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Clinical Nursing May Exam > Dermatology > Flashcards

Dermatology Flashcards

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1
Q

state some dermatology problems

A 
pruritus
scale
alopecia
crusting
ulceration
nodules
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2
Q

define pruritus

A

itchy skin causing self trauma

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3
Q

what can be causes of pruritus?

A

allergy
parasites
microbial infection

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4
Q

what can cause scale?

A

keratinisation disorders

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5
Q

what is mean by primary skin lesions?

A

develop in skin of own accord

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6
Q

define alopecia

A

hair loss

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7
Q

define bullae

A

localised collection of fluid over 0.5cm diameter

larger than vesicle

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8
Q

define erythema

A

diffuse or localised redness of skin which disappears with diascopy

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9
Q

define macule

A

flat circumscribed skin discolouration less than 1cm diameter without surface elevation and depression

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10
Q

define nodule

A

circumscribed solid elevation greater than 1cm usually extends into dermis

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11
Q

define papule

A

small solid elevation of the skin up to 1cm diameter

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12
Q

what causes papules?

A

infiltration of inflammatory cells, fluid, foreign material with oedema and epidermal hyperplasia

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13
Q

define patch

A

big macule, localised flat change in skin pigment larger than 1cm in diameter

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14
Q

define plaque

A

flat topped elevation of skin usually over 0.5cm, formed by coalition of papules

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15
Q

define pustule

A

small circumscribed elevation of epidermis filled with purulent material

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16
Q

define vesicle

A

small circumscribed elevation of epidermis filled with clear fluid, less than 0.5cm diameter

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17
Q

define wheal

A

sharply circumscribed raised lesion consisting of oedema, usually appears and disappears within hours

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18
Q

list primary skin lesions

A 
alopecia
bullae
erythema
macule
nodule
papule
patch
plaque
vesicle
wheal
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19
Q

list secondary skin lesions

A 
comedone
crust
epidermal collarette
fissure
hyperkeratosis
hyper and hypopigmentation
lichenification
scale
scar
ulcer
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20
Q

what are potential causes of secondary skin lesions?

A

self trauma
trauma
infections
regressing primary lesions

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21
Q

define comedone

A

dilated hair follicle filled with cornified cells and sebaceous material

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22
Q

define crust

A

dried exudate, cells, pus and scale adherent to surface

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23
Q

define epidermal collarette

A

erosion, superficial damage to epidermis

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24
Q

define fissure

A

linear cleavage into the epidermis

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25
Q

define hyperkeratosis

A

increase in thickness of cornified layer of skin

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26
Q

define lichenification

A

thickening of skin resulting in cobblestone appearance

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27
Q

define scale

A

accumulation of loose fragments of cornified layer of skin

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28
Q

define ulceration

A

full thickness loss of epidermis exposing the dermis

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29
Q

how do you approach diagnosing dermatological conditions?

A 
history
flea status
physical exam
problem list
differential diagnosis of possible causes
diagnostic plan for definitive cause
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30
Q

list diagnostic techniques for dermatology

A 
acetate tape for cytology
skin scrapings
impression smear
flea comb
trichogram
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31
Q

what can be seen on acetate tape for cytology?

A

malassezia
bacteria
inflammatory cells squames

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32
Q

what can you see on skin scrapings?

A

demodex if deep
cheyletiella if superficial
sarcoptes

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33
Q

what can be seen on impression smears?

A

inflammatory cells
malassezia
bacteria

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34
Q

what can trichogram show?

A 
anagen
telogen 
mite and lice eggs
pruritus
dermatophytosis
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35
Q

what animals is dermatophytosis mainly found?

A

perisian cats but is zoonotic

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36
Q

what are signs of dermatophytosis?

A

hair loss

scaling

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37
Q

how is dermatophytosis diagnosed?

A

woods lamp to see fluorescence
microscopy to see spores
dermatophyte test medium
culture for 2 weeks at room temperature

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38
Q

how can dermatophytosis be treated?

