1. Which of the following is incorrect. A Resting stem cells are resistant to the toxic effects of chemotherapy drugs B Stem cells give rise to all blood cells C Stem cells are capable of self-renewal D Stem cells are large multinucleated cells 1

2. Which of the following is true of neutrophils? A They circulate for 8 days B They have round nuclei and granular cytoplasm C In blood vessels they are equally distributed between the marginal pool and the circulating pool in dogs D They synthesise globulins 2

3. Erythropoiesis is stimulated by A GM-CSF B Thrombopoietin C Erythropoietin D Deep sea diving

4. Which is true of Reticulocytes? A They are immature red cells which stain blue-pink on Diff-Quick B Released in large numbers following excitement C smaller than normal red cells D contain small round nuclei 6

5. Which of the following is incorrect A Bilirubin may be found in normal cat urine B Urobilinogen may be found in normal cat urine C Bilirubin increases in horses following anorexia D Bilirubin is found in urine in animals with biliary obstruction 7

6. Which film comment is correct? A spherocytes ++ B hypochromic cells C marked polychromasia D Babesia organisms seen 9

7. Which film comment is correct? A Spherocytes ++ B hypochromic cells C Schistocytes D Babesia organisms seen 10

8. These abnormal red cells are seen in A regenerative anaemia B iron deficiency anaemia C vascular neoplasia eg haemangiosarcoma D aged samples 11

10. PP 52g/l60 - 80

11. Which is the most likely differential ? A Hypoadrenocorticoid (Addisons)crisis B Acute internal haemorrhage from abdominal mass (?tumour) C Aplastic anaemia D Acute cardiac failure 12

12. Why is dog so white with PCV of 24%? A PCV performed incorrectly B Dog has cardiac failure C Dog is acutely bleeding/hypovlaemic so reduced peripheral perfusion + PCV does not reflect severity of blood loss in acute haemorrhage E Clinician is colourblind 13

13. What would you do next? A Urine analysis B Serum iron C Xrays + Ultrasound abdo D go down the pub 14

14. 9 year old Bull Terrier with maelena Red cells are hypochromic and microcytic 2+ polychromasia Plasma protein 51g/l60 - 80 5 55

15. This anaemia is: A microcytic hypochromic B microcytic hyperchromic D normocytic normochronic E macrocytic normochromic 15

16. 9 yr old Bull Terrier with maelena What does the pattern of low PCV and low PP suggest? A dehydration B haemorrhage C non-regenerative anaemia D haemolytic anaemia 16

17. What is the most common cause of low MCV A Aged sample B regenerative anaemia C iron deficiency anaemia D beetroot ingestion 17

18. A Urine/faecal analysis B Abdominal radiography C Coombs test D Bone marrow aspirate 9 yr old Bull Terrier with maelena Which test would you perform next? 18

19. 9 yr old Bull Terrier with maelena Urine analysis - no haematuria Faecal analysis - no parasites Ultrasound exam - solitary mass in intestine

20. Ultrasound revealed a solitary SI mass. Would you: A recommend euthanasia B go down the pub C dispense iron tablets and go down the pub D give a blood transfusion followed by ex- lap and surgically remove the mass 19

21. 3 yr old Irish Setter Became unwell over last 7 - 10 days Depressed,lethargic, exercise intolerance Pale mucus membranes Not jaundiced T 40.2 o C, P 135, R 20 Splenomegaly

22. Increased RCDW signifies A Variation in haemoglobin concentration B numerous nucleated red cells C Increased red cell size D variation in red cells size due to large and/or small red cells 1

23. 3 year old F Irish Setter Polychromasia 3+ Anisocytosis 2+ Spherocytes 3+ Reticulocytes 26% Absolute retic count = 26 x 1.22 x 10 = 317 x 10 9 /l

24. Likely Diagnosis? A IMHA B Onion toxicity C Babesia canis D microangiopathic haemolytic anaemia, likely secondary to a tumour 3

25. 4 yr old local Holstein 3 weeks post-calving Depression, jaundice and haemoglobinuria Pl pr 80 g/l 60 - 80

