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.systems based core clinical specialties > SA Dermatology Dz/ Allergies > Flashcards

SA Dermatology Dz/ Allergies Flashcards

1
Q

Ctenocephalides felis (flea)

A

Hypersensitivity to flea salivary Ags
Seasonal (warm)

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2
Q

CS of Ctenocephalides felis (flea)

A

Pruritus, crust, alopecia, erythema, papules
Found on dorsal lumbar area/ caudomedial thighs

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3
Q

Miliary dermatitis (cats)

A

Life cycle (14d): egg →larvae (3 stages) →pupae (most resistant)→ adult
#1 cause of flea allergy in cats

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4
Q

Dx of flea allergies

A

CS/ Lesions/ presence of fleas
Response to therapy
Allergy testing (Intradermal skin test)
Eosinophilia

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5
Q

Therapy to eradicate fleas

A

Activly (topical, Indoxacarb)
Nexguard (oral, afoxolaner)
Bravecto (oral, fluralaner)
Simparica (oral, sarolaner)
Credelio (oral, lotilaner)

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6
Q

Atopic dermatitis

A

Genetically predisposed inflammatory and pruritic allergic skin dz, clinical features associated with IgE directed against environmental allergens

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7
Q

Atopic-like dermatitis

A

Patients with clinical features of atopic dermatitis and no detectable IgE

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8
Q

Atopy

A

Inherited type 1 hypersensitivity
Pruritic face, feet, Axillary, groin
6m-3y

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9
Q

Atopy pathogenesis

A

Mediated by IgE → attaches to mast cell in epidermis → Ag cross links IgE → causes degranulation

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10
Q

Atopy dx

A

History, PE findings
IDST (doesn’t confirm Atopy) and serum allergy testing

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11
Q

Therapy for Atopy

A

Antihistamines, fatty acids, topical anti-itch meds, steroids (if responsive), immunotherapy, avoid allergens, to secondary infections, cyclosporine, oclacitinib, cytopoint

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12
Q

Apoquel (oclactinib)

A

Control of acute and chronic pruritus, flea, food, Atopy and contact allergy
Inhibits the IL-31
Itch relief within 4 hrs

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13
Q

IL-31

A

Mediator of itch
Key cytokine associated with atopic dermatitis, sending the itch signal to the brain

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14
Q

When shouldn’t apoquel be used?

A

Dogs under 12m
Breeding, pregnant or lactating dogs

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15
Q

Side effects of apoquel

A

V/D
May worsen parasitic infections and cancers

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16
Q

Cytopoint (Lokivetmab)

A

Injectable monoclonal Ab designed for dogs
Targets and neutralizes IL-31
SC injection for 4-6w

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17
Q

Food allergies

A

Dx with food elimination diet: 8 weeks of cleansing pets system with novel protein, then individual diet challenge
Tx: avoidance

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18
Q

CS of food allergies

A

Dogs: generalized pruritus, ears, rears and paws
Cats: Facial pruritus, miliary derm and EGC

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19
Q

Allergic contact dermatitis

A

Type 4 hypersensitivity rx
Hairless areas of contact
Pruritic, papular eruption
Dx: patch test and change environ.

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20
Q

Allergic contact dermatitis causes

A

Wandering jew
Commelinceae spp. (spreading day flower) → poison ivy for dogs

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21
Q

Minimal data base for skin infections

A

Skin scraping (parasites)
Skin cytology (secondary bacterial infections)
Ear cytology (fungal growth)
+/- fungal for cx (ring worm)→ always for cats!!

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22
Q

Bacterial pyoderma (secondary bacterial infection)

A

S. psuedintermedius common in dogs
Mild to severe pruritus, pustule

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23
Q

Bacterial pyoderma dx

A

CS, cytology, cx and sensitivity, histopath

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24
Q

Tx for bacterial pyoderma

A

Abx: cephalexin, cefpodoxime, clavamox, clindamycin, SMZ-TMP, chloramphenicol, enrofloxacin
Abx shampoos, sprays, creams and wipes

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25
Q

Surface pyoderma

A

Pytotraumatic dermatitis (hot spot, fleas common source)
Skin fold pyoderma (brachys deeps folds)

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26
Q

Bacterial pyoderma in different species

A

Cat, horse and goat: S. pseudintermedius and aureus
Sheep, cattle: S. aureus
Pig: S. hyicus (Greasy pig dz)

