Derm #4, Cardio #1 Flashcards by Bianca Zayas

What is one of the main disorders of epidermal growth and differentiation?

seborrhea (primary, secondary)

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What are some examples of common endocrinopathies?

Hypothyroidism, hyperadrenocorticism, hyperestrogenism, pituitary dysfunction

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What type of disorder is seborrhea?

Disorder in cornification

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What are characteristics of seborrhea?

Clinically excessive scaling, greasiness, increased rate of epithelial turnover, abnormal intercellular lipids

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What are the two types of seborrhea?

Primary (genetic disease) or secondary to other diseases

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What does seborrhea look like grossly?

White scale on the surface of the skin

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What is malassezia and what disorder is it commonly seen in?

Superficial yeast that likes the stratum corneum, makes keratosis worse, and will smell; common secondary agent to seborrhea

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What are gross features of endocrine dermatopathies?

Bilaterally symmetric alopecia, epidermal thinning, hyperpigmentation, secondary bacterial pyoderma and seborrhea

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What are microcopic changes associated with endocrine dermatopathies?

Hyperkeratosis, epidermal/dermal atrophy, adnexal atrophy, telogen hairs, +/- hyperpigmentation and superimposed inflammatory changes

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What is this?

Malassezia - yeast associated with seborrhea

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What 3 changes can be seen here?

Epidermal atrophy (arrow), orthokeratotic hyperkeratosis, follicular hyperkeratosis

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What is alopecia?

Lack or loss of hair

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How does demodex cause alopecia?

Destroys some hair follicles

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How do dermatophytes cause alopecia?

Destroy hairs

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How do endocrinopathies, metabolic causes, toxins, and drugs cause alopecia?

Atrophy of follicles

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What is hypertrichosis?

Too much hair - can be caused by hirsutism, tumors of the hypophysis, malnutrition, prolonged gestation

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What is a common endocrinopathy that cats get that causes alopecia?

Feline psychogenic alopecia - cat gets stressed and licks all of its hair off

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What disease is associated with bilateral alopecia in dogs?

Cushing’s

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T/F: Seborrhea is an acute change

False

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What are some examples of non-neoplastic tumors?

Follicular cysts, hamartomas, fibroadnexal dysplasia, calcinosis circumscripta, granulomas

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What is this and what causes it?

Verrucous lesion; likely caused by a papillomavirus

What is this cutaneous epithelial neoplasm? What is indicated by the blue arrow?

Squamous cell carcinoma: malignant epithelial neoplasm;

Blue arrow = neoplastic squamous epithelium

What cutaneous neoplasm is seen here? What are they sometimes called?

Round cell tumor: Cutaneous histiocytoma (often in young dogs and benign)

AKA “button tumors”

What change is seen here? What is the cause?

Lymphoma - we see irregular lymphocytes on histo; usually do not know the cause

What change is seen here? Should we consider this to be benign or malignant?

Mast cell tumor; we should always consider these to be potentially malignant

What is histologic grading? Who does this?

Classification based on microscopic appearance of a malignant neoplasm; done by a pathologist

What is staging? Who does this?

Evaluating the extent of spread of a neoplasm in the body. It is a clinical assessment done by the rDVM.

What can cats get as a reaction from vaccination? How should you vaccinate in order to make removal easier?

Vaccine-associated sarcomas; vaccinate on lower limb or on tail in case you have to amputate to remove the tumor

What is this and what can it be a result of? (hint: it is from a cat)

Fibrosarcoma: malignant; can result from nodule formation that malignantly transformed into a sarcoma after vaccinating a cat

What is this? Is it benign or malignant?

Lipoma; benign Don't grow back once removed, not difficult to remove Common in **Schnauzers** and labs

What is this? Is it neoplastic? What can be seen on histo?

Calcinosis circumscripta; not neoplastic; on histo see mineral bordered by macrophages and fibrous tissue (Usually happens on pressure points in dogs, can be dx bc of white, chalky spots on cut surface)

What is this? Is it neoplastic? What will happen if you squeeze it?

Follicular cyst (alopecic nodule, raised, soft, fluctuant and fluid-filled); non-neoplastic; if squeezed will have keratinized material

What is this called once it is ruptured?

Furunculosis (ruptured cyst)

What do you call a malignant neoplasm of sweat glands?

Apocrine adenocarcinoma

What will happen if you have obstruction in the pulmonary vein or in the left heart?

Left-sided heart failure; * Back up of blood * Hydrostatic pressure increases --\> **pulmonary edema** * Patient will cough a lot * There is a decrease in the amount of blood going forward * Kidneys take a large % of cardiac output * Start secreting renin to try to increase output * Sudden drop in output --\> bad for brain --\> fainting

What will happen if you have right-sided heart failure?

Blood backs up into the systemic capillary beds * Hydrostatic pressure increases --\> **systemic edema** * ****Thoracic and/or abdominal cavities * Congestion outside in the thoracic cavity, pericardium, liver, spleen

Where do you find the most cross sectional area in the body's vessels?

capillary beds

What things are associated with acute cardiovascular failure?

Cardiac syncope, acute congestion of tissues, peripheral circulatory failure (hypovolemia), sudden death

What things are associated with chronic cardiovascular failure?

Congestive heart failure --\> pulmonary edema, ascites, hydrothorax, chronic passive liver congestion

What are the 4 basic causes of heart failure?

1. Systolic dysfunction (overload) 2. Decreased functional cardiac muscle mass 3. Altered myocardial contractility 4. Diastolic dysfunction

What occurs during systolic dysfunction that leads to heart failure?

Pressure overload due to valve stenosis and/or hypertension, volume overload due to valvular insufficiency (Heart has to have increased pressure to get blood flowing through the valve)

What are some things that cause decreased functional cardiac muscle mass, thus leading to heart failure?

Neoplasm, inflammation, myocardial infarct

What are some things that alter myocardial contractility and ultimately lead to heart failure?

Arrythmia, advanced hypertrophy

How does diastolic dysfunction lead to heart failure and what is an example of this?

There is impairment of ventricular filling; EX: Cardiac tamponade - fluid builds in pericardium causing an increased pressure on the ventricles. Ventricles cannot fill/relax (often manifests as right sided heart failure)

Of the following conditions, which are associated with diastolic failure vs. systolic failure? A. Mitral valve insufficiency B. Hemopericardium C. Systemic hypertension D. Hypertrophic cardiomyopathy

A = systolic B = diastolic C = systolic D = diastolic

What is a big cause for hemopericardium?

hemangiosarcoma

When does heart failure occur in relation to compensatory mechanisms?

Occurs when compensatory mechanisms are inadequate

What is the goal of compensatory mechanisms?

Maintaining cardiac output

What are some examples of compensatory mechanisms?

Increased heart rate, altered peripheral resistance, decreased flow to non-vital organs, myocardial remodeling (hypertrophy), hypervolemia

What two compensatory mechanisms are initially a good thing, but can become problematic if they happen chronically?

Hypertrophy and hypervolemia

What two things are increased in hypervolemia and why?

1. Fluid volume - due to renal retention of salt and water (renin-angiotensin system) 2. RBCs - due to erythropoeitin