26. Film comment Anisocytosis 3+ Polychromasia 2+ Basophilic stippling Howell-Jolly bodies

27. What is the most likely cause of the anaemia A Babesia bovis B Hypophosphataemia C Bladder neoplasia / haemorrhage D Immune-mediated haemolytic anaemia 4

28. 7 yr Welsh Bay Gelding Weight loss, anaemia, jaundice Pl pr78 g/l 60 - 80 Fibrinogen3 g/l 2 - 4.5

29. Red cell morphology 2+ Anisocytosis No polychromasia A few Howell-Jolly bodies A few nucleated red cells

30. Is the anaemia A Regenerative B Non-regenerative C Not possible to say 6

31. Is the anaemia most likely due to A Haemorrhage B Haemolysis C Primary bone marrow disease D renal failure 7

32. What would you do next? A Slide agglutination test and Coombs test B Bone marrow aspirate C faecal occult blood D abdominal radiography 8

33. 4 month old GSD with skin problem red cells5.16 x 10 12 /l 5.5 - 8.5 Hb12.20g/dl12.0 - 18.0 PCV0.35l/l0.37 - 0.55 MCV68.7fl59.0 - 77.0 MCH23.6pg20 - 26 MCHC34.5g/dl30 - 36 Pl pr57g/l60 - 80

34. What is going on? Chronic GI haemorrhage due to parasitism Acute GI haemorrhage Hypothyroid All normal for a dog of this age

35. 4 month old GSD White cells17.8x 10 9 /l6.0 - 15.0 neutrophils10.5x 10 9 /l2.5 - 12.5 bands0x 10 9 /l0.0 - 0.4 Lymphs5.8x 10 9 /l0.5 - 4.8 monocytes0.7x 10 9 /l< 0.8 eosinophils0.7x 10 9 /l0.05 - 0.8

36. 4 month old GSD Biochemistry Total protein57.0g/l 60 - 80 Urea6.1mmol/l 2.5 - 6.7 Creatinine1.0.0umol/l 20 - 150 ALT10IU/L 5.0 - 60.0 ALP376IU/L < 130 Gamma GT5.0IU/L 0.1 - 9.0 Phosphorus3.48mmol/l 0.8 - 1.6 Calcium3.35mmol/l2.40 - 2.90

37. These are all age-related normal findings

38. 3 yr entire male labrador Scavenged in dustbin 2 days previously Well until yesterday Now lethargic / depressed Clinical exam pale / ?icteric Mild splenomegaly Dark urine noted by owner

39. 3 yr old greedy Labrador red cells3.6 x 10 12 /l5.5 - 8.5 haemoglobin6.9g/dl12.0 - 18.0 PCV0.20l/l0.37 - 0.55 MCV67.2fl60 - 77 MCH23.7pg19.5 – 24.5 MCHC32.3g/dl32 – 36 Pl pr 78 g/l60 - 80

40. Film exam Mild anisocytosis Mild polychromasia Clear areas on one side of cell NMB smear made

41. What is the cause of the anaemia AGi haemorrhage BAIHA CZinc toxicity DOnion toxicity ECopper toxicity

42. 3 yr Old G. Ret 3 weeks depression and weight loss and more recently pyrexia Red cells3.02 x 10 12 /l5.5 - 8.5 Hb 7.3g/dl 12.0 - 18.0 PCV0.24l/l0.32 - 0.55 MCV66fl60 - 77 MCH23pg19.5 – 24.5 MCHC36g/dl32 - 27 Pl Pr72 g/l60 - 80 Red cells normocytic normochromic

43. Comments so far? A Severe regenerative anaemia B Moderate non-regenerative anaemia ? Chronic dx or 1 0 bone marrow dx C Suggestive of recent blood loss 9

44. White cells and platelets white cells7.12x 10 9 /l 6.0 - 15.0 neutrophils1.2x 10 9 /l 0.8 - 4.8 lymphocytes 5.3x 10 9 /l 1 – 4.8 monocytes0.1x 10 9 /l 0.2 – 1.5 eosinophils0x 10 9 /l 0.05 - 0.8 platelets 90x 10 9 /l 150 - 450

45. Now most likely A Anaemia of chronic dx B 1 0 bone marrow dx C IMHA with concurrent IMTP D acute blood loss 10

46. Blood film exam Atypical lymphocytes Irreg nuclei Some nucleoli Thrombocytopenia

47. What is at the top of your differential list? A Plasma cell myeloma B Acute lymphoid leukaemia C Aplastic anaemia D myelofibrosis 12

