Navle

Front 1

How much blood to raise a PCV by 1%?

Back 1

2ml/kg

Front 2

Potomac Horse Fever

Back 2

Ehrlichia risticii (recently renamed Neorickettsia rickettsii)
Summer D+ and laminitis
High fever - Monocytosis

Front 3

Equine Herpes Myeloencephalopathy (EHM)

Back 3

Vasculitis of the central nervous system Neurologic signs = acute. Hindlimb ataxia, hypotonia of the tail/anus, and urinary incontinence. EPM could possibly cause similar signs but is not typically seen in multiple animals on the same farm. Wobbler Syndrome and EDM typically affect young horses.

Front 4

Malignant catarrhal fever (MCF)

Back 4

Dairy cow near sheep
corneal opacity, high fever, lymphadenopathy, and CNS signs. Brain has lymphocytic perivasculitis.
Ovine herpes virus-2.

Front 5

Copper Deficiency

Back 5

Achromotrichia (due to) Dysfunction of tyrosinase which converts L-tyrosine to melanin. I
Spontaneous fractures, secondary respiratory disease, diarrhea, ill thrift, decreased immunity, anemia, and poor reproduction. Molybdenum can cause in diet

Front 6

Bracken Fern toxicity

Back 6

Contains a toxic glycoside (ptaquiloside) plus thiaminase.
In cattle, chronic bracken fern ingestion can result in bone marrow suppression, as well as alkylation of DNA leading to tumors. The problem will manifest as hemorrhages, hematuria, and/or cancers in the bladder or other organs. The bone marrow suppression leads to anemia and neutropenia.
The thiaminase seems to affect horses more than cattle. Horses develop thiamine deficiency manifested as weight loss, ataxia, lethargy, tremors, recumbency, and death.

Front 7

Addisons

Back 7

The classic laboratory finding for an Addisonian includes hyponatremia, hyperkalemia, azotemia, anemia, acidosis, hypoglycemia, and of course a low resting cortisol level or low ACTH stimulation test result.

Front 8

Pedal Osteitis

Back 8

Caused by:Laminitis, Repeated concussion, Corns, Tendonitis, Chronically bruised sole
Inflammation of the structures of the feet associated with demineralization of P3.
Commonly occurs in performance horses and is associated with working on hard surfaces.
Both forelimbs may be affected. Treatment = prolonged rest, NSAIDs and corrective shoeing.

Front 9

Mycoplasma (Enzoonotic) Pneumonia

Back 9

Dry cough and retarded growth.

WILL NOT SEE sneezing, nasal discharge, and dyspnea.

Front 10

Virus Family:
Vesicular Stomatitis
BVD
FMD
Blue tongue

Back 10

The correct answer is Rhabdovirus.
BVD is caused by a flavivirus.
FMD is caused by a picornavirus.
Bluetongue is caused by a reovirus.
Vesicular stomatitis is reportable since the clinical signs are so similar to that of foot-and-mouth disease.

Front 11

What is Amlodipine used for?

Back 11

Amlodipine is the treatment of choice for hypertension in cats. It is a calcium channel blocker and works by preventing calcium influx into vascular smooth muscle cells, thereby causing vasodilation. This relaxes the vessels and allows for reduced blood pressure.

Front 12

Calf Diptheria

Back 12

Fusobacterium necrophorum (aka calf diphtheria or necrotic laryngitis).
Clinical signs- seen between 3-18 months. Signs are usually acute, and the animals may die within the week if they are not treated.
Moist, painful cough and a loud inspiratory stridor. On physical exam, it is noticed that the head and neck are extended, there is a swelling around the larynx, and ozena.
She also has a temperature of 104.6F and episcleral injection. On palpation of the larynx, a cough is easily elicited along with pain and increased stridor.

Front 13

Sorghum

Back 13

Which of the following causes myelomalacia of the lower spinal cord, resulting in pelvic limb incoordination and urine dribbling when ingested by horses?

Front 14

Feline odontoclastic resorptive lesions are most likely to occur in which of the following teeth?

Back 14

Although feline odontoclastic resorptive lesions can occur in any tooth, they are most frequently found in the first premolars, 307 and 407 in feline patients. So far, there is still no explanation for why these teeth are more vulnerable to this process.

