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EV ACVD Study > Things that were highlighted in NAVDF notes > Flashcards

Things that were highlighted in NAVDF notes Flashcards

1
Q

What are the components of the extracellular lipid bilayer?

A

1) Ceramides
2) Free fatty acids
3) Cholesterol

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2
Q

In which layer of the epidermis are tight junctions found?

A

SG2 only!

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3
Q

Which layer of the epidermis provides a permeability barrier?

A

SG2, where tight junctions live

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4
Q

What cell is able to BYPASS tight junctions?

A

Langerhans cells – dendrites can pass, in order to sample superficial AGs

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5
Q

Rate limiting step for collagen synthesis

A

Prolyl hydroxylase

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6
Q

How does hyperbaric oxygen affect the dermis?

A

Promotes collagen formation (prolyl hydroxylase)

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7
Q

How does vitamin C affect the dermis?

A

Promotes collagen formation (prolyl hydroxylase)

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8
Q

What element is needed for lysyl hydroxylase oxidation?

A

Copper

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9
Q

Signals that induce anagen

A

Wnt, Shh, KGF, noggin (BMP antagonist)

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10
Q

Signals that inhibit anagen

A

BMP

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11
Q

Signals that induce catagen

A

TGF-alpha
EGF
FGF-5
BMP

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12
Q

Signal that promotes hair shaft and IRS differentiation

A

BMP
(helps keep the epidermis between the follicles WNL)

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13
Q

How does noggin induce anagen?

A

Acts on Lef-1 transcription factor

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14
Q

Which species’ hair is nonmedullated?

A

Sphinx, sheep wool, angra goats

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15
Q

First hairs to develop

A

Sinus hairs

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16
Q

Location of tylotrich hairs on body

A

Scattered throughout, surrounded by neurovascular tissue

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17
Q

Which hairs have epitrichial sweat glands?

A

Primary only

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18
Q

Which section of hair follicle is shared in compound hairs?

A

Infundibulum

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19
Q

Which phase of the hair cycle is the bulb present in?

A

Anagen

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20
Q

Where does arrector pili muscle attach?

A

Bulge

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21
Q

Inner root sheath only present during this hair cycle phase

A

anagen and catagen

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22
Q

Which direction does IRS keratinize?

A

Outside in (henle first)

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23
Q

Mode of secretion of epitrichial sweat glands

A

MEROCRINE (not apocrine)
-Secretion via exocytosis

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24
Q

Which species do NOT have epitrichial sweat glands?

A

Rodents, ferrets

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25
Q

How are epitrichial sweat glands innervated?

A

NOT directly

Neural control via adrenergic agonists

Humoral control via adrenergic agonists

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26
Q

What medication can downregulate aquaporin 5?

A

Macrolides (horses treated for Rhodococcus)

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27
Q

What sweat gland change occurs in anhidrosis?

A

Downregulation of aquaporin 5 (water channel for rapid fluid movement)

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28
Q

Where are epitrichial sweat glands largest on the body?

A

Glaborous areas

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29
Q

Which part of hair follicle has the entrance for the epitrichial sweat gland?

A

Infundibulum

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30
Q

What cell surrounds equine sweat glands? #Unique

A

Myoepithelial cells (all animals), but in a loose basket-weave pattern with a rich surrounding blood supply!!

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31
Q

Gene responsible for midline white markings in horses

A

KIT mutation

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32
Q

Disease associated with midline white markings in horses

A

Piebaldism

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33
Q

Gene associated with Waardenburg type 2

A

MITF

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34
Q

Gene associated with white spotting and blue eyes +/- deafness in dogs

A

MITF

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35
Q

Mode of inheritance of waardenburg type 2 (White coat/blue eyes)

A

Autosomal dominant

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36
Q

Other name for waardenburg syndrome type 4 in horses

A

Lethal white foal syndrome

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37
Q

Gene in lethal white foal syndrome

A

Endothelin receptor type B (EDNRB)

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38
Q

Mode of inheritance of lethal white foal syndrome (EDNRB)

A

autosomal co-dominant

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39
Q

Clinical signs lethal white foal syndrome

A

White hair, blue eyes, deaf, aganglionic megacolon

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40
Q

What happens if a foal is homozygous for EDNRB mutation?

