100+ Free VTS (Internal Medicine) Practice Questions

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A dog is diagnosed with Stage B2 myxomatous mitral valve disease (MMVD) per ACVIM consensus. Which intervention is indicated?

No medication; recheck in 12 months

Pimobendan to delay onset of congestive heart failure

Furosemide and spironolactone

Emergency thoracocentesis

to track

2026 Statistics

Key Facts: VTS (Internal Medicine) Exam

Sub-Specialty Tracks

AIMVT

3+ yrs

Min Experience

6,000+ hours

40+

Case Logs Required

AIMVT

4-6

Case Reports

AIMVT

40+ hrs

CE Required

Advanced IM topics

$350

Exam Fee

Approximate

The VTS (Internal Medicine) is the advanced specialty credential from AIMVT (Academy of Internal Medicine Veterinary Technicians). Candidates must hold a CVT/LVT/RVT, complete 3+ years (6,000+ hours) of IM-focused clinical work, submit 40+ case logs and 4-6 case reports, earn 40+ CE hours, and pass a written exam in one of seven sub-specialty tracks. The exam fee is approximately $350. AIMVT does not publicly publish a pass rate.

Sample VTS (Internal Medicine) Practice Questions

Try these sample questions to test your VTS (Internal Medicine) exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A dog is diagnosed with Stage B2 myxomatous mitral valve disease (MMVD) per ACVIM consensus. Which intervention is indicated?

A.No medication; recheck in 12 months

B.Pimobendan to delay onset of congestive heart failure

C.Furosemide and spironolactone

D.Emergency thoracocentesis

Explanation: ACVIM Stage B2 indicates cardiomegaly from MMVD without clinical signs of CHF. The EPIC study demonstrated that pimobendan delays the onset of CHF by approximately 15 months. Diuretics are not yet indicated until Stage C.

2Which ACVIM stage describes a dog with a heart murmur from MMVD but no cardiac enlargement on imaging?

A.Stage A

B.Stage B1

C.Stage B2

D.Stage C

Explanation: Stage B1 is a preclinical patient with a murmur but no evidence of cardiac remodeling (normal LA/Ao and LVIDDN). Stage B2 has remodeling. Stage C is symptomatic CHF.

3A cat presents with acute dyspnea, a gallop rhythm, and a murmur. Thoracic radiographs show pulmonary edema. Which breed is most predisposed to HCM?

A.Siamese

B.Maine Coon

C.Persian

D.Abyssinian

Explanation: Maine Coons have a well-documented autosomal dominant MYBPC3 mutation associated with hypertrophic cardiomyopathy. Ragdolls also have an identified MYBPC3 mutation. Genetic testing is commercially available.

4A large-breed dog with DCM has confirmed low whole-blood taurine. Which breed is classically associated with taurine-responsive DCM?

A.Doberman Pinscher

B.Boxer

C.Cocker Spaniel

D.Great Dane

Explanation: American Cocker Spaniels are a well-documented breed for taurine-responsive DCM. Supplementation with taurine and L-carnitine can result in significant improvement or resolution. Golden Retrievers on grain-free diets are another emerging population.

5Boxer dogs are predisposed to arrhythmogenic right ventricular cardiomyopathy (ARVC). Which diagnostic is most valuable for detection?

A.Thoracic radiographs

B.24-hour Holter monitor

C.Serum troponin I alone

D.Abdominal ultrasound

Explanation: Boxer ARVC is characterized by ventricular premature complexes (VPCs) that may be intermittent. A 24-hour Holter is the gold standard; >100 VPCs in 24 hours is considered abnormal, and >1000 is diagnostic in symptomatic Boxers.

6A dog in acute CHF receives IV furosemide. Which electrolyte disturbance is the technician most likely to monitor for?