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27
Q

Superficial pyoderma

A

Imeptigo puppy pyoderma: abx
Bacterial foliculitis: abx
CS: papules, pustules, crusts, alopecia, epidermal collaretes

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28
Q

Deep pyoderma

A

Demodex, dermatophytes, FB
Callus pyoderma
Furunculosis (ruptured hair follicles)
Abx: 4-6w

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29
Q

CS of deep pyoderma

A

Bulla, draining tract, ulceration, crusts, +/- fever, lymphodenopathy

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30
Q

Methicillin Resistant Staph

A

S. aureus
Resistant to B-lactam abx and methicillin
Been replaced with oxacillin

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31
Q

What is methicillin-resistance due to?

A

MecA gene that encodes for the production of the altered penicillin binding protein (PBP2a)
Low affinity for all B-lactam abx

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32
Q

Malassezia dermatitis (yeast infection)

A

M. pachydermitis
Severe, non-steroid responsive pruritus
Erythema, alopecia, lichenification, greasy scale, malodor, hyperpigmentation

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33
Q

Where is Malassezia dermatitis common?

A

Ventral neck, axillae, inguinal area, flexural surfaces of elbows, tarsus

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34
Q

Predisposed breeds to Malassezia dermatiti

A

Westies, cockers, bassetts

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35
Q

How to dx Malassezia dermatiti

A

CS, r/o demodex, pyoderma, dermatophytes, cytology

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36
Q

Tx of Malassezia dermatiti

A

Topical therapy: 4% chlorhexidene, benzyl peroxide, miconazole/ ketoconazole shampoo, lime sulfure dip, enilconazole
Systemic antifungals: Ketoconazole, fluconazole, itraconazole 3-4 x week

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37
Q

Dermatophytosis (zoonotic- ring worms)

A

Fungus that invades keratinized structures
Primary host is man
Transmission direct or fomites

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38
Q

Different types of fungal infections

A

Geophilic (inhabits soil)
Zoophilic (animals)
Anthrophilic (humans)
invades hair follicles or S. corneum

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39
Q

Lesions of fungal infections

A

Broken stubby hairs, scaling, erythema
Kerion (nodules rx with ulceration and drainage and extreme inflamm.)

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40
Q

Different species fungal infections

A

M. canis: feline reservoir, asymptomatic
M. nanum- pigs
T.eqinum- horses
T. verrucosum- cows and sheeps

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41
Q

Fungal infection dx

A

Fungal cx/ DTM (sabourauds dextrose agar with clycoheximide, gentamycin, cholrtetracycline)
Macroconidia (microscopic ID)
Wood’s lamp
KOH prep

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42
Q

Fungal infection tx

A

Spontaneous remission in 4m
Itraconazole, clean environ./ clip hairs. topical therapy to reduce contamination

43
Q

Papillomaviruses

A

Nonenveloped DNA virus transmitted by direct and indirect contact (benign)
Infects epithelial cells @ site of damaged skin or mm
Incubation: 1-2 m

44
Q

What do papillomaviruses turn into?

A

Squamous cell carcinomas in some K9s

45
Q

PV regression

A

Humoral immunity protects against viral challenge
Cellular immunity important in PV regression and infiltration with CD4 and CD8+ lymphos for viral clearance

46
Q

Five syndromes of cutaneous papillomas

A

K9 oral papillomatosis
Cutaneous inverted paps
Multiple pigmented, papular, cutaneous paps
Multiple pigmented plaques
Multiple paps

47
Q

K9 oral paps

A

Common and affects young dogs
White flat smooth shiny papules and plaques → gray pedunculated or cauliflower hyperkeratotic mass

48
Q

What do K9 oral papillomas affect?

A

Buccal mucosa, tongue, palate, pharynx, epiglottis, lip, nasal planum, skin, eyelids, conjunctiva, cornea

49
Q

Cutaneous inverted papillomas

A

Dogs 8m-3y
Lesions on ventral abdomen and groin
Small, raised and firm with central pore opening to skin surface

50
Q

Multiple pigmented plaques

A

Mini schnauzers, pugs and shar-peis
@ 2-4 yrs of age on ventrum and medial thighs

51
Q

Characteristics of pigmented plaques

A

Melanotic macules and plaques becomes progressively scalier and more hyperkeratotic

