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FCP > 10. Dermatology > Flashcards

10. Dermatology Flashcards

1
Q

What 3 things make an ectoparasite ‘important’

A

Clinical importance
Zoonotic importance
Economic importance

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2
Q

Which 3 types of parasites are found on the skin surface of the host

A

Fleas
Lice
Surface mites

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3
Q

Name the main surface mites found on the following species: cattle, sheep and horse

A

Cattle: Chorioptes bovis, Psoroptes
Sheep: Psoroptes ovis, Chorioptes bovis
Horse: Chorioptes equi, Psoroptes spp, Neotrombicula spp (harvest mite)

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4
Q

Name the main surface mites found on the following species: dogs/cats and rabbits (3 for each)

A

Dogs/cats: Ootodectes (ears), Cheyletiella (fur mite), Neotrombicula (harvest mite)
Rabbits: Cheyletiella, Leporacus gibbus, Psoroptes cuniculi (painful!!)

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5
Q

What 2 types of parasites are found below the skin surface

A

Burrowing mites
Demodex

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6
Q

What burrowing mites are found on the following species: dog, guinea pig and birds

A

Dog: Sarcoptes scabei
Guinea pig: Trixacarus
Birds: Knemidocoptes

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7
Q

Which 3 animals are demodex most likely to affect

A

Dog, hamster and sometimes cats

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8
Q

what is the importance of ticks

A

Affect many species
Vectors of disease
heavy infestation can be debilitating
Tick granuloma if mouthparts are retained

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9
Q

What is the importance of cutaneous myiasis

A

Sheep and rabbits
‘Blowfly strike’ is potentially fatal
Larvae feed on host tissue - major welfare problem

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10
Q

What 3 parasites are unlikely to be detected on the host (live In the environment)

A

Midges e.g. Culicoides spp. => sweet itch and vectors of disease
Nuisance flies => irritants, transmit disease and skin disease
Dermanyssus gallinae (Poultry red mite) => zoonotic

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11
Q

Name 3 places where bacteria can come from to cause skin disease - and give examples

A

Present on normal skin => ‘endogenous infection” - Dermatophilus congolensis
From the environment - Mycobacteria from soil
From other animals - Treponema funiculi infection from rabbit

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12
Q

State 6 reasons why bacterial skin disease occurs

A
  1. Normal protective mechanisms of the skin are compromised
  2. Mechanical damage
  3. Immunocompromise
  4. Defects in skin barrier function
  5. Changes to the skin microclimate e.g. warm/moist
  6. Dysbiosis - imbalance of microbes of the skin
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13
Q

3 portals of entry for bacteria to cause skin disease

A

Via follicles
Direct entry through damaged skin
Haematogenous spread (rare)

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14
Q

Name 3 reasons why bacterial skin disease manifestation varies

A

Depth of infection
Type of inflammatory response
Lesion distribution and severity

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15
Q

Name 5 clinical manifestations of bacterial skin disease

A
  1. Surface pyoderma
  2. Superficial pyoderma
  3. Deep pyoderma
  4. Bacterial granulomatous dermatitis
  5. Skin lesions secondary to systemic bacterial infections or infections with toxin-producing bacteria
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16
Q

What is surface pyoderma and give 3 examples

A

When bacteria multiply on skin surface only
Example: canine intertrigo (skin fold pyoderma), acute moist dermatitis, bacterial overgrowth syndrome

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17
Q

What is superficial pyoderma and give 6 examples

A

Infection within the epidermis or hair follicles
1. Greasy pig disease - Staphylococcus hyicus
2. Bacterial folliculitis
3. Impetigo
4. Exfoliative superficial pyoderma
5. Dermatophilosis (rain scald)
6. Fleece rot (Pseudomonas in sheep)

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18
Q

What is deep pyoderma and give 3 examples

A

Infection outside epidermis or hair follicle epithelium due to furunculosis, penetrating wounds or sepsis
1. Furunculosis
2. Abscesses
3. Cellulitis

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19
Q

What is bacterial granulomatous dermatitis and give 2 types and causative agents

A

Mycobacterial (pyo)granulomas caused by traumatic implantation of saprotrophic organisms
1. Non-filamenous bacterial granulomas e.g. staph, strep and actinobacillus => lesions contain small yellow granules
2. Filamenous bacterial granulomas e.g. Actinomyces, Nocardia => lesions are nodular masses which may involve bone

