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My 2017 RUSVM SAM 2 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

dr derm word for itching

A

pruritic

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2
Q

what meds can cause derm reactions

A

sulfonamides

penicillins

cephalosporins

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3
Q

what are 2 examples of “common” systemic illnesses that can cause derm issues

A

hyperadrenocorticism

hypothyroid

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4
Q

what is dermogram

A

lesion distribution chart

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5
Q

what is primary derm lesion

A

Initial eruption that develops spontaneously directly related to underlying disease

appear & disappear quickly

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6
Q

what is secondary derm lesion

A

evolve from 1° lesion or induced by pt response or external factors

stay around for longer than 1° lesion

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7
Q

Macule

or

patch

A

Macule: change in skin color w/o inflammation < 1 cm

patch: change in skin color w/o imflammation > 1 cm

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8
Q

purpura, petechial, ecchymoses

A

type of macule or patch caused by bleeding into skin

name NB size (eg. petechia = pinpoint, ecchymoses = bigger than pinpoint)

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9
Q

Papule

A

small, solid elevation in skin up to 1 cm, (inflammation present)

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10
Q

plaque

A

coalescence of papules forming flat topped elevation >1 cm

e.g. a hot spot great example!

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11
Q

pustule

A

small elevation of epidermis filled w/ pus

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12
Q

vesicle

A

elevation of pidermis filled w/ clear fluid

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13
Q

bulla

A

vesicle >1 cm

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14
Q

wheal

A

sharply delineated lesion of edema

in humans = hives

in animals = urticaria

ACUTE CS

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15
Q

nodule

A

solid raised palpable lesion >1 cm

can include abscess (fluctuant lesion in dermis or SQ from pus)

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16
Q

Nodule: Tumor

A

Large palpable mass - neoplastic

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17
Q

cyst

A

epithelial lined cavity with solid or fluid material

  • sebaceous most common
  • arise from dermis layer structures not epidermis*
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18
Q

alopecia

A

absence of hair from area where it is normally present

  • Important to ask if pruritis present for ddx of endocrine dz or not (ectoparasite or something else)
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19
Q

Scale

A

accumulation of loosse fragments of horny layer of skin

seborrhea sicca

seborrhea oleosa

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20
Q

crust

A

accumulation of dried serum, exudate on surface of skin (scab)

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21
Q

follicular casts

A

accumulation of keratin & sebaceous material stuck to a hair shaft

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22
Q

comedone

A

dilated hair follicle filled w/ debris

another derm lesion that can be caused by hypothyroid or hyperadrenocorticism

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23
Q

epidermal collarette

A

scale arranged in circular pattern

associated w/ pustule, vesicle or bullae

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24
Q

scar

A

fibrous tissue has replaced the damaged dermis or s/c tissue

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25
Q

excoriation

A

linear abrasion of skin

  • self trauma
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26
Q

erosion

A

shallow ulcer that does not break basal epidermal layer

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27
Q

ulcer

A

break in epidermis w/ exposure of dermis

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28
Q

fissure

A

linear cleavage (cracks) in epidermis or dermis caused by dz or injury

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29
Q

lichenification

A

thickening & hardening of skin

exaggerated skin lines

sign of chronic issue, time enough for melanocytes to migrate to area causing pigmentation

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30
Q

callus

A

localized hyperplasia of the stratum corneum of the epidermis caused by pressure or friction

Elbows & lateral hock areas are common sites for callus formation in the dog

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31
Q

name this skin parasite

A

demodex

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32
Q

what can be seen on this skin cytology

A

neutrophils & streptococci

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33
Q

what can be seen on this skin cytology

A

neutrophils & rods

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34
Q

what can be seen on this cytology

A

yeast & cocci

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35
Q

what is here

A

malassezia yeast

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36
Q

flourescence detected or not?

A

detected!

now if confirmation needed can pluck some hairs with known fluorescence and place in DTM

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37
Q

When is a fungal culture indicated?

A

All cats w/ skin dz

Dogs w/ inflammatory skin lesions

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38
Q

Your dog has suddenly developed these primary lesions - what are they?

A

wheals

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39
Q

What is this primary lesion?

A

vesicle

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40
Q

What is this organism?

