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CY Small Animal Dermatology > Nutritional skin diseases > Flashcards

Nutritional skin diseases Flashcards

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Dermatology Board Prep flashcards
1
Q

What are clinical signs suggestive of a nutritional disorder?

A

scaling, crusting, alopecia, comedones, erythema, pruritus, and hair coat changes (dull, dry or greasy)

Protein deficiency: Hyperkeratosis, epidermal hyperpigmentation, loss of hair pigment; patchy alopecia with hairs that are thin, rough, dry and brittle; slow growing coat, increased duration of shedding; scales or crusts

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2
Q

What trichographic findings might you see to suggest a nutritional, endocrine, or metabolic disease is playing a role in your patient?

A

inappropriate numbers of telogen hairs; recall telogen is where growth stops

inappropriately curled, misshapen or malformed hairs suggest an underlying nutritional or metabolic disorder

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3
Q

What are ddx for breaking hairs?

A

DDx: nutritional disorders, dermatophytosis or congenitohereditary disorders (like color dilution alopecia)

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4
Q

What are ddx for unusual pigmented hairs?

A

external sources (salivary staining, chemicals, topical medications), nutritional disorders, color dilution/color mutant disorders, and endocrine

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5
Q

Hair is composed of ___% protein. The amino acid that is present in the hairs is ___.

A

95%; sulfur

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6
Q

__% of a patient’s daily protein intake is required for normal hair growth and keratinization.

A

25-30%

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7
Q

What percent dry matter is required for adequate protein ingestion in a dog or cat’s food?

A

dog: 25%
cat: 33%

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8
Q

Which amino acids can affect hair coat color?

A

aromatic amino acids such as phenylalanine, tryptophan, tyrosine

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9
Q

An amino acid deficiency can be remedied by supplementing with which amino acids?

A

arginine, glutamine, cysteine…also eggs/meat

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10
Q

How much amino acid deficiency is usually seen in patients with Superficial necrolytic dermatitis?

A

o Total serum amino acid levels frequently drop to 1/3 of normal
 Greatest decreases in arginine, leucine, lysine, methionine, proline, threonine, and valine

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11
Q

Ski requires _____ and ___-rich keratohyalin granules in the stratum granulosum, else the epidermis is susceptible to amino acid deficiency

A

requires HISTIDINE and LYSINE-rich keratohyalin granules in the stratum granulosum

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12
Q

What were the conclusions from AJVR 2017 paper, Characterization of aminoaciduria and hypoacidemia in dogs with hepatocutaneous syndrome?

A

Hypoaminoacidemia in dogs with HCS prominently involved amino acids associated with the urea cycle and synthesis of glutathione and collagen. Marked lysinuria and prolinuria implicated dysfunction of specific amino acid transporters and wasting of amino acids essential for collagen synthesis. These findings may provide a means for tailoring nutritional support and for facilitating HCS diagnosis.

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13
Q

What situations has SND been correlated with?

A

phenobarbital administration, vacuolar hepatopathy, glucagonoma of the pancreas, intestinal disease

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14
Q

SND has been reported in which species?

A

humans, dog (shelties, wastes, cockers, scotties, shih tzu?), cat, black rhinoceros

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15
Q

What are the characteristic histopathologic and ultrasonographic findings of SND?

A

Marked parakeratosis (red) with inter- and intracellular edema (white) and hyperplastic basal cells (blue)

“honeycomb” or “Swiss cheese” pattern consisting of variable sized hypoechoic regions surrounded by hyperechoic borders

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16
Q

If the characteristic ultrasonographic findings are not observed in a dog with SND, what else should you look for?

A

drug history (phenobarbital), pancreatic tumor!

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17
Q

Lipids are rich in ___ acid which is key for ceramide production in the skin

A

Lipids are rich in LINOLEIC acid which is key for ceramide production in the skin

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18
Q

insulin stimulates/inhibits protein synthesis

A

insulin inhibits protein synthesis

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19
Q

Cotton fur syndrome in chinchillas is associated with which nutritional imbalance?

A

protein excess! Chinchillas require 15% protein, so if they have a diet >28% protein, they’re in trouble!

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20
Q

On halloween, you meet a cat who is reddish brown. what deficiencies do you suspect?

A

a) Tyrosine and phenylalanine deficiencies can turn a black cat into reddish brown - these are precursors to melanin

B) copper deficiency, since this it is required for tyrosinase

C) EXCESS zinc which can cause a relative copper deficiency

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21
Q

Deficiency or decreased ____ and ___ can result in weak wool of sheep

A

Decreased methionine or lysine= inhibited growth and weak wool fibers

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22
Q

Deficiencies of protein can cause guinea pigs to present with:

A

generalized alopecia

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23
Q

T/F: Saturated fats have 2+ double bonds and PUFAs have no double bonds

A

F: PUFAs have 2+ double bonds; saturated fatty acids have 0 double bonds

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24
Q

MCTs contain how many carbons?

