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1、北美执业兽医考试中英双语版1. 一只4岁雌性已绝育哈士奇由于眼睛，鼻子和嘴巴周围出现的如下图所示的结痂和角化过度转诊而来。皮肤刮片检查未找出病因。你会怎样治疗这只狗？ 单选题 *Zinc supplementation 补充锌(正确答案)Daily wiping with chlorhexidine pads 每天用洗必泰擦拭Corticosteroids 糖皮质激素Ivermectin treatment 伊维菌素答案解析：Zinc responsive dermatopathy occurs most frequently in the Siberian Husky. Other spec
2、ies such as cattle, goats, and humans have a similar condition. The exact cause is unknown, but it has been linked to defective intestinal absorption of zinc. Lesions may vary in severity. The response is typically seen within days. The key to answering this question appropriately was to recognize t
3、he signalment of the patient, the location of the lesions which is characteristic of zinc responsive dermatopathy, and the fact that there was no infectious etiology such as demodex identified.锌反应性皮肤病最常见于哈士奇犬。其他物种入牛，羊和人也有相似的问题。根本的病因未知，但已经证明该病与肠道内锌的吸收不良有关。病情不同症状差别可能较大。但治疗后会在几天内有好转。回答这道问题的关键点在于认识病患的特点
4、，病变的位置是典型的锌反应性皮肤病的好发部位以及没有找到其他如蠕型螨之类的感染性原因。2. Which diseases are classically associated with a high anion gap (AG)?哪种疾病很典型得与阴离子间隙升高有关？*单选题 *Eosinophilic enteritis, hypothyroidism, gastrinoma 嗜酸性粒细胞性肠炎，甲状腺机能减退，胃泌素瘤Prostatic adenocarcinoma, pleural effusion, lymphangiectasia 前列腺癌，胸腔积液，淋巴管扩张Diabetes me
5、llitus, pancreatitis, proliferative enteritis 糖尿病，胰腺炎，增生性肠炎Hypercalcemia of malignancy, hypoadrenocorticism, displaced abomasum 癌症导致的高血钙，肾上腺机能减退，真胃变位Grain overload, ethylene glycol toxicity, renal failure 食物过载，乙二醇中毒，肾衰(正确答案)答案解析：Typically, expect an increased anion gap with: Diabetic ketoacidosis，Re
6、nal failure，Ethylene glycol toxicity，Lactic acidosis from grain overload or strenuous exercise. Anion gap is typically measured as positive cations (Na+, K+) minus negative anions (Total CO2, Cl-). You can also calculate AG using HCO3- in place of TCO2. Anion gap = (sodium + potassium) - (TCO2 + chl
7、oride). Decreased anion gap is UNcommon. Think hemodilution, hypoalbuminemia, hypercalcemia.一般情况下在糖尿病酮酸中毒，肾衰，乙二醇中毒，粮食过载导致的乳酸酸中毒或剧烈运动后看到明显的阴离子间隙升高。一般来说，阴离子间隙由带正电荷的阳离子（Na+，K+）减去带负电荷的阴离子（总CO2，Cl-）得到。你还可以使用HCO3-代替TCO2来计算AG。AG=（钠离子+钾离子）-（TCO2+氯离子）。阴离子间隙降低的原因未知Abdominocentesis reveals sanguineous fluid. H
8、ow can you determine that it is fresh blood rather than just hemorrhagic fluid?3. 3. 腹腔穿刺液为血样。你该怎样区分这些是新鲜血液还是血性液体？ 单选题 *See if it clots 看它是否凝结(正确答案)Measure lactate 检测其乳酸值Evaluate red blood cell morphology microscopically 显微镜检查红细胞形态Take another sample, and check color 再次穿刺采样看其颜色Measure viscosity 检测其黏
9、度答案解析：If sanguineous fluid from abdominocentesis clots, it is fresh blood rather than just free hemorrhagic fluid from within the abdomen.如果腹腔穿刺液凝结了，则说明它是新鲜血液而不仅仅是血性液体。考虑血液稀释，低白蛋白血症，高血钙。4. 4. A surgical repair of a patent ductus arteriosus was performed via thoracotomy in a four-month-old Labrador p
10、uppy. In recovery, the puppy is found in his cage, crying and whining. His breaths are short and fast. When a technician attempts to comfort him, he tries to get away, cowers in the corner, and cries louder. Which of the following is the best explanation of this scenario?一只4月龄的拉布拉多接受了开胸手术治疗动脉导管未闭。在麻
11、醉复苏阶段发现该犬在笼子里嚎叫哀鸣。他的呼吸短而快。当有人尝试接近安抚他时，他一边叫一边躲到角落里叫得更大声了。以下哪个选项解释了这个情况？*单选题 *Recovery is prolonged, stage II signs are still occurring 苏醒期延长，II 期表现依旧存在The patient has cerebral hypoxia, likely due to sustained hypotension 动物出现脑组织缺氧，可能由于术中低血压导致This puppy is painful, pain management is inadequate 该犬感受到了
12、疼痛，疼痛管理不足(正确答案)Labradors often do this in recovery, they have low pain tolerance 拉布拉多犬常常在苏醒期有这种表现，因为它们对疼痛耐受性差答案解析：This puppy is painful, pain management is inadequate, as these are signs of pain. Behavioral changes are the most reliable signs of pain in animals.Tolerance levels and socialization ski
13、lls certainly vary in all species, however, signs of pain should be anticipated, repeatedly evaluated, and treated in all cases. A thoracotomy is one of the most painful procedures performed in animals and humans. Intense pain management is required, including: 1) an opioid in combination with a tra
14、nquilizer or sedative, 2) a non-steroidal anti-inflammatory agent, and 3) intercostal and intrapleural nerve blocks with a long acting local anesthetic, e.g. bupivacaine. Continuous infusion of lidocaine, ketamine, and/or an opioid such as fentanyl or morphine provides excellent analgesia and some s
15、edation. This can replace # 1 above. Shallow respiration is common in patients with chest pain; hypoventilation and hypoxemia can result. Opioids can depress respiratory function, but adequate pain management will improve ventilation when it doesnt hurt so much to breathe. Although labrador puppies
16、are generally most gregarious and responsive to people, they still exhibit signs of pain when present. Sometimes we need to look very closely; dont believe that wagging tail!这只狗的表现说明疼痛管理不足。行为改变是判断动物是否处于疼痛状态中的可靠手段。不同动物的疼痛耐受水平以及互动技能不尽相同，所以需要重复进行疼痛评估并且在任何需要的情况下给予治疗。开胸手术是动物和人类中疼痛级别最高的一种手术之一。需要高级的疼痛管理，包括1）阿片类药物配合镇静药物 2）非甾体类抗炎药结合3）使用长效局部麻醉药如布比卡因进行肋间神经和胸膜内神经阻断。衡速输注利多卡因，氯氨酮和/或阿片类药物如芬太尼或吗啡都可以提供很好的镇痛和镇静效果。这些可以结合
