Navigating the NAVLE Tutorial: Key Insights and Takeaways

Preparing for the North American Veterinary Licensing Examination (NAVLE) can feel like gearing up for a monumental challenge. The exam evaluates a broad range of veterinary knowledge, and understanding what to expect is crucial. To help you feel confident on test day, we took the NAVLE tutorial and came away with valuable insights.

A Guided Tour of the NAVLE

The NAVLE tutorial is designed to simulate the actual testing experience, offering prospective examinees a glimpse into the interface, question structure, and general flow of the exam. Here’s what we learned:

1. User-Friendly Interface:

   • The tutorial provides a clear and intuitive interface that mirrors the actual testing environment. You’ll navigate through a series of multiple-choice questions while having access to features like highlighting text and striking through incorrect answers to streamline your process.

2. Time Management:

   • The clock counts down each section's allotted time, helping you practice your pacing. With each block lasting around an hour and containing approximately 60 questions, efficient time management becomes essential to ensure all questions are attempted.

3. Question Diversity:

   • Questions encompass a wide range of veterinary topics, from small animals and exotics to farm animals and public health. Understanding how different subjects are tested can help identify knowledge gaps early and refine study strategies.

4. Flagging Questions:

   • The ability to flag questions lets you quickly return to challenging items within a block. This is handy if you’re stuck on a question and need to revisit it after addressing easier ones.

5. Review Process:

   • Each block ends with a review screen that displays all answered, unanswered, and flagged questions. This feature is crucial for ensuring nothing gets left behind, giving you a final chance to revise your answers.

NAVLE Tutorial Details from the ICVA

The International Council for Veterinary Assessment (ICVA) offers a free tutorial for use by NAVLE candidates. All candidates are advised to download and use the tutorial before they take the actual examination at a Prometric testing center. The tutorial illustrates how the computerized test works and provides the opportunity to practice using 20 sample items.

The same tutorial, sans the 20 sample items, will be available at the Prometric testing center on the day of the examination. Candidates will have 15 minutes to view it before they begin the examination. This practice run is invaluable for familiarizing yourself with the exam environment and interface.

The tutorial is available in both English and French versions. Candidates are encouraged to follow the instructions provided after opening the tutorial to maximize its benefits.

Takeaways for NAVLE Prep

• Practice Makes Perfect: The NAVLE tutorial reinforces the importance of consistent practice. Becoming familiar with the format reduces exam-day stress and increases confidence.

• Study with Strategy: Recognizing which topics frequently appear can help focus your study sessions. Work on weaker areas early to build comprehensive knowledge.

• Simulate Exam Day: Practicing with time constraints helps mimic real conditions, allowing you to refine your pacing and develop a rhythm that works for you.

• Self-Care Matters: While mastering the material is important, maintaining your well-being is essential for peak performance. Balance your study sessions with breaks, exercise, and quality sleep.

Final Thoughts

The NAVLE tutorial is a crucial tool in your exam preparation toolkit. By understanding the layout and pacing, you can walk into the exam with a well-rounded strategy. Make the most of the tutorial’s features, and combine it with a targeted study plan to ensure you’re thoroughly prepared for test day. You’ve got this—happy studying! You can try it out here: https://www.icva.net/navle/navle_tutorial/

NAVLE Prep Questions Analyzed from Sample Test

 

Hey there! Let's gear up for the NAVLE exam together. I've got some sample questions from the NAVLE tutorial. Let's break them down and discuss how to pick the right answers.

 

Question one:  A 4 year old Holstein cow that freshened four days ago is producing 35 pounds of ml per day. Temperature is 102.8 F, heartbeat is 90 beats per minute, and respiratory rate is 30 breaths per min. The cow stands with elbows abducted. Physical examination shows jugular pulses and an expiratory grunt. Muffled heart sounds with some splashing sounds are heard on thoracic auscultation. which of the following is the most likely diagnosis:

A.    Bovine viral diarrhea

B.       Brisket disease

C.      Paratuberculosis

D.      Traumatic reticuloperitonitis

E.        Ventricular septal defect.  

 

Analysis: Based on the clinical presentation of the 4-year-old Holstein cow, the most likely diagnosis is traumatic reticuloperitonitis, commonly referred to as hardware disease. The symptoms and findings described fit well with this condition. Here’s a detailed breakdown of why Traumatic reticuloperitonitis  is the most likely diagnosis:

Clinical Signs and Symptoms of traumatic reticuloperitonitis

·      Elbows abducted: This stance is typically assumed by cows to relieve discomfort or pain in the abdomen.