48. Which test would be most useful? A Epo assay B Ultrasound spleen C Bone marrow aspirate D Lymph node aspirate 13

49. 8 yr Mn Boxer 1 cm cutaneous hairless mass A excise and send for histopath B advise revisit in 6 weeks C dispense Synulox D take a fine needle aspirate 1

50. What would you use to take a fine needle aspirate? A 18 ga needle B Trucut needle C 23 ga needle D Jamshidi needle 2

51. Which is true of sampling thoracic masses A Large mediastinal masses can be aspirated if the no aerated lung in penetrated B if the needle is long enough, any mass may be sampled safely C Needle aspiration of lung/chest masses is highly risky and should not be performed D A large bore 14 - 18 ga needle should be used 3

52. Which statement is incorrect A adding a coverslip increased clarity when examining smears B The condenser should be positioned low for cytology / haematology film exam C Diff-Quick is a suitable stain for cytology D Haematology is my favourite subject 4

53. In normal cows the predominant cell type is A lymphocyte B neutrophil C monocyte D eosinophil 5

54. Which of the following is not a toxic change seen in neutrophils A basophilic cytoplasm B foamy cytoplasm C hypersegmented nuclei D Dohle inclusions 6

55. In early acute inflammation the neutrophilia results from A prolonged neutrophil circulation time B release of neutrophils form the marginating pool to the circulating pool C release of neutrophils from the storage/maturation pool D shift of neutrophils from the tissues into the circulation 7

56. 13 y6r old entire female cocker spaniel 6 yr Female JRT

57. Which is the most likely cause of these white cell abnormalities A stress leucogram B acute inflammatory response C physiological / adrenaline induced neutrophilia D chronic granulocytic leukaemia 8

58. 6 year F Labrador with depression and fever

59. What is the likely cause of the neutropenia A Increased demand due a focus of severe infection B Aplastic anaemia eg due to oestrogen toxicity C Reduced neutrophil production due to leukaemic infiltrate D Blood loss 9

60. Which describes the stress leucogram A neutrophilia, lymphopenia, monocytosis, eosinopenia B neutrophilia, lymphocytosis, monocytopenia, lymphopenia C neutrophilia, lymphopenia, monocytopenia, eosinophilia D neutropenia, lymphocytosis, eosinopenia, monocytosis 10

61. 1 Which is not a potential cause of increased PCV A Renal tumour B Chronic renal failure C Severe pulmonary dx D Dehydration E Polycythaemia rubra vera

62. 2 Which test would not be useful in establishing the cause of polycythaemia A Serum proteins B Ultrasound of kidneys C Bone marrow aspirate D Chest X ray E EPO assay

63. 3 Which of the following is true of immunosuppressive therapy? A Cyclosporin blocks T cell activation and does not suppress neutrophil production B Hi dose prednisolone can be used with minimal side effects in dogs C Azathioprine is a suitable drug for IMHA in cats D Danazol works by reducing anti-body production E Human IG is a cheap alternative to cyclophosphamide

64. 4 Which is true of feline blood groups? A Most DSH cats are type B B Most BSH cats are type A C All type A cats have hi titres of anti-B antibody D All type B cats have hi titres of anti-A antibody E All type AB cats have low titres of anti- A antibody

65. 5 Which statement is true of Cross matching A always do prior to any transfusion in dogs B In the major cross match donor cells are mixed with recipient serum C No agglutination or haemolysis means the donor and recipient are the same blood type D Rouleaux formation in a cross match is regarded a positive result E A positive minor cross match is not significant

66. 6 A dog with severe AIHA is deteriorating in spite of therapy. The PCV is now 8% and dog very weak. What would you give this dog? A Whole blood B Oxyglobin C Packed red cells D Fresh-frozen plasma E Platelet-rich plasma

67. 7 Which is not present in fresh frozen plasma A Albumin B Vit K dependant factors C Factor VIII D Von Willebrands factor E Platelets