Front 15

Coccidioidomycosis
Blastomycosis
Cryptococcus

Back 15

Finding spherules on cytology is pathognomonic for Coccidioidomycosis
With blastomycosis you see broad based budding of the yeast.
With Cryptococcus neoformans you will see narrow-based budding.

Front 16

Mouldy Sweet Clover

Back 16

Moldy sweet clover results in a coagulopathy because it inhibits the function of vitamin K (necessary for production of factors II, VII, IX, and X). This coagulopathy results in hemorrhage. Water deprivation results in hemolysis because these animals develop hypernatremia then they drink water; the water rushes into their RBCs and they lyse.

Front 17

Tyzzer's disease

Back 17

Clostridium piliformis, which causes an acute necrotizing hepatitis.
It affects only foals from about 1-6 weeks of age
fever, icterus, and diarrhea acutely. Bloodwork shows hyperfibrinogenemia, hypoglycemia, and elevated liver enzymes

Front 18

Red Maple Toxicity

Back 18

Red maple toxicity leads to Heinz body anemia due to oxidative damage to red blood cells.

Front 19

Perilla mint

Back 19

The Perilla mint (Perilla frutescens) plant has a pneumotoxin that is absorbed and metabolized to a toxic intermediate that damages Type I pneumocytes and bronchiolar epithelial cells. Animals become acutely dyspneic and may begin open-mouth breathing and frothing at the mouth. Necropsy shows wet, heavy, emphysematous lungs.

Front 20

Morphine and Mast cell tumours

Back 20

Morphine causes histamine release - don't use on mast cell tumours

Front 21

The classic laboratory finding for an Addisonian

Back 21

hyponatremia, hyperkalemia, azotemia, anemia, acidosis, hypoglycemia, and of course a low resting cortisol level or low ACTH stimulation test result.

Front 22

Terbutaline

Back 22

Feline asthma
Beta-2 agonist -will relax bronchial smooth muscle.

Front 23

A necropsy of an aborted bovine fetus shows enlarged lymph nodes and spleen, destructive lesions to the thymus, and evidence of chronic granulomatous infection. What is the most likely cause of this abortion?

Back 23

also called foothill abortion. This is an important disease of heifers and newly introduced cows in California foothills. The lesions are consistent with this diagnosis. The etiologic agent of EBA has yet to be identified, however we know that the vector is a tick, Ornithodoros coriaceus.

Front 24

A positive Ortolani sign occurs in affected dogs when manipulating this bone.

Back 24

The correct answer is femur. During manipulation of the femur one may hear/feel a "clunk" which is actually subluxation of the coxofemoral joint. This test is important to perform in puppies in order to assess for hip dysplasia. The positive Ortolani sign indicates joint laxity.

Front 25

Clostridium piliformis

Back 25

This is a motile, filamentous, gram negative, spore forming, obligate intracellular bacterium. Clinical signs associated with Tyzzer's include depression, anorexia, coma, convulsions, and jaundice. Horses between 6 days and 6 weeks of age are affected; however, most are affected at 1-2 weeks. Affected foals will have elevated liver enzymes, marked hypoglycemia, and acidosis.

Front 26

Black widow spider bite

Back 26

Latrodectus mactans and L. hesperus are the scientific names for this spider. They make a toxin that binds to calcium channels, increasing membrane permeability and enhancing depolarization. Ascending motor paralysis and destruction of peripheral nerves endings occur. A single bite may be serious to adult humans and could kill a small animal. Clinical signs occur almost immediately with pain, due in part to the release of acetylcholine, which stimulates contraction of major muscle groups. There may be ascending motor paralysis, muscle spasms, muscle rigidity, and salivation. Death from respiratory or cardiovascular failure is possible.

Front 27

Enzootic pneumonia and gangrenous mastitis in sheep (blue bag) can both be caused by _______.

Back 27

Mannheimia hemolytica (formerly Pasteurella hemolytica biotype A...it takes several years for boards to catch up with nomenclature, so you should remember this name too) causes blue bag and enzootic pneumonia which is a hemorrhagic bronchopneumonia of young lambs and their dams. Pasteurella multocida causes primarily pneumonia and septicemia. Fusobacterium causes necrotic fetid lesions of the mouth or feet. Staphylococcus aureus is a cause of blue bag and arthritis. Mycoplasma mycoides ssp mycoides causes a number of conditions including pleuropneumonia, mastitis, polyarthritis, and meningitis, but is seen mainly in goats. The Mycoplasma that causes pneumonia in sheep is Mycoplasma ovipneumoniae.