A

Malassezia pachydermatitis

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41
Q

Which test is best to identify know environmental allergens causing atopy, after performing your initial dermatological exam?

A

intradermal allergy test

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42
Q

What is the most common cause of pruritus in a 4 month old dog?

A

Flea bite dermatitis

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43
Q

What is the most likely cause for this skin condition?

A

Flea allergic dermatitis

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44
Q

Atopic dermatitis is cause by what type of reaction?

A

Type 1 hypersensitivity reaction

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45
Q

Flea allergic dermatitis is caused by what type of reaction?

A

Type 1 hypersensitivity

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46
Q

Which is the second most common cause for an allergic dermatitis in a 4 mo puppy?

A

Food allergens!

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47
Q

in dogs <6 mos of age what is the order of the top three commom causes for an allergic dermatitis?

A
  1. Fleas
  2. Food allergens
  3. Environmental allergens
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48
Q

in dogs >6 mos of age what is the order of the top three commom causes for an allergic dermatitis?

A
  1. Fleas
  2. Environmental allergens
  3. Food allergens
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49
Q

Which of the followind treatments doesn’t show fair to strong evidence to control pruritis in an atopic dog?

  1. Glucocorticoids (Prednisolone)
  2. Cyclosproine A (Atopica)
  3. Antihistamines (Chlorpheniramine)
    1. Skin lipid therapy (Duoxo)
A
  1. Antihistamines (Chlorpheiramine)

show weak evidence of effectiveness!

50
Q

Carbohydrates is the most common type of food allergen in dogs & cats

True or False

A

False!

  • # 1 = proteins*
  • # 2 = glycoproteins*
51
Q

Hydrolysed food diets can be used for food allergy dogs. Which statement is false?

  1. Protein particle sizes are <3000 to 10,000 Daltons in most foods
  2. Hydrolysed food is more unpalatable compared to regular diets
  3. Owner compliance is easily obtained
  4. The lipid & carbohydrate source is also hypoallergenic
A
  1. The lipid & carbohydrate source is also hypoallergenic
52
Q

Which one of the following products would give you good local & environmental control in a dog dxd w/ FAD

  1. Frontline (fipronil)
  2. Advantage (imidocloprid)
  3. Permethrin dip
  4. Capstar (nitenpyram)
A
  1. Advantage (imidocloprid)
53
Q

An owner has decided on intradermal allergy testing & hyposensitisation. According to literature - what % of dogs will get a good to excellent control of atopic dermatitis through hyposensitisation?

  1. 100%
  2. 75%
  3. 50%
  4. 25%
A
  1. 50%
54
Q

Which ONE of the following is not a way to diagnose contact dermatitis?

  1. Skin bx & histopathology
  2. Patch test
  3. Corticosteroid response
  4. Mechanical barrier (jacket/jersey)
A
  1. corticosteroid response
55
Q

what type of pyoderma is this

A

surface pyoderma = hot spot

56
Q

what type of pyoderma is this

A

superficial pyoderma = pustules

57
Q

what type of pyoderma is this

A

superficial pyoderma = papules or pustuls

58
Q

what type of pyoderma is this

A

deep pyoderma

59
Q

what type of pyoderma is this

A

deep pyoderma

60
Q

what are the characteeristics of surface pyoderma

A

mixed bacterial population

cytology critical

never culture

Tx: topical

61
Q

what are the characteristics of superfcial pyoderma

A

overwhelmingly Staphylococcus

cytology suportive

s__ometimes culture

Tx: systemic & topical

62
Q

what are the characteristics of deep pyoderma

A

Mostly Staph. but can be mixed

Cytology often negative

Frequently cultured

Tx: systemic, long term, topical

63
Q

when is culture mandatory

A

intracellular rods on cytology

hx of MSRP, MSRA

64
Q

what are benefits of topical tx

A

helpful

decr. duration of systemic Abs

prophylactical use

little to no side effects

65
Q

indication for benzoyl peroxide product

A

pyoderma w/ oily seborrha or comedones

66
Q

indication ofr chlorhexidine product

A

pyoderma w/ dry seborrhea or normal skin/coat

67
Q

what are the 2 special topicals

A

Mupirocin

silver sulfadiazine

68
Q

mupirocin info

A

bacteriostatic @ low conc. / bactericidal @ high conc.

