Final Exam Inflammation & Repair Deck 2 Flashcards
1
Q
What are the pathological cardinal signs of inflammation?
A
Erythema
Edema
Exudate
Heat
Pain/Itching
2
Q
T/F
If there are pustules or crust, that means there is an inflammatory component to the lesion
A
TRUE
3
Q
T/F
Immune mediated inflammatory lesions can cause depigmentation
A
TRUE
4
Q
T/F
The difference between inflammatory infiltration and neoplasia is that in inflammatory infiltration, you will see papules, plaques, and nodules, but in neoplasia, you won’t.
A
FALSE
You can see these symptoms in BOTH inflammatory infiltration AND neoplasia
5
Q
T/F
The only kind of pigmentation you will see with Dermatitis is hyperpigmentation
A
FALSE
you can see BOTH hyperpigmentation OR hypopigmentation
6
Q
Pyoderma is indicative of this type of infection of the skin
A
bacterial infection will produce pus
7
Q
Another name for
Superficial Pustular Dermatitis
A
Impetigo
8
Q
Greasy Pig Disease is an example of ________ pyoderma
A
superficial
9
Q
T/F
Dermatophilosis is pyoderma of the deep dermis
A
FALSE
it is pyoderma of the superficial EPIDERMIS and hair follicles
10
Q
Bacterial furunculosis and abcesses are examples of pyoderma found in the ______ _______
A
deep dermis
11
Q
Infections of the skin often involve this bacteria, which produces exfoliative toxins that cause intraepidermal splitting.
What is the exception?
A
Staphylococcus
EXCEPT for dermatophilosis
12
Q
What is intertrigo?
A
Skin fold pyoderma
Do not get confused with Impetigo, which is superficial pustular dermatitis
13
Q
What is the MDx for Intertrigo?
A
MDX: Neutrophilic dermatitis
Always think Staphylococcus if you get this MDx
14
Q
T/F
You should always start treatment with antibiotics before taking a biopsy
A
FALSE!!!
ALWAYS biopsy BEFORE antibiotics!!
15
Q
The more common term for Pyotraumatic Dermatitis
A
HOT SPOT
16
Q
You see hairless, slightly raised, well circumscribed lesions and ulcerations with crust on the skin of your dog.
What is this called?
A
HOT SPOT (Pyotraumatic Dermatitis)
17
Q
You see hairless, slightly raised, well circumscribed lesions and ulcerations with crust on the skin of your dog.
What kind of infection is this?
A
Bacterial infection
18
Q
You see hairless, slightly raised, well circumscribed lesions and ulcerations with crust on the skin of your dog.
What is the underlying cause?
A
FLEA Allergy Dermatitis
19
Q
This disease, that can be fatal for neonatal pigs, is also called “Exudative Epidermitis”
A
Greasy Pig Disease
20
Q
What is the bacterial cause of Greasy Pig Disease or Exudative Epidermitis?
A
Staphylococcus hyicus
21
Q
T/F
Pyoderma is a pathological term
A
FALSE
it is a clinical term, caused by an infection
22
Q
What is Dermatophilosis caused by?
A
Dermatophilus congolensis
23
Q
What condition is associated with “train tracks” morphology?
A
Dermatophilosis
24
Q
What are the predisposing factors for Dermatophilosis?
A
Wet weather in humid climates- “Rain Rot”
Prolonged wetting of skin/wool/hair allows penetration of epidermis by zoospores
25
In sheeps, another name for Dermatophilosis caused by
## Footnote
*Dermatophilus congolensis*
LUMPY WOOL
*the exudate dries and pulls wool together, then in sloughs off*
26
How do you confirm *dermatophytes* is the pathogen?
Use a **wood's lamp** to light it up
or take a **fungal culture** and make a smear on a slide
27
T/F
Canine Superficial Spreading Pyoderma is a secondary condition
TRUE
28
If you see Dermatitis AND folliculitis, what is on your DDx?
Bacterial pathogen like *Staph*
or a fungal pathogen like *ringworm (dermatophytes)*
it could also be *demodicosis (mites)*
Rule out dermatophytes using a Wood's lamp
and Mites by doing a smear slide
29
What is it called when follicular inflammation leads to rupture?
Furunculosis
30
What are two conditions grossly indistinguishable from
Canine Superficial Pyoderma?