Front 28

A Paint horse is found to be approximately 7% dehydrated after a several day trail ride. Assuming there are no other ongoing losses and the horse weighs 500kg how many liters of fluid will you need to give this horse over a 24 hour period to correct the deficit and account for maintenance requirements?

Back 28

The deficit is 35L (deficit x BW). Maintenance needs for a horse is approximately 60ml/kg/day. In this case, 30L. Adding the deficit and maintenance fluids together yields a total of 65 liters.

Front 29

Which of these is an appropriate treatment for an animal showing signs of strychnine toxicity?

Back 29

he correct answer is methocarbamol. Strychnine is found is some snail baits and other poisons. Strychnine competitively antagonizes the action of glycine and causes a loss of impulse control in the spinal cord and brainstem. Clinical signs can begin suddenly and progress from anxiety to tetanic convulsions spontaneously or in response to stimuli. The poison affects all striated muscles. There is no specific antidote, so treatment is symptomatic. Convulsions can be controlled with anesthetic drugs and/or methocarbamol. Stimulation should be prevented.

Front 30

You are presented with a 6 month old Saler bull which is depressed, off feed, and breathing hard. He was shipped to the new farm 7 days previously. On physical exam, you find T=105F, HR=80, RR=45, and the scleral vessels are injected and dark. The animal is dyspneic and open-mouth breathing (see image). The cranioventral lung fields auscult abnormally, with harsh inspiratory and expiratory sounds as well as expiratory wheezes. Percussion of the thorax reveals ventral consolidation. Which of the following is the most likely correct diagnosis?

Back 30

Mannheimia hemolytica bronchopneumonia

Front 31

Zinc toxicity from ingestion of pennies minted after 1983 can cause which of the following?

Back 31

The correct answer is hemolysis. Zinc causes a Heinz body anemia and hemolysis.

Front 32

Erysipelas

Back 32

Gram-positive, slender, pleomorphic rods

Front 33

Which type of urolith occurs most commonly in western U.S. range cattle?

Back 33

Silicate stones are the result of high intakes of silica in mature range grasses, combined with other factors such as dehydration. Struvites (calcium, magnesium, and phosphate) tend to be found in feedlot animals receiving large amounts of grain. Calcium carbonate stones are most common in sheep grazing pastures high in calcium and oxalates.

Front 34

A 43 kg male castrated Rottweiler presents to your practice for surgery to repair a ruptured cranial cruciate ligament. Preoperative bloodwork and thoracic radiographs are within normal limits. What is an appropriate fluid rate of LRS to maintain this dog at while under anesthesia for the 2 hour procedure?

Back 34

Animals under anesthesia for surgery need 5-10 mls/kg/hr of an isotonic crystalloid for "maintenance". In this case, a 43 kg dog needs between 215-430 ml/hr to be in this range. Therefore 360 is the best answer as it corresponds to about 8.4 ml/kg per hour. You will not be allowed to use a calculator at your exam, and you should be able to evaluate these numbers without one. The easiest way to do this is to say that 10 ml/kg per hour would per 430 ml/hr for this dog and therefore, half of that (215 ml/hr) would be the lower end of this range.

Front 35

You are called to a sow farm to investigate an abortion outbreak. The owner has 600 sows and is concerned because 5 sows aborted overnight. Upon arrival you find that all 5 sows that aborted were at least 95 days pregnant. Everyone seemed fine 2 days ago but yesterday a few sows started to cough and were off feed. Today there are a lot more sows coughing. The aborted sows all have temperatures of 105.0 - 106.5F. Which of the following samples is most important in helping you confirm your diagnosis?

Back 35

The correct answer is collect nasal swabs from all aborted sows. In this case the sudden onset of coughing that is highly contagious is highly suggestive of swine influenza virus. Swine influenza virus does not go systemic. It causes abortion by creating a systemic illness (fever) but the virus does not spread via the blood. The virus is not found in the blood or the aborted fetuses. A necropsy of an affected sow is not necessary to confirm the diagnosis as nasal swabs of acutely affected animals are great diagnostic specimens.

Front 36

Moldy sweet clover contains a toxin that affects which of the following?