A

Lethal

(heterozygous for lethal white foal syndrome)

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41
Q

Gene for grey horse phenotype

A

Syntaxin 17 (STX17)

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42
Q

Mode of inheritance of STX17 in grey horses

A

autosomal dominant

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43
Q

What happens if melanin is outside of an endosome/unbound?

A

Cytotoxic

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44
Q

Gene in Gray collie syndrome

A

AP3 (adaptor protein complex 3)

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45
Q

Which bloodwork finding would you see in Gray Collie Syndrome

A

Cyclical neutropenia –> ultimately die

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46
Q

Silver cat with large cytoplasmic neutrophil granules and clumped melanin pigment on trichogram. Diagnosis?

A

Chediak Higashi syndrome

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47
Q

Gene mutation in Chediak Higashi syndrome

A

LYST/CHS1

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48
Q

Rate limiting step for melanin synthesis

A

Tyrosinase enzyme

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49
Q

Enzyme needed for eumelanin production

A

TYRP1, TYRP2, TYR

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50
Q

OCA type 4 in doberman pinschers –> clinical outcome

A

Make melanoma at a young age

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51
Q

Which gene in white doberman pinschsers makes them develop melanomas?

A

SLC45A2

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52
Q

Breed with SLC45A2 mutation, white coat, make melanomas

A

Doberman pinscher

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53
Q

Gene for OCA type 1

A

Tyrosinase

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54
Q

Gene for OCA type 2

A

TYRP1 (eumelanin)

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55
Q

Gene associated with cAD in Golden Retrievers

A

Filaggrin
RAB3C

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56
Q

Gene associated with cAD in GSD

A

Plakophilin 2
Gene enhancers associated with a risk haplotype

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57
Q

Gene associated with cAD in WHWT

A

Cytochrome P450 26B1

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58
Q

NAME THAT GENE

Pro-inflammatory molecule on the epidermal differentiation complex (EDC)
-Correlated with severity of cAD and TNFa
-EDC includes filaggrin, loricin, involucrin

A

S100A8

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59
Q

Environmental influences that INCREASE cAD (5)

A

1) Urban
2) Regular bathing
3) C-section
4) Household hygeine
5) HDM exposure

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60
Q

Environmental influences that DECREASE cAD (4)

A

1) Rural
2) Multi-animal household
3) Non-commercial food
4) Skin barrier protective diet

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61
Q

Inflammatory signals released by keratinocytes (6)

A

1) ICAM-1
2) MHC class II
3) TARC
4) TNFalpha
5) IL-8

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62
Q

How does the microbiome affect the skin barrier? (3)

A

Healthy bacteria are associated with:
1) Increased ceramides
2) Decreased TEWL
3) Decreased SCORFAD

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63
Q

Mutation in cAD dogs across breeds, geography

A

TSLP receptor

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64
Q

Lower levels of _______ cells at an early age was associated with a higher risk of cAD at an older age in WHWT

A

TReg cells

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65
Q

What happens to the diversity of microorganisms on cAD skin?

A

Decreased diversity

Skewed to Staphylococcus

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66
Q

Biodiversity hypothesis

A

Modern version of hygiene hypothesis

Loss of macrodiversity in the environment and microdiversity within an individual leads to –>
1) Microbe dysbiosis
2) Immune dysfunction
3) Inflammatory dysresponse, lack of tolerance
4) Clinical symptoms of AD (also arthritis, diabetes, other immune mediated diseases)

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67
Q

How long does complete healing of the tympanic membrane take

A

21-35d
Thicker after injury

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68
Q

What is the origin of the outer membrane of the tympanic membrane (3-layer membrane)

A

Ectoderm–> outer ear origin

Center layer = fibrous
Inner layer = pharyngeal pouch origin

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69
Q

What happens to the sebaceous glands in OE canals

A

Less active
But MORE active/dilated ceruminous (apocrine) glands

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70
Q

What do Staphylococcus have to promote Type 2 inflammation?

A

Superantigens (endotoxin)

(Forces MHC cl II on APC and TCR on T cells to bind –> activate nonspecific, robust T cell response!)

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71
Q

Which 3 cell signals are implicated in hyperinnervation in cAD?