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20
Q

3 common diagnostics tests to diagnose bacterial skin disease

A

Cytology
Culture
Histopathology with skin biopsy

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21
Q

3 broad principals of treating bacterial skin disease

A

Kill the organism
Enhance body’s defences
Address underlying cause

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22
Q

Should you use systemic antibiotics for bacterial skin disease

A

Avoid if possible
Use topical antibacterials when possible
Systemic antibiotics should only be used for deep infections

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23
Q

3 classifications of dermatophytes

A

Geophilic - adapted for the environment
Zoophilic - adapted for mammals
Anthropophillic - adapted for man

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24
Q

Stages of infection of dermatophytosis

A

Skin micro trauma and damage
Inoculation and germination of infective arthroscopes
Germ tube penetrate stratum corner
Growth of fungal hyphae
Lesions

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25
Q

Which 2 species of fungi most commonly cause dermatophytosis

A

Microsporum spp.
Trichophyton spp.

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26
Q

Clinical features of dermatophytosis

A

Zoonotic
Infection of hair/surface keratin
Folliculitis => alopecia
Variable pruritus
Adherent scale
Haired skin almost always affected
Lesions normally asymmetric

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27
Q

4 uncommon presentations of dermatophytosis

A
  1. Furunculosis
  2. Fungal kerion
  3. Pseudomycetoma
  4. Onychomycosis (claw disease)
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28
Q

5 methods of diagnosis of dermatophytosis

A
  1. Direct examination of hairs/scales
  2. Wood’s lamp
  3. Fungal culture
  4. Fungal PCR
  5. Skin biopsy => histopathology
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29
Q

Pathogenesis of Malassezia infection

A

Host factors - skin folds, other skin diseases, systemic disease leads to
Increased Malassezia numbers, decreased species diversity => Dysbiosis
OR
Shift towards a more pathogenic strain

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30
Q

Clinical presentation of a Malassezia infection

A

Pruritis
Erythema, grease, scale, crust
Malodourous
Ears - erythropoietin-ceruminous otitis - rarely purulent

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31
Q

Diagnosis of a Malassezia infection (3 steps)

A
  1. Identify appropriate lesions
  2. Identify Malassezia at these sites with cytology
  3. Assess response to anti-fungal therapy
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32
Q

Why viral skin diseases are so important

A

Many are NOTIFIABLE

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33
Q

General clinical signs of vesicular disease (type of viral skin disease)

A

Vesicles and erosions on non-haired skin mostly
Can lead to shed hooves and horns

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34
Q

Name 5 notifiable vesicular diseases

A
  1. Foot and Mouth
  2. Vesicular Stomatitis
  3. Swine vesicular disease
  4. Bluetongue virus
  5. Rinderpest
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35
Q

General characteristics of Papilloma viruses (viral skin disease)

A

Warts (papillomas)
Enter via micro abrasions
Rarely undergo malignant transformation => squamous cell carcinomas

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36
Q

Which papilloma virus affects cattle and how does it transmit

A

Bovine papilloma virus
Indirect transmission

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37
Q

Which 2 papilloma viruses affects horses and how does it transmit

A
  1. Bovine papilloma virus
  2. Equine papilloma virus
    Transmits via flies and tack
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38
Q

Which papilloma virus affects dogs

A

Canine papilloma virus

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39
Q

General feature of Pox viruses (viral skin disease)

A

Macules, papules, vesicles, pustules, crust

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40
Q

Name pox viruses affecting the following species: cow, cat, horse, pigs, sheep/goats, rabbits
Identify which ones are notifiable

A

Cattle: cowpox (rare) and lumpy skin disease (NOTIFIABLE)
Cats: cowpox
Horses: horsepox
Pigs: swinepox
Sheep/goats: sheep pox and goat pox (both NOTIFIABLE)
Rabbits: myxomatosis

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41
Q

Give 3 examples of parapoxviruses

A
  1. Contagious pustular dermatitis (Off)
  2. Pseudocowpox
  3. Bovine papular stomatitis
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42
Q