Clinical signs include *folliculitis, erythematous macules, alopecia, scaling*
MDx: Neutrophilic Dermatitis and Folliculitis
Demodicosis (*Demodex spp. mites*)
Dermatophytosis (*Epidermophyton, Microsporum, Trichophyton*)
31
Which species are you most likely to see *Demodicosis* in?
Dog (young)
32
If you see an adult dog with *Demodicosis*, what should you be worried about?
A systemic disease like *Neoplasia* or
* Endocrinopathy *or
* Immunosuppressive therapy*
33
What is the site of colonization of *Epidermophyton, Microsporum, *and *Trichophyton*,
agents that cause *Dermatophytosis*?
Keratin!!
Immunosuppressed animals are predisposed
34
T/F
*Demodicosis *is zoonotic
FALSE
*Dermatophytosis *IS zoonotic, not *Demodicosis*
35
What are predisposing factors for *Dermatophytosis*?
Young animals
Immunosuppressed animals
Hot/humid environments
36
What stains are used histologically for fungus?
GMS stains
## Footnote
*Dermatophytes may have a granulomatous response*
37
A 5-year-old dog has acutely developed some nasty skin lesions
You see *crusting and ulcerations around the eyes and nose*
and *erythema with pustules and more crusting around the paw pads.*
What is your MDx?
MDx:
Exudative Dermatitis
or
Pustular Dermatitis
38
A 5-year-old dog has acutely developed some nasty skin lesions
You see *crusting and ulcerations around the eyes and nose*
*and erythema with pustules and more crusting around the paw pads.*
What is your suspected EDx? How do you confirm?
EDx suspected:
Bacterial Dermatitis
*Do a cytology on pustules and crust. Biopsy during the acute phases, not months later*
39
A 5-year-old dog has acutely developed some nasty skin lesions
* You see crusting and ulcerations around the eyes and nose*
* and erythema with pustules and more crusting around the paw pads.*
After histology, the following results are given:
**There is leukocyte infiltration of the epidermis**
**No mites or fungus is seen on skin scraping**
**No fluorescence seen with Wood's Lamp**
**No fungal growth seen in culture**
**The pustules have *eosinophils* and some bacteria, but NOT in the cytoplasm of leukocytes**
**There are few neutrophils**
**Keratinocytes have lost connection to eachother**
***WHAT IS YOUR DIAGNOSIS?***
***Pemphigus folliaceous***
40
A group of autoimmune diseases involving type II hypersensitivity against *cell adhesion proteins* (desmosomes)
Pemphigus
41
The most common and milder form of *pemphigus* reported in horses, dogs, cats, and goats
and often involves
*face, ears, footpads and clawbeds*
with **vesicles, pustules, crusts, **and **ulcers**
*Pemphigus folliaceous*
42
*Pemphigus folliaceous *can be
spontaneous, drug-induced, or associated with \_\_\_\_\_\_\_\_
skin disease
_allergic_
43
Cross reaction with the _______ that are holding the skin together is the most common immune-mediated response of dermatological *Pemphigus Folliaceous *skin disease in dogs
_desmosomes_
44
In inflammation and repair:
If you see *suppurative/pustular/exudative/neutrophilic*
lesions
What is your best guess at the pathological process?
**Bacterial or Autoimmunity**
45
In inflammation and repair:
If you see *proliferative lesions*
What is your best guess at the pathological process?
**Viral pathogen**
46
In inflammation and repair:
If you see *vesicular lesions*
What is your best guess at the pathological process?
**Viral or Autoimmunity**
47
In inflammation and repair:
If you see *granulomatous lesions*
What is your best guess at the pathological process?
**"Higher" bacteria**
**Mycobacteria**
**Fungus**
**or**
**Foreign substance**
48
In inflammation and repair:
If you see *eosinophilic lesions*
What is your best guess at the pathological process?
**Allergy**
**or**
**Parasite**
49
In inflammation and repair:
If you see *interface*
What is your best guess at the pathological process?
**Autoimmunity**
50
Piglets in a zoo display come down with skin lesions.
You see a raised, slightly encysted area with multiple papules.
What is your MDx?
**Papular dermatitis**
51
Piglets in a zoo display come down with skin lesions.
You see a raised, slightly encysted area with multiple papules.
**But something is being "added" to the epidermis, so this is most likely a disturbance of growth, or inflammatory.**
What is your DDx?
Not mineral deposit, because it is not white.
Grossly, it looks like a papule
So you gotta think **Viral pathogen**
52
Piglets in a zoo display come down with skin lesions.
