ECVCP Exam 2014

A. Giordano, C. Trumel, A. Geffré

HEMATOLOGY

1. MCQ
2. Projected images
3. Glass slide
Hematology : MCQ
Hematology : MCQ
 Hematology : MCQ

MCQ 1
•Which is true of erythroid loops?
A. They are typically characterised in copper toxicosis
B. They can be seen after snake bite without haemolysis
C. They are typically characterised as oxidative damage of red blood cells
D. Phospholipase A2 containing viper venoms can cause “erythroid loop”
formation in canine blood
 Hematology : MCQ

MCQ 1
•Which is true of erythroid loops?
A. They are typically characterised in copper toxicosis
B. They can be seen after snake bite without haemolysis
C. They are typically characterised as oxidative damage of red blood cells
D. Phospholipase A2 containing viper venoms can cause “erythroid loop”
formation in canine blood
 Hematology : MCQ

MCQ 2 : "pyramid" question

•Which combination of immune markers can best prove plasma
cell differentiation?
1. IgG
2. IgM
3. CD34
4. MUM-1
5. CD3

A. 1, 2, 4
B. 1, 2, 3, 4, 5
C. 2, 3, 4
D. 3, 4
 Hematology : MCQ

MCQ 2 : "pyramid" question

•Which combination of immune markers can best prove plasma
cell differentiation?
1. IgG
2. IgM
3. CD34
4. MUM-1
5. CD3

A. 1, 2, 4
B. 1, 2, 3, 4, 5
C. 2, 3, 4
D. 3, 4
 How to prepare MCQ

Follow the rules : Format

1. Each question should by typed double-

spaced on a single page.
2. At the top of each page, think the
exam section and indicate any
classification.
3. Label the choices letters A to D; there
should be only ONE correct answer (i.e.
an answer like
“D. All of the above are correct" or C.
None of the above are correct” is NOT
acceptable).
 How to prepare MCQ in hematology

Follow the rules

4. Arrange the choices in increasing or
decreasing length of the answer. For
pyramid questions,
place answers in strict numerical order.
1
1, 3
2, 4
3, 4, 5

5. Indicate the correct answer at the

bottom of the page.Write out the
answer beside the letter.
 How to prepare MCQ in hematology

Follow the rules

5. Indicate the correct answer at the

bottom of the page.Write out the
answer beside the letter.
 How to prepare MCQ in hematology

Follow the rules

6. Cite a complete reference including

specific page numbers (see the official
reading list reported
in the esvcp/ecvcp website). The
inclusion of a photocopy of the journal
article or relevant page
or pages from the source material would
allow the ECVCP exam committee to
more easily
verify the question and citation.
7. Place your name as contributor at the
bottom of the page.
 How to prepare MCQ in hematology
Follow the rules : Construction
• 1. Multiple choice questions for the
ECVCP examination generally consist
of a brief stem
• (introductory question) and 4 short
responses or "foils" (one correct and
three distractors).
• MCQ 1
• Which is true of erythroid loops?
A. They are typically characterised in copper
toxicosis
B. They can be seen after snake bite without
haemolysis
C. They are typically characterised as oxidative
damage of red blood cells
D. Phospholipase A2 containing viper venoms can
cause “erythroid loop” formation in canine blood
 How to prepare MCQ in hematology