68. 9 Which is true of blood groups in horses A Blood typing is not available in the UK B Most TBs are Qa and Aa -ve C Naturally occurring isoantibodies to Aa are common D Foals of Aa -ve mares are at risk of developing NI E Ka and Pa are the most immunogenic blood types

69. 10 Which would be best for a very anaemic foal with NI A sire’s whole blood B mare’s whole blood C sire’s washed red cells D mare’s washed red cells E mare’s plasma

70. 1. Which of the following is not involved in primary haemostasis Afibrinogen B calcium C platelets D vWF

71. 2. Which factors are Vitamin K dependant A II, V, IX, X B II, VII, IX, X C V, VII, IX, X D II, VIII, IX, X

72. 3. Which signs in unlikely in a disorder of 2ndry haemostasis A haematoma B haemarthrosis C petechial haemorrhage D haemothorax

73. 4. Which of the following would be unaltered in an animal with a 1 0 haemostatic disorder A Buccal mucosal bleeding time B Clot retraction C WBCT D OSPT

74. 5. You are presented with a dog with epistaxis. To attribute this to thrombocytopenia what is the maximum number of platelets you would see on a x100 field A < 15 B < 3 C < 6 D < 30

75. 6. Which of the following deficiencies would not prolong OSPT A X deficiency B VIII deficiency C VII deficiency D V deficiency

76. 7. Which of the following findings would not be consistent with immune- mediated thrombocytopenia A Marked thrombocytopenia B regenerative anaemia C neutropenia D Large platelets seen in blood film

77. 3 month old G Ret presents with dyspnoea due to pleural effusion and a large haematoma over the elbow. In the previous history there had been bleeding associated with teething Platelet count 110 x 10 9 /l (200 - 500) OSPT 10 secs, (control 9 seconds) APTT 210 seconds (control 18 seconds) FDPs negative

78. 8. What is the most likely cause of this dog’s clinical signs A Immune-mediated thrombocytopenia B Warfarin poisoning C Haemophilia A D Von Willebrands disease Mild thrombocytopenia likely d/t blood loss

79. 10 yr male Lab Appeared normal till last night when began bleeding profusely from both nostrils. Bleeding will not stop and dog now collapsed. Clin exam - petechiae on gums, hypothermic, tachycardic and vv pale Cranial abdominal mass palpable

80. 10 yr male lab PCV 24%(36 - 55) Platelets 48 x 10 9 /l (200 - 500) APTT 72 seconds (15 - 25) OSPT 32 seconds (7 - 10) FDP + Fibrinogen 1 g/l (2 - 4)

81. 9. What is the cause of the epistaxis A nasal tumour B warfarin poisoning C immune-mediated thrombocytopenia D DIC

82. 10 yr male Doberman Severe epistaxis 18 hours duration No previous spontaneous bleeding, BUT bled ++ at tooth extraction 2 months previously No history of nasal disease Dog depressed, weak and tachycardic

83. 10 yr old Doberman Platelet count 133 x 10 9 /l (200 - 500) WBCT 4 mins (< 6) OSPT 9 seconds (control 8 seconds) APTT 20 seconds (control 16 secs) Clot retraction poor

84. 10 What is the most likely cause of the bleeding A nasal tumour B Factor VIII deficiency C von Willebrands disease D DIC

85. 1. Artefacts occur in “old“ urine Which would not occur? A crystals form B casts break down C pH decreases D red cell lyse

86. 2. Hyposthenuric urine would not occur in which of these? A diabetes insipidus B Hypercalcaemia C Cushings syndrome D Chronic renal failure

87. 9 year old DSH with PD/PU, ascites Ascitic fluid - true transudate Urine analysis Sediment exam –SG 1.012hyaline casts –Protein 3+RBC < 5 / hpf –pH 7WBC < 5 / hpf –Blood -ve UPCR = 9 –WBC -ve –Glucose -ve

88. Is this a significant proteinuria?

89. Biochemistry Albumin 12 g/l(25 - 40) Globulin 33 g/l(20 - 45) Cholesterol 10 mmol/l (2 - 5) ALP 30 iu/l (< 60) ALT 35 iu/l (< 65)

90. 3. What is the cause of the proteinuria and low serum albumin A Glomerular proteinuria B Preglomerular proteinuria C Post-glomerular proteinuria due to inflammation in LUT D Post-glomerular proteinuria due to Fanconi syndrome