A

products for small localised lesions
can use topical therapy
clipping to reduce load but can spread on host
systemic therapy for general or chronic infection

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39
Q

what is the main cause of dermatophytosis contaminating the environment?

A

fungal spores on hair

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40
Q

how can you reduce environmental contamination of dermatophytosis?

A 
cleaning
chemical agents
throw away toys, bedding etc
wash in antifungal disinfectant
thorough vacuuming
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41
Q

what are indications for skin biopsies?

A 
neoplasia
generalised dermatosis
conditions poorly responsive to therapy
no results from other tests
vesicles
bullae
erosions
ulcers
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42
Q

describe how skin biopsies are done

A

LA, sedation or GA
clip hair but dont prepare skin as removes pathogens
take from multiple sites and fully developed lesions
avoid traumatised lesions
punch 4-8mm wide and excise

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43
Q

where do skin biopsies get sent?

A

histopathology
culture
cytology

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44
Q

what can be results from submitting skin biopsies?

A

diagnosis
compatible with clinical diagnosis
not compatible with clinical diagnosis
non-diagnostic

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45
Q

what is meant by the itch scratch cycle?

A

once itchy continues to scratch

itching influenced by flare factors

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46
Q

list flare factors

A 
fleas
bacteria
yeast
dry skin
sweating
psychological factors
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47
Q

how is pruritus clinically assessed?

A

visual analogue scale from normal to itching taking over normal tasks
itching behaviours

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48
Q

how do animals develop clinical signs of allergic dermatitis?

A

increase in allergic load pushes over amount they can tolerate

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49
Q

what are clinical signs of canine atopic dermatitis?

A 
alopecia
erythema
excoriation
hyperpigmentation
lichenification
self trauma
secondary infections
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50
Q

how is canine atopic dermatitis diagnosed?

A

rule out other pruritic causing conditions

intradermal and blood testing to select allergens for immunotherapy

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51
Q

what is the purpose of canine atopic dermatitis allergy testing?

A

doesnt diagnose
identify allergens of clinical significance
basis for allergen specific immunotherapy and desensitisation

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52
Q

what are examples of microbial infection?

A

pyoderma

malassezia

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53
Q

what are clinical signs of pyoderma?

A

intraepidermal pustules easily disrupted
transient primary lesions
secondary crusting, erosion lesions
peripheral spread with peeling epidermal collarette
recurring disease if underlying cause unmanaged

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54
Q

what are common underlying disorders of pyoderma?

A

ectoparasites
allergy
endocrinopathies

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55
Q

what are the two types of pyoderma?

A

superficial

deep

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56
Q

what is the main cause and signs of deep pyoderma?

A

demodex

weepy skin, infection in skin follicle

57
Q

list antibiotics used for pyoderma treatment

A

clindamycin
trimethoprim
clavulanic acid and amoxicillin
cefalexin

58
Q

how long does it normally take to treat superficial pyoderma?

A

3-4 weeks

59
Q

how can topical treatments help treat pyoderma?

A

remove scale, crust and exudate
reduce bacterial number
promote drainage of deeper lesions
reduce pain and pruritus

60
Q

what is malassezia pachydermatitis?

A

opportunistic yeast pathogen

61
Q

where does malassezia normally live?

A

external ear canal
chin
perioral
interdigital

62
Q

what is the effect of malassezia infection?

A

hypersensitivity to microbes agents

63
Q

what predisposes to malassezia infection?

A

alteration in skin microclimate, sebum, moisture

allergic and bacterial skin disease

64
Q

what are clinical signs of malassezia infection?

A 
pruritus
effects ventral region, feet, face, skin folds
erythema
scale
hyperpigmentation
malodour
65
Q

how is malassezia infection diagnosed?

A

impression smears
acetate strip preparations
culture

66
Q

how can you treat malassezia?

A

topical chlorhexidine therapy 2x weekly

systemic itraconazole therapy for 7 days

67
Q

what is main sign of malassezia otitis?

A

otitis externa

68
Q

what is the cause of malassezia otitis?

A

ceruminous glands provide lipid rich material for bacteria to survive

69
Q

how can you treat malassezia otitis?