Follow the rules : Construction

1. Questions with more than one possible

response can be submitted if properly
formatted as:
a. "pyramid" questions. These will still have
four possible responses that are combinations
of numbers, listed in choices, A to D. These
should be kept to a minimum, as they are
difficult to write in the clear and concise
manner required for their inclusion in the
examination. Use this format only for those
questions where it will contribute to a better
quality question
 How to prepare MCQ in hematology
Follow the rules : Construction
3. b. Stems are preferably one line in length
and should not be more than two typed lines.
Questions requiring data interpretation should
be reasonable in the amount of data
included. Remember, candidates have only a
limited time to read and answer the question
and find the correct answer. This is not an
exam to test reading speed.
c. Avoid unfamiliar terminology! The difficulty
must arise from the subject matter not from
wording.
• Question on hemoglobin measurement with the ADVIA 120 and 2120
•  
• Hemoglobin measurement: which statement is CORRECT concerning
the cyanidmethemoglobin-based method on the ADVIA 120 and the
cyanide-free, colorimetric method on the ADVIA 2120?
•  
• A Both methods show a poor correlation in goats, but
excellent correlations in dogs, cats and horses.
•  
• B Both methods show an excellent correlation in goats, dogs,
cats and horses and biases close to zero in those species.
•  
• C Both methods show an excellent correlation in goats, dogs,
cats and horses, but mean proportional biases with overestimation of
the results by the cyanide-free method.
•  
• D Both methods show an excellent correlation in goats, dogs,
cats and horses, but mean proportional biases with underestimation of
the results by the cyanide-free method.
•  
• E Both methods show a poor correlation in goats, dogs, cats
and horses and large systematic biases with underestimation of the
results by the cyanide-free method.
•  
Hematology : Projected images
Hematology : Projected images
 Case 1 – (4 points)
• Dog, mixed breed, male, 2 y, pale mucous membrane and dyspnea

Question 1 (2 pts): Based on the picture, which is/are the most relevant finding/s
Question 2 (2pts): Which are the most frequent clinical conditions associated to this
finding/findings in dogs?
 Dog, mixed breed, male, 2 y, pale mucous
membrane and dyspnea

Question 1 (2 pts): Based on the picture, which is/are the most relevant finding/s
Answer : Eccentrocytes (1 points); Heinz-bodies (0.5 point); Anisocytosis (0.5 point)

Question 2 (2pts): Which are the most frequent clinical conditions associated to this
finding/findings in dogs?
Answer : Drug administration (0.5 point); Food (onion and garlic ingestion) (0.5 point)
Vitamin K antagonist intoxications (0.5 point); Diabetes mellitus or other metabolic
oxydative stress (0.5 point)
Hematology : Glass slides
Hematology : Glass slides
RBC :
1- Quantitative description
2- Organisation of RBC
3- Qualitative description

WBC :
1- Quantitative description
2- Organisation of WBC
3- Qualitative description

PLT :
1- Quantitative description
2- Organisation of PLT
3- Qualitative description

Synthesis of abnormalities : Interpretation

Differential and suggested additionnal investigations
Quality :
Cellularity
Megakaryocyte lineage
- Quantitative evaluation
- Maturation process
- Qualitative evaluation
Myeloid lineage
- Quantitative evaluation
- Maturation process
- Qualitative evaluation
Erythroid lineage
- Quantitative evaluation
- Maturation process
- Qualitative evaluation
Lymphoid lineage
Macrophages
Iron store
Other cells

Interpretation : synthesis of observed abnormalities

Differential and suggested additionnal investigations
GENERAL CLINICAL PATHOLOGY

1. MCQ
2. Short answer essay questions
 Gen Clin Path : MCQ

MCQ no.9
•Which of the following mechanisms may contribute to impaired renal
concentrating ability?
1. Solute overload
2. Increased medullary hypertonicity
3. A deficiency of ADH production
4. Failure of the nephrons to respond to ADH

A. 1,2,3
B. 1,2,3,4
C. 1,3,4
D. 2,3,4
 Gen Clin Path : MCQ

MCQ no.9
•Which of the following mechanisms may contribute to impaired renal
concentrating ability?
1. Solute overload
2. Increased medullary hypertonicity
3. A deficiency of ADH production
4. Failure of the nephrons to respond to ADH