effective vs G + including MRSA

69
Q

silver sulfadiazine

A

topical sulfonamide/silver antibacterial

used on burns

activity vs Pseudomonas

can be prepared w/ water for ear administraion

70
Q

what are 1st tier systemic Abs for empiric tx

A

1st gen cephalosporins = cephalexin

amoxi/clav

clindamycin

71
Q

what are 2nd tier empirical Abs

A

sulfas

erythromycin

lincomycin

doxycyline

72
Q

what are 2nd tier based on C/s results ideally

A

chloramphenicol

rifampin

amikacin

73
Q

what are 3rd tier LAST RESORT based on c/s results Abs

A

fluoroquinolones

3rd gen cephalosporins

USE ONLY IF: no other antibiotic is a feasible option

culture shows suceptibility

74
Q

how long to tx pyoderma

A

superficial:

3-4 wk min

1 wk beyone resolution

deep

3-12 wks

2 wks beyond resolution

signs often appear improved but don’t stop tx prematurely

75
Q

what is another name for acute traumatic pyodermatitis

A

hot spot

76
Q

what is a common superficial pyoderma puppies get

A

puppy pyoderma or impetigo

77
Q

what type of pyoderma is nasal folliculitis/furunculosis

A

superficial & deep pyoderma

78
Q

what type of pyoderma is chin acne or chin pyoderma

A

deep pyoderma

79
Q

what type of pyoderma is a lick granuloma

A

deep pyoderma

very common

AKA: acral lick dermatitis

80
Q

what are the CS of mucocutaneous pyoderma

A

mucocutaneous swelling, erythema, crusting

affects lps symmetrically, commisures affected

81
Q

what is the pathogenesis of pyotraumatic dermatitis

A

2o to underlying dermatitis (flea allergy)

82
Q

CS of hotspots

A

lesion, red, moist, exudative, crusting

denuded

painful

lesions in areas of primary irritation

83
Q

Dx & tx of hotspots

A

typical lesions w/ associated cause

response to tx

antibacterial disinfectant

antibioti/steriod

seek predisposing cause

84
Q

pathogenesis of impetigo & CS

A

bacterial dz caused by Staphylococcus spp.

young dogs

poor husbandry

Vesicales/ pustules

non-follicular pustules

ventral hairless areas

85
Q

Dx of impetigo

A

typical CS

cytology

tx: antibacterial shampoos

toical antibiiotic washes/creams

86
Q

pathogenisis of superficial pyoderma

A

Staphylococcus pseudintermedius

superficial hair follicle

self trauma

parasistic infestation

folliculitis may progress to furunculosis to cellulitis

87
Q

3 most common causes of folliculitis in dogs

A

bacterial

dermatophytes

Demodex

88
Q

CS of superficial pyoderma

A

tiny pustules with hair shaft protruding from center

follicular papule

patchy focal alopecia (moth eaten)

epidermal collarettes

scaling - seborrhea

hyperpigmentation or excoriations

89
Q

Dx of superficial pyoderma

A

recognition of lesions

cytology

  • degen. meutrophils, phagocytosed cocci, proteinaeous backround
90
Q

tx of superficial pyoderma

A

Abs 21-28 days min

1 WK PAST RESOLUTION

antibacterial shampoo

91
Q

what is important to recognize about deep pyodermas

A

there could be underlying disorder

92
Q

pathogenesis of deep pyoderma

A

bact adhesion is prerequisite

bacteria can produce toxins

compromised skin defense > infection 2o usually, try to find underlying dz

Staphylococcus pseudintermedius

allergy most common predisposing cause

follicular pathology

Ehrlichia, Distemper (dogs), retrovirus (cats)

93
Q

CS of deep pyoderma

A

breeds: GSDs, Bull terriers

deep draining tracts, clusters of ulcers, necrohemorrhagic purulent bullae or abscesses

94
Q

What is a ddx for deep pyoderma in light haired dogs

A

SCC

95
Q

what about pyoderma in cats

A

feline pyoderma is very rare!