A

1) IL-31
2) NGF
3) Artemin (made when AHR is bound to pollutants)

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72
Q

How does allergen immunotherapy work? 4 major mechanisms

A

1) Desensitization of mast cells, basophils, eosinophils (QUICK): increase inhibitory Fc receptors, increase H2 receptors (block action of histamine)
2) Tolerance: generation of Treg, DCreg, IL10+ ILC (ILCreg), Breg, Tfreg; Reduction of Th2 to Th1 ratio
3) Decrease IgE, increase IgG1, IgG2, IgG4, IgA
4) Decreased # mast cells, basophils, eosinophils in tissue

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73
Q

What cells are involved in a Type 2 response

A

*Keratinocytes (alarmins, chemokines, IL-1)
*ILC2 (IL-5, IL-13)
*Th2 (IL-4, IL-13; express CTLA, CCR4, CRTH2)
*DC2 (OX40L)
*B cells (respond to IL-4 to make IgE)
*Eosinophils (express H4R, CRTH2 for prostaglandin binding)

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74
Q

What is FoxP3

A

Treg marker!
Transcription factor
Binds DNA to induce expression of Treg development and functional proteins

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75
Q

How does the Type 2 response affect the skin barrier?

A

1) Downregulates ceramide synthesis
2) Downregulates Filaggrin expression
3) Downregulates antimicrobial peptide expression
4) Alters skin protein and limit content

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76
Q

T or F: histamine is the most important molecule for induction of itch in atopic dermatitis

A

FALSE

NONhistaminergic pathway is more important (TSLP, IL4, IL13, IL31)

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77
Q

What type (greek letter) papillomavirus is BPV 1?

A

DELTA papilloma virus

This means not only does it infect keratinocytes, but ALSO dermal fibroblasts

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78
Q

4 major branches of the skin barrier

A

1) Physical (disorganized lamellar layers, reduction of CER 1, CER 9, CER; Lipids organized as hexagonal; decreased claudin/occludin of tight junctions, corneodesmosin)
2) Chemical (Decreased antimicrobial peptides; Natural hydration factors, lysozyme, phosphlipase A)
3) Immunological (Treg downregulated, Th2 increased. Hyperactive DC with extra IgE R. Keratinocyte alarmins, chemokines)
4) Microbiological (Dysbiosis; more Staphylococcus. Switch from M restricta to pachydermatis. Bacteria adhere to corneocytes more than normal)

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79
Q

What is the main physical blocker against penetration of external agents in the deeper epidermis?

A

Tight junctions in SG2

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80
Q

How do urocanic acid and carboxylic pyrrolidone (NMFs) affect skin pH and protease activity?

A

Decrease pH (more acidic)

Acidic pH INHIBITS protease activation

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81
Q

Outside-Inside-Outside theory

A

Primary defects in cutaneous barrier in AD → penetration of more allergens, stimulates immune system → exacerbation of skin barrier defect
***

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82
Q

T or F: there is a decrease in ceramides in NONlesional cAD skin?

A

True

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83
Q

Which TLRs induce production of TSLP by keratinocytes?

A

TLR3
TLR4

(NOT TLR2, TLR7)

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84
Q

4 phases of wound healing

A

1) Hemostasis/coagulation
2) Inflammation (neutrophils, then macs)
3) Repair/granulation phase
4) Remodeling/scar formation

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85
Q

What marks the END of the coagulation phase

A

Fibrin clot

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86
Q

Cells that stores TGF B

A

Platelets

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87
Q

What type of collagen is present in scar tissue

A

Collagen 1

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88
Q

What type of collagen is present in granulation tissue

A

Collagen 3

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89
Q

Which growth factor is overexpressed in proud flesh. Which cell is hyperplastic in proud flesh?

A

TGF-B1

Mast cell hyperplasia

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90
Q

Which medications are synergistic with HBOT (4)

A

1) Fluoroquinolones
2) Aminoglycosides
3) Beta-lactams
4) Amphotericin B

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91
Q

Which phase of wound healing would you expect to see exudate (septic or nonseptic)

A

Inflammatory phase

(neutrophils getting eaten up by macs)

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92
Q

Risk factors for poor wound healing (6)

A

1) Infection
2) Medications
3) Comorbidities (age, endocrine, liver/kidney, neoplasia, immune-med)
4) Nutrition (need Glu, protein, Mg, Vit A)
5) Location
6) Radiation tx

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93
Q

What is ENDEMIC pemphigus foliaceus?