Back 36

The correct answer is the coagulation cascade. Moldy sweet clover contains dicumarol, which is a vitamin K antagonist and can thus lead to coagulopathy. Treatment is with vitamin K1.

Front 37

Which of these is an adrenergic vasopressor in dogs?

Back 37

The correct answer is dopamine. Adrenergic vasopressors are frequently used to treat hypotension during anesthesia. Drugs in this category are dopamine, dobutamine, ephedrine, phenylephrine, and norepinephrine.

Front 38

The current drug of choice for the treatment of Potomac Horse Fever is _________.

Back 38

The correct answer is oxytetracycline. Treatment for 7-10 days is usually effective in preventing the progression of the disease.

Front 39

Which of the following is true about eperythrozoonosis in pigs

Back 39

The correct answer is it is often associated with anemia, fever, icterus, and reproductive failure. Eperythrozoonosis in pigs is caused by Mycoplasma suis (previously called Eperythrozoon suis), a disease vectored by biting insects. Clinical signs include anorexia, weakness, anemia, icterus, and reproductive failure. Younger pigs are more severely affected than older pigs. The treatment of choice for the disease is tetracycline antibiotics. Vaccines are not available for the disease.

Front 40

You examine a 6-year old Quarter Horse gelding for a complaint of lameness. He has a short-strided, stilted gait in the forelimbs, is more painful on a hard surface than on a soft grass surface, and head nods when led in a tight circle at the trot in either direction. The hoof tester elicits pain in the posterior third of the foot on both forefeet. The hoof appears normal except that it has narrow heels. A block of the palmar digital nerves seems to result in loss of hoof tester sensitivity and an improved gait. Which of these is the most appropriate treatment?

Back 40

The case describes a horse with navicular disease. Pain from navicular disease can be reduced by a shoe that elevates the heel.

Palmar foot pain can be the result of pain from any number of structures including the navicular bone, navicular suspensory or deep digital flexor tendon, navicular bursa, or several other heel areas. Navicular disease is a term used for pain associated with any of these structures.

Front 41

Fescue

Back 41

With fescue toxicity you see lameness, sloughing of rear hooves, decreased weight gain, decreased milk production, and fat necrosis.

Front 42

Which is the least common site of osteochondrosis in large animals?

Back 42

The correct answer is elbow. The hock is actually the most common site.

Front 43

cause of hydrocephalus in fetal calves?

Back 43

Hydrocephalus in livestock is usually a result of in utero infection of the fetus.
BVD, Akabane virus, and bluetongue can all produce hydrocephalus.

Front 44

At what age are piglets normally weaned on North American commercial swine farms?

Back 44

16 to 21 days of age

Front 45

Which of the following drugs is a selective serotonin re-uptake inhibitor (SSRI) which you could prescribe as part of the treatment for the cat's anxiety-related behavioral problems?

Back 45

Fluoxetine (Prozac) is an anti-depressant and SSRI that can be used to treat cats for anxiety related disorders at a dose of 0.5 mg/kg orally once daily

Front 46

You are presented with a horse that has immune-mediated hemolytic anemia. Under which of these conditions would it be contraindicated to treat the horse with corticosteroids?

Back 46

The correct answer is the horse had a positive Coomb's and Coggin's test. In this case, the probable cause of the immune-mediated hemolytic anemia is the equine infectious anemia retrovirus. It is known that corticosteroids tend to cause recrudescence of viremia and worsen anemia in infected animals. If a horse is receiving an antibiotic prior to development of immune-mediated hemolytic anemia, the drug should be discontinued, because it may be the cause of the anemia due to a drug reaction. In such an instance, a completely different class of antibiotic should be chosen in its place.

Front 47

A 3-year old German Short Hair Pointer presents for vomiting, lethargy, and diarrhea. A fecal exam reveals the eggs of Nanophyetus salmincola, the salmon poisoning fluke. What treatment should be administered to treat the symptoms of the dog?

Back 47

The correct answer is tetracycline antibiotics. The causative agent for the dog's clinical signs is Neorickettsia helminthoeca. Treatment of choice for this rickettsial agent is tetracycline antibiotics.

Front 48

Which of the following is not true about Paragonimus kellicotti?

