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Endo and derm Flashcards

1
Q

What products are POMC cleaved into in the anterior pituitary gland?

A

ATCH
also MSH and CLIP and b-endorphins

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2
Q

What hormone acts on the pars intermedia to produce ACTH? And on what cells?

A

TRH
Melanocytes

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3
Q

What inhibits the HPA axis at the level of the pituitary?

A

Inhibition = dopamine

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4
Q

What happens to pars intermedia output as day length shortens

A

Increases so hormone concentrations are greater in Autumn

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5
Q

Histological pituitary appearance in PPID?

A

Single large adenomas or multiple small adenomas

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6
Q

What causes PPID?

A

Loss of dopamine inhibition due to neurodegeneration

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7
Q

Haematological finding (compared to dogs)?

A

High ACTH in blood
dogs = high cortisol in blood

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8
Q

What hormone excess causes dullness in PPID?

A

B-endorphin

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9
Q

What hormone excess causes obesity in PPID?

A

a-MSH = reduced cytokine response = appetite satiety unbalanced = obesity

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10
Q

4 common signs of early PPID

A
  1. Muscle atrophy (inc pot belly)
  2. Hair abnormalities (dull coat and retained hair)
  3. Lack of energy, poor performance (b-endorphin)
  4. Regional adiposity (a-MSH)
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11
Q

4 signs of advanced PPID

A
  1. Metabolic shifts (hyperinsulinemia and laminitis)
  2. Secondary bacterial infections
  3. Hyperhidrosis/anhidrosis (lots of sweat or no sweat)
  4. PUPD
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12
Q

When is the TRH stimulation test good to use? And when not?

A

In early cases
doesn’t work that well in autumn and winter

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13
Q

What is the most common test to use for PPID?

A

The ACTH baseline test

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14
Q

When should the insulin blood test be used in PPID cases?

A

When the horses have laminitis

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15
Q

Sampling considerations when testing ACTH

A
  1. Natural increases in autumn and winter
  2. Increases with stress, excitement
  3. Increases with severe pain
  4. Increases with alpha-2 (take test 5-10 mins after sedation)
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16
Q

How to collect and transport TRH and ACTH tests?

A

Fasting not required
EDTA
Chilled

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17
Q

What drug is used to treat PPID?

A

Pergolide (Prascend)
Dopamine receptor agonist

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18
Q

What drugs can be added if there is a lack of response to Pergolide

A

Cyproheptadine (serotoninergic)
Also cabergoline

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19
Q

What is the role of adipose tissue

A

To store fat, and produce cytokines and hormones

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20
Q

What causes EMS?

A

Associated with insulin dysregulation (Hyperinsulinemia), along with a combination of increased fat deposits and a reduced ability to loose weight

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21
Q

What happens in compensated insulin dysregulation (stage 1)?

A

Low insulin = high glucose = Pancreas secretes excess to cope = tissues store glucose
High insulin, low glucose seen

22
Q

What happens in uncompensated insulin dysregulation (stage 2)?

A

Tissues are overwhelmed and unable to respond
High insulin, high glucose seen

23
Q

What is the third stage of insulin resistance?

A

Persistent hyperglycaemia because of inadequate insulin output (pancreatic β-cell exhaustion)