A

8-12 carbons = medium chain

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25
Q

Which is an essential fatty acid:

a) oleic acid
b) linoleic acid
c) arachidonic acid
d) linolenic acid
e) palmitoleic acid

A

B linoleic acid and D linolenic acid

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26
Q

Which fatty acid is a precursor for eicosanoid synthesis?

A

arachidonic acid

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27
Q

List the EFAs in cats:

A

linoleic acid, linolenic acid, arachidonic acid

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28
Q

List the EFAs in dogs:

A

linoleic and linolenic acid

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29
Q

EFAs are highly saturated/unsaturated

A

unsaturated

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30
Q

You’re home-cooking your cat’s diet. Which of these oils MUST you include and why? Multiple answers possible

a) EVOO
b) Sunflower oil
c) corn oil
d) Coconut oil
e) cod liver oil

A

b) sunflower oil

c) corn oil, source of linoleic acid which is essential

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31
Q 
The main dietary source of omega-3 fatty acids in pet food is:
a) Linoleic acid
b) linolenic acid
c) alpha linolenic acid
d) alpha linoleic acid
d)
A

d) alpha linoleic acid

32
Q

What are the metabolites of alpha linoleic acid?

A

 Eicosapentaenoic acid (EPA)

 Docosahexaenoic acid (DHA)

33
Q

What are metabolites of linoleic acid?

A

 Gamma-linoleic acid (GLA)
 Dihomo-gamma-linoleic acid (DGLA)
 Arachidonic acid (AA)

34
Q

t/f: Omega-3 fatty acids compete with omega-6 fatty acids for the same metabolic enzymes, resulting in less production of and displacement of omega-6 fatty acids in phospholipids

A

T

This results in EPA in place of AA. Resultant EPA mediators (eicosanoids) are neutral, less inflammatory or anti-inflammatory

35
Q

t/f: : eicosanoids produced from EPA can directly counteract those produced by AA

A

T

36
Q

Evening primrose oil is which type of fatty acid?

A

linolenic acid source; O-6

 Elongated to DGLA which directly competes with AA as substrate for cyclo-oxygenase and 15-lipoxygenase
 Metabolism of DGLA results in formation of PGE1 and 15-hydroxy-8,11,13-eicosatetranooic acid – both of which have anti-inflammatory effects.

37
Q

How does EPA decrease inflammation?

A

Metabolism of EPA by the lipoxygenase enzymes result in leukotriene B5 (LTB5) and 15-hydroxyeicosapentanoic acid

  • Both are thought to counteract Leukotriene B4 (LTB4), which is more inflammatory.
38
Q

Arachidonic acid is metabolized into two main classes of eicosanoids. What are they, and what do they do?

A

Prostaglandins: alter vascular permeability, potentiate vasoactive substances, modulate lymphocyte function, potentiate pain and pruritus

Leukotrienes: alter vascular permeability, activate neutrophils, modify lymphocyte function, and cause potent neutrophil and eosinophil chemotaxis

39
Q

How much fat is required in dog food?

A

Canines need at least 3% of fat in canned food and 7-8% in dry food

40
Q

How much fat should be in a pig’s diet?

A

1%; else swine parakeratosis which can be related to FA deficiency

41
Q

What is “fur slip”?

A

Chinchillas with cutaneous signs of flaking, reduced hair growth, +/- pruritus and ulcers due to deficiency of LA and AA; can be caused by homemade diets or poorly preserved food or inadequate antioxidants and rancididty

42
Q

Which EFA can be helpful in dogs with seborrhea sick?

A

linoleic acid; usually these dogs have high levels of oleic acid but low cutaneous levels of linoleic acid.

43
Q

Why must vitamin A be administered with food?

A

it’s a fat-soluble vitamin, higher bioavailability when given with food

44
Q

What are the 2 receptors for vitamin A?

A
  • All-trans retinoic acid receptor (RAR)

- 9-cis retinoic acid receptor (RXR)

45
Q

What effects does vitamin A have?

A
  • Antiproliferative, but topical can induce desquamation through induction of EGF
  • Anti-inflammatory effect via downregulation of nitrites and TNF-α
  • Enhance wound healing; stimulating fibroblasts to produce TGF
  • Inhibitors of Hair Growth (Inhibit Anagen, Induce Catagen, Prolong Telogen)
  • Affect proteases, prostaglandins, humoral/cellular immunity, and cellular adhesion/communication
  • Maintenance of normal reproductive and visual functions
46
Q

Why do cats require preformed vitamin A?

A

Cats require preformed vitamin A because they can’t convert B-carotene to vitamin A

47
Q

How Is vitamin A stored in the liver?

A

Stored in liver as retinyl palmitate

48
Q

You examine a horse who’s been left to fend for it’s own nutrition. It’s been foraging only on barley for months.