·      Jugular pulses and expiratory grunt: These signs suggest an increase in thoracic pressure or fluid accumulation, common in cows suffering from TRP due to inflammation and potential infection in the thoracic cavity.

·      Muffled heart sounds with a splashing sound: These are indicative of a fluid-filled space around the heart or in the chest cavity, a condition known as hydropericardium or traumatic pericarditis, which can occur with TRP.

Differential Diagnoses:

·      Bovine Viral Diarrhea (BVD): Primarily affects the gastrointestinal and immune systems and would not typically present with the acute, localized signs of distress and the specific auscultation findings seen in this case.

·      Brisket Disease (Right Heart Failure): Would more likely present with signs of systemic circulatory congestion such as distended jugular veins, dependent edema, and ascites.

·      Paratuberculosis (Johne’s disease): This chronic bacterial infection primarily affects the intestines and would lead to weight loss and chronic diarrhea, not the acute respiratory or thoracic signs observed.

·      Ventricular Septal Defect: A congenital heart defect that would typically present earlier in life and not typically associated with the acute onset of respiratory signs and the specific physical stance observed.

 

Why TRP Fits:

Traumatic reticuloperitonitis occurs when a sharp object (typically metal) is ingested and penetrates the reticulum, potentially leading to leakage of contents into the peritoneal or thoracic cavity, causing inflammation and infection. The presence of hardware disease can lead to various complications including localized peritonitis, generalized peritonitis, and even traumatic pericarditis if the foreign body migrates close to or into the heart area. The splashing sound heard on thoracic auscultation (succussion splash) could indicate this complication.

 

Given these findings and the typical clinical presentation, it is most probable that this cow is suffering from traumatic reticuloperitonitis. Immediate veterinary intervention is necessary to manage the condition, which might involve the use of antibiotics, anti-inflammatory drugs, and possibly surgical intervention to remove the foreign object and correct any internal damage.

 

Question Two: During a routine examination of a 3 year old female amazon parrot, a penlight shown into the bird's eye products a direct pupilary light response, but there is no consensual response.  Which of the following is the best explanation and why is the correct answer correct?

A. The bird has an inflammation of the pecten

B. The bird has uveitis,

C. the penlight is not bright enough.

D. the room was not darkened enough before

E. This is Normal findings


 The correct explanation for the observation that shining a penlight into a bird's eye produces a direct pupillary light response but no consensual response is E. Normal findings.

 

Here's why this is the correct answer:

Anatomy and Physiology of Bird Eyes:

 

Birds, particularly parrots, have a unique anatomical feature in their eyes known as the pecten. The pecten is an opaque, highly vascular structure that projects into the vitreous body from the optic disc, believed to nourish the retina and possibly aid in ocular oxygenation. Due to its structure and placement, the pecten can obstruct the passage of light from one eye to the other, preventing a consensual pupillary light response. In many birds, it is normal for only the direct pupillary light response to be observable when light is shone into one eye.

 

Considering Other Options:

A. Inflammation of the pecten: If the pecten were inflamed, other signs such as changes in eye color, shape, or additional ocular discharge might be present. The simple absence of a consensual response is not indicative of inflammation.

 

B. Uveitis: This condition, involving inflammation of the uveal tract, would likely present with other symptoms such as redness, photophobia, tearing, or cloudiness of the eye. Again, the absence of a consensual pupillary response alone does not suggest uveitis.

 

C. The penlight is not bright enough and D. The room was not darkened enough:

Both of these factors would more likely affect both the direct and consensual responses equally. If a direct response is observed, it indicates that the test conditions (light intensity and room lighting) were adequate.

 

Summary:  Since the bird shows a normal direct response and no observable additional symptoms or signs of distress, the most likely explanation is that this is a normal finding specific to the anatomy of the bird's eye, influenced by the presence of the pecten.

This understanding highlights the importance of considering species-specific anatomical and physiological differences when interpreting clinical findings.

 

Question three: Pigs on a 1500 sow-farrow to finish farm are experiencing disease in all phases of production. Pigs in the grower and finisher have poor growth rates and have a high incidence of respiratory infections. Pigs in the nursery have poor growth rates and the number of deaths attributed to Streptococcus suit infections have increased. The incidence of pneumonia has increased in the nursery. Sows develop transient cyanosis of the ears are febrile, and occasionally abort. The number of premature farrowing and stillbirths alone with preening mortality have increased. Sows to not return to estrus regularly and the conception rate has decreased. Which of the following is the most likely cause? And why is the correct answer correct?

