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Diseases and Diagnosis > Block 5+6 > Flashcards

Block 5+6 Flashcards

1
Q

What is the most common ectoparasite of dogs and cats?

A

Ctenocephalides felis felis (cat flea)
Ctenocephalides Canis (dog flea)

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2
Q

Where does the adult ctenocephalides live?
Other stages?

A

Adult: Entire life on the host
Other: environment

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3
Q
A
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4
Q

How long does it take for the flea egg to hatch?

A

1-10 days

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5
Q

What is the lifespan of an adult flea?

A

100 days

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5
Q

What is the only life stage that is not susceptible to flea treatment?

A

Pupa (can wait up to 140 days for a stimulus before it emerges)

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6
Q

What type of hypersensitivity reaction is FAD?

A

Type 1 = immediate IgE hypersensitivity (Type IV less common

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7
Q

When are most FAD developed?

A

At 1-5 years (uncommon prior to 6m)

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8
Q

What is FAD primary lesion?

A

papules

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9
Q

What is the dermagram for FAD?

A

“Pants region”

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10
Q

What are hot spots?

A

Pyotraumatic dermatitis

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11
Q

What are the top 3 pruritic skin diseases in dogs?

A

Sarcoptic mange, FAD, CAFR

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12
Q

What are the 3 thing that make up eosinophilic granuloma complex?

A

Eosiniphilic plaques
Indolent ulcer
Linear granuloma

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13
Q

What must be in the flea treatment to see an immediate response to therapy?

A

adulticide

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14
Q

What are the 3 canine demodex?

A

Demodex canis (medium)
Demodex cornei (small)
Demodex injai (long)

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15
Q

What is the likely cause of disease caused by demodex?

A

Immunocompetence (normal resident on skin)

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16
Q

What are the 2 forms of demodex infection?

A

Localized and Generalized

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17
Q

What are teh 2 forms of generalized demodex?

A

Juvenile (>12m)
Adult (>18m) likely has compromised immune system

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18
Q

Which type of demodex do you treat?

A

Generalized!!

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19
Q

In general, demodex in dogs is not pruritic but a secondary infection could cause pruritus

A
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20
Q

How long should demodex take to resolve?

A

4-8 weeks

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21
Q

What should be considered in anaimals that have generalized demodicosis?

A

It is heritable so spay/neuter

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22
Q

What are the 4 types of generalized demodicosis?

A

Squamous: scaly, alopecia
Dorsal scaly skin
Pustular (red mange): may be life threatening, Gram - deep infection
Pododemodicosis: Difficult to treat, just the paws

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23
Q

What are the 3 types of feline demodex

A

D. cati (long)
D gatoi (stubby)
D. felis (medium)

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24
Q

What is special about D. gatoi?

A

It is pruritic AND contagious

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25
Q

How do you diagnose demodicosis?

A

Deep skin scrape or trichogram

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26
Q

what is a pyoderma?

A

A skin infection that includes pus technically

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27
Q

What predisposes an animal to a pyoderma?

A

Something alters the normal cutaneous defense mechanism

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28
Q

In general, what is a predisposing factor to pyodermas?

A

Anything that compromises the immune system

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29
Q

What is the most common agent with pyodermas?

A

Staphylococcus pseudintermedius

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30
Q

Other than penecillins, what is s. pseudintermedius usually resistant to?

A

Streptomycin and tetracycline

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31
Q

What does s. pseudintermedius produce?

A

beta lactamase (can’t use penecillins)

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32
Q

What is the most frequent type of pyoderma in dogs?

A

Invasion of the epidermis and follicular ostium “bacterial folliculitis”

pustule, bacteria getting into the hair follicle space

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32
Q

What are surface pyodermas?
Infection confined to the intefollicular epidermis

A

Hot spots

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33
Q

What will deep pyodermas have?

A

Draining tracts

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34
Q

What are 3 parts to the diagnosis of pyoderma?

A

Recognition of skin lesion
Bacterial identification - skin cytology
**identify underlying primary disease (most important)

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35
Q

What has the job of organ of protection?

A

Stratum corneum (outer most part of epidermis)

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36
Q

What is filaggrin?

A

Protein that plays a role in maintaining skin barrier function

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37
Q

What happens with atopic dermatitis?

A

Loss of function mutation with filaggrin

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38
Q

What is first line of defense for topical barrier rehydration?

A

Shampoos

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39
Q

What is downside to conditioners?

A

usually left on after showers

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40
Q

What is the best treatment for ears?

A

Creams and ointments

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41
Q

What is seborrhea sicca?

A

Dry skin (dandruff)

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42
Q

What is seborrhea oleosa?

A

Greasy skin

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43
Q

What is her favorite cream?

A

Bio-Groom Super Cream Conditioner

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44
Q

What do ceramides do?

A

Repel transepidermal water loss
Repel irritants

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44
Q

What does sulfer do?

A

 Keratolytic & Keratoplastic
Not a good degreaser

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45
Q

What is the chronic form of pruritus?

A

Lichenification

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46
Q

What are 3 things in cat pruritus not seen in dogs

A

Non-inflammatory alopecia
Miliary dermatitis
Eosinophilic granuloma complex

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47
Q

What is specifically concerning about scabies?

A

Zoonotic

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48
Q

What is specifically rare in cats?

