Dermatology

Question 1

What is the most common bacterial skin commensal?

What is the most common fungal skin commensal?

Answer 1

Staphylococcus pseudintermedius

Malassezia

Question 2

What is an example of a primary skin pathogen?

Answer 2

Dermatophytes

Question 3

What is pyotraumatic dermatitis caused by?

What is the treatment?

Answer 3

Self-trauma due to underlying trigger: allergy, pruritus, pain
Clip, clean, topical antiseptics/antimicrobials, steroids

Question 4

What is the common locations for Bacterial Overgrowth?

What is the differential diagnosis

Answer 4

Ventral trunk and interdigital spaces

Malassezia dermatitis

Question 5

What may you see on cytological examination of deep pyoderma that you wouldn’t see with superficial or surface pyoderma?

Answer 5

Erythrocytes

Macrophages

Question 6

Is surface pyoderma pyogenic? What WOULDN’T you see on cytological exmination?

Answer 6

Not pyogenic

Wouldn’t see neutrophils

Question 7

What is the best way to sample a deep pyodermal infection for culture?

Answer 7

Fresh tissue sample (biopsy punch)

Question 8

What is MRSP?

What is it resistant to?

Answer 8

Meticillin Resistant S. pseudintermedius
Beta-lactams (penicillins) + fluoroquinolones
Can be multidrug resistant or panresistant

Question 9

What are risk factors for MRSP?

Answer 9

Hospital admission
Multiple vet visits
Previous (especially broad spectrum) systemic antimicrobials

Question 10

How long should you treat deep pyoderma with systemic antimicrobials?
What do you do if progress stops with treatment?

Answer 10

Treat past clinical, cytological and palpable cure (4-12 weeks)
Repeat culture

Question 11

What are the 4 mechanisms of pathogenesis of Canine Atopic Dermatitis?

Answer 11

1. Cutaneous inflammation and pruritus
2. Defective skin barrier function
3. Microbial colonisation
4. Other flare factors

Question 12

What is the age range at which dogs develop signs of cAD?

What about FIAD?

Answer 12

< 3 years old (up to 6 years)

FIAD < 1 year old

Question 13

How many of Favrot’s criteria is needed for a diagnosis of cAD with 85% sensitivity and 79% specificity

Answer 13

5/7 criteria

Question 14

Name a pruritic cytokine involved in cAD

Answer 14

Interleukin-31 (IL-31)

Question 15

Name a pruritic cytokine involved in cAD

What specific therapy targets this?

Answer 15

Interleukin-31 (IL-31)
Lokivetmab (Cytopoint) injections
Anti-canine IL-31 monoclonal antibody

Question 16

When should oclacitinib (Apoquel) NOT be used?

Answer 16

In dogs < 12 months

Question 17

When should oclacitinib (Apoquel) NOT be used?

What is its action?

Answer 17

In dogs < 12 months, immunosuppressed
Breeding dogs
Serious infections Underlying neoplasia
Janus kinase inhibitor (JAK 1)

Question 18

If ear margins are affected, what is your most likely diagnosis?

Answer 18

Mites

NOT cAD

Question 19

If ear margins are affected, what is your most likely diagnosis?
If dorso-lumbar area affected?

Answer 19

Mites
Fleas
NOT cAD

Question 20

What is a signs of a compromised skin barrier?

Answer 20

Increased transepidermal water loss

Question 21

What is an adverse effect of systemic glucocorticoids in relation to the endocrine system?

Answer 21

Iatrogenic hyperadrenocorticism

Question 22

What is the mechanism of Ciclosporin (Atopica)?

Why is it not often used?

Answer 22

Oral calcineurin inhibitor

Expensive in large breed dogs

Question 23

Rate the treatments for cAD with:
Ant-inflammatory
To
Antipruritic

Answer 23

Corticosteroids/systemic glucocorticoids
Ciclosporin
Oclacitinib
Lokivetmab

Question 24

Which is the gold-standard for elimination diets?

Answer 24

Home-cooked

Question 25

What part of the body is Oclacitinib not advised for? What is the risk?

Answer 25

Feet | Pododermatitis

Question 26

What are two differential diagnosis for ear margin seborrhea? What breed is predisposed to it?

Answer 26

1. Scabies 2. Vasculitis (early) Dachshunds

Question 27

What two types of glands are located in the ear?

Answer 27

Sebaceous and ceruminous

Question 28

What is a common disease progression of secondary disease in otitis externa?

Answer 28

1. Malassezia 2. Staphylococci 3. Gram -ve rods Psudemonas aeruginosa (end-point)

Question 29

Name 3 primary causes of otitis externa

Answer 29

Grass seeds Parasites FIAD/cAD

Question 30

Name 3 perpetuating causes of otitis externa

Answer 30

1. Rupture/dilation of tymphanum 2. Hyperplasia of glandular tissue 3. Changes in ear canal (stenosis, oedema, hyperplasia, inflammation)

Question 31

Name 4 predisposing causes of otitis externa

Answer 31

1. Ear confirmation 2. Obstructive (polyps, neoplasia) 3. Water 4. Altered microflora

Question 32

What are 3 consequences of Otitis Media?

Answer 32

1. Conduction deafness 2. Vestibular syndrome 3. Horner's syndrome

Question 33

What breeds can present with PSOM (Primary Secretory Otitis Media)

Answer 33

CKCS | Brachycephalics

Question 34

What is myringotomy? | Where is the incision made?

Answer 34

Creating a hole in the tymphanic membrane for sampling/fluid drainage Caudoventral aspect of pars tensa

Question 35

What 4 clinical signs can present with otitis interna?

Answer 35

1. Head tilt (towards the affected side) 2. Falling 3. Vomiting/anorexia 4. Asymmetrical limb ataxia (NO PARESIS)

Question 36

What is the most likely cause of these type of exudates from the ear? 1. Dry coffee grounds 2. Moist brown exudate 3. Purulent yellow/green + malodourous 4. Ceruminous discharge, little smell

Answer 36

1. Otodectes cynotis 2. Staphylococcus spp. or Malassezia spp. 3. Pseudomonas spp. (or other gram -ves) 4. cAD, FIAD

Question 37

How do you check the integrity of the tymphanic membrane?

Answer 37

Flush back and forth with sterile saline, if bubble(s) appear there is a hole present

Question 38

When should you ALWAYS do bacteriology in otitis?

Answer 38

If rods present (for antibiotic choice) If treatment failure or suspicion of MRS(P) In pyogranulomatous inflammation (hard to see organisms on cytology)

Question 39

What type of ear cleaner should you pick if presented with waxy discharge? What abut mucoid, purulent discharge?

Answer 39

Ceruminolytics (emulsify ear wax for easier removal, Cleanaural) High water content (TRIZChlor or Otodine)

Question 40

What should you NOT use in the treatment of Chronic allergic otitis? (FIAD, cAD)

Answer 40

Antibiotics | Use cleaning, control of the cAD, and local topical steroids

Question 41

What does Psuedomonas cause in the tymphanic membrane and how?

Answer 41

TM rupture | Production of collagenase

Question 42

What is the treatment for Pseudomonas otitis?

Answer 42

Ear cleaner - TRIZChlor (disenfectant) Ear cream - Marbofloxacin/Dexamethasone Prednisolone