What type of virus causes Post-weaning Multisystemic Wasting Disease (PMWD)/ Porcine Dermatitis Nephropathy Syndrome (PDNS)

A

Circovirus
Differential diagnosis for classic and African swine fever (NOTIFIABLE)

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43
Q

what type of virus causes Psittacine beak and feather disease

A

Circovirus

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44
Q

What type of virus causes Boarder disease in sheep

A

Pestivirus

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45
Q

2 routes of diagnosis of a viral skin disease

A
  1. Detection of the actual virus/viral antigen/ nucleic acid
  2. Diagnostic serology - detection of antibodies to the virus
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46
Q

What type of disease is Leishmaniasis, what is it caused by and how is it spread

A

Protozoal skin disease
Caused by Leishmania spp.
Transmitted by blood-sucking sandflies
Zoonotic

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47
Q

Name 6 triggers for allergic skin disease

A
  1. Environmental allergens
  2. Food
  3. Ectoparasites
  4. Contact allergens
  5. Microorganisms
  6. Drugs
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48
Q

Which hypersensitivity is most commonly associated with allergic skin disease

A

Type 1
But others can be involved

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49
Q

Environmental atopic dermatitis - dogs
Which type of adaptive immune response is associated with chronic or acute lesions

A

Acute - lymphocytes follow TH2 pathway => IgE = Type 1 hypersensitivity
Chronic - more complex, TH1, TH2 and other T cell responses

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50
Q

Pathogenesis of environmental atopic dermatitis in dogs (2 ways)

A
  1. Aberrations in the skin barrier
  2. Dysregulation of microbiome
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51
Q

What 2 phases are required for a type 1 hypersensitivity reaction

A

Sensitisation phase
Provocation/re-exposure phase

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52
Q

Clinical features of environmental atopic dermatitis in dogs

A

Breed predisposition
age of onset - 6months-3 years
Highly heritable
Seasonal/non-seasonal
Relapsing pruritus
Responsive to glucocorticoids

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53
Q

Clinical signs of food-induced atopic dermatitis

A

Age of onset <1 year
Response to glucocorticoids variable
GI signs
Non seasonal

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54
Q

2 types of feline atopic syndrome

A

Feline atopic skin syndrome (FASS)
Feline food allergy (FFA)

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55
Q

What are the 4 cutaneous skin reaction patterns in cats

A
  1. Face, head, neck pruritus (FHN)
  2. Self induced alopecia (SIA)
  3. Miliary dermatitis (MD)
  4. Eosinophilic granuloma complex (EGC)
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56
Q

Equine atopic dermatitis - what type of allergen

A

Environmental
Often co-existing with insect bite hypersensitivity

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57
Q

3 types of ectoparasite allergies

A
  1. Flea allergic dermatitis
  2. Insect bite hypersensitivity - Culicoides spp, mosquitos
  3. Mite hypersensitivity - Psoroptes, Sarcoptes
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58
Q

What are the predominant hypersensitivity types in Cutaneous Immune-Mediated Diseases (CIMDs)

A

Type II - antibodies
Type III - immune-complex disease
Type IV - T cells

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59
Q

3 types of cutaneous immune-mediated disease affecting the epidermis

A
  1. Pemphigus foliaceus
  2. Facial cutaneous lupus erythematosus
  3. Vitiligo
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60
Q

Name the target, immune mechanism, presentation and main differential diagnosis for pemphigus foliaceus

A

Target = desmosomal proteins in the upper epidermis
Immune mechanism = antibody (Type II)
Presentation = pustules rapidly developing into crusts, leaving erosions
Main d/d = superficial pyoderma (pustle doesn’t form around a single follicle in pemphigus foliaceus)

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61
Q

Name the target, immune mechanism, presentation and main differential diagnosis for facial cutaneous lupus erythematosus

A

Target = epithelial cells
Immune mechanism = T cells (Type IV)
Presentation = damaged epithelium with ulceration and depigmentation due to bystanding melanocytes being affected
Main d/d - Mucocutaneous pyoderma and Epitheliotrophi lymphoma

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62
Q

Name the target, immune mechanism, presentation and main differential diagnosis for vitiligo

A

Target = melanocytes
Immune mechanism = Antibodies and T cells (type II and IV)
Presentation = removal of pigment from epithelium, minimal inflammation
Main d/d = any inflammatory disease causing depigmentation