You see a raised, slightly encysted area with multiple papules.
**No mites or fungus seen on skin scraping**
**Cytology reports a few lymphocytes and some keratin**
**Culture of the crust shows *Staph *spp.**
**Histopathology shows *Proliferative Dermatitis with "ballooning degeneration" and intracytoplasmic inclusion bodies. The cytoplasm compartment is clear***
What is your diagnosis?!
SWINE-POX is the cause!!
53
The following is pathognomic for a virus in pigs. Which virus is it?
Proliferative dermatitis with "ballooning degeneration"
and
intracytoplasmic inclusion bodies
Swine-Pox Virus
54
What do pox virus lesions look like?
Papules with *necrotic or depressed centers*
## Footnote
**"umbilicated depressed center"**
55
What is the sequence of lesions for a poxvirus infection?
Macule→Papule→Vesicle→Umbilicated pustule→Crust→Scar
56
*Poxviruses* have a gene that is similar to **epidermal growth factor**
which causes ________ \_\_\_\_\_\_\_\_\_
_epidermal_ _hyperplasia_
57
In a lamb, you see vesicles and papules early on, and then later see crusts and scabs on the mouth.
Your MDx is *Papular vesicular dermatitis/chelitis*
and epidermal hyperplasia (acanthosis), ballooning degeneration, and vesicles with *neutrophilic infiltration* which results in pustules.
**What is your diagnosis?**
**Contagious ecthyma**
caused by a
*poxvirus*
58
T/F:
Contagious ecthyma is zoonotic
TRUE
## Footnote
*see painful, umbilicated papules on hands mostly in humans*
59
You are seeing some
*lameness, ptyalism, *and *anorexia* in some **backyard livestock**
When you open the mouth of your sheep, you see **hard vesicles**
In between the toes, you see **vesicles, but mostly ulcers**
**What is your MDx?**
Vesicular Ulcerative Dermatitis and Stomatitis
and
Pododermatitis on the feet
60
You are seeing some
lameness, ptyalism, and anorexia in some backyard livestock
When you open the mouth of your **cow**, you see hard vesicles
In between the toes, you see vesicles, but mostly ulcers
*Histopathology shows something damaging keratinocytes*
so know the process is **degeneration/necrosis or inflammatory**
**What is your diagnosis?**
**Vesicular Stomatitis Virus (VSV) **in cows
61
NEVER FORGET ________ when you see Vesicles
_VIRUSES!_
62
Vesicular dermatitis is caused by _______ virus
*_HERPESvirus_*
63
T/F:
*Herpesvirus* can cause cutaneous vesicles
TRUE
64
What viruses can cause vesicles?
* Herpes*
* Poxvirus*
* Foot and Mouth Disease*
* Vesicular Stomatitis Virus*
* Swine Vesicular Disease*
* Vesicular Exanthema of Swine*
**FMD, VSV, SVD, VES, H, P**
65
*Feline Herpesvirus 1* causes
this MDx
which occurs around their **eyes, lips, and nose**
MDx: Pustular vesicular dermatitis/chelitis/rhinitis
66
What are clinical signs seen with
## Footnote
*Bovine Herpesvirus 2*
Ulcerative mammilitis
and
Pseudo-lumpy skin disease (vesiculo-ulcerative dermatitis)
67
What is the predilection site for *BHV-2 (Bovine herpesvirus 2) *?
TEATS!
Causing vesicles and ulcerations
68
If something is being added to the epidermis, the pathological process is likely due to what?
Disturbance of growth
or
Inflammation
69
What is the LEAST likely cause of
papules, nodules, and plaques
Mineral deposition
70
It's not an abcess if it's not filled with \_\_\_\_
_pus_
71
What is it called when macrophages have uncontrolled growth and division in Idiopathic Sterile Granuloma and Pyogranuloma Syndrome, a rare disease in dogs?
Neoplasia
72
Fungal dermatitis is an *infectious granulomatous disease*
caused by *Pythium* and *Lagenidium *spp.
It is also known as this.
Swamp Cancer
73
Swamp Cancer, or Fungal Dermatitis resembles this pathogenic process clinically, because of its invasive lesions and involvement of regional lymph nodes
Neoplasia
74
What is the MDx for fungal dermatitis, or "Swamp Cancer"?
MDx: Granulomatous dermatitis
*an infectious granulomatous disease*
75
What kind of cells will be seen in lesions of
Granulomatous Dermatitis, caused by *Pythium* and *Lagenidium *spp. ?