91. 4. Which of the following is not a potential cause glucosuria A Diabetes melitus B Stressed cat C Fanconi syndrome D IV fluids containing glucose E None of the above (I.e. they all could cause glucosuria)

92. 11 year old Lab marked icterus, vomiting pH 7 Urine dark orange/yellow Protein trace Glucose -ve Ketones -ve Bilirubin +++++ Urobilinogen -ve Blood/Hb -ve

93. 5. What is the most likely cause of the icterus/bilirubinuria A IMHA B Intra- hepatic disorder C Complete post-hepatic biliary obstruction D contamination of collection vessel with antiseptic

94. 6. A urine sample has 2+ Blood/Hb, SG 1.005, sediment no red cells seen Animal’s plasma is clear Which can be ruled out? A haemoglobinuria due to intravascular haemolysis B haematuria C myoglobinuria

95. 7. Chronic haematuria in aged bitch. Diagnosis? A cystitis B urolithiasis C Neoplasia D Idiopathic renal H++

96. 8. What are these crystals from a bitch’s urine? pH 8.5 Sediment –WBC 15 / hpf –Bacteria seen –RBC 30 / hpf A oxalate B struvite C cystine D urate

97. 9. Which of the following crystals are not seen in normal urine A triple phosphate / struvite B oxalate C CaCO3 D Cystine

98. 10. Which is incorrect of casts A Formed in kidney tubules but not always seen in renal disease B Hyaline casts may be seen in normal urine C White cell casts may be seen in normal urine D Red cells casts are fragile and break up rapidly

99. 7 yr old BSH cat, tachycardia dyspnoea, muffled heart sounds, pleural effusion Creamy pink fluid Protein 32 g/l Cell count 6500 / ul Triglyceride 8 mmol/l (< 1.2)

100. 3 Which statement is correct A The fluid is a exudate and likely due to bacterial infection B the fluid is a transudate and likely due to congestive heart failure C the fluid is chyle and most likely due to congestive heart failure D the fluid is chyle and most likely due to traumatic rupture of the thoracic duct

101. 3 yr DSH cat pyrexia, V+ depression ascites Fluid is turbid and yellow Cell count 120,000/ul Protein 45 g/l

102. 4. What would you do next? A Inject amoxycillin and send home on oral antibiotics B ultrasound heart C administer antibiotic and fluids to stabilise then perform ex lap D perform urine analysis

103. 8 yr G Ret with pericardial effusion PCV 28% Nucleated cell count 5600/ul Protein 48 g/l

104. 5 Which is not a possible cause A Coagulopathy B Intra-pericardial neoplasia C idiopathic benign haemorrhage D congestive heart failure

105. 6 Which of the following is not a potential cause of modified transudate A protein loosing nephropathy B congestive heart failure C non-exfoliating neoplasia D Liver disease

106. . 1 yr DSH rescue cat ascities, pleura effusion, wt loss Protein 70 g/l Albumin 22 g/l Globulin 48 g/l Cell count 6800 / ul Mostly neutrophils Some macrophages

107. 7. What is the likely diagnosis? A Lymphocytic cholangitis B Neoplasia C FIP D Congestive heart failure

108. 5 yr GSD with pyrexia, weight loss and generalised stiffness X rays show ST swelling Joint taps from both carpii and hocks were similar Viscosity reduced Fluid turbid Cell count 20,000 / ul

109. 8 What is the likely diagnosis A septic arthritis seeding from septic focus elsewhere B rheumatoid arthritis C degenerative joint disease D non-erosive IMPA

110. 9.Which is true of CSF A Normal CSF is clear amber fluid B ideally samples should be taken cranial to the site of the lesion C Cell counts should be performed using a haematology analyser D analysis should be performed quickly because cells degenerate fast

111. 2 yr old BMD marked pyrexia, neck pain. CSF analysis: Slightly turbid Cell count 1200 /ul Protein 0.6 g/l Cytology 85% neutrophils, 15% monocytes No bacteria seen

112. 10. What is the most likely diagnosis A cervical disc protrusion B bacterial meningitis C spinal cord neoplasia D steroid-responsive meningitis