A.    CIrcovirus infection

B.       Parvovirus infection

C.      Porcine reproductive and respiratory syndrome (PRRS),

D.      Pseudorabies

E.        Swine influenza

 

The most likely cause of these symptoms on a 1500-sow farm is C. Porcine Reproductive and Respiratory Syndrome (PRRS).

Here's why:

 

Clinical Signs Across Production Phases:

Grower and Finisher: The poor growth rates and high incidence of respiratory infections are characteristic signs of PRRS. This virus directly targets the immune system, making pigs more susceptible to secondary infections like pneumonia.

 

Nursery: The high mortality rate due to Streptococcus suis infections and increased pneumonia are commonly seen in PRRS outbreaks. The virus causes immunosuppression, predisposing young pigs to these infections.

 

Sows: PRRS is notorious for causing reproductive issues like abortion, increased stillbirths, premature farrowing, and cyanosis ("blue ear"). The reduced conception rates and irregular return to estrus are also typical reproductive symptoms of PRRS.

 

Differential Diagnosis:

A. Circovirus Infection: While porcine circovirus type 2 (PCV2) does cause growth delays and increases susceptibility to secondary infections, its reproductive effects are not as severe or consistent as those seen with PRRS.

B. Parvovirus Infection: Porcine parvovirus is primarily associated with reproductive issues like mummified fetuses and stillbirths but not with respiratory disease or significant immunosuppression.

 

D. Pseudorabies: Also known as Aujeszky's disease, pseudorabies can cause reproductive failure and nervous system symptoms in piglets, but it’s less likely to cause the widespread immunosuppression and respiratory symptoms found with PRRS.

 

E. Swine Influenza: This viral disease does cause respiratory issues but is not associated with reproductive failure to the extent seen here.

 

Summary: PRRS is a disease that significantly affects both the respiratory and reproductive systems of pigs. The combination of symptoms in all phases of production on this farm points strongly toward PRRS as the most likely cause. A thorough laboratory diagnosis would confirm the presence of the virus.

 

Question four: Two high producing dairy cows have painful blisters on their teats. Several cows in the milking parlor are moving slowly.  Milk production in the affected cows has decreased significantly.  Physical examination shows small, raised vesicles in the mouth of one of the affected cows. Which of the following is the most likely cause? And why is the correct answer correct?

A. Ask the media to warn farmers of a possible foreign disease outbreak.

B. Begin treatment with broad-spectrum antibiotics and apply coper naphthenate to the cows’ feet.

C. Tell the farmer to separate the affected cows from the unaffected cows. D. Immediately notify the state veterinarian.

E. Notify officials if diagnostic tests are positive for a foreign animal disease.

 

Given the symptoms of painful blisters on the teats and vesicles in the mouth, the presentation is highly suggestive of a vesicular disease like Foot-and-Mouth Disease (FMD) or Vesicular Stomatitis (VS). Both are highly contagious, reportable foreign animal diseases. The correct answer is: D. Immediately notify the state veterinarian.

 

Here's why this is the correct answer:

Clinical Signs:

Blisters on Teats: Vesicular lesions on the teats are characteristic of Foot and Mouth Disease (FMD) and Vesicular Stomatitis (VS).

Vesicles in the Mouth: Vesicular diseases often cause blister-like lesions in the oral cavity, leading to painful eating and reduced milk production.

 

Lameness: Vesicular diseases can cause lameness as a result of painful lesions on the feet.

Public Health and Biosecurity:

These diseases are highly contagious and can lead to significant economic loss due to production decreases and the potential culling of affected animals.

 

Immediate notification to the state veterinarian ensures that appropriate biosecurity measures are swiftly enacted to prevent further spread.

 

Regulatory Requirements:

Vesicular diseases are classified as "reportable" or "notifiable" due to their potential to spread rapidly and cause widespread economic damage. By law, state and federal authorities need to be involved immediately to confirm the diagnosis and manage the outbreak.

 

Other Answers Considered:

A: Warning the media without proper confirmation could create unnecessary panic, and state veterinarians need to be the first to respond.

B: Broad-spectrum antibiotics and copper naphthenate are ineffective against viral diseases like FMD and VS.

C: Separation is important but secondary to immediate reporting and implementing strict biosecurity measures.

E: Waiting for a positive test result before reporting could delay containment efforts, risking further spread.

 

In summary, rapid response through official channels is essential, and notifying the state veterinarian is the first crucial step.