A

Infectious etiologies (yeast or bacteria)

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49
Q

What should you put every cat on no matter what?

A

Flea prevention

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50
Q

***What is AD/FASS considered?

A

A diagnosis of exclusion

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51
Q

Is there a connection between a recent diet change and a CAFR?

A

No

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52
Q

What are the 4 cutaneous reaction patterns in cats?

A

Feline symmetric alopecia
Head and neck generalized pruritus
Miliary dermatitis
Eosinophilic granoloma complex

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53
Q

Do hair and saliva tests work for CAFR?

A

N

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54
Q

Do serum or skin allergy tests work for CAFR?

A

No

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55
Q

What are teh 2 general choices when it comes to selecting a diet for CAFR diet trial?

A

Novel ingredient
Hydrolyzed protein

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56
Q

How do a hydrolyzed diet work?

A

Proteins are broken down into amino acids so small that they are too small to cross bind with IgE (Type I) on mast cell

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57
Q

How should a hydrolyzed diet be picked for cats?

A

Send the patient home with all hydrolyzed options and let them pick the one that they like the best

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58
Q

How long should a food trial be tried?

A

8-12 weeks

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59
Q

What is the average time to flare with rechallenge?

A

7 days

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60
Q

What cells migrate to skin in atopic dermatitis pathogenesis?

A

Th2 cells

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61
Q

When does AD usually set in?

A

Younger dogs (6m to 3 years)

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62
Q

Is there a primary lesion for atopic dermatitis?

A

No

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63
Q

What is the most outstanding feature?

A

Pruritus

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64
Q

Is there seasonality with atopic dermatitis?

A

Yes

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65
Q

What is the average onset of Feline atopic skin syndrome?

A

young (6m to 12m)

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66
Q

Is feline atopic skin syndrome seasonal??

A

No

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67
Q

What are the 3 P’s of ALD (Acral Lick Dermatitis)

A

Primary (boredom/stress), predisposition (change in habitat), perpetuating factor (bacterial infection)

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68
Q

What are the 3 pruritic feline dermatoses?

A

Allergic
Parasitic
Infectious

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69
Q

Is miliary dermatitis a disesae?

A

No

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70
Q

What are the 2 types of feline symmetric alopecia?

A

Self-induced and non-self-induced

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71
Q

How do you tell if it is self induced or not?

A

Trichogram!

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72
Q

What are the 4 off label treatments for demodicosis?

A

Fluralaner
Sarolaner
Afoxolaner
Lotilaner

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72
Q

What is the time frame for spontaneous resolution of demodex in 90% of cases?

A

4-8 weeks

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73
Q

What coul dbe a cause of non-self-induced alopecia?

A

Endocrine
-Hyperthyroidism
- D. mellitus
- hyperadrenocorticism (Cat cushing)
Paraneopastic
-biliary carcinoma

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74
Q

What are the 4 clinical presentations of demodicosis?

A

Squamous, greasy, pustular, pododemodicosis

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74
Q

What do you change with different species of demodex?

A

Nothing, all treated the same

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75
Q

What are the 3 methods of diagnosis for demodicosis?

A

Deep or superficial skin scrape
Hair pluck
Biopsy
(Generalized >5 spots, local <5 spots)

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76
Q

What should you never use for treatment of demodicosis?

A

Steroids!

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77
Q

What is the reason for no longer using high-dose ivermectin?

A

MDR1 mutation

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78
Q

What is the best treatment for demodicosis then?

A

One of the “laners” but it is extra label

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79
Q

Where is feline demodicosis localized?

A

Chin and periorbital area

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80
Q

What does feline democidosis look like?

A

Feline acne

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81
Q

What is most important part of treating acute moist dermatitis (hot spots)?

A

Treating the underlying cuase

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81
Q

What is important about demodex gatoi?

A

Pruritc and contagious

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82
Q

How do you treat demodex cati?

A

2% lime sulfur
Bravecto (Fluralaner) / revolution plus

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83
Q

How do you treat demodex gatoi?

A

Same way but need to treat all cats that were in contact

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84
Q

What is the etiology of acute moist dermatitis?

A

Self inflicted

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85
Q

What is another name for acute moist dermatitis?

A

Hot spots

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86
Q

What are the 3 forms of localized deep pyoderma?

A

Interdigital furunculosis
Canine acne
Deep hot spot

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87
Q

What are cytology characteristics of chin acne?

A

Pyogranulomatous with eosinophils

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88
Q

What is intertrigo pyodermo?

A

Pyoderma related to lesions within skin folds

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89
Q

What breeds are most affected by fascial fold pyodermas?

A

Brachycephalic breeds

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89
Q

What is treatment for skin fold pyoderms?

A

Clip hair, treat infection and inflammation, wipes (Douxo - chlorhex), TrizChlor 4 (TrizEDTA/Chlorhex), Ointments/Lotion (Mupirocin - antibacterial, mometamax - mometasone, tresaderm - dexamethasone)

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90
Q

What are teh 4 types of intertrigo pyoderma?

A

Fascial fold
Lip fold
Vulvar fold
Tail fold

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91
Q

What is the hard-to-diagnose deep pyoderma in between digits?

A

interdigital furunculosis

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92
Q

What is furunculosis?