A

steroids to control cerumen production

70
Q

describe the lifecycle of fleas

A

intermediate stages found in environment

fleas stay on host unless removed by scratching etc

71
Q

what is flea bite hypersensitivity?

A

clinical condition in animals sensitised to antigenic components of flea saliva

72
Q

how is flea bite hypersensitivity diagnosed?

A 
history
compatible clinical signs
flea evidence
dipylidium caninum infestation
positive response to flea treatment
elimination of differential diagnoses
serology testing for flea saliva antigen
73
Q

what can affect the efficacy of flea control?

A 
formulation
application
hair length
bathing
insect growth development inhibitors in environment
74
Q

what are control measures for fleas in environment?

A

thorough vacuuming to remove eggs, debris and faeces

75
Q

what is the main aim of flea control and how is it achieved?

A

prevention using prophylaxis

76
Q

how are animals with flea allergy dermatitis treated?

A 
insecticides
long term insect growth inhibitor
glucocorticoids
antibiotics if needed
preventative control
77
Q

what prevents management of fleas?

A

not treating all animals contacted
not preventing
not removing all fleas from environment

78
Q

what are signs of demodex?

A

itchy skin
alopecia
crusting
secondary infection

79
Q

what can be seen on histology caused by demodex?

A

folliculitis
furunculosis
nodular dermatitis

80
Q

how is demodex diagnosed?

A

deep skin scraping
hair plucks
skin biopsy
observation of lesions general or local

81
Q

what is prognosis for generalised demodicosis?

A

50% spontaneously recover as immune system matures

good with treatment

82
Q

when does localised demodicosis affect animals?

A

juveniles

83
Q

what is the effect of localised demodicosis?

A

mild disease rarely becoming generalised

focal alopecia and erythema

84
Q

where does local demodicosis normally affect?

A

legs and head

85
Q

why is localised demodicosis normally not treated?

A

spontaneously resolve

86
Q

what animals are prone to adult onset demodex?

A 
immunocompromised
corticosteroids
hyperadrenocorticism
neoplasia
hypothyroidism
87
Q

how is demodex treated?

A

acaridicidal treatment

manage bacterial pyoderma with oral cefalexin and chlorhexidine baths

88
Q

describe the lifecycle of sarcoptes scabei?

A

3 weeks long

eggs laid in deep burrows in host

89
Q

what are signs of sarcoptes scabei infection?

A

pruritus

hypersensitivity

90
Q

how is sarcoptes scabei diagnosed?

A

skin scrapings
skin biopsies, rarely diagnostic
ELISA blood test
transmission between contacts or environment

91
Q

how is sarcoptes scabei treated?

A

treat concurrent staphylococcal infections
corticosteroids for pruritus
treat mites

92
Q

state an example of ear mites

A

otodectes cynotis

93
Q

what are signs of ear mites?

A

irritation

hypersensitivity

94
Q

how are ear mites treated?

A

give to all animals in house

remove wax before applying topical treatment

95
Q

what is cheyletiellosis?

A

large surface mites
obligate parasites
zoonotic and highly contagious

96
Q

where does cheyletiellosis live?

A

epidermal pseudo-tunnels feeding on tissue fluids

eggs attached to hair

97
Q

what are signs of cheyletiellosis?

A 
hypersensitivity
lesions
scaling
mild pruritus
dermatitis
alopecia
98
Q

how is cheyletiellosis diagnosed?

A

microscopy to identify mites or eggs
hair plucks
superficial skin scrapings
acetate tape impressions

99
Q

how us cheyletiellosis treated?

A

selamectin monthly
moxidectin
baths or sprays

100
Q

what are harvest mites?

A

6 legged larvae of trombicula autumnalis

101
Q

describe the life cycle of harvest mites

A

most prevalent in autumn as orange larvae on vegetation
attach to host and feed for 3 days
complete lifecycle in environment

102
Q

what are signs of harvest mite infection?

A

erythema
papules
crusting
hypersensitivity

103
Q

where do harvest mites tend to live on animals?