 

Question five:  A 12 year old Arabian broodmare has had colic for the past three hours. Rectal temperature is 100.5F, heart rate is 54 beats per minute, and respiratory rate is 24 breaths per minute. Physical examination shows a distended abdomen and decreased borborygmi.  Rectal palpation of the abdomen discloses an impaction of the large colon. Fresh red food covers the veterinarian’s sleeved hand and wrist following the rectal examination. Which of the following is the most appropriate initial step that the veterinarian should follow and why is that answer correct? 

A. Contact the liability insurance carrier.

B. Euthanize the mare.

C. Inform the owner.

D. Initiate treatment

E. Refer the case to a surgical facility.

 

 The most appropriate initial step in this scenario is C. Inform the owner.

Here's why:

Ethical Obligation:

As veterinarians, it is essential to maintain transparency with the animal owner, especially when complications arise. Fresh red blood covering the examining sleeve indicates a rectal tear or other significant injury made while examining the rectal area, which could have serious consequences for the horse.

 

Informing the owner promptly allows them to make decisions in the best interest of their horse, given the potential severity of the condition.

 

Legal Responsibility:

 

Veterinarians have a duty to inform the owner of any adverse findings or incidents during an examination. This keeps the client fully aware of the horse's current status and any risks involved.

 

Further Steps:

Once the owner is informed, appropriate treatment measures (D) or referrals to a surgical facility (E) can be considered, depending on the extent of the rectal tear and the overall clinical status of the horse. A rectal tear may need immediate veterinary attention at a specialized surgical facility if the tear is serious.

 

Contacting the liability insurance carrier (A) can be done later if needed, but it’s not the first step because the priority is ensuring the horse receives prompt and appropriate care.

Euthanasia (B) is not the immediate step unless the prognosis is extremely poor and confirmed after a thorough assessment.

Informing the owner promptly sets the stage for appropriate next steps while ensuring the client's trust and involvement in the decision-making process.

 

Question six:  A 2 year old intact female Manx cat is brought to the clinic because it has been straining to defecate for the past week.  The cat had sustained pelvic trauma at 3 months of age.  Palpation of the abdomen discloses a large, firm intra-abdominal mass.  Radiographs show full intestines.  Which of the following is most likely the explanation and why?

A. Cystic caldulus

B. Duodenal leiomyosarcoma

C. Gravid uterus

D. Megacolon

E. Sublumbar lymphadenopathy  

The most likely explanation for the clinical presentation of a 2-year-old intact female Manx cat that has been straining to defecate for the past week, sustained pelvic trauma at 3 months of age, and shows a large, firm intra-abdominal mass with radiographs indicating full intestines, is D. Megacolon. Here’s why this diagnosis is the most probable:

 

Background and Symptoms:

Straining to Defecate: This is a classic symptom of megacolon, which is characterized by chronic constipation and the inability to properly evacuate the colon.

 

History of Pelvic Trauma: Pelvic trauma can lead to a narrowing of the pelvic canal, which may subsequently affect the normal passage of feces, contributing to the development of megacolon.

Large, Firm Intra-abdominal Mass: In the context of megacolon, this description fits with a severely distended and impacted colon, which feels like a large mass on palpation.

 

Radiographic Findings:

Full Intestines: This finding supports the diagnosis of megacolon, where the intestines, particularly the colon, are filled with an excessive amount of fecal material due to severe constipation and motility issues.

 

Differential Diagnosis:

 

A. Cystic Calculus: Typically would not cause a large intra-abdominal mass feeling firm on palpation nor would it typically be associated with full intestines in radiographic findings.

B. Duodenal Leiomyosarcoma: A specific type of cancer that would be uncommon in a young cat and typically would not present with symptoms primarily related to defecation difficulties.

C. Gravid Uterus: While this could potentially explain an abdominal mass, it would not typically cause a week-long straining to defecate, nor would it be visible as full intestines on radiographs.

E. Sublumbar Lymphadenopathy: Would involve enlargement of the lymph nodes near the lumbar spine and may not directly cause the gastrointestinal symptoms observed.

 

Summary: Given the combination of symptoms, history, and radiographic evidence, megacolon due to complications from earlier pelvic trauma is the most plausible explanation. It is important to manage this condition through dietary changes, laxatives, enemas, or potentially more aggressive interventions such as surgery if conservative treatments fail.

 

Question seven: A 6 year old holstein cow is evaluated because of weight loss and decreased milk production since calving three weeks ago.  Physical examination shows decreased anal and tail tone and hindlimb weakness bilaterally.  Rectal palpation discloses a mass in the right uterine horn and moderately enlarged sublumbar lymph nodes.  Which of the following is the most likely diagnosis and why?

