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RUSVM SAM 2 > Pruritus 1 - FAD and Atopy > Flashcards

Pruritus 1 - FAD and Atopy Flashcards

1
Q

The unpleasant sensation of the skin the provokes the urge to scratch?

A

Pruritus

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2
Q

What does the owner see that indicates pruritus?

A 
Biting 
Licking
Chewing
Scratching
Gnawing 
Rubbing
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3
Q

What lesions do we see with pruritis?

A

Alopecia
Erythema
Excoriation

Followed by..
lichenification
Hyperpigmentation
Seborrhea

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4
Q

What are causes of pruritus in the dogs?

A

Allergens
Ectoparasites
Infections

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5
Q

What are possible allergens in a dog?

A

Flea bite allergy

Atopic dermatitis
Cutaneous adverse food rxn
Insect bite hypersensitivity/contact dermatitis
Vaccine/drug/heat and cold/sunlight/stress

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6
Q

Ectoparasites of dog?

A 
Sarcoptes 
Demodecosis 
Cheyletiella 
Lice 
Chiggers
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7
Q

Infections causing pruritus in dog?

A

Pyoderma
Dermatophytosis
Yeast

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8
Q

What is most commonly assorted with pruritus of the caudal dorsum ?

A

Flea allergy

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9
Q

What is most commonly associated with pruritus of the of the feet (licking/chewing)?

A

Food allergy/ atopy

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10
Q

What is most commonly associated with pruritus of the elbows and ears?

A

Sarcoptic mange

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11
Q

What pruritic conditions are affected by seasonality?

A

Flea allergy
Atopy
Insect allergy

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12
Q

Which pruritic conditions are not affected by seasonality?

A 
Scabies 
Food allergy 
Flea allergy 
Atopy 
Secondary infection 
Demodecosis
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13
Q

Pruritus can be graded on a scale of 1-10.. which conditions tend to be extremely pruritic at the high end of this scale?

A

Scabies
Flea bite allergy
Food allergy

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14
Q

If pruritis came before the lesions appeared.. what diseases will be at the top of you DDX?

A

Allergies

Scabies

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15
Q

If lesions showed up before pruritis.. what diseases will be at the top of your DDX?

A

Demodecosis

Dermatophytosis

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16
Q

What is generally part of your therapeutic plan in a pruritus case>

A

Flea control

Treat pyoderma if present - topical and systemic

Treat yeast infection if present

Treat for sarcoptes if suspected

Treat ear dz if present

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17
Q

Flea allergy dermatitis causes a type _____ hypersensitivity reaction

A

1

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18
Q

Classical distribution of flea allergy dermatitis?

A

Lumbo-sacral distribution

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19
Q

Lesions associated wtih flea allergy dermatitis?

A

Pruritic, crusting eruption and secondary erythema, seborrhea, alopecia

Excoriation
Pyoderma
Hyper pigmentation
Lichenification

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20
Q

Cats can present with a _____ dermatitis with flea allergy dermatitis

A

Miliary

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21
Q

T/F: an infestation of fleas is NOT necessary to cause flea allergy dermatitis?

A

True

Can only take one flea bite to set off allergic resposne

22
Q

Diagnosis of FAD?

A

Age - any

Distribution of lesions

  • dorsal lumbrosacral
  • tail base
  • cauda medial thigh
  • ventral abdomen
  • flank

Observe fleas or flea dirt

23
Q

What is a definitive diagnostic test for FAD?

A 
Flea antigen test 
3 injections  
- negative control - saline 
- positive control - histamine 
- flea allergen