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63
Q

What are the 5 dermal targets for Cutaneous Immune-Mediated Diseases

A
  1. Isthmus of the hair follicle
  2. Hair bulb
  3. Sebaceous glands
  4. Dermal blood vessels
  5. Anchoring fibrils
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64
Q

3 types of cutaneous immune-mediated disease affecting the dermis

A
  1. Sebaceous adenitis
  2. Vasculitis
  3. Panniculitis
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65
Q

Name the target, immune mechanism, presentation and main differential diagnosis for sebaceous adenitis

A

Target = sebaceous glands
Immune mechanism = T cells (Type IV)
Presentation = Gland is destroyed, broken hair, scale and alopecia
Main d/d = superficial pyoderma, dermatophytosis and other scaling diseases

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66
Q

Name the target, immune mechanism, presentation and main differential diagnosis for vasculitis

A

Target = dermal blood vessels
Immune mechanism = antibodies and antibody immune complexes (Type II and III)
Presentation = tissue death and hair loss in the area supplied by the blood vessel
Main d/d = causes of alopecia, tumours, trauma

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67
Q

Name the target, immune mechanism, presentation and main differential diagnosis for panniculitis

A

Target = subcuticular fat
Immune mechanism = unclear
Presentation = soft, fluctuating nodules that may rupture
Main d/d = Tumours, deep infections

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68
Q

What 4 conditions are sterile pyogranulomatous dermatitis and panniculitis (SPDP) seen with

A
  1. Pancreatic neoplasia
  2. Pancreatitis
  3. Polyarthritis
  4. Systemic lupus erythematosus
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69
Q

Apart from the skin, what other areas of the body can vasculitis affect

A

Kidneys, joints and eyes

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70
Q

How to accurately diagnose CIMDs

A

Exclusion of differential diagnoses
conformation of correct histopathological pattern

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71
Q

General approach to investigating cause of skin disease

A

Signalment
History
Differential diagnoses
Initial diagnostic tests
Diagnosis
Further investigations
Trial therapy

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72
Q

What aspects of signalment are important when investigating skin disease

A

Age - Immature, young, old
Sex - entire male/female
Breed - predispositions

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73
Q

Important things to ask about the history of patient when investigating skin disease

A

Any underlying systemic disease
Systemic disease which may affect diagnostic or treatment plans
Drug history

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74
Q

Important aspects of lifestyle/management when investigating skin disease

A

Housed/stabled
If not housed, nature of environment
Any recent introductions to the group of animals
Contact with other species
Do they hunt

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75
Q

Key questions to ask when obtaining a dermatological history

A

Details of in-contact animals and people
Past dermatological history
Onset of current problem - when, nature of lesion, area affected, pruritus, seasonality

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76
Q

What are the common tests and what are they used for in common dermatological conditions

A

Coat comb - surface parasites/fleas
Acetate tape strip unstained - surface parasites
Superficial skin scrape - surface parasites
Deep skin scrape - deep parasites
Trichogram - parasites of hair shaft, dermatophytes, hair abnormalities
Cytology - bacteria and yeast detection, cell type
Woods lamp - Microsporum canis
Swab for culture - yeast and bacteria

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77
Q

Why biopsy the skin

A

Establish a diagnosis that cannot be reached through less invasive testing
Rule out certain conditions

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78
Q

Best site to biopsy for alopecia

A

Across the margin of the alopecic area
Area of maximum hair loss
Normal haired skin

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79
Q

Best site to biopsy for ulcerated skin

A

Skin just adjacent to the ulcer where the epidermis is still intact

80
Q

Best site to biopsy for pustules, vesicles or bullae

A

Remove the whole lesion without disruption

81
Q

How to prepare the biopsy sample site

A

Avoid disturbing skin surface
Clip hair, not too short
Do not disturb crusts
Do not scrub the skin
If using local anaesthetic draw a circle around the lesion and infiltrate local into subcutis around edge of the circle

82
Q

What are the 2 types of biopsy

A

Punch biopsy
Wedge biopsy - excision or incisional

83
Q

how to handle biopsy sample for histopathology

A

10% formalin
Minimum 10x volume of the tissue sample
Is thin sample prevent curling by using stiff card