24
Q

What are the three available EMS tests

A
  1. Basal glucose/insulin
  2. OST (Karo light sugar syrup given by owner and blood levels tested later)
  3. OGTT (Oral glucose tolerance test)
    (4. CGIT (combined glucose and insulin test))
25
What drugs can help with weight loss
Metformin Levo-Tyroxin
26
Diet changes for laminitis/EMS ponies
Poor quality forage (Hay) Soak hay for 30-60 mins Eliminate concentrates and high sugar treats (If at grass give grazing muzzle)
27
How to manage laminitis
Induce feet vasoconstriction (ice water) Restore balanced diet Provide NSAIDs (Flunixin or Phenylbutazone) Confine to stable with deep bedding Support the digit under the frog +/- dole with commercial devices
28
what 3 factors contribute to EMS
1. Obesity 2. Incretins (released by the GIT) 3. Genetics
29
What can cause Hyperlipaemia (physiological and pathological)
Physiological causes = Decreased intake = Increased requirements Pathological causes =Sepsis/SIRS = Azotemia
30
What sequence of events causes Hyperlipaemia
Negative energy balance => Fat mobilisation for energy => Triglycerides released into blood as VLDL => lipoprotein lipase should remove VLDL but it can't keep up => accumulate
31
Diagnostic test for hyperlipidemia
Gross appearance of sour is cloudy/white Test blood Triglycerides Confirmed if over 5mmol/L Also may have high insulin
32
How to treat hyperlipidemia
Provide calories in any way you can Enterally or parenterally
33
Typical melanoma locations
tail perineum parotid commissure of eyes/lips
34
Tx for melanomas
On small masses: - 5-Fluorouracil - Mitomycin C cream Intralesional therapy: - Cisplatin beads every 2-4 weeks - Mitomycin C (IV) - Carboplatin (IV)
35
what virus can cause sarcoids
bovine papilloma virus type 1
36
6 types of sarcoids
1. Occult = mild, small and superficial. Hairless skin 2. Verrucose = wart like. Hyperkeratosis + scale. Can become ulcerated if damaged 3. Nodular = Firm, spherical, sub cut. Usually not issue unless injured 4. Fibroelastic = Fleshy, ulcerated. Can be confused with injured nodular but these are more irregular in shape 5. Mixed = 2+ types 6. Malignant = severe, invasive via lymph, often occur after trauma or failed treatment
37
sarcoid tx
5-FU cream: 55% success, every day for 15 days Intralesional therapy: - Cisplatin every 2-4 weeks - Mitomycin C CANNOT surgically excise sarcoids
38
what is the second most common tumour
sCC
39
locations of mites chorioptes trombicula (harvest) Psoroptes
C = distal limb in winter T = head and legs, dense feathering. Autumn/winter and deep bedding P = head, tail and ears. all year round
40
Chorioptes CS, appearance and treatment
CS: pruritus, stamping, matting of hair, alopecia Appearance: Fat front legs that are funnel shaped Tx: Treat all horses. Doramectin injections - Clip feathers, fipronil spray daily
41
Trombicula autunnalis CS, appearance and treatment
CS: Pruritus, stamping, papules A: red, long legs Tx: Remove straw bedding, normally self limiting - can use pyrethrin and fiprinol spray
42
Psoroptes equip signs and Tx
- Tail rubbing, broken tail hairs, scaling of ears, ear discharge Otitis: Ivermectin or moxidectin oral
43
common lice location and treatment
- Mane, base of tail and dorsum most common - Permethrin pour-on - Fipronil spray daily
44
What is sweet itch
Insect bite sensitivity to Culicoides - Allergy to saliva antigens in flies - Develops early in life and worsens with age - Presents in spring or early autumn - Wet areas, riversides, marshes
45
Signs and Dx of sweet itch
- Dorsal or ventral distribution, or combo - Rubbing against object, chewing dorsum - Crusted papules: mane, rump, base of the tail, face, pinna, neck Dx: - Intradermal allergy test
46
Tx of sweet itch
- fly rug - keep away from water - stable at night - Permethrin pour-on repellent
47
What is Dermatophilosis (D. congolensis)
AKA Rain scald/rot - Skin damage and moisture allows bacteria to enter - Predisposed by poor nutrition and hygiene - Contagious
48
CS and Tx of rain scald
- Tufted papules = coalesce = become exudative - Thick crust and pus - Located on rump, saddle areas, face, neck, pastern Tx: Clean tack, avoid sunlight - Chlorhexidine or povidone-iodine wash daily for 1 week then once a week - Highly exudative or painful cases = Penicillin or TMPS
49
What causes ring worm and how to treat
Trichophyton equinum (+++) and Mycrosporum gypseum - Isolate - Disinfect tack - Sunlight may be helpful - Chlorhexidine spray for 7 days - CHX + Miconazole spray/shampoo 2-3 times a week
50
what is pemphigus
Exfoliative dermatitis (type II hypersensitivity) with antibodies directed epidermal cells
51
what is urticaria
Immune rection against allergens in contact with skin = histamine release = increased vascular permeability = angioedema and oedematous papules
52
What is mud fever also known as
pedal/pastern dermatitis Skin dermis flora => disruption (moisture, dirt, UV, wounds) => colonisation by bacteria or fungi => dysbiosis

Equine (11 decks)

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