Back 48

The answer is it is a nematode. Paragonimus is a lung fluke, not a nematode. Eggs are passed into airways and coughed up and swallowed; therefore fecal sedimentation can be a useful diagnostic test. The eggs may also be seen in tracheal wash samples. The snail and crayfish are required intermediate hosts.

Front 49

A 2-year old mare presents for head shaking and rubbing of the ear. A skin scraping of the ear reveals a mite organism. What organism should you be most suspicious of?

Back 49

The correct answer is Psoroptes. Psoroptic mange is a reportable disease. Clinical signs may or may not be present. When they are present, pruritus of the ear is commonly observed. A definitive diagnosis is based on skin scrapings and otoscopic examination

Front 50

What can be concluded from a urine specific gravity of 1.004 in a dog?

Back 50

The correct answer is the dog's renal function is capable of diluting urine. The dog is hyposthenuric (specific gravity between 1.001-1.007) which requires work to dilute the urine. Renal failure cannot be diagnosed without knowing the animal's BUN and creatinine status. You can not say the dog is PU/PD without knowing the quantity of water it drinks and quantity of urine it produces. A dehydrated animal should have concentrated urine, instead of dilute urine.

Front 51

A 4 year old horse presents to you with a mucopurulent nasal discharge, lethargy, and depression. On physical exam, the horse has a temperature of 103.7F and has markedly enlarged mandibular and retropharyngeal lymph nodes. You suspect that the horse has strangles. What would you expect to see if you aspirated one of the enlarged lymph nodes?

Back 51

The correct answer is purulent inflammation and gram positive cocci with large capsules. The causative agent of strangles is streptococcus equi ssp. equi which is a gram positive cocci with a large capsule. It causes suppurative abscessation and enlargement of the mandibular and retropharyngeal lymph nodes.

Front 52

A 2 month old hamster presents for wet tail. The hamster is lethargic and dehydrated on physical exam. What is the most likely diagnosis?

Back 52

The correct answer is proliferative ileitis. Lawsonia intracellularis is thought to play a key role in this disease, which carries a grave prognosis.

Front 53

HCM

Back 53

Use Atenolol

Front 54

Claviceps purpura

Back 54

Claviceps purpura is a parasitic fungus found on rye, oats, wheat, and Kentucky bluegrass. Its toxicity comes from alkaloids and causes vascular constriction, thrombosis, gangrene, and vomiting, colic, diarrhea, and constipation. Diagnosis is made by identifying ergot on the grain.

Front 55

Meibomian glands produce which portion of the tear film?

Back 55

The correct answer is lipid. There are three layers of the tear film. The mucous portion lies against the cornea and keeps the tear film adhered to it. This is made by conjunctival goblet cells. The aqueous portion has nutritional and immunologic factors and is in the middle. It is produced by the lacrimal gland and the gland of the 3rd eyelid. The lipid portion of the tear film is the most outer part, and it allows for even spreading and prevents evaporation of tears. It is produced by the meibomian glands.

Front 56

Quittor defines a chronic infection of what part of a horse?

Back 56

The correct answer is the cartilage of P3. Quittor can result in a draining tract from the coronary band due to infection and inflammation of the affected cartilage. Surgery is the treatment of choice.

Front 57

Which of the following is a cause of early embryonic death in cattle?

Back 57

The correct answer is Campylobacter fetus. The other choices result in abortions ranging from mid to late gestation.

Front 58

This breed is predisposed to development of enteroliths

Back 58

The correct answer is Arabian. Development of enterolithiasis is mainly a problem in Florida and California. Enteroliths are usually made up of magnesium ammonium phosphate.

Front 59

You are called out to a horse farm to look into a recent storm of abortions. You find out that about 4 months ago, many of the foals developed copious nasal discharge. This was not treated, and the foals recovered over several weeks. The abortions that are currently occurring are in mares that are in their last trimester. What is your diagnosis?

Back 59

Equine herpesvirus. The key to answering this question is in the time frame. The foals developing clinical signs of herpesvirus infection several months prior to an abortion storm is classic for this virus. The mares are typically asymptomatic initially and then abort. It causes abortions in horses 7-11 months pregnant.

Front 60

Your client's turkey developed nasal and ocular discharge, weight loss, inappetence, and then died. You performed a necropsy and found pneumonia, multifocal necrosis in the liver and spleen, and severe pericarditis. Histopathologic findings included many basophilic intracytoplasmic inclusions found in the affected organs. What is the most likely cause of death?