A

*Fogo salvagem (Brazil)
*Sand fly salivary antigen LJM11

Also: young, poor women in S Tunisia. High temp, UV radiation, contact with ruminants, infections, genetic susceptibility

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94
Q

What drugs can cause PF in cats?

A

*Cimetidine
*Doxycycline

*Econazole/Neomycin/Triamcinolone/Amoxicillin
*Itraconazole/lime sulfur

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95
Q

Major autoantigen for canine PF

A

DSC-1

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96
Q

T or F: Absence of anti-DSC IgG can be used to rule out PF

A

FALSE.

Many dogs with trunk-dominant PF do not have detectable anti-DSC IgG, even though their major autoantigen is still DSC-1

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97
Q

Feline PF treatments

A

*Oral glucocorticoids
*Pulse therapy not helpful in cats
*Apoquel (1 mg/kg BID tapered to 0.5mg/kg BID)
+/-
*Cyclosporine
*Chlorambucil

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98
Q

Which layer of haired skin/foot pad has the most DSC1

A

Stratum granulosum, Stratum spinosum

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99
Q

How does autoantigen IgG lead to blisters in AISBDs?

A

Fab region binds to autoantigen, which induces C1q component of complement system –> Complement-dependent cytotoxicity –> Blisters

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100
Q
A
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101
Q

Mechanism of steric hinderance –> acantholysis

A

Binding of auto-Ab prevents bonding of desmoglein on same cell AND desmosomes between 2 cells

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102
Q
A
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103
Q

Mechanism of signal transduction –> acantholysis

A

Auto-Ab affects the signal transduction pathway is affected. Leading to steric hinderance and desmoglein depletion

*Overexpression of c-myc in PV dogs interferes with signaling cascade needed for DSG-3 expression

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104
Q

Autoantigen for BP

A

*BP180 (Collagen 17)
>
*BP230 (BPAG1e)

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105
Q

Autoantigen for EBA

A

Type VII collagen

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106
Q

What factors are released by inflammatory cells that lead to blister formation in AISBDs?

A

*Neutrophil elastase
*MMP-9
*ROS

Degradation of BMZ structures –> results in deep blister

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107
Q

Which AISBD is mucosal/MC dominant with minimal skin lesions

A

MMP

108
Q

Which AISBD is haired skin only

A

BP

109
Q

Generic modified cyclosporine achieved ______ blood concentrations at 1 hr post-administration than Atopica

A

HIGHER (but only for the 1st hour!!)

After 1.5 hours, no significant difference!!!

We need bioequivalent pharmacokinetic studies based on AUC + Cmax

110
Q

Mechanism of cyclosporine

A

1) CsA binds cyclophillin
2) Cyclophillin binds to calcineurin, which inhibits calcineurin function (does not dephosphorylate NFAT)
3) NFAT cannot translocate to nucleus
4) No increase in IL-2

111
Q

Which disease was successfully treated with mycophenolate monotherapy

A

ECLE

112
Q

Higher doses of Apoquel can cause immunosuppression via reduction in _________

A

*IL-2
*IL-15
*IL-18
*IFNg

*Induces apoptosis of CD4+, CD8+ T cells

113
Q

Which cells are NOT affected by Bruton’s tyrosine kinase

A

T cells

BCR not present in T cells!

114
Q

Histopath difference between SGPS and sarcoidosis in dogs

A

*No neutrophils in sarcoidosis
*Sarcoidosis does not affect adnexa or extend to panniculus

115
Q

Histopath difference between reactive histiocytosis and sarcoidosis in dogs

A

Reactive histiocytosis is bottom heavy

Sarcoidosis is top heavy

116
Q

Which special stain can help determine CAEDE vs Sweets-like?

A

Luna stain (eosinophilic infiltration amount)

117
Q

Which MMPs are upregulated in Perianal fistula

A

MMP 9, MMP 13

*Implicates macrophages in pathogenesis
*Explains extensive tissue destruction

118
Q

Feline plasma cell pododermatitis: Sex

A

Males (esp neutered)

119
Q

What is the virulence factor and target in Exudative Epidermitis?