OR

Elevated serum allergen specific IgE

24
Q

T/F: 80% of skin allergies are flea related

25
What is the treatment for FAD?
Flea eradication - knock down product (nitenpyram, fipronil, imidacloprid, permethrin) - insect growth regulator (S-methoprene, imidacloprid) Environmental control Monthly controls
26
What are monthly spot-ones that can be used for fleas in dogs>??
Advantage multi (imidacloprid and moxidectin) Revolution (selamectin) Frontline plus (fipronil and s-methoprene) Vectra 3D (dinotefuran, permethrin, and pyriproxygen) Promeris (metaflumizone and amitraz)
27
T/F: most of the flea eggs, larvae, an pupae live in the environment and not not the pet
True —> environmental control is very important
28
You have a secondary bacterial infection from FAD.. how will you treat this?
Treat the secondary bacterial infection - topical antibiotics Use prednisolone in moderate to severe cases once pyoderma is eliminated (lowest possible dose to control clinical signs—> reduce/stop pruritus )
29
What type of hypersensitivity reaction is atopy?
Type 1
30
Characteristic signs of atopy?
Pruritis Chronic/relapsing/seasonal Onset at 4months to 7yrs Paws, face, distal extremities, elbow, ventrum, otitis externa
31
What is the most common cause of primary otitis ?
Atopy (allergic dermatitis)
32
What diagnostics can you do to confirm atopy?
``` Serum tests (RAST and ELISA tests) Intradermal skin tests ``` Detect —> allergen-specific IgE
33
When should allergy tests be done?
If clinical diagnosis of atopy is made If allergen-specific immunotherapy (ASIT) is been considered If allergen avoidance measures are been considered
34
What is the gold standard test for atopy?
Intradermal allergy testing
35
What allergens are tested for with intradermal allergy testing?
Seasonal —> trees, grasses, weeds, molds Non-seasonal —> dust mites, cockamouse, moths, dander, storage mites
36
How will you preform intradermal allergy testing?
Avoid antihistamines and essential fatty acids 2 weeks before Avoid oral and topical steroids for at least a month No baths for at least 5 days Clip hair and sedate Marker to indicate where allergen is given 0.05ml of allergen Pos control - histamine Neg control- saline Grade 1-4
37
What is hyposensitisation?
Injection of diluted allergens into the patient —> concentration increased up to a maintenance dose
38
What factors effect the efficacy of hyposensitisation in atopic dermatitis?
Patients selection - dogs with less than 10 allergens have a better response Allergen selection - based on IgE testing Dose of allergen - higher dose protocol appears better Administration of immunotherapy - conventional vs rush protocol Time —> 2-5months improvement Duration of allergen specific immunotherapy
39
What are three possible therapies for atopy?
ASIT (allergen-specific immunotherapy) - hyposensitisation Allergen avoidance Symptomatic relief
40
What are two forms of allergy shots for allergen-specific immunotherapy?
Subcutaneous immunotherapy — increased the dose and concentration slowly Sublingual immunotherapy - twice daily
41
What symptomatic therapy has the best evidence for atopy treatment?
``` Glucocorticoids Cyclosporine A Oclacitinib Monoclonal antibody IL31 Recombinant canine interferon gamma ```
42
What is the MOA of skin lipid therapy?
With atopy the epidermal barrier is compromised —> more penetration by allergens, irritants, and yeast Skin lipid restores the barrier —> dermoscent —> duoxo —> allerderm
43
In an allergic crisis of as a therapeutic trial for atopy, corticosteroids can be used.. what preparations can be used?
Oral prednisolone Injectable dexamethasone
44
What are disadvantages to corticosteroids?
PU/PD PP and weight gain ``` Iatrogenic hyperadrenocortisim Iatrogenic hypoadrenocorticism (if withdrawn quickly) ``` Less effective over time More susceptible to infections Urinary incontinence Temperament/behavior changes
45
What is the MOA of cyclosporine A (Atopica)?
Anti-allergic and immunosuppressive by blocking Tcell activation Better absorbed on empty stomach
46
Side effects of cyclosporine A (atopica)?
Vomiting/diarrhea | Exacerbate skin infections
47
What is the MOA of oclacitinib (Apoquel)?
JAK 1 and 3 inhibitor -> inhibits proinflammatory mediators and cytokines Decrease itching and inflammation
48
What is a monoclonal antibody against IL31?
Cytopoint — single injection 4-8weeks IL31 is responsible for itching sensation
49
T/F: antihistamines are effective in treatment of atopic dermatitis?
False
50
What is the purpose of fatty acid supplementation in atopic dermatitis?
Steroid sparing effect Improve cell membrane barrier Less inflammatory eicosanoids Less pro-inflammatory products Less inflammation

RUSVM SAM 2 (44 decks)

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