Back 60

The correct answer is Chlamydia psittaci. The intracytoplasmic inclusions, along with involvement of multiple organs and supportive clinical findings, are indicative of this disease. Chlamydia psittaci is known as ornithosis in turkeys.
Treat with doxycyline

Front 61

You are called to evaluate a turkey flock after several turkeys have died. You notice several turkeys appear dull and depressed, standing by themselves with ruffled feathers and yellow droppings. You perform a necropsy on one of the recently deceased birds and find inflammatory lesions, ulcerations, and thickening of the cecal wall. The contents of the cecum are dry and cheesy (much like board review study material). The liver has large ring shaped yellow lesions.

How should you manage the flock?

Back 61

The case describes the typical findings for Histomoniasis (also known as Blackhead) in turkeys. This disease is caused by the protozoan parasite, Histomonas meleagridis. It is usually transmitted in embryonated eggs of the cecal nematode Heterakis gallinarum. The combination of liver and cecal lesions are strongly suggestive of this disease in turkeys.

Nitarsone is an arsenical compound used as a feed additive for the prevention and treatment of histomoniasis in turkeys.

Front 62

What type of urinary stone is likely to form in an animal being treated with too much allopurinol?

Back 62

The correct answer is xanthine stones. Allopurinol is used in the treatment of urate stone forming Dalmatians. It acts by inhibiting the enzyme, xanthine oxidase, which metabolizes xanthine. The idea is that by stopping the purine metabolism pathway at this point, uric acid will not be formed in high quantities. However, if given at too high of a dose, xanthine will accumulate to levels where xanthine stones will form.

Front 63

What developmental defect is seen in lambs born from ewes infected with bluetongue virus during pregnancy?

Back 63

The correct answer is hydranencephaly. This abnormality is a condition in which the brain`s cerebral hemispheres are like swiss cheese or absent and replaced by sacs filled with cerebrospinal fluid. Ewes infected with bluetongue virus while pregnant can have lambs with this defect.

Front 64

Which of the following is the causative agent of infectious coryza in chickens?

Back 64

The correct answer is Haemophilus paragallinarum. This is a gram negative, pleomorphic, microaerophilic rod. Clinical signs include respiratory disease. In particular, you will see nasal discharge, sneezing, and swelling of the face underneath the eyes. Older birds seem to be more susceptible. Diagnosis is based on isolating the organism or inoculation on a healthy bird and then evaluating for development of clinical signs. Swelling of the face and wattle must be differentiated from fowl cholera, which is caused by Pasteurella multocida. This condition is treated with antibiotics. Additionally, turkey coryza is caused by bordetella avium.

Front 65

Continued loss of large volumes of saliva in a cow can result in __________.

Back 65

The correct answer is metabolic acidosis. Ruminant saliva has lots of bicarbonate to help neutralize fatty acids being produced in the rumen. Ruminants have about 80 meq/L of bicarbonate in their saliva. Horses, on the other hand, have lots of chloride in their saliva and develop hypochloremic metabolic alkalosis when they lose saliva.

Front 66

A horse presents for ingestion of Jimsonweed which contains scopolamine. Which of the following is the treatment of choice against such an intoxicant?

Back 66

The correct answer is physostigmine. Scopolamine is an atropine-like alkaloid and causes depression and is parasympatholytic to the autonomic nervous system. It can cause convulsions, respiratory failure, incoordination, mydriasis, and constipation. Treatment consists of activated charcoal, laxatives, diazepam to control convulsions and physostigmine (a parasympathomimetic).

Front 67

A litter of 3-week old piglets is presented for shifting leg lameness. They have warm swollen joints in all legs, a temperature of 107.0F, and are dyspneic. Necropsy of one dead animal shows fibrinopurulent pleuritis and peritonitis. What is the most likely diagnosis?

Back 67

Haemophilus parasuis causes Glasser's disease, which is usually characterized by sudden death but can often also lead to painful joints, pneumonia, and occasionally neurologic signs. Lesions show fibrinopurulent pleuritis, pericarditis, and peritonitis. Meningitis is usually responsible for the cause of neurologic signs and seizures. This disease most commonly affects piglets from 2 weeks to 4 months of age. Morbidity rate can reach up to 50-75% and mortality rate up to 10%.