A

*Exfoliatin toxin
*DSG-1

120
Q

Histopath Darier Disease

A

*Suprabasilar acantholysis
*Corps ronds/ round bodies = dyskeratotic keratinocytes
*Basal cell vacuolation
*Decreased lateral desmosome adhesion
*Separation of keratin filaments from desmosomes –> Circular accumulation of keratin around nucleus, “perinuclear keratin rings”

121
Q

Which level of epidermis are corps ronds present in Darier Disease

A

Stratum spinosum

Parakeratotic stratum corneum: “grains”

122
Q

Trichophyton proteases that may cause proteolytic acantholysis

A

*Substilisins
*Fungalysin metalloproteases
*Di-peptyl-peptidases
*Amino- or caroboxy- peptidases

123
Q

Target of Exudative epidermitis

A

DSG1

124
Q

Cutaneous and Renal Glomerular Vasculopathy (AKA “alabama rot”: clinical signs

A

Acute, with rapid deterioration

Edema, erythema –> hemorrhage, ulcers

HINDlimbs, footpads, mucosae

25% get acute kidney injury AKI. Usually AKI happens AFTER skin lesions.

125
Q

Breeds with familial vasculitis (all in puppies)

A

1) Beagles (familial necrotizing arteritis). ANCA positive.

2) GSD Familial Cutaneous Vasculopathy. Autosomal recessive. 2’ vaccination? Foot pads, nasal bridge. Self recover, but relapse with future vax.

3) Jack Russel Terrier Familial Cutaneous Vasculopathy. Vaccination? Ulcers, alopecia on boney prominences, pinnae, footpads.

4) Scottish Terrier Hereditary Vasculitis (pyogranuloma and vasculitis of the nasal planum); Autosomal dominant. Ulcer of nasal planum.

5) Shar Pei Vasculitis (life threatening! Idiopathic. Fever, hemorrhagic papules, deep ulcers, epidermal detachment. Tx GC)

126
Q

Familial dermatomyositis: environmental factors

A

*Estrus
*Sun exposure
*Trauma

*?? virus, vaccine, drugs, toxins, stress

127
Q

Familial dermatomyositis: genes

A

Risk alleles:
*PAN2
*MAP3K7CL polymorphisms
*MHC cl II haplotypes

128
Q

Hyperkeratotic Erythema multiforme: sex

A

Males > females

129
Q

Which cytokine is important for EM, by upregulating MHC cl I and clI, enabling keratinocytes to present MORE antigens?

A

IFNg

130
Q

Triggers for Erythema multiforme in cats

A

*Infections: FHV
*Drugs (up to 100%): usually antimicrobials
*Neoplasia (thymoma)
*Idiopathic

131
Q

What causes thickening of the BMZ in DLE, MCLE, hyperkeratotic EM

A

Deposition of immunglobulins and immune complexes

132
Q

Which chemokines are UPREGULATED in FAS lesional skin in cats (2)

A

TARC/CCL17
RANTES/CCL5

133
Q

ASIT response in feline asthma; glucocorticoid impact

A

*Not completely allergen specific

*Response is REDUCED by concurrent systemic steroids

*Response is UNAFFECTED by inhaled steroids

134
Q

Horse breed with high rate of Culicoides hypersensitivity

A

Icelandic born horses

135
Q

Which cytokine is upregulated in skin of IBH horses

A

TSLP, IL-13

NOT IL-4

136
Q

Which type of T cell is higher in skin from IBH horses

A

CD4&raquo_space;> CD8

137
Q

Which transcription factor is downregulated in skin of IBH horses (lesional and nonlesional skin)

A

FoxP3 (TF for TRegs)

138
Q

T or F: Blood eosinophil numbers correlate with IBH severity

A

TRUE

139
Q

Function of 5-hydroxytryptamine (5-HT) at high and low doses

A

Low dose: itch
High dose: pain

140
Q

Most effective treatment for IBH

A

Insect avoidance

-move away from standing water
-stable horses at night
-use fans

141
Q

Horse breeds predispoed to Atopic Dermatitis

A

*Arabians
*Finn horses
*Thoroughbreds

142
Q

Atopic Dermatitis in horses: top 3 clinical signs

A

1) Urticaria
2) Pruritus
3) Urticaria + Pruritus

143
Q

Location of pruritus for Atopic Dermatitis in horses

A

Face, trunk, flexural surfaces

+/- urticaria

144
Q

Reasons why prednisolone > prednisone in horses

A

*Poor absorption
*Rapid excretion
*Failure of hepatic conversion of prednisone to prednisolone via 11-B hydroxysteroid dehydrogenase