A

Rupture of a hair follicle

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93
Q

What is teh treatment for acute moist dermatitis?

A

Clip and remove matted hair
Clean with chlorhexidine
Mild: Topical steroid
Severe: Systemic steroid

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94
Q

What defines a deep pyoderma?

A

Infection affects tissue deeper than the hair follicle

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95
Q

What lip is most commonly affected in lip fold pyoderma?

A

Lower lips

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96
Q

What must you rule out with deep hot spots?

A

Fungal infections

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97
Q

What is most likely seen on acute moist dermatitis’ cytology?

A

Cocci and degenerate neutrophils

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98
Q

How do you differentiate beween deep hot spots and normal hot spots?

A

Deep hot spots will form hot spots when squeezed

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99
Q

How are deep hot spots treated differently from superficial moist dermatitis?

A

Systemic antibiotics are used based on culture results
Steroids are used to reduce self trauma

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100
Q

What do insect growth regulators not cover?

A

Not adulticidal

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101
Q

What does environmental flea control cover?

A

Larvicidial and ovicidal

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102
Q

What flea adulticide is toxic to cats?

A

***Synthetic pyrethroids
Ones that end in “thren”

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103
Q

What does IGR stand for?

A

insect growth regulator

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104
Q

What is the most common cause of superfiical pyoderma in dogs?

A

Staphylococcus pseudintermedius

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105
Q

Is S. pseudointermedius + or -

A

+

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106
Q

What other Staph can cause pyoderma?

A

S. schleiferi and S. aureus

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107
Q

What is the most important factors leading to the emergence of antimicrobial-resistance

A

use and misuse of antimicrobial therapy

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108
Q

What is the most common inappropriate use of antibiotics?

A

Inappropriate duration

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109
Q

What does MRS stand for?

A

Methicillin-resistant staphylococcus

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110
Q

What are MRS bacteria resistant to?

A

all beta lactam antimicrobials (cephalosporins +penicillins) and carbapenems

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110
Q

Should all patients with open wounds, abscesses or draining lesions be treated as if that have MRS?

A

Yes!

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110
Q

What is the definition of MDR drugs?

A

Bacteria that are resistant to at least 3 antimicrobial classes

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111
Q

What does MDR stand for?

A

Multi-drug resistant bacteria

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112
Q

What are most S pseudintermedius resistant to beside penecillins?

A

Tetracyclines
Streptomycins

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113
Q

What is a good empirical treatment of uncomplicated superficial pyodermas?

A

Cephalexin (1st gen)

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114
Q

How long should superficial pyodermas be treated?

A

7-10 days past clinical cure

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115
Q

How long should deep pyodermas be treated?

A

14-20 days past clinical cure

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116
Q

What is the most commojn cause of treatment failure?

A

Insufficient course of treatment

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117
Q

What is a bacterin commonly used?

A

Staphage lysate

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118
Q

What are 3 ways that you can get a cytology for mallasezia?

A

Cotton swab, superficial scrapings, acetate tape impressions

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119
Q

Which method identifies malassezia the most?

A

Acetate tape

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120
Q

What is a good topical option?

A

Miconazole 2% with 2% chlorhexidine shampoo

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120
Q

What is the best treatment of yeast?

A

Topical

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121
Q

What are 2 good systemic options?

A

Ketoconazole for 3 wks
Itraconazole for weeks

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122
Q

What are side effects of ketoconazole systemic use?

A

Hepatitis
Adrenal suppression

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123
Q

What species is very sensitive to side effects of ketoconazole?

A

Cats

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124
Q

Does ketoconazole or itraconazole have more side effects?

A

Keto has more! itra has less:)

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125
Q

How often are rechecks for yeast infections?

A

3-4 weeks

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126
Q

What is a non-azole effective against yeast?

A

Terbinafine

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127
Q

Is malassezia zoonotic?

A

YES!

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128
Q

What are the 3 phases of hair growth?

A

Anagen - active
Catagen - transition phase
Telogen - resting phase

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129
Q

What are hormones that affect hair cycle?

A

Thyroidal, gonadal, adrenal, pituitary, and pineal

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130
Q

What are 3 non-inflammatory follicular dysplacia alopecias?

A

Color dilution alopecia
Black hair follicular dysplasia
Seasonal flank alopecia

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131
Q

What are 4 non-inflammatory endocrine dermatopathie alopecias?

A

Sertoli cell tumors
hypothyroidism
Cushings
Alopecia X

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131
Q

What breed usually gets alopecia X?

A

Pomeranians

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132
Q

What breed usually gets pattern baldness?

A

Dachshunds

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133
Q

What is pathogenesis of post-clipping alopecia?

A

Not understood (hair cycle arrest)

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134
Q

What is color dilution alopecia?

A

Abnormality in melanin transfer and storage

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135
Q

What does trichosis mean?

A

A heavy growth of hair

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136
Q

What is a leucoderma and what skin condition can get it?

A

Loss of skin pigementation (white)
color dilution alopecia

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137
Q

What lesions are often seen with Cushings?

A

Comedones

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138
Q

What is seen with syndrome 4?

A

50% of cases show follicular dysplasia

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139
Q

What is treatment for hypothyrodiism?

A

Levothyroxine

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140
Q

What is a common sequela of hypothyroidism?