84
Q

Special consideration for bacterial and fungal tissue culture

A

DO NOT use formalin - use sterile saline
Withdraw antibiotics for 5-7 days, topical antimicrobials for 3 days before sampling

85
Q

How to label sample for the histopathologist

A

Give brief history
Suspect differential diagnoses

86
Q

Name the 8 dermatological patterns

A
  1. Perivascular dermatitis
  2. Interface dermatitis
  3. Vasculitis
  4. Nodular and or diffuse dermatitis
  5. Vesicular/pustular dermatitis - intra or subepidermal
  6. Folliculitis/furunculosis/adenitis
  7. Panniculitis
  8. Atrophic dermatosis
87
Q

Name the features of the perivascular dermatitis pattern and when is it seen

A

Prominent blood vessels
Leukocytes around vessels
Oedema of the dermis
Examples - Canine atopy, FAD, pyoderma

88
Q

Name the features of the interface dermatitis pattern and when is it seen

A

Band-like mononuclear infiltrate crossing dermo-epidermal junction (cell rich or poor)
Pigment incontinence
Hydronic degeneration of basal keratinocytes
+/- apoptosis
Example - immune mediate disease

89
Q

Name the features of the vasculitis pattern and when is it seen

A

Inflammation of blood vessels - degeneration of vascular walls with inflammatory cells around
May have micro haemorrhages
+/- panniculitis, dermal necrosis, atrophy of hair follicle
Example - primary or secondary to inflammation, infection, drug reactions, neoplasia or vaccination

90
Q

Name the features of the nodular/diffuse dermatitis pattern and when is it seen

A

Convergence of nodules leading to a diffuse pattern
Call type can vary - neutrophils (pyogenic), macrophages (foreign body/mycobacteria), neutrophils and macrophages (fungi), eosinophilic (parasite), lymphocytic (insect bite)

91
Q

Name the features of the Intraepidermal vesicular/pustule dermatitis pattern and when is it seen

A

Clefting in epidermis => vesicles/pustules
Due to epidermal inflammation, pacantholysis or intracellular oedema

92
Q

How can the intraepidermal vesicular/pustule dermatitis pattern be further classified

A

By position - sub corneal, suprabasilar, in follicular externall root sheath
By cellular infiltrate - neutrophils or eosinophils

93
Q

Name the features of the subepidermal vesicular/pustular dermatitis pattern and when is it seen

A

Separation of the epidermis from the dermis
Rare
Autoimmune
Thermal burns
Severe dermal oedema

94
Q

Name the features of the Folliculitis/furunculosis/adenitis pattern and when is it seen

A

Inflammation affecting different hair follicle structures
Folliculitis = inflamed hair follicle
Furunculosis = deep infection of the hair follicle leading to abscess formation with accumulation of pus and necrotic tissue
Sebaceous Adenitis = inflammation of sebaceous gland

95
Q

Name the features of the panniculitis pattern and when is it seen

A

Inflammation of the subcutaneous adipose tissue
Causes - infectious agent, foreign body, trauma, pancreatic disease, vasculitis
Can be sterile idiopathic

96
Q

Name the features of the atrophic dermatosis pattern and when is it seen

A

Atrophy of: epidermis, hair follicles, collagen and sebaceous glands
Various endocrine causes - HAC, hypothyroidism

97
Q

what are the 3 main causes of pruritus

A
  1. hypersensitivity
  2. parasites
  3. microbial infections
98
Q

What is the first step in investigating environmental/food-induced atopy

A

Exclusion diet trial for 6-8 weeks

99
Q

what order you you work in when a pruritic animals comes in

A

Make a ranked d/d list
Investigate parasites and microbial infections first
Then do a diet trial
Then consider environmental atopic dermatitis

100
Q

What kind of lesions are pustules and papules

A

Primary lesions

101
Q

What are the common causes of pustules and papules

A

Infections - superficial bacterial pyoderma/folliculitis most common
Ectoparasites
Hypersensitivities

102
Q

what type of lesion is scale

A

usually secondary lesion

103
Q

what type of lesion is crust

A

always secondary lesion

104
Q

What are the 2 main causes of scale

A

Hyperkeratosis
Increased or disrupted epidermal turnover

105
Q

What causes crust

A

When exudates dry on the skin surface

106
Q

What are the common bacterial causes of crust/scale

A

Pyoderma/folliculitis
Dermatophilosis

107
Q

What are the common fungal causes of crust/scale?