96
Q

Dx of deep pyoderma

A

cytology

  • pyogranulomatous exudate
  • cocci found

histopathology

  • biopsy - infection may mask underlying dz
  • allergy = flea, food, atopy

bact culture and antibiogram

97
Q

what are the rules when tx deep pyodermas

A

use B-lactamase resistant penicillins

if multiple organisms cultured - TX S. pseudintermedius first!

dosage must be high enough

tx long

98
Q

common Abs for deep pyodermas

A

Amoxi/clav

cephalexin

clindamycin

99
Q

pathogenesis of Actinomyocosis

A

Actinomyces organisms

trauma, penetrating wounds

CS:

SQ abscesses, draining tracts

Exudates, thick, yellow-grey, hemorrhagic, foul smelling +/- sulphur granules

100
Q

Dx Actinomyces

A

Anaerobic culture

DDx nocardiosis

Tx: surgical debulking

clindamycin

Px for cure is guarded!

101
Q

pahtogenesis of nocardiosis

A

G + filmentous aerobe

CS same as Actinomyces

pyothorax

102
Q

Dx of nocardiosis

A

FNA/cytology

Histopathology

Culture

Tx: surgical debulking, drainage

Px: guarded

103
Q

pathogenesis of opportunistic myobacteriosis

A

saprophytic mycobacterium

CS: slow developing, sq nodules, etc.

104
Q

Dx of Mycobacterium

A

cytology

histopathology

culture

Tx: wide surgcal excision

105
Q

pathogenesis of skin fold pyoderma aka intertrigo

A

skin folds

maceration

superficial infection

CS: lip folds in spaniels, facial folds in bulldogs, tail root folds, vulva folds, body folds in Shar Pei

106
Q

Dx & Tx of intertrigo

A

Dx: clinical presentation, signalment

Tx: shampoos, rinses, topcal Abs

107
Q

etiology of Malassezia dermatitis

A

dogs - Malassezia pachydermatis

cats - M. sympodialis & globosa

ear (otitis externa), lip folds, ventral neck, axilla, interdigital, perianal. May generalize! CHECK FOLDS! CHECK EARS!

commensal - 2o infections

hypersensitivity to yeart product & antigens

108
Q

signalment seen w/ Malassezia dermatitis

A

WHWT

109
Q

what is malassezia associated with

A

allergic dermatitis

endocrinopathies

keratinization disorders

immunosuppression

110
Q

CS malassezia

A

pruritus

malodor

erythema, greasy scaly plaques

paronychia (nail inflammation)

111
Q

CS for dogs & malassezia

A

concurrent underlying dz

rancid like odor

ears: black wax & rancid
hair: red-brown color

112
Q

CS for cats & malassezia

A

Rare

immunosuppressive dz (FIV, FeLV)

113
Q

dx malassezia

A

cytology

>2/HPF (1000x) important

114
Q

tx of malassezia

A

id & tx underlying factors if possible

topical: anti yeast shampoos 2-3 x wk
systemic: ketoconazole, itraconazole (better < hepatic side effects)

115
Q

pathogenesis of dermatophytosis

A
  • Microsporum canis (NB), M. gypseum, Trichphyton metagraphytes*
  • 70% are M. canis*

fungal spores can last long in environment

young, immunosuppressed

  • FeLV, FIV
  • E. canis
  • endocrinopathies
  • malignancies
  • steroid use
    *
116
Q

what is important to remember about dermatophytosis

A

ZOONOTIC

M. canis also the most common fungal infection in humans

117
Q

Dx dermatophytosis

A

Wood’s lamp

mocroscopy of hair pluck

fungal culture

biopsy

DDx in dogs: bact folliculitis, demodecosis

facial lesions (dogs) - pemphigus foliceous/erythematosus

118
Q

mgmt of dermatiophytosis

A

tx underlying dz, tx source, tx organizm

topical therapy: clip around lesions/wb

topical shampoos

systemic tx: griseofulvin, ketoconazole, itraconazole

6-12 mos

119
Q

cattery/multi-cat households dermatophytosis management

A

separate infected animals

tx individuals

toothbrush cultures of all cats

decontaminate environment

120
Q
A

My 2017 RUSVM SAM 2 (8 decks)

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