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

24 sample cards from the Companion Animal Medicine and Surgery deck

Sampled from the end of the deck, so these are different cards from the ones shown on the syllabus page.

1. Define normal capnograph values and the significance of a sudden drop in ETCO2 to near zero.

   Normal $\text{ETCO}_2$ is $35\text{--}45\,\text{mmHg}$. A sudden fall toward zero indicates a catastrophic event—oesophageal intubation, airway disconnection/obstruction, or cardiac arrest (no pulmonary perfusion)—and demands immediate action.

2. List common intra-anaesthetic complications and first-line responses for hypotension and hypothermia.

   Hypotension (MAP $<60\,\text{mmHg}$): reduce inhalant, give a fluid bolus, then a positive inotrope/vasopressor (e.g., dopamine, dobutamine, ephedrine). Hypothermia: active warming (forced-air blanket), warmed fluids—it prolongs recovery and reduces MAC.

3. Describe how to recognise acute pain in dogs and cats and one validated scale for each.

   Behavioural and physiological cues: guarding, altered posture, reluctance to move, tachycardia, and (cats) facial grimace. Validated tools include the Glasgow Composite Measure Pain Scale (canine) and the Feline Grimace Scale / Glasgow feline scale.

4. Explain the WHO-style analgesic ladder/multimodal approach and which receptor classes are targeted.

   Combine agents acting at different sites: opioids (mu/kappa receptors), NSAIDs (COX/prostaglandin inhibition), local anaesthetics (sodium-channel blockade), and adjuncts (ketamine—NMDA antagonist; alpha-2 agonists; gabapentin). Pre-emptive and multimodal dosing reduces central sensitisation and total drug doses.

5. State the components of a primary survey in emergency triage (the ABCs) for veterinary patients.

   Airway, Breathing, Circulation, then Disability (neurological) and Examination/Exposure. Identify and treat immediately life-threatening problems (haemorrhage, airway obstruction, shock) before a full secondary survey.

6. Define the shock fluid resuscitation 'bolus' approach for dogs and cats with hypovolaemic shock.

   Isotonic crystalloid in incremental boluses—dogs roughly $10\text{--}20\,\text{mL/kg}$ (up to a full 'shock dose' of $\sim80\text{--}90\,\text{mL/kg}$ titrated), cats more conservatively $5\text{--}10\,\text{mL/kg}$ (shock dose $\sim40\text{--}60\,\text{mL/kg}$)—reassessing perfusion endpoints after each bolus.

7. Describe gastric dilatation-volvulus (GDV): signalment, key radiograph sign and treatment priorities.

   Large/giant deep-chested breeds; the right-lateral radiograph shows a 'double bubble' / compartmentalised 'Popeye/smurf hat' gas-filled stomach. Priorities: aggressive shock fluids and gastric decompression first, then surgical derotation and gastropexy to prevent recurrence.

8. Compare the lesion distribution of flea allergy dermatitis, atopic dermatitis and sarcoptic mange in the dog.

   Flea allergy: dorsal lumbosacral/tail-base and caudal thighs. Atopic dermatitis: face, ears, paws, ventrum, axillae (often pruritus before lesions). Sarcoptic mange: ear margins, elbows, hocks, ventral abdomen with intense pruritus and a positive pinnal-pedal scratch reflex.

9. What is the diagnostic value of cytology of skin/ear: cocci vs rods vs Malassezia, and treatment implication?

   Cocci suggest Staphylococcus (often respond to first-line topical/systemic antibacterials); rods suggest Gram-negative (e.g., Pseudomonas—needs culture and targeted therapy); peanut/footprint-shaped Malassezia yeast indicate antifungal therapy. Cytology guides empirical treatment.

10. List the components of the Schirmer tear test and ophthalmic emergency triage for a red, painful eye.

    The Schirmer tear test I measures aqueous tear production over 1 minute; normal $\geq 15\,\text{mm/min}$, with KCS (dry eye) typically $<10\,\text{mm/min}$. A red painful eye demands ruling out glaucoma (tonometry), corneal ulcer (fluorescein) and uveitis before any steroid is applied.

11. Differentiate the fluorescein and Seidel test interpretations in corneal disease.

    Fluorescein stains exposed corneal stroma green, confirming an ulcer; it does not adhere to intact epithelium or to Descemet's membrane (so a descemetocele shows a clear centre with stained rim). A positive Seidel test (stream of dilution of dye) indicates a perforating leak of aqueous.

12. State the canine and feline normal intraocular pressure range and the glaucoma threshold.

    Normal IOP by applanation/rebound tonometry is approximately $10\text{--}25\,\text{mmHg}$. Sustained IOP $>25\text{--}30\,\text{mmHg}$ indicates glaucoma; acute glaucoma with vision threat is an emergency requiring rapid IOP reduction (e.g., mannitol, topical agents).