Macrophages and a rim of lymphocytes
Fungal hyphae seen in necrotic regions
76
In Actinomycete Mycetomas,
*Nocardia *or *Actinomyces *spp. of bacteria
is introduced via
traumatic injury
77
Large clumps seen in Actinomycete Mycetomas
are grossly evident as ________ \_\_\_\_\_\_\_\_
_sulfur_ _granules_
78
These bacteria cause persistent lesions that can eat away at underlying bone, and are introduced into the host via traumatic injury
*Nocardia* or *Actinomyces *spp.
which cause **pyogranulomatous dermatitis (MDx)**
79
Feline Leprosy is also known as
Mycobacterial Dermatitis
80
Feline Leprosy, or Mycobacterial Dermatitis is caused by
this bacteria, an obligate intracellular organism
*Mycobacterium lepraemurium*
81
What are the predisposing factors for a cat with Mycobacterial Dermatitis (Feline Leprosy)?
Cats in cold, wet areas
FIV or other underlying viral infections
Debilitation
82
How is the MDx for Actinomycete Mycetomas different from the MDX for Mycobacterial Dermatitis?
Actinomycete Mycetomas: MDx- **pyogranulomatous dermatitis**
Mycobacterial Dermatitis: MDx: **granulomatous dermatitis**
83
Another name for Mycobacterial Dermatitis (Feline Leprosy) is
Opportunistic Mycobacteriosis
84
Mycobacterial Dermatitis of dogs, especially boxers, is also known as this.
Canine Leproid Granuloma
85
A boxer with cute floppy ears presents with nodules involving
the dorsal pinna. This is difficult to culture and
ZN stain is needed to see the
acid fast bacilli within macrophages
**What is your number 1 DDx?**
Leproid Granuloma
MDx: Granulomatous Dermatitis
86
Another name for Juvenile Sterile Granulomatous Dermatitis is
Puppy Strangles
87
A puppy that is 3 months old presents with pustules and enlarged lymph nodes. After about a week and a half, the same dog has
*alopecia, edema, crusting, *and its lymph nodes are even larger. It's face and ears along with mucocutaneous junctions are all very swollen.
**What is your diagnosis?**
Puppy Strangles
(Juvenile Sterile Granulomatous Dermatitis)
88
What is the pathogenesis of Puppy Strangles (Juvenile Sterile Granulomatous Dermatitis)?
Pustules--\> Pyogranulomas--\> Granulomas --\> Lymphadenitis (swollen lymph nodes)
Will also have "pyelosteopathy"
89
What is your MDx for Puppy Strangles?
MDx: Pyogranulomatous dermatitis and panniculitis +/- lymphadenitis
(Fever and joint pain often accompany this)
90
What is your MDx for "Lick Granuloma", also called "Acral Lick Dermatitis"?
## Footnote
**This is NOT actually a Granuloma**
MDx: Dermal fibrosis and epidermal hyperplasia
91
A dog presents with his front paws having circumscribed lesions, with hair loss in those areas and some ulceration. Upon Histology, *epidermal hyperplasia, granulation tissue, and fibrosis*
are seen. What is your diagnosis?
Acral Lick Dermatitis
aka
"Lick Granuloma"
**which is NOT actually a granuloma, only called this because grossly looks raised**
92
A 3 years old mixed breed dog is brought in because his constant itching is driving everyone in the family crazy, especially at night.
The dog presents with erythema, alopecia, and scaling and the areas are warm to the touch.
**The pathological process is most likely....**
**Inflammatory!**
**ALLERGY is at the top of the list because of the itching, but you must distinguish this clinically.**
93
A 3 years old mixed breed dog is brought in because his constant itching is driving everyone in the family crazy, especially at night.
The dog presents with erythema, alopecia, and scaling and the areas are warm to the touch.
**A skin scraping shows no mites or fungus, and bacterial culture just shows *Staph *spp. **
**Histopathology shows *Eosinophilic dermatitis with epidermal hyperplasia *and *perivascular leukocyte infiltrate*.**
**WHAT IS YOUR DIAGNOSIS?**
ALLERGIC SKIN DISEASE!!
94
What is your MDx for Allergic Skin Disease?
MDx: Eosinophilic Dermatitis with Epidermal Hyperplasia
95
What is the name for areas where the epidermis is thickened?
Acanthosis
96
What 4 things can cause Allergic Skin Disease?