A.Hyperkalemia

B.Hypokalemia

C.Hypernatremia

D.Hypercalcemia

Explanation: Loop diuretics promote potassium excretion at the distal tubule, causing hypokalemia. Hypokalemia predisposes to arrhythmias and muscle weakness. BUN and creatinine should also be monitored for prerenal azotemia.

7A dog presents in atrial fibrillation with a heart rate of 220 bpm and signs of low output. Which drug class is used for rate control?

A.Beta-agonists

B.Calcium channel blockers (e.g., diltiazem) or digoxin

C.Nitroprusside

D.Mannitol

Explanation: Rate control in canine atrial fibrillation is typically achieved with diltiazem and/or digoxin, which slow AV nodal conduction. Target ventricular response in dogs is approximately 100-140 bpm. Cardioversion is not commonly pursued in dogs.

8A Golden Retriever presents with muffled heart sounds, weak pulses, and jugular distension. Echocardiogram confirms pericardial effusion. What is the most common cause in this breed?

A.Idiopathic pericardial effusion

B.Hemangiosarcoma of the right atrium

C.Heartworm disease

D.Bacterial pericarditis

Explanation: Hemangiosarcoma of the right atrium/auricle is the most common cause of hemorrhagic pericardial effusion in Golden Retrievers and German Shepherds. Idiopathic is more common in smaller breeds. Heart base tumors (chemodectoma) are another differential.

9During pericardiocentesis, the technician notes the fluid does not clot in a plain red-top tube. What does this suggest?

A.Active hemorrhage into the pericardium

B.Chronic pericardial effusion (defibrinated blood)

C.Inadvertent venous puncture

D.Lymphatic rupture

Explanation: Blood within the pericardial sac is defibrinated by cardiac motion and does not clot. If fluid clots, the technician likely aspirated a cardiac chamber or vessel, and the needle should be repositioned. PCV comparison to peripheral blood also helps.

10Which NT-proBNP finding in a cat supports occult cardiomyopathy versus primary respiratory disease?

A.Markedly elevated NT-proBNP

B.Undetectable NT-proBNP

C.Mildly decreased NT-proBNP

D.NT-proBNP is not useful in cats

Explanation: NT-proBNP is released in response to myocardial stretch. Elevated values (>270 pmol/L on plasma assay, or positive SNAP fBNP) in a dyspneic cat support cardiac cause of dyspnea. Echocardiography remains the gold standard.

About the VTS (Internal Medicine) Exam

The VTS (Internal Medicine) credential, administered by AIMVT, recognizes credentialed veterinary technicians with advanced expertise in internal medicine. Candidates select one of seven sub-specialty tracks: Small Animal Internal Medicine (SAIM), Large Animal Internal Medicine (LAIM), Cardiology, Neurology, Oncology, Equine IM, or Production Animal IM.

Questions

100 scored questions

Time Limit

Approximately 3 hours

Passing Score

Set annually by AIMVT (scaled)

Exam Fee

$350 (approximate) (AIMVT (Academy of Internal Medicine Veterinary Technicians))

VTS (Internal Medicine) Exam Content Outline

25%

Cardiology

MMVD, ACVIM staging, HCM, DCM, CHF management, arrhythmia recognition, pericardial disease

15%

Neurology

Seizures, status epilepticus, IVDD, MRI/CSF interpretation, MUA/GME/NME, vestibular disease

15%

Oncology

USP 800 chemotherapy safety, CHOP protocol, extravasation management, mast cell tumors, osteosarcoma, TCC

15%

Endocrine

Diabetes mellitus, DKA, Addison's, Cushing's, hyperthyroidism, hypothyroidism

10%

Gastroenterology

IBD, PLE, pancreatitis, megaesophagus, feeding tubes, hepatic disease

10%

Nephrology & Urology

IRIS staging, CKD nutrition, transfusion medicine, AKI, hemodialysis

Respiratory

Feline asthma, chronic bronchitis, laryngeal paralysis, tracheal collapse

Equine & Large Animal IM

Colic, EHV-1, Potomac Horse Fever, RAO, salmonellosis, foal pneumonia

How to Pass the VTS (Internal Medicine) Exam

What You Need to Know

Passing score: Set annually by AIMVT (scaled)
Exam length: 100 questions
Time limit: Approximately 3 hours
Exam fee: $350 (approximate)

