehorses with a prevalence of 20-65%. It is characterised by excessive mucus in the airways, coughing and/ or reduced performance. It may also be subclinical. Link to WikiVet:"
feedback3="'''Incorrect.''' Diagnosis of inflammatory airway disease does not necessarily imply a life-long condition. The correct answer is that IAD is seen in young racehorses with a prevalence of 20-65%. It is characterised by excessive mucus in the airways, coughing and/ or reduced performance. It may also be subclinical. Link to WikiVet:"
feedback4="'''Incorrect.''' Although there is some overlap of cytological findings on examination of bronchoalveolar lavage (BAL) fluid between recurrent airway obstruction (RAO) and inflammatory airway disease (IAD), when other factors such as age and environment are taken into account, BAL cytology CAN help differentiate the two conditions. Typically, RAO BAL fluid cytology shows a marked neutrophilia, whereas IAD BAL cytology shows mild neutrophilia and possibly lymphocytosis and monocytosis. The correct answer is that IAD is seen in young racehorses with a prevalence of 20-65%. It is characterised by excessive mucus in the airways, coughing and/ or reduced performance. It may also be subclinical. Link to WikiVet:"
feedback1="'''Incorrect.''' Although the definitive cause of IAD is unknown, a link between equine herpes virus or rhinovirus has not been proven. Implicated causes are bacterial infection with streptococcus spp, mycoplasma and actinobacillus. The correct answer is that IAD is seen in young racehorses with a prevalence of 20-65%. It is characterised by excessive mucus in the airways, coughing and/ or reduced performance. It may also be subclinical. Link to WikiVet:"
image="">
</WikiQuiz>
<WikiQuiz
questionnumber="10"
question="Which of the following is true with regards to testing for contagious equine metritis in the UK?"
choice2="A positive culture of Taylorella equigenitalis is notifiable"
choice3="Pre-breeding clitoral and endometrial swabs can be taken at any time of the oestrous cycle"
choice1="Positive cultures of Klebsiella pneumoniae or Pseudomonas aeruginosa are notifiable"
choice4="Stallions that have not previously been used for breeding purposes are classified as low risk"
choice5="All swabs should be cultured both aerobically and anaerobically"
correctchoice="2"
feedback2="'''Correct!''' A positive culture for the contagious equine metritis organism (CEMO), Taylorella equigenitalis, is notifiable by law in the UK. The CEM test also tests for Klebsiella pneumoniae and Pseudomonas aeruginosa, however positive cultures of these two organisms are not notifiable. Link to WikiVet: Taylorella equigenitalis Link to HBLB: CEM Code of Practice"
feedback3="'''Incorrect.''' The testing protocol differs depending on the level of risk of the mare, and the circumstances (i.e. whether she is a 'walk in' mare or boarding on the same premises as the stallion) but endometrial swabs must always be taken during oestrus from the lining of the uterus via the open cervix to demonstrate whether the uterus is free from infection. Clitoral swabs can be taken at any time of the cycle to demonstrate whether the clitoral fossa and sinuses are free from infection. The correct answer is that a positive culture for the contagious equine metritis organism (CEMO), Taylorella equigenitalis, is notifiable by law in the UK. The CEM test also tests for Klebsiella pneumoniae and Pseudomonas aeruginosa, however positive cultures of these two organisms are not notifiable. Link to WikiVet: Taylorella equigenitalis Link to HBLB: CEM Code of Practice"
feedback1="'''Incorrect.''' CEM swabbing tests for Taylorella equigenitalis, Klebsiella pneumoniae and Pseudomonas aeruginosa,. A positive culture for the contagious equine metritis organism (CEMO), Taylorella equigenitalis, is notifiable by law in the UK. However positive cultures of K. pneumoniae and P. aeruginosa are not notifiable. Link to WikiVet: Taylorella equigenitalis Link to HBLB: CEM Code of Practice"
feedback4="'''Incorrect.''' Stallions that have not previously been used for breeding purposes are classified as high risk; for other high risk factors, see Appendix 1 of the HBLB CEM Code of Practice. The protocol for testing stallions is as follows: swabs should be taken from three sites; the urethra, urethral fossa and penile sheath, plus pre-ejaculatory fluid when possible. Separate swabs should be used for each site and cultured aerobically and microaerophilically in all circumstances. The correct answer is that a positive culture for the contagious equine metritis organism (CEMO), Taylorella equigenitalis, is notifiable by law in the UK. The CEM test also tests for Klebsiella pneumoniae and Pseudomonas aeruginosa, however positive cultures of these two organisms are not notifiable. Link to WikiVet: Taylorella equigenitalis Link to HBLB: CEM Code of Practice"
feedback5="'''Incorrect.''' The endometrial swabs from low risk mares should be cultured aerobically only, but all other cultures from low and high risk stallions and mares should be cultured both aerobically and microaerophilically. The correct answer is that a positive culture for the contagious equine metritis organism (CEMO), Taylorella equigenitalis, is notifiable by law in the UK. The CEM test also tests for Klebsiella pneumoniae and Pseudomonas aeruginosa, however positive cultures of these two organisms are not notifiable. Link to WikiVet: Taylorella equigenitalis Link to HBLB: CEM Code of Practice"
image="">
</WikiQuiz>
<WikiQuiz
questionnumber="11"
question="How is the carrier state for equine strangles best diagnosed or excluded?"