A. 1,2,3
B. 1,2,3,4
C. 1,3,4
D. 2,3,4
MCQ no.10
•The analytical sensitivity (as defined by the International Federation of Clinical
Chemistry) is:
A. The ability of an assay to detect only the substance of interest
B. The ability of an assay to produce a change in the signal for a defined change of the
quantity
C. The smallest quantity of an analyte that can be detected with reasonable certainty
for a given range
D. The ability of an assay to produce the same value for replicate measurements of
the same specimen
MCQ no.10
•The analytical sensitivity (as defined by the International Federation of Clinical
Chemistry) is:
A. The ability of an assay to detect only the substance of interest
B. The ability of an assay to produce a change in the signal for a defined change of the
quantity
C. The smallest quantity of an analyte that can be detected with reasonable certainty
for a given range
D. The ability of an assay to produce the same value for replicate measurements of
the same specimen
General pathogenesis of the disease
- Fanconi syndrome may be inherited or less frequently, acquired (0.5)
- Fanconi syndrome is a rare adult-onset autosomal-dominant genetic renal disease
of primarily the Basenji dogs (0.5) (FAN 1 gene mutation) (0.5)
- Approximately 10% of adult Basenjis have Fanconi’s syndrome and because this
may not be diagnosed until later in life (0.5), subclinicaly-affected dogs may pass on the
disease to their offspring (0.5)
- Also exist a Iatrogenic Fanconi's syndrome, commonly reported following
idiosyncratic reactions to preservatives in some dog treats (jerky treats) (0.25)
- Is defined as a proximal renal tubular dysfunction (1.0). The defect in the
proximal renal tubule is believed to be due to a failure of endocytosis by the proximal
tubule of glucose and proteins filtered by the glomerulus (1.0)
- Fanconi's syndrome can occur as a secondary phenomenon (0.25) as a result of
various renal insults from ingested toxins, infections or idiosyncratic drug reactions that
collectively damage the proximal renal tubule and interrupt normal functioning (0.5)
- Secondary Fanconi’s syndrome has been associated with a number of primary
disease states, including: (1.0 if at least 3 are mentioned)
- congenital renal dysplasia
- exposure to heavy metals
- iatrogenic - antibiotics
- renal neoplasia - multiple myeloma and monoclonal gammopathies
- copper storage hepatopathy
- hypoparathyroidism
 2. Describe what happens in the target organ and which may be the clinical
consequences (3.25 pts)

Pathogenesis of renal damage

- Increased membrane cholesterol content in proximal tubule epithelial cells
(0.5)
- alters the conformational motility and function of membrane transport
proteins. (1.0)
- Impaired renal tubule reabsorption results in loss of glucose, phosphate,
sodium, potassium, uric acid, and amino acids. (0.25 pts for each molecule
mentioned)
- Polyuria results from the glucosuria and natriuresis (PU/PD). (0.5)
- Renal papillary necrosis is the result of dehydration and acidosis. (0.5)
- Death is due to renal failure. (0.5)
 3. List and explain the pathogenesis of expected changes
in laboratory parameters (2.75 pts)

Clinico-pathological changes
Dogs with Fanconi syndrome will have high amounts of the solutes normally reabsorbed
back into the body (0.25) including glucose, sodium, phosphorus, calcium, amino acids,
potassium, and bicarbonate, lactate, carnitine. Any combination of these can be present
(0.25 for each of the following)
Decreased creatinine clearance and azotemia
hypo/isosthenuria
Paradoxic glucosuria (glucosuria with normoglycemia)
Aminoaciduria (generalized or limited to cystinuria)
Increased renal fractional excretion of sodium, potassium, calcium, and phosphorus
Low level of these solutes in the blood
Proteinuria
high liver enzyme activities (secondary)
hyperchloremic metabolic acidosis. (high pH, low bicarbonate)
Compensatory polypnea may forestall metabolic acidosis
CYTOLOGY

1. MCQ
2. Projected images
3. Glass slide
 Cytology : MCQ

MCQ no. 2:
Which of the following statements regarding feline conjunctivitis is FALSE?
A. Viral inclusions are often not found in FHV-1 infection using Romanowsky
stains
B. Chlamydial inclusions are seen in epithelial cells and are more often
located at or near the outer edge of the cell.
C. Inflammation is expected with Chlamydia felis and Mycoplasma felis
infections, but not always in herpes virus infection
D. Inclusions of Chlamydia felis are most easily detected early in the course of
disease and have been reported to disappear 14 days post-inoculation
 Cytology : MCQ

