Royal College of Veterinary Surgeons Membership Exam (RCVS) Companion Animal Medicine and Surgery Syllabus

Companion Animal Medicine and Surgery syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Companion Animal Medicine and Surgery in Royal College of Veterinary Surgeons Membership Exam (RCVS), not a summary of it.

1. 1

   Small Animal Internal Medicine

   6 topics

   • Cardiorespiratory disease
     • Myxomatous mitral valve disease and dilated cardiomyopathy
     • Feline hypertrophic cardiomyopathy and arterial thromboembolism
     • Chronic bronchitis, feline asthma and pneumonia
   • Gastrointestinal and hepatic disease
     • Acute and chronic enteropathies
     • Pancreatitis and exocrine pancreatic insufficiency
     • Hepatobiliary disease and portosystemic shunts
   • Urinary and renal disease
     • Chronic kidney disease and acute kidney injury
     • Feline lower urinary tract disease and urolithiasis
   • Endocrine disorders
     • Diabetes mellitus and ketoacidosis
     • Hyperthyroidism and hypothyroidism
     • Hyperadrenocorticism and hypoadrenocorticism
   • Haematology, immunology and infectious disease
     • Immune-mediated haemolytic anaemia and thrombocytopenia
     • Canine and feline infectious diseases
   • Neurology and neuromuscular disease
2. 2

   Small Animal Soft Tissue and Orthopaedic Surgery

   5 topics

   • Principles of surgery and asepsis
     • Aseptic technique and theatre discipline
     • Suture materials, patterns and wound closure
     • Surgical haemostasis and tissue handling
   • Common soft tissue procedures
     • Neutering of dogs and cats
     • Gastrointestinal surgery and foreign body removal
     • Gastric dilatation-volvulus management
   • Wound management and reconstruction
     • Open wound management and healing phases
     • Drains and basic reconstructive techniques
   • Orthopaedic conditions and fractures
     • Fracture classification and fixation principles
     • Cranial cruciate ligament disease
     • Hip and elbow dysplasia
   • Lameness investigation and joint disease
3. 3

   Anaesthesia, Analgesia and Critical Care

   5 topics

   • Pre-anaesthetic assessment and planning
     • ASA status and risk stratification
     • Anaesthetic protocol selection
   • Anaesthetic agents and techniques
     • Premedication, induction and maintenance agents
     • Local and regional anaesthesia
   • Monitoring and complications
     • Cardiovascular and respiratory monitoring
     • Management of common anaesthetic crises
   • Pain assessment and management
     • Acute and chronic pain scoring
     • Multimodal analgesia
   • Emergency and critical care
     • Triage and shock recognition
     • Fluid therapy and transfusion
     • Cardiopulmonary resuscitation (RECOVER principles)
4. 4

   Companion Animal Dermatology, Ophthalmology and Dentistry

   4 topics

   • Dermatological disease
     • Allergic skin disease and atopic dermatitis
     • Ectoparasites and pyoderma
     • Otitis externa investigation
   • Ophthalmology
     • Ophthalmic examination and the red eye
     • Corneal ulceration and glaucoma
   • Dentistry and oral disease
     • Periodontal disease and dental charting
     • Extractions and oral pathology
   • Oncology principles
     • Common skin and mast cell tumours
     • Staging, biopsy and treatment options
5. 5

   Preventive Healthcare and Zoonoses

   4 topics

   • Vaccination and infectious disease prevention
     • Core and non-core vaccination protocols
     • Vaccine schedules and duration of immunity
   • Parasite control
     • Endoparasite and ectoparasite programmes
     • Lungworm and tick-borne disease
   • Zoonotic disease and public health
     • Rabies, leptospirosis and important zoonoses
     • Pet travel, antibody testing and biosecurity
   • Nutrition and obesity management

Companion Animal Medicine and Surgery flashcards for Royal College of Veterinary Surgeons Membership Exam (RCVS)

25 of 70 cards from the Companion Animal Medicine and Surgery deck — real questions with worked answers.

1. What is the classic auscultation finding in a cat with hypertrophic cardiomyopathy (HCM), and what murmur/sound may accompany it?