A

Secondary infection due to breakdown of epidermis resulting in recurrent pyoderma and otitis externa

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141
Q

What is the best way to manage sertoli cell tumors?

A

Castration

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142
Q

What is seen on trichogram for color dilution alopecia?

A

Hairs with large melanin clumps

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142
Q

What is atypical hyperadrenocortisism?

A

More hormones are secreted like estradiol

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142
Q

What is seen on histopath for color dilution alopecia?

A

Follicles are misshapen and melanin clumping is seen in lower segments

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142
Q

What is teh most sensitive test for hypothyroidism?

A

T4 and fT4

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142
Q

What is treatment for alopecia X?

A

Melatonin + Trilostan + microneedling + laser therapy

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142
Q

What percent of HAC are pituiatry dependent?

A

80-85% (most)

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142
Q

What is the most common endocrine disease in dogs?

A

Hypothyroidism (primary)

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142
Q

What is the first sign of alopecia X?

A

Loss of secondary hairs causing a puppy-like coat

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142
Q

What is seen with sydrome 3?

A

Strucutral defect of the hair shaft

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142
Q

What is seen on bloodwork for 75% of hypothyroidism cases?

A

Hypercholesterolemia

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143
Q

What can be used if there is metastasis?

A

Cisplatin

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143
Q

What can you use in combination with T4 and fT4 to increase sensitivity?

A

TSH (by itself, not sensitive)

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144
Q

What is calcinosis cutis?

A

a condition characterized by the deposition of calcium salts in the skin and subcutaneous tissues

145
Q

Where does the alopecia usually first appear?

A

In areas of friction like the collar

146
Q

When does seasonal flank alopecia usually occur?

A

Late fall, early spring

147
Q

What are 2 decent screening tests for Cushings

A

LDDS
Creatinine:cortisol ratio

148
Q

What is a common characteristic of hypothyroid alopecia?

A

Rat tail and myxedema

149
Q

What percent of cryptorchid dogs get sertoli cell tumors?

150
Q

What is Black hair follicular dysplasia?

A

All black hairs are lost until there arent any left

151
Q

What usually causes the excess cortisol secretion?

A

Pituitary microadenomas
(macroadenomas cause neuro signs)

152
Q

What parts of the body are usually spared from alopecia X?

A

Head and distal legs

153
Q

When should you recheck hypothyroid doseage and response?

154
Q

What is treatment for black hair follicular dysplasia?

155
Q

What do pituitary adenomas caused?

A

Increased ACTH secretion causing more cortisol

156
Q

What is the definition of hyperadrenocroticim?

A

Excess cortisol production

157
Q

What are 4 syndromes of pattern baldness?

A

1 - pinnae, ventral neck, ventrum, caudomedial thighs
2 - Hyperpigmentation of pinnae
3- Bald thigh sydrome of sighthounds
4- American water spenial alopecia (neck, trunk, caudal thigh)

158
Q

What do you need to know about sighthounds and T4?

A

Their range is lower than other dogs

159
Q

What percent of thyroid gland must be destroyed beofre clinical signs develop?

160
Q

What is the mean age of hypothyroid diagnosis?

161
Q

What is hyperkeratosis?

A

a condition characterized by an excessive thickening of the outermost layer of the skin, known as the stratum corneum

162
Q

What is treatment for hypothyroidism?

A

Levothyroxine

163
Q

What is seen on histopath for seasonal flank alopecia?

A

Finger-like projections into the dermis

164
Q

What test do you perform if you suspect iatrogenic disease?

165
Q

UC:CR has a low ot high specificity?

166
Q

What will be seen during an ACTH stim for it is iatrogenic cause?

A

Minimal to no increase in cortisol levels

167
Q

What is the treatment for AT cushings?

A

Mitotane, trilostaine, surgery

168
Q

What is the treatment for PDH Cushings?

A

Mitotane, trilostane, surgery, radiation

169
Q

What is canine scabies?

A

Sarcoptes scabiei canis

170
Q

What is feline scabies?

A

Notoedres cati

171
Q

What is walking dandruff?

A

Cheyltiella

172
Q

what do posterior legs of sarcopted canis look like?

A

2 pairs, do not extend beyond border of its body

173
Q

Does scabies respond to steroids?

174
Q

What are the predilection sites for scabies?

A

Pinna, hock, elbow, ventrum

175
Q

What are the most common lesions of scabies?

176
Q

What is a unique was to diagnose scabies?

A

Pinnal-Pedal reflex

177
Q

What is treatment for scabies?

A

Advantage Multi
Moxidectin + Imidacloprid

178
Q

Is cat mange zoonotic?

178
Q

What is life cycle length of cat mange?

A

17-21 days

179
Q

What is something charateristic of cats infested with mange?

A

The notoedric hemit

179
Q

How do you treat cat mange?

A

NO FDA approved treatment!
Lotilaner
flurilaner
sarolaner
selamectin
sulfur dip

180
Q

How long is cheyletiella life cycle?

A

21-42 days

181
Q

How many life phases are there?

182
Q

Where is pruritus usually localized?

183
Q

What is easiest diagnosis in cats?

A

Fecal float

184
Q

How long do oyu have to treat cheyletiellosis after resolution of signs?

185
Q

Does cheyletiella live longer off host than other mites? What does this mean?

A

Yes, need to treat environment!