A

Dermatophytosis
Malassezia

108
Q

What are the common viral causes of crust/scale

A

Viral papillomas
Occult sarcoids

109
Q

Give 3 examples of surface mites which cause scale/crust

A

Chorioptes
Cheyletiella
Psoroptes

110
Q

Give 3 examples of burrowing mites which cause scale/crust

A

Sarcoptes
Trixacarus
Cnemidocoptes

111
Q

What is a primary keratinisation disorder

A

Defects in normal keratinisation process
e.g. abnormal formation of keratinocytes or abnormal sebaceous gland function

112
Q

Name 5 causes of swellings of non-dermatological origins

A
  1. hernias
  2. oedema
  3. bursitis
  4. emphysema
  5. mammary tumour
113
Q

What are the main 3 categories of skin masses

A

Inflammatory - infectious/non infectious
Cysts
Neoplasams

114
Q

Name 4 infectious causes of inflammatory skin masses

A
  1. Access/cellulitis
  2. Furunculosis
  3. Bacterial granulomas
  4. Deep/subcutaneous or systemic fungal granuloma
115
Q

Name 3 bacteria which can cause bacterial granulomas

A

Actinobacillus
Nocardia
Actinomyces

116
Q

Name 4 non infectious causes of inflammatory skin masses

A
  1. Urticaria, angioedema
  2. Seroma
  3. Haematoma
  4. Other e.g. tick/insect bite granuloma
117
Q

what can be the causes of urticaria

A

Allergic (type I or type III)
Non immunological cause

118
Q

What skin neoplasia is most common in horses

A

Melanomas - grey horses mostly

119
Q

What 3 neoplasias are most common in dogs

A

Lipomas
Sebaceous adenomas
Mast cell tumours

120
Q

what 4 main things are we looking for in a general clinical exam for an animal with skin masses

A

Pyrexia
Peripheral lymphadenopathy
Other systemic abnormalities
Non dermatological swelling

121
Q

What are the 3 methods for taking fine needle aspirate

A

Needle only with no suction
Continuous suction
Intermittent suction

122
Q

2 reasons to take a tissue biopsy

A

Histopathology
Tissue culture

123
Q

Define primary alopecia

A

Failure of hair to grow normally

124
Q

Define secondary alopecia

A

Hair grows normally but is subsequently lost/damaged

125
Q

Define true alopecia

A

Direct damage to hair follicle unit => loss of whole hair follicle unit

126
Q

Define apparent alopecia

A

Hair shaft is damaged but not lost from the hair follicle unit
Hair cropped short

127
Q

3 main mechanisms of primary alopecia

A

Lack of stimulation of anagen (growth) phase
Elongation of the telogen (resting) phase
Abnormal growth factors

128
Q

Name 4 main causes of alopecia

A

Congenital alopecia (rare)
Hair follicle inflammation (most common)
Hair cycle abnormalities
Hair morphological abnormalities

129
Q

Which species are ringworm most common in

A

Cattle, horses, cats and hedgehogs

130
Q

What are the common causes of alopecia in immature animals

A

Infections (demodicosis, dermatophytosis, superficial pyoderma)
Congenital alopecia

131
Q

What are the common causes of alopecia in middle-aged/older animals

A

Endocrinopathies
Neoplasia
demodicosis

132
Q

What conditions in entire females can cause alopecia

A

ovarian neoplasia

133
Q

What conditions in entire males can cause alopecia

A

Sertoli cell tumour => oestrogen production => hair loss

134
Q

When can alopecia be normal

A

Sphinx cats
Flank scent glands on hamsters
Normal coat shedding

135
Q

How to differentiate between true and apparent alopcia

A

Trichogram
can see the broken distal tips of the hair suggesting apparent alopecia

136
Q

Name 3 initial tests to narrow down differentials for alopecia

A

Skin scrape
Dermatophyte investigations - woods lamp, direct microscopy
Trichograms

