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Nursing support for disease diagnosis > Skin and hair > Flashcards

Skin and hair Flashcards

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1
Q

Why might a vet perform a dermatology exam?

A

Ecto-parasites

Skin lesions

Pruritis

Neoplasia

Chronic dermatitis

Erythema

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2
Q

Describe patient preparation for dermatology exams

A

Skin/hair ample should be performed prior to administration of drug therapy if possible

Ideally, patient should be ‘drug free’ for a 7-10 day period prior to sampling

Patients should be suitably restrained but handled by as few staff as possible

Patients skin should NOT be clipped, scrubbed or washed prior to obtaining sample

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3
Q

Consider healthy and safety for a dermatology exam

A

Potential risk of zoonosis and cross contamination so PPE very important- clients should also be aware

Equipment and surfaces thoroughly disinfected and sterilised after use and dispose of used single used equipment

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4
Q

Describe dermatitis

A

Reddening and swelling of the skin from direct irritation by an external agent or allergen

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5
Q

Describe lesions

A

Tissue abnormality commonly caused by disease or trauma

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6
Q

Describe a rash

A

Widespread eruption of lesions

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7
Q

Describe erythema

A

Reddening of the skin due to increased blood supply

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8
Q

Describe a skin cyst

A

A papule containing fluid of semi solid material e.g. epidermoid and pilar cysts

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9
Q

Describe pyoderma

A

Primary skin infection, commonly staphylococcal or streptococcal

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10
Q

Describe a papule

A

Small, palpable lesion, raised above the skin

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11
Q

Describe a pustule

A

Purulent vesicle (pus filled sac)

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12
Q

Describe plaque

A

Palpable, flat lesion, greater than 0.5mm in diameter

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13
Q

Describe atopy

A

Localised hypersensitivity reaction to an allergen

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14
Q

Describe lichenification

A

Seen with chronic atopy

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15
Q

Describe alopecia

A

Hair loss

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16
Q

Name skin sampling techniques

A

Skin scrapes

Hair brushing

Cytaneous cytology

  • Tape impressions
  • Hair plucks
  • Swabs

Skin biopsy

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17
Q

What are the advantages of a skin scrape?

A

Quick and easy

Generally painless

Often examined in house

Minimal trauma

RVN can perform under vet instruction

Sedation not normally required

Allows examination of full thickness of epidermis and hair follicles

Used to detect cuticular and sub-cuticular parasites

18
Q

Describe a superficial skin scrape?

When should you do one?

A

Superficial skin scrape that does not enter the epidermal layer of the skin

One every patient with scaly or pruritic skin

19
Q

What may you find from a superficial skin scrape?

A

Sarcoptes scabeii

Cheyletiella sp.

Notoedres cati.

Dermatophyte spore infested hair shaft

Lice

20
Q

Describe sarcoptes spp.

A

Intensley itchy, highly contagious and zoonotic mite is transmitted via direct contact

Lesions develop over ventral chest and abdomen, elbows, leg and ears

21
Q

How else could you test for sarcoptes spp.?

A

Sarcoptes antibodies can be detected using ELISA technology

22
Q

Describe a deep skin scrape

When should you do one?

A

Allows collection of sample from air follicle, results in light capillary ooze. Squeeze the skin prior to sampling

When should I do it?
Non-inflammatory and inflammatory alopecia
Pustules
Crusts

23
Q

What might a deep skin scrape find?

A

Demodex sp.

24
Q

How would you choose a sampling site for a deep skin scrape?

A

Head, eats and feet are commonly affected

Areas of erythematous skin

Papules, scales or crusts

Areas of alopecia

25
Q

Describe demodex

A

A mite that often presents with hair loss beneath or around the eyes

In severe cases, the whole body is affected

Not pruritic but secondary pyoderma is

26
Q

What are the advantages of hair brushing?

A

Quick and easy

No sedation required

Patient enjoys

Can be examined in house

RVN can perform under vet instruction

Non traumatic

Inexpensive

Allows collection of cutaneous parasites

27
Q

When should you do a hair brushing sample?

A

Generally itchy patients

Patients with suspected flea infestation

Patients with excess scurf

28
Q

What might a hair brushing sample find?