186
Q

How long are spores off host viable?

187
Q

What are 3 phases of ring worm development

A
  1. Adherence to skin cells (hours)
  2. Penetrate stratum corneum (days)
  3. Invasion of dermatophyte (weeks)
187
Q

What is most common type of ringworm in dogs? cats?

A

M. canis. M. canis (both!)

188
Q

What is most common type of ringworm?

A

Microsporum canis

189
Q

What is a nodular dermtophytosis?

A

Kerion (dome-shaped exudative nodule)

190
Q

What cats get pseudomycetoma?

A

Persian cats

191
Q

What is treatment for pseudomycetoma?

A

Systemic therapy +/- surgical excision

192
Q

What are 3 differential diagnoses for dermatophytosis?

A

Demodicosis
Staph folliculitis
Pemphigus complex

193
Q

What is diagnosis for ring worm?

A

Wood’s lamp
Trichogram
Fungal culture
Histopath
PCR

194
Q

What color is woods lamps?

A

Apple green

195
Q

What percent of M canis fluoresce?

195
Q

What is best recommendation for daignosis?

A

Fungal culture

196
Q

What should you do if hairs fluoresce under the wood’s lamp?

A

Fungal culture

197
Q

When do you do a biopsy?

A

Kerion or pseudomycetoma

198
Q

What do you treat with in every ring worm infection?

A

Sytemic therapy until 2 negative fungal cultures

199
Q

What are the 3 treatments for ring worm systemically?

A

Ketoconazole (NOT in cats!!!)
Itraconazole
Terbinafine

200
Q

How long do you treat for?

A

Until 2 negative fungal cultures

201
Q

What is the age of juvenile cellulitis?

A

3wks to 4months

202
Q

How do you treat juvenile cellulitis?

A

Prednison
Cyclosporine to achieve remission
Abx for secondary infection

203
Q

What gram + cause paronychia?

A

Staph and strep

204
Q

What Gram - cause paronychia?

A

E. Coli, proteus, pseudomonas

205
Q

What is treatment for paronychia?

A

Wipes with chlorhexidine or antifungal

206
Q

What is dermatophytosis of the nail bed called?

A

Onychomycosis

207
Q

If you see multiple affected paws, what should you do?

A

Take radiogrpahs of lungs

208
Q

What is this called?

A

Lung-digit syndrome

209
Q

What cancer likely is causing this?

A

Bronchial adenocarcinoma

210
Q

How do you treat SLO?

A

Empiral treatment. Mostly with steroids or cyclosprorine

211
Q

How do you treat SND?

A

IV amino acid infusion
High protein diet
Zinc supplementation
Eventually euthanasia

212
Q

How do you treat anal sac impaction?

A

Frequent expression

213
Q

How do you treat anal sac infection?

A

Topical therapy (Mometamax, otomax)

214
Q

What are the 3 main mechanisms suggested to explain development of autoimmunity?

A

Molecular mimicry
Epitope spreading
bystander activation

215
Q

What disease is bystander activated?

A

Systemic Lupus Erythematosus (SLE)

216
Q

What are the 2 most common autoimmune skin diseases in dogs and cats?

A

Pemphigus and Lupus

217
Q

What are the 3 types of pemphigus?

A

P. foliaceus
P. erythematosus
P. vulgaris

218
Q

What causes pemphigus?

A

Autoantibodies against demoscollins
Desmocollins form part of the desmosome

219
Q

When else are acnothocytes seen?

A

In dermatophytosis caused by trichophyton mentagrophytes

220
Q

What are acanthocytes?

A

Detached keratinocytes

221
Q

What are teh 4 distribution areas of PF?

A

Dorsal muzzle
Pinnae
Pawpads
Paronychia (in cats around pawpad)

222
Q

Why is it important to rule out infectious causes first?

A

Treatment will be immunosuppressive so don’t want to limit healing ability

223
Q

What is uniquely targest in pemphigus vulgaris?

A

Oral cavity and other mucocutaneous jxns

224
Q

What exacerbates DLE?

225
Q

Cobblestone is classic appearnce of lupus

A

Animal is usually otherwise healthy with lupus

226
Q

What is treatment for lupus?

A

Sunscreen
Topical steroid
Tacrolimus
Vitamin E

227
Q

What are 2 pig side effects for pred?

A

Iatrogenic cushings
Diabetes mellitus

228
Q

What is contraindicated in cats?

A

Azathioprine!!

229
Q

What is use of azathioprine?

A

Can be used as steroid sparing agent or as a sole therapy

230
Q

What is main side effect of cyclosporine?

231
Q

What diseases can tacrolimus be used as the sole therapy for topcially?

A

DLE and PE

232
Q

What are the treatment options for autoimmune skin diseases?

A

Pred
Dexamethasone
Tacrolimus
Mycophenolate mofetil
Cyclosporine
Azathioprine
Vitamin E
Chlorambucil
Triamcinolone
Sunscreens

233
Q

What are 3 common diseases difficult to control that may result in mortality (QOL euthanasia maybe)?

A

Atopic dermatitis
Canine generalized demodicosis
Otitis externa/media

234
Q

What 3 neoplasias is paraneoplastic alopecia associated with?

A

Pancreatic adenocarcinoma
Bile duct carcinoma
Hepatocellular carcinoma

235
Q

What are the 5 most common drugs to cause cutaenous reactions?