145
Q

Reason glucocorticoids may trigger laminitis

A

*Vasoconstriction
*Increased circulating insulin or glucose
*Decreased collagen production in lamellae
*Diminished keratin production in hoof wall
*Diminished growth of coronary band

146
Q

MOA of pentoxifylline

A

*Synthetic xanthine derivative

*Inhibits phosphodiesterase

ALLERGY: inhibits T and B cell activation, increase IL-10, PGE2, decrease leukocyte adhesion, decrease neutrophil superoxide, degranulation, IFNg, NK cell activity

*Rheological effects
*Improves wound healing (Increased fibroblast collagenases, decrease TNFa)

147
Q

Efficacy of ASIT in horses

A

70% improve

2/3 stay in remission after ASIT d/c

148
Q

Which medications should NOT be combined with azathioprine, as it inhibits xanthine oxidase

A

Allopurinol, ACEi (enalapril)

Allopurinol is a xanthine oxidase inhibitor, so more of the azathioprine is pushed to active metabolite form (XO would make inactive metabolite = safer)

149
Q

Which medication should NOT be combined with azathioprine, as it inhibits TPMT

A

Sulfasalazine

Myelosuppression

150
Q

Why are IVIg beneficial for autoimmune diseases

A

IVIg increases catabolism of pathogenic IgG

IVIg preferentially binds to neonatal Fc receptors (FcRn). If bound to FcRn, Ig is protected from degredation. Because IVIg is taking all the FcRn spots, pathogenic IgG cannot bind–> so it is degraded.

151
Q

4 anti-inflammatory mechanisms of doxycycline

A

1) Decrease cytokines (IL-1, IL-6, IL-8, TNFa)
2) Inhibit MMPs
3) Reduce leukocyte chemotaxis
4) Reduces NO synthase function

152
Q

MOA of niacinamide

A

Endogenous inhibitor of PARP-1

1) Inhibits proinflammatory cytokines
2) Reduces ICAM-1 expression (decreased neutrophil chemotaxis)
3) Reduces B cell differentiation

153
Q

Which medication should be avoided with colchicine

A

Cyclosporine

Both are p-glycoprotein substrates!

154
Q

T or F: expression of antimicrobial resistance genes is a virulence factor

A

FALSE.

Not necessarily more invasive or proinflammatory

May need to trade a virulence factor in order to have a resistance mechanism (fitness cost)

155
Q

2 virulence factors to help Staphylococcus evade the host immune response

A

*Coagulase (coa gene)– promotes fibrin clot scaffold for tissue invasion –> abscessation, protection of bacterial clusters from neutrophils
*von Willebrand factor-binding protein– known as an indicator of pathogenic potential

156
Q

What are the 2 major clonal lineages of MRSP?

A

ST 71 (Europe, Japan)
ST 68 (USA)

Same mecA gene as MRSA. Probably came from the same CoNS.

157
Q

Risk factors for MRSA in horses

A

*Hospitalization
*Preventative penicillin use
*Ceftiofur
*Aminoglycosides

*Exposure to previously colonized horses
*Antibiotics within 30 days
*Admission to neonatal ICU, hospital

158
Q

What bacteria are considered normal commensals in most food animals

A

S aureus
S hyicus

159
Q

What is the MRSA sequence type that is present in food animals and humans (+ dogs, rats, horses)

A

ST 398

160
Q

What is the infectious stage of Dermatophilus congolensis

A

Ovoid Zoospores!!

161
Q

Bacteria that can cause:
-Necrotizing Fasciitis and Myositis
-Toxic Shock Syndrome

A

Streptococcus canis!

-M Protein: antiphagocytic, destroys C3 convertase

162
Q

Which antibiotic can TRIGGER Toxic Shock Syndrome

A

Fluoroquinolones.

Can trigger more expression of superantigen TSST-1 by S. canis!