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

VTS (Internal Medicine) Study Tips from Top Performers

1Master the ACVIM MMVD staging system (A, B1, B2, C, D) and the associated therapies — this is high-yield on the cardiology track

2Memorize USP 800 PPE and spill-kit protocols; chemotherapy safety is heavily tested across oncology and SAIM tracks

3Know the difference between doxorubicin extravasation (cold + dexrazoxane) and vincristine extravasation (warm + hyaluronidase)

4Study IRIS CKD staging thresholds (dog vs cat creatinine cutoffs) and substaging by UPC and blood pressure

5Practice CRI calculations (lidocaine, dopamine, fentanyl) until they are automatic

6Review transfusion medicine in detail: canine DEA 1 typing, feline Type A/B/AB and Mik antigen, and cross-match indications

7Use AIMVT-approved CE (ACVIM Forum, IVECCS, NAVC, WVC) and organize case logs alongside daily clinical work

Frequently Asked Questions

What are the prerequisites for the VTS (Internal Medicine) exam?

Candidates must hold an active CVT/LVT/RVT credential, have at least 3 years (6,000+ hours) of internal medicine-focused clinical experience, submit a minimum of 40 case logs and 4-6 detailed case reports, complete 40+ hours of advanced CE in internal medicine, and secure endorsement letters. Specific requirements vary by sub-specialty track.

How many sub-specialty tracks does AIMVT offer?

AIMVT offers seven sub-specialty tracks for the VTS (Internal Medicine) credential: Small Animal Internal Medicine (SAIM), Large Animal Internal Medicine (LAIM), Cardiology, Neurology, Oncology, Equine Internal Medicine, and Production Animal Internal Medicine. Candidates choose the track that best reflects their clinical focus and case load.

How much does the VTS (Internal Medicine) exam cost?

The exam fee is approximately $350, though candidates should confirm current pricing on aimvt.com. Additional costs include AIMVT application fees, case report submission fees, CE expenses, and travel to the NAVTA Symposium or designated testing site. Total investment typically ranges from $600-$1,500 depending on CE choices.

What is the pass rate for the VTS (Internal Medicine) exam?

AIMVT does not publicly publish pass rate data. Anecdotally, the credentialing package (case logs, case reports, CE, and written exam) is rigorous, and many candidates report that thorough preparation with practice questions, study groups, and mentorship significantly improves success rates.

How long does it take to become a VTS (Internal Medicine)?

The minimum timeline is 3 years of dedicated internal medicine experience (6,000+ hours), plus time to compile case logs, write case reports, complete 40+ CE hours, and prepare for the written exam. Most candidates complete the full pathway in 4-6 years. Case report writing alone often takes 6-12 months.

What topics are covered on the VTS (IM) exam?

The exam covers cardiology (MMVD, HCM, DCM, CHF management), neurology (seizures, IVDD, vestibular disease), oncology (USP 800 chemo safety, CHOP protocol, extravasation), endocrine (DM, DKA, Addison's, Cushing's, thyroid), gastroenterology (IBD, PLE, pancreatitis, feeding tubes), nephrology (IRIS staging, transfusion, CKD), respiratory, and equine/large animal IM depending on track.

Is USP 800 chemotherapy safety tested?

Yes. USP 800 standards for hazardous drug handling are a core competency for the Oncology and SAIM tracks. Expect questions on PPE (double chemo gloves, chemo gowns, N95, eye protection), closed-system transfer devices (CSTDs), spill kit use, vesicant extravasation management (doxorubicin cold + dexrazoxane; vincristine warm + hyaluronidase), and hazardous waste disposal.