A

Sulfonamides
Penicillins
Cephalosporins
Levamisole
Dietyl carbamazine

236
Q

What are teh 3 manifestations of cutaneous adverse drug reactions?

A

Erythema multiforme
Toxic epidermal necrolisis
Cutaneous vasculitis

237
Q

What is the most common type of reaction?

A

Erythema multiforme (59%)

238
Q

What is diagnosis of toxic epidermal necrolysis?

A

Nikolsky sign (skin slough)

239
Q

How do you treat toxic epidermal necrolysis?

A

Fluid therapy
Wound management
Immunosuppressive drugs

240
Q

How do you treat cutaneous vasculitis?

A

Pentoxifylline***
Immunosuppression
Doxycycline niacinamide

241
Q

What are the 3 P’s of otitis?

A

Predisposing factor
Primary cause
Perpetuating

242
Q

What are common causes of otitis externa predisposition?

A

Stenotic ear canals
Hair in ear canal
Pendulous pinnae

243
Q

What is the most common parasite to cause ear infections?

A

Otodectes cynotis

244
Q

What is the most common cause of otitis externa in dogs?

245
Q

What is #1 cause of ear infection in cats?

246
Q

What are the main cocci of the ear?

A

Staph pseudintermidius

247
Q

What are teh main rods of teh ear?

A

Pseud. aeruginosa

248
Q

What direction is the nystagmus on otitis interna?

A

Horizontal

249
Q

What direction does the head tilt for otitis interna?

A

Toward the lesion

250
Q

Is a C/S needed in every case?

251
Q

What xray views do you take to look at ears?

A

Right and left lateral OBLIQUES!
Rostrooventral-caudodorsal

252
Q

Do you use MRI or CT for soft tissue?

A

MRI! CT for bone

253
Q

Is Actinomycosis Gram + or -?

A

+ anaerobic

254
Q

How do you treat actinomycosis?

A

Surgical debulking
Penecillin or amoxicillin
Continue treatment for 1 month after complete remission (3-4m total)
Relapse 15-42%

255
Q

How do you treat nocardia

A

 Surgical resection and antibiotics
 Antibiotics based on susceptibility
 Potentiated sulfas are common
 Treat at least one month past

256
Q

How do you treat mycobacterium?

A

Surgery + antibiotic based on susceptibility use at least 2

257
Q

What class of antibiotic is almost always used?

A

Fluoroquinolones (and doxycycline apparently)

258
Q

What is the usual length of therapy?

A

3-6 months (1 month past resolution)

259
Q

What is acronym for Hypercalcemia?

260
Q

What are 3 causes of hyposthenuria in dogs?

A

Pschygenic, Cushing, diabetes

261
Q

If there is low Ca, what will the phosphorus look like?

A

High (inverse relationship

262
Q

What are the 2 causes of “profound hypercalemia?

A

Primary HP and hypercalcemia of malignancy

263
Q

What diagnostics can you do to differentiate between primary HP and malignancy?

A

Malignancy panel (PTH-rP), minimal PTH-rP likely means primary HP

264
Q

What is another diagnostic?

A

US to check size of parathyroid (enlarge likely means primary HP)

265
Q

What is a treatment for primary hyperparathyroidism?

A

Surgical removal
US-guided ethanol ablation

266
Q

What is a risk associated with surgical removal?

A

Hypocalcemia (post-op)
Need to monitor iCa at least once daily

267
Q

What to do if there is hypocalcemia as a result?

A

Give Ca and/or calcitriol

268
Q

Can you see calcium oxalate on rads in cat?

269
Q

What does prozasin do?

A

Relaxes urethra

270
Q

What age are idiopathic hypercalcemia cats?

A

Young to middle aged

271
Q

How do you treat IHC?

A

Dietary motification

272
Q

What are nutritional goals?

A

dietary calcium <200mg/100kcal
Ca:P <1.4:1
Increase water consumption

273
Q

What is something that can be added to diet to normalize Ca?

A

Chia seeds

274
Q

What are 2 medical managements of idiopathic hypercalcemia that dont respond to diet or chia seeds?

A

Pred - increases diabetes chances
Bisphosphates

275
Q

What is a side effect of alendronate (a bisphosphate)

A

Osteosclerosis and mandibular osteonecrosis

276
Q

Give 5 causes for hypocalcemia

A

Eclampsia
Pancreatitis
Malabsorption
Hypoparathyroidism
Secondary hyperparathyroidism

277
Q

What is your top differential for super low Ca?

A

Secondary hyperparathyroidism or PLE (PLE you would see low proteins and cholesterol)

278
Q

What is acute treatment of hypocalcemia?

A

Calcium gluconate

279
Q

What is long term treatment of hypocalcemia?

A

Calcitriol

280
Q

If PTH is high and iCa is normal, what is that consistent with?

A

Nutritional hyperparathyroidism

281
Q

What are the 2 medical treatments for Cushings?

A

Mitotane
Trilostane

282
Q

What is more common, pituitary or adrenal dependent Cushings?

A

Piuitary depenedent

283
Q

What are the management complications if you dont treat Cushings?

A

proteinurea
hypertension
hypercoagulability

284
Q

What is the best way to treat the protein urea associated with Cushings if you don’t treat the root cause?