What are signs in the equine of hypovitaminoses A?

A
  • coronitis!
  • night blindness, excessive lacrimation, reproductive problems, neurologic disorders
  • rough, dull haircoat which progresses to alopecia, scaling and hyperkeratosis
49
Q

You are examining a chameleon who has swollen lateral lip commissures, and both eyes are closed. He has halitosis. What questions do you ask next?

A

history of inappropriate diet? losing weight? dysphagia?

50
Q

You are examining a chameleon who has swollen lateral lip commissures, and both eyes are closed. He has halitosis. What treatment do you start?

A

swab lips w/ chlorexidine and start vitamin A 2000 IU/30 g PO q 2 weeks

51
Q

You are examining an Amazon parrot who is fed only seeds. What do you think is the cause of its hyperkeratosis, blepharitis and white plaques on oral mucosa.

A

hypovitaminosis A

 Vitamin A is essential in caged birds to maintain skin and feathers.
 Seeds are deficient in vitamin A
 Amazon parrots are predisposed to vitamin A deficiency

52
Q

What diet do you expect of turtles that predisposes them to hypovitaminoses A?

A

all-meat diets, especially captive terrestrial box turtles

53
Q

Why are cats fed a high liver diet poorly groomed?

A

high liver diet leads to cervical ankyloses

54
Q

What are signs of vitamin A deficiency?

A

Epidermal hyperkeratosis and scaling, occlusion of sebaceous ducts, papules associated with follicular hyperkeratosis, poor hair coat and alopecia; also reproductive failure, retinal degeneration and night blindness, increased susceptibility to infections

55
Q

What are signs of vitamin A toxicity?

A

Epidermal scaling, unkempt hair coat, anorexia, weight loss, bone decalcification, liver damage

56
Q

What are signs of vitamin D deficiency?

A

Rickets in young, osteomalacia in adults, chest deformity, poor eruption of teeth

57
Q

What are signs of vitamin D toxicity?

A

Increased blood calcium levels, soft-tissue calcification, diarrhea, kidney failure, death

58
Q

What are signs of Vitamin E deficiency?

A

Pansteatitis (seen in cats fed diets high in polyunsaturated fatty acids), seborrhea, muscular dystrophy, reproductive failure, intestinal lipofuscinosis, impaired immunity with predisposition to bacterial skin infections and demodicosis (dogs)

59
Q

What are signs of vitamin E toxicity?

A

anorexia

60
Q

What are signs of vitamin K deficiency?

A

Hemorrhage, poor clotting

61
Q

What are signs of Vitamin C deficiency?

A

Rickets, impaired wound healing, bleeding, anemia, increased susceptibility to infections

62
Q

What is another name for vitamin B1?

A

Thiamine

63
Q

What are signs of thiamine deficiency?

A

Anorexia, weight loss, vomiting, dehydration, ventral flexion of neck, paralysis, incoordination

64
Q

What’s another name for Vitamin B2?

A

riboflavin

65
Q

What are signs of vitamin B2 deficiency?

A

Retarded growth, dry scaly skin, erythema, posterior muscle weakness, anemia, ocular lesions (pannus), glossitis, reduced fertility, testicular hypoplasia, fatty liver

66
Q

What is another name for Vitamin B6?

A

Pyridoxine

67
Q

___ is a component of xanthine oxidase that’s required for epithelial cell maturation, and considered nontoxic.

A

Riboflavin (vit B2)

68
Q

What are signs of Niacin deficiency?

A

Blacktongue (pellagra), pruritic dermatitis, diarrhea, dementia, anorexia, anemia, emaciation, and death

69
Q

What are signs of niacin toxicity?

A

cutaneous flushing, pruritus

70
Q

___ is required for normal red blood cell development and DNA synthesis, and a deficiency in this can cause anemia, leukopenia, stunted growth, glossitis.

A

Folic acid

71
Q

What’s another name for vitamin B12?

A

cobalamin

72
Q

Vitamin ___ is required for synthesis of nucleic acids, involved in purine synthesis and CHO and fat metabolism.

A

B12/cobalamin

73
Q

Biotin is also called ___

A

vitamin B7

74
Q

Niacin is also called ____

A

vitamin B3

75
Q

Which nontoxic water soluble vitamin is required for metabolism of fats and amino acids, essential for skin and hair health, functions in enzyme systems?

A

Biotin/Vit B7

76
Q

Calcium toxicity can result in secondary deficiencies of which other minerals?

A

zinc, phosphorous, copper (interference with absorption)

77
Q

Phosphorous toxicity can cause an EXCESS/DEFICIENCY of calcium.

A

Phosphorous toxicity can cause secondary calcium deficiency. also kidney damage, impaired skeletal development.

deficiency can be manifested as Rough hair coat, pica, anorexia, slow growth, rickets in young, osteomalacia in adults

CY Small Animal Dermatology (6 decks)

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