13. Describe the modified Triadan numbering and how to identify a tooth (e.g., tooth 108 / 204).

    Triadan uses three digits: first digit is the quadrant (1 = right maxilla, 2 = left maxilla, 3 = left mandible, 4 = right mandible for permanent teeth; 5–8 for deciduous), and the last two digits number the tooth from midline. Thus 108 = right maxillary 4th premolar (carnassial); 204 = left maxillary canine.

14. List the stages of periodontal disease and the principal radiographic feature used for staging.

    Stages 0–4 based on attachment loss: 0 normal, 1 gingivitis only, 2 early (<25% attachment loss), 3 moderate (25–50%), 4 advanced (>50%). Dental radiography quantifies alveolar bone loss, the key staging determinant.

15. State the principles of oncological surgery and define surgical margins (marginal, wide, radical).

    Achieve complete excision with appropriate margins guided by tumour type and grade. Marginal: through the pseudocapsule (risk of residual tumour). Wide: a cuff of normal tissue (e.g., 2–3 cm lateral and one fascial plane deep for soft tissue sarcoma/mast cell). Radical: removal of the entire compartment/structure.

16. Explain the TNM classification used in veterinary oncology.

    T = primary tumour size/extent, N = regional lymph node involvement, M = distant metastasis. It standardises clinical staging to guide prognosis and treatment, supplemented by histological grading for tumours like mast cell tumours and soft tissue sarcomas.

17. Compare grading and prognosis of cutaneous mast cell tumours (Patnaik and Kiupel systems).

    Patnaik is a 3-tier system (grade I well-differentiated/good, II intermediate, III poorly differentiated/poor). The Kiupel 2-tier system (low vs high grade) improves consistency—high-grade tumours have higher metastatic risk and shorter survival; mitotic count and KIT/Ki-67 refine prognosis.

18. Differentiate core from non-core vaccines for dogs in the UK and the recommended primary course.

    Core (WSAVA): canine distemper virus, canine adenovirus, canine parvovirus (DHP), with leptospirosis treated as core in the UK due to endemicity. Primary course of two-to-three doses finishing at ~16 weeks, a booster at ~6–12 months, then core revaccination typically every 3 years (lepto annually).

19. List feline core vaccines and the immunological reason for finishing kitten vaccination at ~16 weeks.

    Feline panleukopenia (FPV), feline herpesvirus-1 (FHV-1) and feline calicivirus (FCV) are core; rabies where relevant. The final dose at ~16 weeks ensures maternally derived antibody has waned enough not to block the kitten's active immune response.

20. Outline a comprehensive parasite control approach covering endo- and ectoparasites.

    Risk-based protocol: routine roundworm/tapeworm treatment (e.g., monthly–quarterly), Angiostrongylus vasorum prevention in endemic areas, flea control year-round, and tick prevention. Tailor to lifestyle, travel (PETS scheme requires tapeworm treatment for Echinococcus) and zoonotic risk.

21. Compare the lifecycle and zoonotic significance of Toxocara canis vs Echinococcus granulosus.

    Toxocara canis: ascarid with transplacental/transmammary transmission; zoonotic causing visceral/ocular larva migrans in children. Echinococcus granulosus: small tapeworm in dogs (definitive host) with sheep intermediate hosts; human ingestion of eggs causes hydatid cyst disease—hence mandatory tapeworm treatment for pet travel.

22. List three important companion-animal zoonoses and their public health control measures.

    Rabies (vaccination, quarantine/PETS controls), leptospirosis (vaccination, rodent control, PPE), and dermatophytosis/ringworm (Microsporum canis—hygiene, isolation, treatment). Toxoplasma gondii from cat faeces also matters for immunocompromised and pregnant people.

23. State the resting energy requirement (RER) formula and how maintenance energy is derived.

    $\text{RER} = 70 \times (\text{body weight in kg})^{0.75}$ kcal/day; a linear approximation for 2–45 kg is $\text{RER} = 30 \times \text{BW} + 70$. Maintenance energy requirement is RER multiplied by a life-stage/activity factor (e.g., $1.2\text{--}1.6$ for neutered adults).

24. Describe body condition scoring (BCS) and the relationship between BCS and ideal weight for a weight-loss plan.

    BCS uses a 9-point scale where 4–5/9 is ideal; each point above 5 represents roughly $10\text{--}15\%$ over ideal weight. Feed RER (or ~80% of RER for ideal weight) of a calorie-restricted, high-protein diet and reassess every 2–4 weeks targeting $\sim1\text{--}2\%$ body-weight loss per week.

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