163
Q

What’s special about Listeria monocytogenase

A

Facultative intracellular gram + rod in MACROPHAGES

Escapes humoral immune response

164
Q

Which cytokines are crucial for inducing macrophage anti-leishmanial activity

A

IFN-g
IL-2
TNFa

(Th1)

165
Q

Immune response type that makes you RESISTANT to Leishmania infection

A

Th1

166
Q

Immune response type that makes you SUSCEPTIBLE to Leishmania infection

A

Th2

167
Q

Histopath stain to find Leishmania amastigotes

A

Giemsa stain

168
Q

Predisposed signalment for Nocardia infection

A

Male, immunocompromised

169
Q

Fungi that are present on NORMAL dog and cat skin

A

*Alternaria
*Aspergillus
*Cladosporium
*Penicillium
*Rhizopus
*Trichoderma

170
Q

Infective portion of dermatophyte

A

Arthrospore

Forms by segmentation and fragmentation of fungal hyphae

171
Q

Predisposed breeds for M canis

A

*Yorkshire terrier
*Pekingese
*Persian
*Himalayan

172
Q

In what phase of the hair cycle does dermatophyte growth cease?

A

Telogen, as no new keratin production

-Hairs are weak and easily broken

173
Q

What is the dermatophyte antigen that is MOST immunologically active?

What type of hypersensitivity reaction does it produce?

A

Glycopeptide (cell wall)

-Carb portion: immediate-type hypersensitivity
-Peptide portion: delayed-type hypersensitivity

174
Q

Which dermatophyte species is least likely to cause alopecia

A

Microsporum persicolor

Infects surface keratin, does NOT invade hair

Scaling w/no alopecia

175
Q

What dermascopy findings would you expect with dermatophytosis vs alopecia areata

A

Dermatophyte: comma hair
Alopecia areata: Exclamation point hair

176
Q

T or F: Malassezia pachydermatis can grown on a media without lipids

A

FALSE. Lacks fatty acid synthase gene (like all Malassezia)

Uses lipid fractions from within peptones of Sabouraud’s dextrose agar

But technically called “non-lipid-dependent”, because it is the only Malssezia that can grow on Sabouraud’s dextrose agar

177
Q

PAMPs identify _____ on Malassezia

A

*Mannan
*Zymosan

178
Q

PRRs for Malassezia

A

C-type lectins! Need Ca2+ to bind carbohydrates

*Langerin
-Recognizes mannose, beta-glucans
-on Langerhan cells
Many fungi

*Mincle
-Recognizes glucosyl and mannosyl-glycolipids
-on Phagocytes
Malassezia specific

*D-lectin + Mincle stimulate proinflam cytokines (IL-10, TNFa, MIP2)

179
Q

Antimicrobial resistance in Malassezia (2)

A

1) Increased expression of ERG11 gene

Encodes lanosterol 14-alpha-demethylase (Azole target)

2) Increased expression of Drug efflux pumps (CDR1, CDR2; MDR1)

180
Q

Black grain mycetomas organisms

A

*Curvularia geniculata
*Madurella

181
Q

White grain mycetomas organisms

A

*Acremonium
*Pseudallescheria

182
Q

At what temperature are dimorphic fungi a yeast? At what temperature are dimorphic fungi a hyphae/mold

A

Yeast in TISSUE

Hyphae at ENVIRONMENTAL temperatures

ie: Sporothrix, Histoplasma, Blastomyces, Coccidiodes

183
Q

Why is Pythium not a true fungus

A

1) NO CHITIN in cell walls
-Instead: cellulose, B-glucan

2) NO ERGOSTEROL in cell membrane

3) Sexual process = oogamy
4) Infective biflagellate zoopspores in wet environments

184
Q

Characteristics of mycetomas (3)

A

1) Tumefaction (swelling)
2) Draining tracts
3) Grains (aggregates of fungi)

185
Q

T or F: Pythium can be visualized on histopath with PAS

A

FALSE. Lack chitin

186
Q

T or F: Oomycosis is zoonotic

A

FALSE. Infective zoospores only form in water, not in tissue

187
Q

Immune response needed to clear Blastomycosis

A

T-cell mediated
Directed to BAD-1 (adhesin)

188
Q

Diagnosis of Blastomycosis

A

Urine ELISA is best! Can use to monitor response to treatment

Serology: 41-90% sensitive, 90-100% specific

189
Q

Predisposed dogs to Coccidiodes immitis

A

*Young, male dogs.
*Boxers, Dobermans

+/- immunocompromised (more severely affected)

190
Q

Best stain to visualize Coccidiodes immitis spherules

A

Pap stain
(capsular wall = refractile, purple-black. Cytoplasm= yellow. Endospores = red-brown)

Can also use PAS, Wrights stain

191
Q

What needs to be added to DTM for Trichophyton verrucosum

A

Thiamine (100%), inositol (80%)

192
Q

What needs to be added to DTM for Tricophyton equinum

A

Niacin

193
Q

T or F: Orf (Parapoxvirus) is zoonotic

A

True

(Also, Pseudopox in cows causes Milkers Nodules. Orf looks similar. Depends on if contact is sheep vs cow!)