A

Ctenocephalides

Flea excrete/debris

Cheyletiella sp.

Dermatophytes

29
Q

Describe the hair brush sampling technique

A

Put on gloves

Stand the animal over white background i.e. white paper or tissue and restrain properly

Brush coat with fine toothed comb to collect debris

Place sample collected on the comb and any collected on the paper into a labelled, sterile container

Wetting black particles may indicate the presence of fleas if the dampened particle leaves a red mark on the paper

30
Q

Describe the microscopic evaluation technique

A

Place a cover slip on to the microscope slide, over a portion of the collected sample

Examine on low power x4-x10 under the microscope using the battlement technique

Record the vernier scale, if parasite identified, to allow relocation

If large amount of hair is collected, a hand lens can be used

31
Q

Describe cheyletiella spp.

A

‘Walking dandruff’ causes skin irritation and dandruff

Transmitted directly or indirectly (from bedding)

Causes itchy, flaky skin, sometimes with raised spots and scabs

Commonly affects the dorsal trunk, however infestation of nasal passage may occur, causing sneezing

Humans are at risk of transient infection

Produces pruritic lesions on arms, legs, trunk and buttocks

32
Q

Describe cutaneous cytology

A

Impression smear

Aspiration smear

Sterile cotton tip

33
Q

When should you do cutaneous cytology?

A

When bacterial or yeast infection is suspected (pustules,papules, scales, ulcers, crusts)

Nodules or tumours

Otitis externa

34
Q

What might you find from cutaneous cytology?

A

Cocci and rod shaped bacteria

Inflammatory cells, eosinophils, macrophages

Malassezia

Neoplastic cell

35
Q

Describe impression smear sampling

A

A strip of scotch tape can be pressed onto area to collect cells and surface organisms

Glass side can be rubbed onto moist, exuding skin or greasy surface of infected skin

Clean cotton bud can be rolled onto surface of skin or into ear canals, then roll tip onto glass slide to transfer for examination

Dampen cotton tip with sterile water and rub between digits to obtain inter-digital cutaneous samples

Insert a 25-27g needle into pustule, parallel to the skin to avoid involvement of deeper cells

Take impressed of ruptured pustule using glass side

36
Q

Describe slide evaluation

A

Air dried slides can be stained using the ‘diff quick’ technique and examined under oil immersion

Tape samples can be adhered to the slide and will act as cover slip

37
Q

Describe malassezia pachydermatitis

A

Yeast infection which can be both commensal and pathogenic

Very low risk zoonosis documented in immuno-compromised humans

Commonly occurs in atopic animals with immu-compromise, affecting the skin and eat canals

Can present in low numbers on normal skin, infection is indicated by increased numbers on sample

38
Q

What are the advantages of a Trichogram (hair pluck)

A

Inexpensive

Quick and easy

Minimal trauma

Can be examined in house

Often sedation not required

RVN can do

39
Q

When should you do a Trichogram?

A

In patients with alopecia - look at hair bulbs (3 stages of hair growth cycle)

In patients with broken hair tips - indicating self trauma

Suspected dermatohytosis

To identify colour dilution alopecia

Alternative to deep skin scrape in suspected demodex

40
Q

What might you find from a trichogram?

A

Broken hair tips - indicating self trauma

Demodex

Hair shafts covered in dermatophyte spores or positive for ringworm culture

Melanin clumped into hair shaft -indicating colour dilutionalopecia

Cheyletiella sp.

41
Q

Describe a culture for dermatophytosis

A

Dermatophyte test medium can be used to identify ringworm from a hair pluck and mackenzie brush samples

Specialised agar which is based on sabourauds dextrose agar is used, this contains bacterial inhibitors

pH indicators are incorporated to produced a colour change from amber to red - when fungal growth produces alkaline by products (ringworm) and no colour change - when fungal growth produces acid by products

42
Q

Describe the Mackenzie brush technique

A

If no lesions are present, a sterile toothbrush is used to brush the affected area for 5 minutes

Imbedded the brush and sample into the culture media, sterile forceps can be used to dislodge debris and hair from the brush onto the agar

Nursing support for disease diagnosis (13 decks)

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