52
Q

Multiple papillomas

A

Foodpads of adult dogs
Firm, hyperkeratotic, horn-like appearance, larger lesions= lameness

53
Q

Feline papillomaviruses

A

Oral (FdPV-2) and skin (FdPV-1) forms
Melanotic macules → plaques progressive and scaly, hyperkeratotic, greasy

54
Q

Oral feline papillopaviruses

A

Causes tongue lesions
6m-9y
Multifocal, small, soft, light pink, oval and slight raised flat topped lesions

55
Q

Multiple viral papillomas (feline papillomaviruses)

A

Middle aged to old
Lesions anywhere on the body (esp. head, neck, dorsal thorax, ventral abdomen and proximal limbs)

56
Q

Dx of Papillomavirus

A

PCR (no sensitive to ID of viral DNA)
Southern blot (specific and sensitive, long time)
Dot blot and reverse blot (sensitive, laborous, accurate)

57
Q

Clinical management for papillomavirus

A

Sx excision, cryosx, electrosx, CO2 laser ablation and observation without tx (spontaneous regression)
Retinoids
Autogenous vx (injection site squamous cell carcinoma)

58
Q

Demodicosis (Red Mange, parasite)

A

Demodex canis
Mom to pup via nursing
Entire life cycle on the dog
Periocular, lips, forelimbs

59
Q

Tx for demodicosis (localized form)

A

Resolve over 6-8w
Tx: none, benzoyl peroxide, goodwinol

60
Q

Juvenile onset demodicosis (generalized)

A

Immunosuppression
Guarded prognosis
Onset <1.5 yrs

61
Q

Breeds predisposed to juvenile onset demodicosis

A

Dobes, GSD, Sheltie, pitbull, Shar pei, boxers
30-50% spontaneously resolve

62
Q

Generalized adult onset demodicosis

A

Most > 4 yrs of age
Look for underlying cause: hypothyroid, allergies, stress, immunosuppression

63
Q

Feline demodicosis

A

Demodex cati (in hair, not contagious) or gatoi (contagious)

64
Q

Dx for demodicosis

A

Deep SS in dogs/ superficial inc cats
Bx for pododermatitis/ Shar pei

65
Q

Demodicosis in other species

A

Rabbits: D. cuniculi
Hamsters: D. criceti
GP: D. caviae

66
Q

Demodicosis tx

A

Tx pyoderma
Amitraz (mitaban) → clip long hair dogs
Ivermectin (contrain in MDR1 gene dogs)
Milbemycin
Lime sulfur dips

67
Q

Sarcoptic Mange/ Scabies (dogs)

A

Sarcoptes scabiei var. canis - zoonotic
Papular eruption, extremely pruritic
Ears, hocks, elbows and ventrum

68
Q

Dx sarcoptic mange

A

SSS, CS, Hx, Pinnal-pedal*

69
Q

Tx for Sarcoptic mange

A

Lime sulfur, selamectin, ivermectin, paramite, amitraz, fipronil spray

70
Q

Scabies in cats

A

Notoedres cati (zoonotic)
Cheyletiella (walking dandruff)- zoonotic, entire life cycle on host, not species specific

71
Q

Abscesses in cats (parasites)

A

Anaerobes: Bacteroides, fusobacterium
Aerobes: P. multocida, Strept.
Lance good ventral drainage, abx

72
Q

Feline acne

A

Bacterial or Malassezia
MC location chin
Tx: benign neglect, topical astringents, abx, benzyl peroxide

73
Q

Mycobacterial infections

A

Internal/ SQ granulomas: M. bovis, M. tuberculosis, M.avian/ intracellulare
Feline leprosy: M. lepraemurium
Sx excision

74
Q

Spreading, SQ, pyogranulomatous in cats

A

Opportunistic (atypical) mycobacteria
M. fortuitum, M. chelonei most common in US
Dx with cx and sensitivity

75
Q

Tx for mycobacterial infections

A

Doxycycline, tetracycline, enrofloxacin, clarithromycin

76
Q

Mosquito bite sensitivity

A

Symmetrical, papular/ erosive dermatitis
Nose, muzzle, ears,
Seasonal occurrence
Tx: steroids, avoidance

77
Q

Indolent ulcer

A

Rodent/ eosinophilic ulcer
MC on upper lip
Tx: steroids

78
Q

Eosinophilic plaque

A

Erosive patch/ plaque lesions on the lateral thighs, inguinal, perineal regions
Intense pruritus, onset may be acute
Tx: underlying allergies and steroids

79
Q

Eosinophilic granuloma

A

Cd./ medial thighs or lateral thorax, chin, oral cavity, interdigital spaces
Conjunction with ulcers, heritable
Tx: steroids, immunosuppressive drugs, tx allergies

80
Q

Autoimmune Dz in dogs and cats

A

Pemphigus complex (4 types)
Ab formation of IC desmosomes
Loss of IC adhesion and ancanthoytic cells
Hereditary, drug induced, UV light, stress

81
Q

What are the 4 types of Pemphigus complex?