choice3="Culture and polymerase chain reaction (PCR) of guttural pouch washings"
choice1="Culture of 3 nasopharyngeal swabs taken 1 week apart"
choice2="Polymerase chain reaction (PCR) of a nasopharyngeal swab"
choice4="PCR of blood sample"
choice5="Polymerase chain reaction (PCR) of guttural pouch washing"
correctchoice="3"
feedback3="'''Correct!''' Culture of 3 nasopharyngeal swabs, collected a week apart, is the most common way to diagnose the strangles carrier state, however it only diagnoses 66% of carrier horses. PCR increases the sensitivity to 90%, and using guttural pouch washes increases this further, making culture and PCR of guttural pouch washings the most sensitive test for the strangles carrier state. Link to WikiVet: Strangles"
feedback1="'''Incorrect.''' Culture of 3 nasopharyngeal swabs, collected a week apart, is the most common way to diagnose the strangles carrier state, however it only diagnoses 66% of carrier horses. PCR increases the sensitivity to 90%, and using guttural pouch washings increases this further, making culture and PCR of guttural pouch washings the most sensitive test for the strangles carrier state. When taking nasopharyngeal swabs, it is important to sample the back of the pharynx around the opening of the guttural pouch, to get the most reliable sample. This is done using specially designed elongated swabs with enlarged absorbent heads. Shedding of S. equi into the nasopharynx often occurs intermittently, so repeated swabbing is recommended to confirm negative results. Link to WikiVet: Strangles"
feedback2="'''Incorrect.''' Whilst PCR is more sensitive than culture, S. equi is only shed into the nasopharynx intermittently, so a single swab is unreliable for the carrier state. The most common way to diagnose the strangles carrier state, is culture of 3 nasopharyngeal swabs collected a week apart, however it only diagnoses 66% of carrier horses. PCR increases the sensitivity to 90%, and using guttural pouch washings increases this further, making culture and PCR of guttural pouch washings the most sensitive test for the strangles carrier state. When taking nasopharyngeal swabs, it is important to sample the back of the pharynx around the opening of the guttural pouch, to get the most reliable sample. This is done using specially designed elongated swabs with enlarged absorbent heads. Link to WikiVet: Strangles"
feedback4="'''Incorrect.''' Blood samples can be used to diagnose an active strangles infection, but the latent carrier state may not be diagnosed in this way. The most common way to diagnose the strangles carrier state, is culture of 3 nasopharyngeal swabs collected a week apart, however it only diagnoses 66% of carrier horses. PCR increases the sensitivity to 90%, and using guttural pouch washings increases this further, making culture and PCR of guttural pouch washings the most sensitive test for the strangles carrier state. When taking nasopharyngeal swabs, it is important to sample the back of the pharynx around the opening of the guttural pouch, to get the most reliable sample. This is done using specially designed elongated swabs with enlarged absorbent heads. Link to WikiVet: Strangles"
feedback5="'''Incorrect.''' You are correct in realising that guttural pouch lavage fluid gives greater sensitivity for diagnosis of the strangles carrier state; however, a positive PCR result may detect dead DNA, where viable, infectious organisms are no longer present, so bacteriological culture should always be used to definitively confirm status. The correct answer is culture AND PCR of guttural pouch washings is the best way to diagnose the strangles carrier state. Link to WikiVet: Strangles"
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</WikiQuiz>
<WikiQuiz
questionnumber="12"
question="Which bacteria is responsible for causing strangles in horses?"