A

pinnae
pre-auricular regions
interdigital spaces
eyelids

104
Q

how is harvest mite infestation diagnosed?

A

observing 6 legged orange larvae confirmed by microscopy

105
Q

how are harvest mites treated?

A

flea products
glucocorticoids for hypersensitivity
fipronil spray to prevent attachment

106
Q

describe typical lice lifecycle

A

2-3 weeks
eggs attach to hairs
hatch
3 nymph stages before adult

107
Q

what are clinical signs of lice?

A

pruritus
scaling of dorsum
self trauma

108
Q

how are lice infestations diagnosed?

A

exam for eggs or adults
acetate tape impression
coat brushings
hair pluckings

109
Q

how are lice treated?

A

selamectin
moxidectin
clip heavily infested animals to reduce burden and allow topical therapy to be effective

110
Q

what is the problem of ticks?

A

carry tick borne diseases such as encephalitis, lyme

111
Q

how are ticks prevented?

A

monthly tick control

112
Q

what are the hosts for echinococcus granulosus?

A

DH- carnivores

IH- humans, sheep that ingest DH

113
Q

what is the effect of echinococcus granulosus infection on IH?

A

humans- cysts in liver and lungs

sheep- production losses

114
Q

how is echinococcus granulosus infection diagnosed in IH?

A

post mortem
ultrasound
radiography

115
Q

how is echinococcus granulosus treated?

A

DH- praziquantel

IH- no treatment

116
Q

how can echinococcus granulosus be controlled?

A

dog treatment and control
meat inspection before consumption
disposal of offal

117
Q

what stage of taenia causes issues?

A

intermediate stage

118
Q

how can you control taenia infection?

A

prevent dogs eating offal
stop sheep eating eggs in dogs defecations
up to date worming

119
Q

what are the hosts for taenia?

A

DH- dog

IH- sheep

120
Q

what is the effect of taenia infection in sheep?

A

space occupying lesions
destruction of coenurus cerebralis
head tilt

121
Q

what are the hosts for echinococcus multiocularis?

A

DH- dog, fox, cat
IH- rodents, humans
spend some time not on host

122
Q

what is the lifecycle of toxocara canis?

A

hepato tracheal migration
somatic arrest in various body tissue in adults
reactivation by transplacental and transmammary infection

123
Q

how is toxocara canis treated and controlled?

A

routine worming

early worming puppies

124
Q

what are worming products used for toxocara canis prevention?

A

benzimidazoles
endectocides
piperazine citrate
praziquanal

125
Q

what is normal puppy worming protocol for toxacara canis?

A

week 2, 4, 6, 9, 12

every 3 months

126
Q

what is the protocol for worming pregnant bitches?

A

fenbendazole daily from day 42 to 2 weeks post whelping

only reduces not removes so assume all pups infected

127
Q

what is routine worming protocol in dogs?

A

monthly to 3 monthly
test and treat
remove faeces

128
Q

how are kittens treated for worms and why?

A

from 3-4 weeks as only transmammary not transplacental transmission

129
Q

why do you need to worm cats?

A

hunt and eat hosts containing worm

130
Q

what are signs of early angiostrongylus infection?

A 
coughing
dyspnoea
anaemia
depression
anorexia
coagulopathy
131
Q

what are signs of chronic angiostrongylus infection?

A

verminous pneumonia
anorexia
emaciation
pulmonary hypertension

132
Q

how is angiostrongylus diagnosed?

A

faecal exam

blood test

133
Q

define macroscopic

A

visible with naked eye but need microscope to distinguish

134
Q

how do lice eggs attach to host?

A

attach to hairs with cement

135
Q

how is identity of surface mites confirmed?

A

magnification

136
Q

state type of fur mites

A

cheyletiella spp

137
Q

state type of ear mites

A

otodectes

138
Q

where do ear mites reside?

A

superficially feeding on ear debris

eggs in ear canal

139
Q

define microscopic

A

need microscope to see and identify

Clinical Nursing May Exam (22 decks)

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