137
Q

Name some further tests for alopecia

A

Cytology - pyoderma
Endocrine function tests
Skin biopsies

138
Q

Name the 4 aspects of multimodal therapy for atopic dermatitis

A
  1. control of inflammation and pruritus
  2. allergen avoidance and allergen-specific immunotherapy
  3. improving skin barrier
  4. control of the flare factors
139
Q

What are the 4 main classes of drugs used to control inflammation and pruritus

A
  1. Glucocorticoids
  2. Oclacitnib (apoquel)
  3. Lokivetmab (cytopoint)
  4. Cyclosporin
140
Q

What tests can be used to identify non dietary allergens

A

Intraderamal testing
IgE serology

141
Q

Give 3 things used to help improve the skin barrier

A

Moisturisers
Oral/topical essential fatty acids
Essential oils

142
Q

Name 3 methods to control flare factors of atopic dermatitis

A

Controlling microbial populations
Good ectoparasite control
Avoid overheating of the skin

143
Q

Name the 4 aspects of therapy for autoimmune disease

A

Induction
Titration
Maintenance
Monitoring

144
Q

Explain the process of the induction step in autoimmune therapy

A

Rapid control of lesions
Systemic treatment usually with glucocorticoids at immunosuppressive doses
Continue until most lesions healed and no new lesions for 2 weeks

145
Q

Which glucocorticoids are commonly used to treat autoimmune diseases

A

Prednisolone in dogs and cats
Dexamethasone or prednisolone In horses

146
Q

Describe the titration step in therapy of autoimmune disease

A

Tapering down the dose of glucocorticoids to lowest effective dose
Often need adjunctive treatments to keep lesions under control

147
Q

Name 6 adjunctive treatments used to help reduce dose of glucocorticoids

A

Azathioprine - not for cats!
Chlorambucil
Mycophenolate mofetil
Ciclosporin - esp for T-cell-mediated diseases
Oclacitinib – emergent information
Gold salts - rare use

148
Q

Describe the maintenance step in autoimmune therapy

A

Reduce prednisolone to alternate-day therapy if possible
Aim for maintenance of remission without harmful side effects of medication

149
Q

Describe the monitoring step of autoimmune therapy

A

Reexamining and monitoring for lesion control and any side effects of drugs

150
Q

When would you use topical glucocorticoids for autoimmune disease

A

local lesions

151
Q

What are the 6 main aims of dermatologic therapy

A
  1. Kill/repel parasites
  2. control/kill microbial infections
  3. control inflammation/pruritis
  4. Moisturise/ improve skin barrier function
  5. Resolve scale
  6. treat otitis externa
152
Q

What 3 agents are used to moisturise/improve the skin barrier

A
  1. emollients
  2. moisturisers
  3. agents to improve skin barrier function e.g. essential fatty acids
153
Q

What is the proper name for agents used to control scale

A

Antiseborrhoeic agents

154
Q

Name 2 forms of antiseborrhoeic agents (controlling scale)

A

Keratolytic
Keratoplastic

155
Q

what do keratoplastic agents do

A

restore normal epidermal epithelialisation and keratinisation

156
Q

what to keratolytic agents do

A

break down keratin

157
Q

Give 3 examples of keratolytic/keratoplastic agents

A
  1. sulphur
  2. salicylic acid
  3. ammonium lactate
158
Q

What are the 2 main groups of drugs used to treat otitis externa

A

Polypharmacy ear drops/creams (POM-V)
Ear cleaners (non POM-V)

159
Q

What criteria is used to select which POM-V ear drop is required for otitis externa

A

Organism present
Level of inflammatory activity required
Potential for ototoxicity if tympanic membrane is ruptured
Nature of exudate in the ear
Frequency of application required

160
Q

give the common glucocorticoids used in ear cleaners in order from low to highest potency

A

Hydrocortisone
Prednisolone dexamethasone/ betamethasone/ hydrocortisone aceponate
Mometasone

161
Q

what active ingredients are ototoxic if the tympanic membrane is ruptured

A

Gentamycin
Polymixin - B

162
Q

which drug is inactivated if there is pus in the ear

A

Polymixin B

163
Q

What agents may non POM-V ear cleaners contain

A

Cerumenolytics
Surfactants
Astringents
Antimicrobials

164
Q

Give examples of cerumenolytics

A

squalene
propylene glycol
glycerine
mineral oils

165
Q

Name some positives of topical therapy

A

less concerns about side efects
Direct delivery of the drug
Can achieve higher concentrations of the drug
can target the therapy to the site

