03 - General Assessment of the Dermatology Patient

Question 1

(General Assessment of the Dermatology Patient)

1-4. What are the four steps?

Answer 1

1. History
2. Physical Examination
3. Diagnostic Aids
4. Therapy

Question 2

(History)

(Signalment)

(Breed)

It is often useful to make of the breed because some are heritable, some just occur more in some breed than others

(name that condition - not sure if i need to know these)

1. terriers, labs, golden retrievers, boxers, etc.
2. american cocker spaniels
3. german shephards
4. collies, shelties, kuvasz
5. siberian huskies and alaskan malamutes

Answer 2

1. atopic dermatitis
2. primary idiopathic seborrhea; otitis externa, atopic dermatitis
3. perianal fistulas, deep pyodermas
4. familial dermatomyositis
5. zine responsive dermatosis

Question 3

(History)

(Signalment)

(Breed)

It is often useful to make of the breed because some are heritable, some just occur more in some breed than others

(name that condition - not sure if i need to know these)

1. pomeranaians, chows, samoyeds, malamutes and mini poodles
2. bulldogs, pugs, and pekingeses
3. bulldogs, pugs, boston terriers
4. standard poodles, vizslas, akita, samoyeds and havaneses
5. doberman pinchers

Answer 3

1. alopcia X
2. fecial fold pyoderma
3. tail-fold pyoderma
4. sebaceous adenitis
5. hypothryroidism, acral lick dermatitis, follicluar dysplasias and color dilution alopecia (blue and fawn Dobermans)

Question 4

(History)

(Signalment)

(Age)

1. What diesases ar more common in younger animals?
2. more common in middle age to older?
3. Many don’t have an age relationship
4. One must remember that age of the animal upon presentation often is clearly different from the age of onset of the problem. It is important to define the age at which the disease was first apparent and to have some understanding of the progression.

Answer 4

1. allergy, demodicosis (mange, can’t control mites), dermatophysis (ringworm)
2. endocrinopathies, autoimmune disease, neoplasia

Question 5

(History)

(Signalment)

(Sex)

1. occasionally this may suggest what?
2. can there be a predilection for one sex over the other?

Answer 5

1. endocrinopathy related to reproductive hormones
2. yes

Question 6

(History)

(signalment)

(color)

1. Blue dobermans and any breed with coat color dilution (blue, fawn) can have what?
2. Alopecia can develop in areas of black haircoat in a condition called hwat?

Answer 6

1. color dilution alopecia
2. black hair follicle dysplasia

Question 7

(History)

(Environment, Contagion, Diet, Health Status and Lifestyle)

(Environment)

1. It is important to note if the animal is primarily indoor or outdoor and what type of living environment it inhabits. Is it likely that fleas or other ectoparasites will survive in the patient’s environment? Does the animal have significant contact with cement, plastic or plants (these can cause contact dermatitis or hypersensitivity). Does the pasture contain photosensitizing plants?

Question 8

(History)

(Environment, Contagion, Diet, Health Status and Lifestyle)

(Contagion)

1. Are other pets coexistent in the household and do they have skin disease? Are human beings affected? If so think of zoonotic skin conditions such as dermatophytosis, cheyletiellosis, sarcoptic mange, notoedric mange, sporotrichosis, and pox and parapox viral diseases.

Question 9

(History)

(Environment, Contagion, Diet, Health Status and Lifestyle)

(Diet)

The current diet should be noted and past history of diet or diet changes. This will be helpful not only to plan a food elimination trial (see food allergy) but also to determine whether or not the diet is adequately balanced.

1. A diet that is not adequately balanced can
   result in what?

Answer 9

1. poor hair coat quality and keratinization disorder (scaling)

Question 10

(History)

(Environment, Contagion, Diet, Health Status and Lifestyle)

(Health Status)

1. Questions regarding general health status are important and appetite, water intake, exercise, body condition, and mental attitude should be assessed. Is the dog on regular heartworm prevention? Sexual behavior may be useful information.

Question 11

(History)

(Environment, Contagion, Diet, Health Status and Lifestyle)

(Lifestyle)

1. There are many questions that can be asked regarding the life style of the animal. Does the animal swim regularly (ear and skin infections which may aggravate signs of allergy)? Does the animal go to work with the owner (animals left alone at home may develop psychogenic dermatoses)? The country of origin or travel history may be of importance as well (Europe, South America – Leishmaniasis).

Question 12

(History)

(History of the Disease)

This is very important and often difficult to clarify especially in chronic cases

1-6. What five question should you ask?

Answer 12

1. When did the disease begin?
2. What did it look like?
3. How did it progress?
4. Was the onset sudden or gradual?
5. What parts of the body were first and later affected?
6. Is the animal pruritic/itchy?
7. How does pruritis correlate with lesions?
8. Is animal licking feet or legs?

Question 13

(HIstory of the Disease)

(When did the Disease Begin?)

a) Knowing the age of the animal at the time the disease started can be helpful in formulating a sensible list of differential diagnoses (see above).
b) Knowing the disease duration (chronic vs. acute) can help in the interpretation of clinical signs and in the formulation of a sensible treatment plan.

Question 14

(HIstory of the Disease)

(How did it progress?)

1. In what two conditions do the sings progress slowly?

In what do the signs typically progress rapidly?

2. Does the disease wax and wane?

The clinical signs of what two typically do this?

Answer 14

1. hypothyroidism and Cushing’s disease

pemphigus foliaceus

2. dermatomyositis and pemphigus foliaceus

Question 15

(HIstory of the Disease)

(Was the Onset Sudden or Gradual?)

1. What typically develop rapidly?

Answer 15

1. pemphigus foliaceus and contact dermatitis