Atopy
Food Allergy
Contact Hypersensitivity
Insect Bite Hypersensitivity
97
Type 1 Hypersensitivity to environmental allergens
aka
"inhalant allergy"
Atopy
98
How is Atopy "inhalant allergy" diagnosed?
Intradermal skin test
99
A golden retriever has erythema, alopecia, and erosions in the skin around the eye and muzzle. The lesions are caused by self-trauma from rubbing and scratching as a result of pruritis.
What is the cause of these clinical signs?
Atopic Dermatitis
"inhalant allergy"
*Looks like demodex because it was around the eyes*
100
Contact dermatitis is Type ___ Hypersensitivity
Type _4_ Hypersensitivity
101
Lesions in allergic skin diseases vary:
*Erythema, alopecia, and excoriation* are due to
Self-inflicted trauma
102
Lesions in allergic skin diseases vary:
**Papules, Pustules, **and **Crusts**
are lesions due to
Secondary Pyoderma
103
Lesions in allergic skin diseases vary:
**Lichenification, Hyperpigmentation, **and **Scaling**
are lesions due to
Chronicity
104
Insect Bite Hypersensitivity is Type __ and/or __ Hypersensitivity reaction
Type _1_ and/or _4_ Hypersensitivity
105
What is the most likely cause of Insect Bite Type 1 or 4 Hypersensitivity in a horse and where would you see the clinical signs?
*Culicoides *saliva
Effects seen at **tail base, withers **and **head**
106
What is the most likely cause of Insect Bite Type 1 or 4 Hypersensitivity in a dog or cat
and where would you see the clinical signs?
Flea saliva
**Tail base **for **dogs**
**Neck** for **cats**
107
What is the most likely cause of Insect Bite Type 1 or 4 Hypersensitivity in a cat (not flea)
and where would you see the clinical signs?
Mosquito saliva
On the **nose **and **face**
108
What is the MDx for Insect Bite Hypersensitivity?
MDx: Papular/Pustular Dermatitis
109
A dog with flea bite hypersensitivity also commonly has
this **secondary self-trauma associated pyoderma**
**Pyotraumatic dermatitis**
MDx: Chronic and Exudative Dermatitis
110
**Miliary dermatitis **is not a disease, its just a pattern. Describe the pattern
Small erythematous papules
111
**Macropapular dermatitis** commonly seen in cats
with allergic skin disease
is also known as
Miliary Dermatitis
112
T/F
Eosinophilic granuloma complex in cats is a disease that causes ulcers on the upper lips
FALSE
Eosinophilic Granuloma Complex is NOT a disease, it is just a pattern of lesions
113
What are the 3 ways that Eosinophilic Granuloma Complex in cats can present?
1. _Indolent Ulcer_ (upper lip ulcer)
2. _Eosinophilic plaque_ (discrete red to ulcerated plaques on **abdomen or medial thighs bilaterally symmetrical**)
3. _Eosinophilic granuloma_ (nodules on thighs, face, mouth)
114
What is the MDx for Eosinophilic Granuloma Complex?
MDx: Eosinophilic Ulcerative Dermatitis/Chelitis
115
What 4 things can cause an **Eosinophilic Granuloma**?
Parasitic reaction
Insect bite hypersensitivity
Foreign body reaction
Underlying mast cell neoplasia
116
Summer sores in a horse (*cutaneous habronemiasis*)
cause these lesions via larval migration of
*Habronema* or *Draschia *spp.
deposited into a wound by house or stable flies
Cutaneous eosinophilic granulomas
117
What is a very common finding histologically within eosinophilic granulomas?
Degenerate collagen fibers (collagenolysis)
118
Discoid Lupus Erythematosis is an _________ disease
_autoimmune_
119
This 2nd most common autoimmune skin disease is induced and exacerbated by **UV light**
Discoid Lupus Erythematosis
120
An Akita presents depigmentation in its nasoplanar area.
Erythema, scaling, erosion, ulceration, and crusting are also seen.
Because the dog has this disease, you will have to
*immediately start it on immune suppressive therapy* before it
**loses its vision!**
**Discoid Lupus Erythematosis**
| (autoimmune disease)
121
What is pigmentary incontinence?
a histopathological lesion in which melanin granules are free
in the dermis and within dermal macrophages;
it is associated with damage to the stratum basale and
basement membrane of theepidermis.
122
What are melanomacrophages?
The macrophages that break down free melanin and pigment cells caused by pigmentary incontinence