 

A.    Bovine immunodeficiency syndrome

B.       Bovine leukemia virus infection

C.      Bovine malignant catarrhal fever

D.      Bovine spongiform encephalopathy

E.        Bovine tuberculosis

The most likely diagnosis for the 6-year-old Holstein cow exhibiting weight loss, decreased milk production, decreased anal and tail tone, hindlimb weakness, a mass in the right uterine horn, and moderately enlarged sublumbar lymph nodes is B. Bovine leukemia virus infection. Here's an explanation:

 

Clinical Presentation:

Weight Loss and Decreased Milk Production: These are common signs associated with generalized illness, particularly when the animal is affected by cancer or severe systemic infection.

 

Decreased Anal and Tail Tone, Hindlimb Weakness: Neurological signs in the hind end can occur due to pressure from lymphosarcoma masses infiltrating nerves and the spinal cord.

 

Rectal Palpation: Finding a mass in the right uterine horn and enlarged sublumbar lymph nodes points toward lymphosarcoma, which is the most common clinical manifestation of bovine leukemia virus (BLV) infection.

 

Pathogenesis:

 

Bovine Leukemia Virus: This retrovirus causes persistent infection in cattle. In a subset of cases, it leads to lymphosarcoma, a type of cancer that affects lymphoid tissues. The affected tissues often include sublumbar lymph nodes and organs like the uterus.

Other Differentials:

A. Bovine Immunodeficiency Syndrome: This is not a recognized disease in cattle and therefore is an unlikely diagnosis.

C. Bovine Malignant Catarrhal Fever: Usually presents with high fever, nasal discharge, and mucosal erosions rather than mass lesions in the uterine horn or sublumbar lymphadenopathy.

D. Bovine Spongiform Encephalopathy: Primarily affects the central nervous system, leading to abnormal behavior, ataxia, and weight loss. Mass lesions are not typical.

E. Bovine Tuberculosis: While it can cause weight loss and lymphadenopathy, it does not typically involve the uterine horn, nor would it typically cause decreased anal and tail tone with hindlimb weakness.

 

Summary: Given the constellation of symptoms and findings, bovine leukemia virus infection leading to lymphosarcoma is the most likely diagnosis. Further diagnostics, like serology or biopsy, can confirm this diagnosis.

Question 8: The recently acquired 6-month old female chinchilla has greasy, unkempt fur.  The chinchilla is housed on aspen wood chips in a wire cage with a plastic bottom. She is fed a commercial chinchilla ration with the occasional raisin as a treat.  Water is provided by a water bottle.  Which of the following is the most appropriate next step in management?

A. Addition of a dietary fatty acid supplement

B. Bathing in an antifungal shampoo

C. Daily brushing by the owner

D. Provision of a dust bath

E. Provision of a mate for mutual grooming  

The most appropriate next step in the management of a 6-month-old female chinchilla with greasy, unkempt fur is D. Provision of a dust bath.

 

Here's why this is the correct choice:

 

Chinchilla Grooming Needs:

Chinchillas require regular dust baths to maintain healthy skin and fur. The dust bath helps absorb and remove excess oils and dirt from their fur, which is crucial because their dense coat can become greasy and matted if not properly maintained.

Evaluation of Other Options:

A. Addition of a dietary fatty acid supplement: This is generally not necessary unless a specific deficiency is diagnosed. It is unlikely to address the immediate issue of unkempt fur directly.

B. Bathing in an antifungal shampoo: This could be considered if there was a suspicion of fungal infection; however, there's no indication of infection based on the description. Additionally, water baths are not recommended for chinchillas as their fur retains moisture, leading to potential hypothermia and fungal infections.

C. Daily brushing by the owner: While brushing can help to some extent, it does not effectively manage the grease and oils in a chinchilla's fur as well as a dust bath can.

E. Provision of a mate for mutual grooming: While social interaction is important for chinchillas, relying on another chinchilla for grooming does not replace the need for dust baths, which are essential for their fur care.

 

Proper Care Practice:

Regular dust baths are a standard and essential part of chinchilla care. Providing a dust bath several times a week helps ensure the chinchilla's fur remains clean and healthy. The dust used should be specific to chinchillas, as it is formulated to mimic the volcanic ash of their native habitat, which is fine enough to penetrate their dense fur without causing harm.

 

Summary: By providing a dust bath, you will directly address the issue of greasy and unkempt fur, helping the chinchilla maintain a healthy coat as per its natural grooming habits.

 

And that's a wrap for today! I'm sure you crushed it! Keep up the studying to ace the NAVLE. We believe in you—keep learning!