   A dynamic left ventricular outflow tract obstruction murmur (often a parasternal systolic murmur) and a gallop rhythm (audible S3 or S4). Gallop sounds and arrhythmias are strong indicators of feline myocardial disease.

2. State the formula used to estimate systemic blood pressure category and define systemic hypertension threshold in dogs and cats.

   Systolic blood pressure $>160\,\text{mmHg}$ indicates hypertension; $>180\,\text{mmHg}$ carries high risk of target-organ damage (eyes, brain, heart, kidneys). Mean arterial pressure $\text{MAP} = \text{DBP} + \frac{1}{3}(\text{SBP} - \text{DBP})$.

3. In canine myxomatous mitral valve disease (MMVD), what ACVIM stage warrants starting pimobendan, and what is the key trial evidence?

   Stage B2 (asymptomatic with cardiac enlargement: $\text{LA:Ao} \geq 1.6$ and $\text{LVIDdN} \geq 1.7$). The EPIC trial showed pimobendan delays onset of congestive heart failure.

4. List the four cardinal components of the standard treatment for acute congestive heart failure (pulmonary oedema) in the dog.

   Oxygen supplementation, furosemide (loop diuretic), pimobendan (positive inotrope/vasodilator), and stress reduction/sedation (e.g., butorphanol). Thoracocentesis if pleural effusion is present.

5. What is the mechanism and main use of pimobendan in heart failure?

   It is an inodilator: a calcium sensitiser increasing myocardial contractility plus a phosphodiesterase-III inhibitor causing vasodilation, reducing both preload and afterload while improving inotropy.

6. Differentiate the typical signalment and effusion type of canine pericardial effusion causing cardiac tamponade.

   Older large-breed dogs (e.g., Golden Retriever, German Shepherd); commonly haemorrhagic effusion from right atrial haemangiosarcoma or idiopathic/heart base chemodectoma. Tamponade causes muffled heart sounds, jugular distension and pulsus paradoxus.

7. What is the key acid-base and electrolyte derangement in a cat with a urethral obstruction, and the immediate life-threatening consequence?

   Hyperkalaemia with metabolic acidosis and azotaemia. Hyperkalaemia causes bradycardia and can progress to atrial standstill and fatal arrhythmia; ECG shows tall tented T waves and loss of P waves.

8. Outline the emergency medical stabilisation of hyperkalaemia in an obstructed cat before unblocking.

   Calcium gluconate (cardioprotective, does not lower K+); then drive K+ intracellularly with dextrose +/- insulin, or use a beta-agonist; IV fluids to restore perfusion and dilute K+. Address acidosis with fluids.

9. Define IRIS staging of chronic kidney disease in cats and give the stage-1/2 boundary creatinine and SDMA cut-offs.

   IRIS CKD is staged on fasting plasma creatinine in a stable patient. In cats, Stage 1 is creatinine $<1.6\,\text{mg/dL}$ ($<140\,\mu\text{mol/L}$) and Stage 2 is $1.6\text{--}2.8\,\text{mg/dL}$ ($140\text{--}250\,\mu\text{mol/L}$). Persistent SDMA $>14\,\mu\text{g/dL}$ also supports early CKD.

10. How is protein-losing nephropathy quantified and what UPC value is considered proteinuric in dogs?

    By the urine protein:creatinine ratio (UPC). $\text{UPC} < 0.2$ is non-proteinuric; $0.2\text{--}0.5$ is borderline; $\text{UPC} > 0.5$ in dogs (>0.4 in cats) is overt renal proteinuria warranting investigation/ACE inhibitor therapy.

11. What is the pathognomonic triad of feline lower urinary tract disease (FLUTD) signs, and what is the most common cause in young cats?

    Pollakiuria, stranguria/dysuria, and haematuria (often with periuria). Feline idiopathic/interstitial cystitis (FIC) is the most common cause in cats under 10 years.

12. Compare the two most common canine urolith types and their pH/dissolution potential.

    Struvite (magnesium ammonium phosphate): forms in alkaline urine, often infection-induced, can be medically dissolved with diet. Calcium oxalate: forms in acidic urine, cannot be dissolved and requires surgical/voiding removal; common in Schnauzers and Bichons.