A

Telmisartan (best ACEi)

285
Q

What is very important to check on Cushing physical exam?

A

Eyes for signs of systemic hypertension

286
Q

Cushings increases the release of cortisol, which increases “stress” level. This will cause hypertension leading to proteinurea. Hypercoag idk but it does

287
Q

What are the 2 ACEi availbale to treat hypertension?

A

enalapril and benazepril

288
Q

What is teh ARB available to treat hypertension?

A

Telmisartan

289
Q

What is the calcium-channel blocker available to treat hypertension?

A

Amlodipine

290
Q

What are the 2 antiplatel drugs used to treat Cushings?

A

Plavix - clopidogrel
low dose aspirin

291
Q

What is a post-ACTH stim for control?

292
Q

What is a post-ACTH stim for Cushings?

293
Q

What is mitotane loading dose?

A

50mg/kg/day

294
Q

What is trilostate starting dose?

A

1mg/kg PO BID or 2mg/kg PO SID

295
Q

What should you base most of your dosing on for trilostaine?

A

Clinical signs

296
Q

When should you attemp to do ACTH stim?

A

3-4 hours post-pill

297
Q

“If moving from BID to SID, dont split the dose in hald at each time, give the same dose at each time, essentailly increasing dose by 2”

298
Q

What dose will most dogs be controlled on?

A

2-4mg/kg/day

299
Q

What is the issue with compounded trilostane?

A

Amount in capsule is incosistent

300
Q

When should you recheck after a dose adjustment?

A

10-14 days

301
Q

How do you treat hyperaldosteronism in cats?

A

Adrenalectomy is optimal treatment

302
Q

What are the top 2 issues with hyperaldosteronism in cats?

A

Hyperkalemia
Hypertension

303
Q

If surgery isnt an option for hyperaldosteronism what are medical treatments?

A

Hyperkalemia - supplement K and spironolactone
Control hypertension - amlodipine or telmisartan

304
Q

What is definition of polydipsia in dogs?

A

> 100mg/kg/day

305
Q

What is polyuria defiintion of spec gavity?

306
Q

What are the only 3 differentials for a hyposethuric dog?

A

Cushings, pschogenic, diabetes

307
Q

What does the 8hr of an LDDS need to be to not be consistent with Cushings

A

<cutoff (1.5ish)

308
Q

What does 4hr need to be to PDH?

A

50% suppressed from baseline
If it isn’t, it is “not not” PDH

309
Q

What is the most common clinical sign of Cushings?

310
Q

What is typical Addison’s?

A

Mineralcorticoids + Glucocorticoids

311
Q

What is atypical Addison’s?

A

Just glucocorticoids

312
Q

What is DOCP?

A

Desoxycorticosterone pivalate

313
Q

What is starting dose of DOCP?

314
Q

What is the duration of DOCP?

315
Q

When should you recheck electrolytes?

A

25 days - before next dose

316
Q

What are 2 values you want to keep track of when adjusting the DOCP dose?

A

hyponatremia and hyperkalemia

317
Q

What is dose of pred?

A

0.1-0.2 mg/kg/day
Taper to lowest dose and frequency that controls clinical signs

318
Q

When might you increase dose of pred and by how much?

A

Increase by double a few days before/during/after stressful events

319
Q

What is a medication that provides both mineralcorticoids and glucocorticoids

A

Fludrocortisone

320
Q

How to treat hypovolemic shock as part of Addisonian crisis?

A

Bolus 0.9%NaCl fluids

321
Q

How to treat hyperkalemia during Addisonian crisis?

A

IV dextrost/insulin or calcium gluconate

322
Q

How to treat Hypoglycemia as part of Addisonian crisis?

A

Dextrose bolus

323
Q

How to treat Anemia as part of Addisonian crisis?

A

Give transfusion

324
Q

What is typical Addisons

325
Q

What are teh only 3 disease types that can have hypocholesterolemia?

A

PLE
Addisons
Liver Dx

326
Q

What are the treatment options for hyperthyroidism in cats?

A

Oral methimazole
Topical methimazole
Radioactive iodine - cure
Diet
Surgery - cure

327
Q

What are the 2 types of methimazole?

A

Tapezole
Felimazole

328
Q

What are some side effects associated with methimazole?

A

GI
Fascial pruritus
Increased ALT
Bone marrow suppression

329
Q

What are the time points for monitoring methimazole

A

Phone convo at 48 hrs and 1 week

330
Q

What percent of I 131 cats develop hypothyroidism?

331
Q

How do you treat a cat that has iatrogrenic hypothyroidism?

A

Levothyroxine

332
Q

What is the dietary management for hyperthyroidism?

A

Iodine restricted
Can only eat this food forever…

333
Q

How do you check for CKD complications before I-131?

A

Do a methimazole challenge

334
Q

How do you treat hypothyroidism?

A

Levothyroxine

335
Q

What species get hyperthyroidism mostly?

336
Q

What species get hypothyroidism mostly?

337
Q

When do you check total T4 for monitoring/

A

4-6 hours after pill administration
Goal is middle to upper reference interval

338
Q

What is apathetic form of hyperthyroidism and what pecent is it?

A

Cats feel ill rather than good, 10-15% of cats

339
Q

What is the shortest acting insulin?