MCQ no. 2:
Which of the following statements regarding feline conjunctivitis is FALSE?
A. Viral inclusions are often not found in FHV-1 infection using Romanowsky
stains
B. Chlamydial inclusions are seen in epithelial cells and are more often
located at or near the outer edge of the cell.
C. Inflammation is expected with Chlamydia felis and Mycoplasma felis
infections, but not always in herpes virus infection
D. Inclusions of Chlamydia felis are most easily detected early in the course of
disease and have been reported to disappear 14 days post-inoculation
Question 1 (1 point): What is the most relevant pathological change represented in the
picture?
Question 2 (1 point): What is the most probable diagnosis?
Question 1 (1 point): What is the most relevant pathological change represented in the
picture? Presence of eosinophilic globular inclusions in the cytoplasms of the
lymphocytes
Question 2 (1 point): What is the most probable diagnosis?
Viral inclusions, probably Distemper virus inclusions
Guide Description  
0,5

Highly cellular, moderate to good

Cellularity and cell preservation preservation
  Main population (up to 2.5)  
1
Cell type, size and shape (inflammatory, round, epithelial, clusters and individual epithelial cells, some
spindle, naked nuclei, undifferentiated or mixed) naked nuclei
0,5 mild to moderate ansiocytosis and
Monomorphic/pleomorphic or anisocytosis anisokaryosis
0,5 Cell arrangements (single or cohesive groups, pallisade,
acinar, rows etc.) individual and clusters
0,5 Cell borders indistinct
2 Cytoplasm (total up to 2)  
Cytoplasm amount or N:C moderate volume
Cytoplasm colour and staining intensity lightly basophilic
Cytoplasm texture (granular, vacuolated or smooth) smooth, slightly foamy
2 Nucleus (total up to 2)  
Location (central or eccentric, basal, polar) paracentral to eccentric
Number single
Shape round to oval

mild anisocytosis and anisokaryosis,

Size including variabiility occasional larger nuclei
Moulding
Chromatin structure granular, open, stippled
Mitoses occasional
2 Nucleolus (total up to 2)  
Visibility indistinct
Location Central
Number usually single
Size including variabiility medium sized
Shape round
up to 3 Other cell populations  
Cell type and number occasional macrophages
Description and size
Extracellular material and amount haemodiluted
Additional non-cellular features
Infectious agents
  Interpetation  
metastatic anal sac
2 Most likely diagnosis adenocarcinoma
1 DDX

  Comments  
Guarded prognosis, further
metastatic potential, may be
1 include prognosis, metastatic potential etc hypercalcaemic
  Futher tests  
staging with CXR, abdo
2 ultrasound
  Quality of answer presentation  
1
BIOCHEMISTRY

1. MCQ
2. Clinical cases
 Biochemistry : MCQ

MCQ no. 5:
Which of the following statements about serum protein electrophoresis (SPE)
tracing is LEAST LIKELY to occur in a clinical patient
A. Gamma globulin is usually decreased with combined immunodeficiency in horses
B. Elevations in the alpha 2 region may be due to increase in acute phase proteins
such as haptoglobin and transferrin
C. Protein loosing nephropathy often presents as selective hypoproteinemia with
alpha 2 globulins within normal limits
D. The patterns seen in hepatic insufficiency may reflect excess of beta 2 globulins and
subsequent beta-gamma bridging
 Biochemistry : MCQ

MCQ no. 5:
Which of the following statements about serum protein electrophoresis (SPE)
tracing is LEAST LIKELY to occur in a clinical patient
A. Gamma globulin is usually decreased with combined immunodeficiency in horses
B. Elevations in the alpha 2 region may be due to increase in acute phase proteins
such as haptoglobin and transferrin
C. Protein loosing nephropathy often presents as selective hypoproteinemia with
alpha 2 globulins within normal limits
D. The patterns seen in hepatic insufficiency may reflect excess of beta 2 globulins and
subsequent beta-gamma bridging
This graph shows the Capillary Zone Electrophoresis results of a 5-year old Golden
Retriever. What is the most likely diagnosis?
A. Leishmaniasis
B. Chronic hepatitis
C. Nephrotic syndrome
D. Acute monocytic ehrlichiosis
This graph shows the Capillary Zone Electrophoresis results of a 5-year old Golden
Retriever. What is the most likely diagnosis?
A. Leishmaniasis
B. Chronic hepatitis
C. Nephrotic syndrome
D. Acute monocytic ehrlichiosis
Hematology results
Biochemistry results
Biochemistry results