13. List the classic clinicopathological features of canine hypoadrenocorticism (Addison's disease).

    Hyponatraemia and hyperkalaemia giving a $\text{Na:K}$ ratio $<27$, lack of a stress leukogram, azotaemia, hypoglycaemia, and absence of cortisol rise on ACTH stimulation. Bradycardia despite hypovolaemia is a clue.

14. What is the diagnostic gold-standard test for hypoadrenocorticism and the expected result?

    The ACTH stimulation test: both basal and post-ACTH cortisol are low/flat (typically $<2\,\mu\text{g/dL}$, $<55\,\text{nmol/L}$), confirming inadequate adrenal cortisol reserve.

15. Differentiate pituitary-dependent (PDH) from adrenal-dependent hyperadrenocorticism using the low-dose dexamethasone suppression test (LDDST).

    In PDH, cortisol often shows suppression at 4 h then escape by 8 h (inverse pattern); in adrenal tumours there is no suppression at any time. Lack of suppression confirms HAC but does not distinguish type alone; endogenous ACTH or imaging differentiates.

16. State the typical insulin type and starting dose for newly diagnosed diabetic cats, and the dietary cornerstone.

    A long-acting insulin such as glargine or protamine zinc insulin, started at roughly $0.25\text{--}0.5\,\text{U/kg}$ q12h. A low-carbohydrate, high-protein diet is the dietary cornerstone and can promote diabetic remission in cats.

17. Describe the hallmark biochemical findings of diabetic ketoacidosis (DKA).

    Hyperglycaemia, ketonaemia/ketonuria, and a high anion-gap metabolic acidosis. Often accompanied by electrolyte derangements—total-body potassium and phosphate depletion despite variable serum values.

18. What are the two most common causes of feline hyperthyroidism signs, and the screening diagnostic test?

    Benign functional thyroid adenoma (adenomatous hyperplasia), occasionally carcinoma. Total T4 (thyroxine) is the screening test; equivocal cases use free T4 by equilibrium dialysis or a T3 suppression test.

19. Name the four definitive/management options for feline hyperthyroidism.

    Anti-thyroid medication (methimazole/carbimazole), radioactive iodine ($\ce{^{131}I}$, curative gold standard), surgical thyroidectomy, and an iodine-restricted prescription diet.

20. What is the classic blood smear finding and Coombs relevance in canine immune-mediated haemolytic anaemia (IMHA)?

    Spherocytosis and autoagglutination, with regenerative anaemia (polychromasia/reticulocytosis). A positive saline agglutination test or Coombs (direct antiglobulin) test supports immune-mediated destruction.

21. Give the diagnostic criteria framework for canine IMHA (signs of immune destruction).

    Requires evidence of immune-mediated destruction (≥2 of: spherocytosis, positive saline agglutination, positive Coombs) PLUS evidence of haemolysis (≥1 of: hyperbilirubinaemia/icterus, haemoglobinaemia, haemoglobinuria, ghost cells).

22. What infectious agent causes feline infectious peritonitis, and what differentiates the effusion in the 'wet' form?

    A mutated feline coronavirus. Wet/effusive FIP yields a high-protein, straw-yellow, viscous exudate with low cellularity and a high albumin:globulin inversion (A:G $<0.4$ supports FIP); Rivalta test is typically positive.

23. Compare primary vs secondary immune-mediated thrombocytopenia and the platelet count at which spontaneous bleeding occurs.

    Primary (idiopathic) IMTP is a diagnosis of exclusion; secondary follows infection, neoplasia, or drugs. Spontaneous mucosal/petechial haemorrhage typically occurs when platelets fall below $\sim 30\text{--}50 \times 10^{9}/\text{L}$.

24. Localise a lesion causing UMN vs LMN signs in the pelvic limbs based on spinal cord segment.

    T3–L3 lesions cause UMN signs to the pelvic limbs (increased tone/reflexes, intact-to-exaggerated withdrawal). L4–S3 lesions cause LMN signs (decreased tone/reflexes, reduced withdrawal, muscle atrophy).

25. Describe the Modified Frankel / neurological grading concept for thoracolumbar IVDD and the prognostic significance of deep pain.

    Grades run from grade 1 (pain only) through paresis, paralysis, to loss of deep pain perception (grade 5). Presence of deep (nociceptive) pain perception is the single most important positive prognostic indicator for recovery after surgery.

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