A

P. foliaceous: intraepidermal/ subcorneal pustules
P. erythematosus: IE/SQ pustules/ lichenoid inflamm.
P. vulgaris: suprabasilar clefts, vesicles
P. vegetans: IE microabscesses

82
Q

Dx Pemphigus complex

A

Cytology: PMNs with acantholytic cells, no bacteria
Histopath: pustule
Direct immunofluorescence and IHC

83
Q

Therapy for pemphigus complex

A

Corticosteroids
Azathprine in dogs
Chlorambucil in cats
Chrysotherapy (gold salts)
Tx pyoderma and avoid UV light

84
Q

Hypothyroidism

A

Naturally occurring or idiopathic
Caused by primary hypothy or lymphocytic thyroiditis

85
Q

CS associated with hypothyroidism

A

Bilaterally symmetric truncal alopecia, dull dry haircoat, thick pitting skin (myxedema), hyperpigmentation, lack of pruritus, susceptible to skin infections

86
Q

Dx hypothyroidism in dogs

A

TT4, FT4 and TSH
Primary dz: low TT4 and FT4, TSH variable

87
Q

Natural hyperadrenocorticism

A

Bilateral adrenocortical hyperplasia
Middle-age to older dogs

88
Q

Iatrogenic hyperadrenocorticism

A

Misuse of exogenous glucocorticoids

89
Q

Predisposed breeds to hyperadrenocorticism

A

boxer, boston terriers, poodles and dachshunds

90
Q

CS of hyperadrenocorticism

A

PU/PD/PP, systemic hair loss of trunk and extremities, lacker luster hair coat, thin hypotonic skin, bacterial pyoderma, easy bruising

91
Q

Dx of hyperadrenocorticism

A

ACTH response test, skin bx
Elevated liver enzymes (ALT, ALKP, AST), cholesterol, triglycerides and glucose
High dose dex suppression test

92
Q

Tx hyperadrenocorticism

A

Adrenal tumors: sx excision
Pituitary dependent: bilateral adrenolectomy, radiation therapy, trilostane, lysodren, cyprohetadine

93
Q

Otitis externa

A

Inflamm. of the externa ear canal
Unilateral and bilateral, acute or chronic
Erythematoceruminous or suppurative

94
Q

Perpetuating factors causing otitis externa

A

Inflamm. and pathology in the ear that prevents the resolution of otitis

95
Q

Otitis externa pathology

A

Acute inflamm. and edema in ear → chr. inflamm.
Glandular changes, fibrosis and scarring, stenosis and occlusion of the ear canal
Calcification and ossification of cartilage

96
Q

Possible sequela to otitis externa

A

Otitis media and aural cholesteatoma

97
Q

CS of otitis externa

A

Head-shaking, pruritus, pain, excoriations, erythema, edema, exudate, odor

98
Q

Otitis externa dx

A

Cytology: ID the number and morphology of bacteria and yeast, fungal hyphae, parasites, number and type of leukos, excessive cerumen…

99
Q

When should culture and sensitivity be done?

A

Rods on cytology
Systemic abx required
Failure to repsond to initial tx
Otitis media dx or suspected
Pseudomonas infection

100
Q

Myringotomoy

A

Rupturing of the tympanic membrane and useful dx tool for otitis media

101
Q

Dx otitis media

A

Rads, CT or MRI (acute) and bx (neoplasia)

102
Q

Otitis externa tx

A

Ear cleaning
Corticosteroids
Topical otic solutions (abx, antifungal, steroid)
Systemic abx

103
Q

Which abx are safe with ruptured tympanic membranes?

A

Enrofloxacin, ticarcillin, ceftazidime
avoid ototoxic abx aminoglycosides

104
Q
A

.systems based core clinical specialties (27 decks)

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