166
Q

Name some disadvantages of topical therapy

A

Labour intensive
some animals won’t tolerate
Possible toxicity/loss of efficacy if the drug is licked off

167
Q

For bites and traumatic wounds, if systemically well and not pyrexic, what is the antimicrobial protocol

A

Topical treatment with 2-4% chlorhexidine

168
Q

For bites and traumatic wounds, if systemically unwell and pyrexic, what is the antimicrobial protocol

A

systemic antibacterial based on cytology

169
Q

What antibacterials would you use for cocci

A

Clindamycin
Cefalexin
Amoxicillin/clavanulate
Trimethoprim/sulphonamide

170
Q

what antimicrobials do you use for rods

A

fluoroquinolone

171
Q

What topical treatments do you use for surface pyoderma

A

2-4% chlorhexidine
Fusidic acid +/- glucocorticoids
Silvers sulphadiazine (if rods present)

172
Q

what antimicrobials do you use for cocci in otitis externa

A

Florfenicol
Fusidic acid/framycetin
Polymixin B/miconazole

173
Q

what antimicrobials do you use for rods in otitis externa

A

Framycetin
Gentamicin
Polymixin B

174
Q

in horses, what is the antimicrobial protocol for superficial bacterial skin infections

A

Topical antibiotics
Correct underlying cause

175
Q

In horses, what is the antimicrobial protocol for deep pyoderma/cellulitis

A

Systemic antibiotics

176
Q

Which is the first line antibiotic for cellulitis in horses and what are the alternatives

A

First = doxycycline
Alternatives = Penicillin and gentamicin

177
Q

Which is the first line antibiotic for pyoderma in horses and what are the alternatives

A

First = trimethoprim and sulphadiazine (TMPS)
Alternatives = doxycycline

178
Q

Name 3 systemic antibiotics that can be used in farm animals for potential bacterial infections

A

Penicillin, cephalosporins, oxytetracycline

179
Q

What is the treatment protocol for abscesses in all species apart from rabbits

A

Avoid antibiotics
Once mature => lance, drain and flush
Give antibiotics if systemically unwell

180
Q

What is the treatment protocol for abscesses in rabbits

A

Pus is caseous so can’t lance and drain
Surgical management required

181
Q

Stages of treatment for dermatophytosis

A

Identify fungus
Remove infective fungal spores from coat and reduce environmental contamination
+/- systemic therapy
Clean the environment as much as possible
Monitor response to therapy

182
Q

Name 2 main topical anti fungal rinses

A

Miconazole
Enilconazole

183
Q

Name 2 main systemic antifungals

A

Itraconazole
Ketoconazole - NEVER in cats

184
Q

What are the issues with itraconazole and ketoconozole

A

GI upset
Hepatotoxicity

185
Q

What is the treatment protocol for malassezia infections

A

Topical antifungals - mainstay of treatment
Systemic is sometimes required but not licensed

186
Q

what 3 things need to be done in pre hibernation for a tortoise

A

Starve 3-4 weeks
Bathe daily in warm water
reduce temperatures

187
Q

3 things to monitor during hibernation to know if something is wrong

A

Defaecation
Urination
Weight

188
Q

What 2 diseases are most common in tortoises

A

Herpes disease
Mycoplasma

189
Q

what temp should it be to hibernate a tortoise

A

3-7 degrees

190
Q

name 3 pro kinetics for rabbit gut stasis

A

Cisapride
Ranitidine
Metaclopramide

191
Q

what 2 vaccines do you use in rabbits

A

Myxomatosis
RHD 1 and 2

192
Q

What vaccines are needed for ferrets

A

Canine distemper
Rabies if going out of the country

193
Q

Name 3 main reasons for lethargy in ferrets

A

Insulinoma
Lymphoma
Heart disease

194
Q

name 4 differentials for hair loss in ferrets

A

Normal moulting
persistent oestrus
hyperadrenocorticism
malnutrition

195
Q

what is the ferret breeding season

A

march to September

FCP (8 decks)

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