choice5="Streptococcus equi subsp. equi"
choice1="Burkholderia mallei"
choice2="Streptococcus equi subsp. zooepidemicus"
choice3="Rhodococcus equi"
choice4="Staphylococcus aureus"
correctchoice="5"
feedback5="'''Correct!''' Streptococcus equi subsp. equi is a very pathogenic bacteria typically causing suppurative rhinitis, pharyngitis and lymphadenitis of the lymph nodes of the head and neck that drain the upper respiratory tract. These lymph nodes often rupture and discharge pus 2-3 weeks after the onset of infection. [[Respiratory Bacterial Infections - Pathology#In Horses|WikiVet Article: equine bacterial ]]"
feedback1="'''Incorrect.''' Burkholderia mallei is implicated in glanders, a disease seen in eastern Europe and Asia and which is notifiable in UK. It is characterised by multiple small submucosal nasal nodules which liquefy and ulcerate. The correct answer is Streptococcus equi subsp. equi, a very pathogenic bacteria typically causing suppurative rhinitis, pharyngitis and lymphadenitis of the lymph nodes of the head and neck that drain the upper respiratory tract. These lymph nodes often rupture and discharge pus 2-3 weeks after the onset of infection. [[Respiratory Bacterial Infections - Pathology#In Horses|WikiVet Article: equine bacterial ]]"
feedback2="'''Incorrect.''' Although Streptococcus equi subsp. zooepidemicus does cause an upper respiratory tract infection that can be indistinguishable clinically from Strangles, but it does not cause suppurative lymphadenitis which the causative bacteria Streptococcus equi subsp. equi does. This is a very pathogenic bacteria typically causing suppurative rhinitis, pharyngitis and lymphadenitis of the lymph nodes of the head and neck that drain the upper respiratory tract. These lymph nodes often rupture and discharge pus 2-3 weeks after the onset of infection. [[Respiratory Bacterial Infections - Pathology#In Horses|WikiVet Article: equine bacterial ]]"
feedback3="'''Incorrect.''' Rhodococcus equi is an important cause of severe, often fatal granulomatous pneumonia in foals and is not associated with strangles. The correct answer is Streptococcus equi subsp. equi, a very pathogenic bacteria typically causing suppurative rhinitis, pharyngitis and lymphadenitis of the lymph nodes of the head and neck that drain the upper respiratory tract. These lymph nodes often rupture and discharge pus 2-3 weeks after the onset of infection. [[Respiratory Bacterial Infections - Pathology#In Horses|WikiVet Article: equine bacterial ]]"
feedback4="'''Incorrect.''' Staphylococcus aureus is not associated with respiratory disease in horses. The correct answer is Streptococcus equi subsp. equi, a very pathogenic bacteria typically causing suppurative rhinitis, pharyngitis and lymphadenitis of the lymph nodes of the head and neck that drain the upper respiratory tract. These lymph nodes often rupture and discharge pus 2-3 weeks after the onset of infection. [[Respiratory Bacterial Infections - Pathology#In Horses|WikiVet Article: equine bacterial ]]"
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</WikiQuiz>
<WikiQuiz
questionnumber="13"
question="What is the permanent dental formula of a horse?"
choice1="2 (I 3/ 3, C 1/ 1, P 3-4/ 3, M 3/ 3)"
choice2="2 ( I 3/ 3, C 1/ 1, P 4/ 4 M 3/ 3)"
choice5="2 ( I 3/ 3, C 1/ 1, P 3-4/ 3, M 4/ 4)"
choice4="2 (I 3/ 3, C 1/ 1, P 3/ 3, M 3/ 3)"
choice3="2 ( I 3/ 3, C 1/ 1, P 3/ 3-4, M 4/ 4)"
correctchoice="1"
feedback1="'''Correct!''' In the horse, upper premolar one, or the wolf tooth, is often lacking, hence the upper dental formula of P 3-4. Horses have three upper and three lower molar teeth on each side, which work in a unit along with their premolars. Females usually don't have canines so the formula is often written 1(0)/ 1(0) for mares. [[ttp:/ / Oral Cavity - Teeth & Gingiva - Anatomy & Physiology#The Horse|WikiVet Article: dental formula. ]]"
feedback2="'''Incorrect.''' The horse only has three lower premolars but usually has an extra upper premolar i.e. premolar one or the wolf tooth. The dental formula should read 2 (I 3/ 3, C 1/ 1, P 3-4/ 3, M 3/ 3).Females usually don't have canines so the formula is often written 1(0)/ 1(0) for mares. [[ttp:/ / Oral Cavity - Teeth & Gingiva - Anatomy & Physiology#The Horse|WikiVet Article: dental formula.]]"
feedback5="'''Incorrect.''' Horses have three lower and three upper molars. The dental formula should read 2 (I 3/ 3, C 1/ 1, P 3-4/ 3, M 3/ 3). Females usually don't have canines so the formula is often written 1(0)/ 1(0) for mares. [[ttp:/ / Oral Cavity - Teeth & Gingiva - Anatomy & Physiology#The Horse|WikiVet Article: dental formula.]]"
feedback4="'''Incorrect.''' Although this dental formula may be correct for many horses, most horses have an extra upper premolar i.e. premolar one, or the wolf tooth. The dental formula should read 2 (I 3/ 3, C 1/ 1, P 3-4/ 3, M 3/ 3). Females usually don't have canines so the formula is often written 1(0)/ 1(0) for mares. [[ttp:/ / Oral Cavity - Teeth & Gingiva - Anatomy & Physiology#The Horse|WikiVet Article: dental formula.]]"
feedback3="'''Incorrect.''' The horse only has three lower premolars but usually has an extra upper premolar i.e. premolar one, or the wolf tooth. Also horses have three lower and three upper premolars so thedental formula should read 2 (I 3/ 3, C 1/ 1, P 3-4/ 3, M 3/ 3). Females usually don't have canines so the formula is often written 1(0)/ 1(0) for mares. [[ttp:/ / Oral Cavity - Teeth & Gingiva - Anatomy & Physiology#The Horse|WikiVet Article: dental formula.]]"
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</WikiQuiz>