Defense & Barriers 2: Skin Exam/Cytology Flashcards
important things to ask in history? (5)
- presence of pruritus?
- travel history?
- diet history?
- duration/progression?
- prior therapies?
what 5 regions should be examined upon dermatologic exam?
**WHAT ARE WE AIMING FOR?
- ears
- paw pads
- claws
- mucocutaneous junctions
- oral cavity
**OVERALL, ENTIRE SKIN SURFACE
in the dermatologic exam…
1. what type of diagnostic test do we almost ALWAYS do?
2. what diagnostic test should we do if pet is ITCHY?
3. what’s the diagnostic test for HAIR PLUCKING?
- SKIN SCRAPING
- ITCHY = FLEA COMBING
- TRICHOGRAM
4 ADVANCED dermatologic tests we can run IF INDICATED?
- DERMATOPHYTE PCR
- FUNGAL culture
- BACTERIAL culture & sensitivity
- skin BIOPSY
IMPRESSION cytology steps?
Impression slides are good for WHAT TYPES OF LESIONS
ACETATE TAPE cytology steps?
how is ACETATE TAPE cytology stained?
IMPRESSION cytology
1. REMOVE crust with EDGE of SLIDE
2. PRESS SLIDE ONTO SKIN
**Good for EXUDATIVE/MOIST lesions
ACETATE tape cytology = use packing tape to press to lesion and remove
STAINED via DiffQuik stain, latter 2
- one big reason for getting a skin cytology?
- what 3 things should we be looking for?
- most animals are PRURITIC and get SECONDARY BACTERIAL INFECTIONS, good to determine
- look for INFLAMMATORY CELLS, ORGANISMS, or FREE-FLOATING KERATINOCYTES
3 things we need to do to PREP slides?
**heat-fixing acetate tape cytology?
- AIR DRY or USE BLOW DRYER
- if GREASY, then HEAT-FIX
- DiffQuik STAIN
**DO NOT HEAT-FIX TAPE SLIDES
what organism is present here?
**what’s a normal finding?
= MALASSEZIA YEAST, present in BIG PURPLE GLOBS
normal finding = BROWN MELANOCYTES
describe this organism in LOCATION
what organism is usually this SHAPE?
EXTRAcellular BACTERIA, COCCI
COCCI = STAPH
describe this organism is LOCATION
what shape?
INTRACELLULAR BACTERIA
RODS
identify this organism (genus & species)
what “shape” does it resemble?
MALASSEZIA PACHYDERMATITIS
resembles PACKING PEANUTS
what is this cell?
what does the protrusion mean?
cell = NUCLEATED KERATINOCYTE
protrusion is a BACTERIA FROM OROPHARYNGEAL REGION, so this is evidence that DOG HAS BEEN LICKING SKIN
what are the 2 steps of microscopic evaluation for SKIN CYTOLOGY? **list 2 diseases per magnification
- start with 10X magnification to identify TYPES of cells present…
–> NEOPLASTIC = HOMOGENOUS
–> INFLAMMATORY = HETEROGENOUS - go to OIL IMMERSION at 100X to identify ORGANISMS
–> BACTERIA = RODS, COCCI
–> YEAST = MALASSEZIA
3 indications for TAPE cytology?
- DRY lesions
- DIFFICULT sample sites like SKIN FOLDS or INTERDIGITAL spaces
- MALASSEZIA
ear cytology…
when should we perform it?
where do we get the sample from? (2)
how to prepare the slide after getting the sample? (2)
how do we evaluate under a microscope & what 3 things are we looking for? (2)
when should we perform it?
FOR EVERY CASE OF OTITIS
where do we get the sample from?
1. JUNCTION between HORIZONTAL & VERTICAL ear canal
2. FROM BOTH EARS regardless of clinical signs
how to prepare slide?
1. ROLL IT ONTO A SLIDE, usually towards the LEFT/FROSTED EDGE
2. HEAT-FIX & STAIN with DiffQuik
microscope evaluation?
1. start at LOW magnification 4-10X and look for “BUSY” region
2. once we get to busy region, move to OIL IMMERSION 100X and look for COCCI, RODS, YEAST
for ALL SKIN cytologies, examine at HIGH ____ and HIG
H ___
MAGNIFICATION, ILLUMINATION