340
Q

What is vetsulin?

A

Porcine lente insulin
Suspension
BID
U-40

341
Q

What is a good insulin for cats?

342
Q

What are the 5 best for cats?

A

ProZinc
Tresiba
Levemir
Lantus
Toujeo

343
Q

What are the 5 best for dogs?

A

Humulin
Vetsulin
Levemir
Toujeo
Tresiba

344
Q

What formulation is Toujeo?

345
Q

What is Bexacat?

A

SGLT2
Increases urine excetion of glucose

346
Q

What are teh 4 factors associated with diabetes management?

A

Diet composition
Stable diet
Calorie intake and obesity
Feeding schedule

347
Q

What is important about diet composition?

A

Increased fiber
Decreased simple sugars

348
Q

What should the feeding schedule look like?

A

Consistent calorie content
Consistent timing of meals
BID feeding

349
Q

What is the starting dose for cats and dogs of insulin?

A

Cats: 1U/inj
Dogs: 0.25/kg/inj

350
Q

Is euglycemia a treatment goal?

351
Q

what are the 3 goals of diabetes treatment?

A

Resolve clinical signs of diabetes
Prevent any consequences
Avoid hypoglycemia

352
Q

What are complications of diabetes?

A

Cataracts will develop even in treated dogs

353
Q

What is the best way to monitor diabetes?

A

Fructosamine

354
Q

When would you use spot glucose?

A

When looking for hypoglycemia

355
Q

o If you use a BG curve, how often should you check?

356
Q

What insulin should you start with in a dog?

357
Q

What insulin should you start with in a cat?

358
Q

When should you initally recheck?

A

2-3 weeks until controlled
Fructosamine at rechecks

359
Q

What is the ranking of best monitoring approaches in order?

A

Clinical signs
Fructosamine or CGM
Glucose curves

360
Q

What should BG not drop below in a diabetic patient?

361
Q

What is a disease that would cause insulin demand to shoot up?

A

Pancreatitis

362
Q

What are the 2 largest players in electrolyte derangements?

A

Potassium and phosphorus

363
Q

What do potassium changes cause?

A

Heart issues

364
Q

What do phosphorus changes cause?

A

Hemolysis issues

365
Q

What is high in the biochem of diabetics?

A

cholesterol

366
Q

What are the 4 aspects to treatment of DKA?

A

Fluids (Not NaCl!)
Electrolytes (P and K)
Insulin (Regular insulin plus dextrose)
Underlying disease

367
Q

What is #1 reason for hypocalcemia in horses?

A

GI disease

368
Q

What are the 4 causes of hypercalcemia in horses?

A

Vitamin D toxicosis
Cancer
Hyperparathyroidism
Renal failure #1 cause

369
Q

Cryptococcus

A

Most common deep fungal infection in cats
Associated with pigeon droppings
Common nasal disease
Narrow base budding
Itraconazole or fluconazole for 6-12months
Maybe prednison for anti inflammatory for a little

370
Q

Blastomycosis

A

Inhaled yeasts from ground
Ocular lesions in ~50%
Broad based budding
Itraconazole 30d beyond resolution of signs
Anti inflammaroy pred when starting

371
Q

Histoplasmosis

A

Bat and bird droppings
Respiratory signs
Looks like a bunch of balls in a call on histo
Itraconazole
Fluconazole if CNS involvement

372
Q

Sporotrichosis

A

Zoonotic
Penetrating wounds
3 forms: cutaneous, cutaneolymphatic, disseminated
Itraconazole Treat past resolution for 1 month

373
Q

Cutaneous histiocytosis

A

Prednisone, or azathioprine, cyclosporine, leflunomide
Tetracycline or niacinamide as maintenance therapy

374
Q

Sterline Nodular Penniculitus

A

Inflammation of fat
Surgical excision
Pred

375
Q

Sterile granuloma/pyogranuloma syndrome

A

Surgical excision
Pred
Potential reaction to other bacteria present

376
Q

Post grooming furnculitis (deep pyoderma)

A

Pseodomonas aeruginosa (Deep pyoderma!)
Common iwth backyard groom
Target Gram - fluoroquinolones (6-8wks)

377
Q

Generalized deep pyoderma

A

Antibacterial baths
Topical antibacterial leave-ons

378
Q

Puppy pyoderma (superficial pyoderma)

A

None if limited, topical shampoo
Systemic antibiotic if severe
<1 year old

379
Q

Bacterial folliculitis

A

Pruritus can be none to intense
Has an underlying disease cause
“If it looks like ringworm, its proabably bacterial folliculititis”

380
Q

Mucocutaneous Pyoderma

A

Treat underlying disease
Antibiotics
Treat for 1 week past resolution of signs

381
Q

Atopic dermatitis

A

Choose from:
Antihistamines
Fatty acids
Topical
Nutraceuticals
Lipid-replacement therapy
Steroids
Atopica
Apoquel
Cytopoint

382
Q

FASS

A

Antihistamines
fatty acids
nutraceutical
steroids
atopica

383
Q

Contact dermatitis

A

Steroids
Pentoxifylline

384
Q

Acral lick dermatitis

A

Treat underlying cause
Fluocinolone
Laser
No surgery
Antibiotics + trazodone
Phovia laser

Diseases and Diagnosis (25 decks)

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