194
Q

Which type of immune response can be detrimental to clearance of BOTH pythium and Leishmania

A

Th2

195
Q

3 Oncogenes for Papillomavirus (and how they affect the immune system)

A

E5:
-Downregulate MHC cl I (immune evasion)
-Decreased gap junctions (KC separate from neighbors)
-Interacts with PDGF (more mitosis)

E6:
-Downregulate p53 (which usually holds cell cycle in G1-S)

E7:
-Cell transformation, pRb phosphorylation

196
Q

Cat breeds with more Malassezia dermatitis

A

Devon Rex
Sphynx

197
Q

Most common Malassezia sp in cat ears

A

Malassezia nana

198
Q

Most common Malassezia species on the cat overall

A

Malassezia pachydermatis

199
Q

Most common Malassezia sp in cat ears

A

Malassezia nana

200
Q

What stimulates phospholipase activity in Malassezia pachydermatis?

A

Endogenous opiod peptides

Beta-endorphins in skin of dogs with dermatitis

Higher phospholipase activity in OE/dermatitis dogs

201
Q

What culture media do you use for most Malassezia species

A

modified Dixons agar (lipid enriched)

1) contact plates = convenient
2) Detergent scrub sampling = gold standard but research only

202
Q

T or F: Cats with FIV/FeLV are at increased risk for dermatophytosis

A

FALSE. They are NOT at increased risk

203
Q

3 main stages of dermatophyte infection

A

1) Arthrospores adhere strongly to keratin
-Mediated by adhesins on arthroconidia, proteases like subtilisins
-Within 2-6 hours of exposure

2) Conidial germination (germ tube emerges from arthroconidia, penetrates SC)

3) Invasion of cornified tissues by producing proteolytic enzymes (keratinase, elastase, collagenase)

Mechanical injury and humidity facilitate penetration

*Hyphae form arthroconidia within 7 days –> complete lifecycle

204
Q

MOA of chlorhexidine

A

Biguanide compound

Affects cell membranes at low concentrations

Congeals cytoplasm at high concentrations

205
Q

MOA of itraconazole

A

Inhibits fungal cytochrome P450 enzyme (140alpha demethylase)

Prevents conversion of lanosterol to ergosterol

Ergosterol needed for cell wall integrity, activity

206
Q

What happens if you combine ketoconazole with ivermectin, midazolam in dogs

or

Cyclosporine in dogs, cats

A

INCREASED plasma concentrations

(Cytochrome p450 inhibitors)

207
Q

What is different about fluconazole compared to the other azoles

A

*Water soluble, minimally protein bound
-Others are lipophilic
*NOT affected by concurrent antacids, do not need food for absorption
*Poor efficacy against dermatophytes

208
Q

Which antifungal medication has the LOWEST MIC for Microsporum and Trichophyton

A

Terbinafine!

209
Q

What is the unique feature of FHV1 on histopath

A

Necrosis of sweat glands

Prominent eosinophils

210
Q

Which flies feed at daytime?

A

*Stable fly (Stomoxys)
*Horse fly (Tabanus)
*Horn fly (Haematobia irritans)

211
Q

What disease is this? Vector?

A

Habronemiasis
“Summer sores”

Vector: Stable fly, Stomoxys

212
Q

Cow Ventral abdomen

A

Stephanofilaria stilesi

Filaria

Vector: Haematobia irritans
“Horn fly”

213
Q

Cow dorsum

A

Warbles
“Cow grubs”

*Hypoderma bovis (spinal cord migration)
*Hypoderma lineatum (esophageal migration

*Cows&raquo_space; Horses
*Warbles = L3 larvae

*Tx = avermectins

214
Q

What disease is this? Which fly is a vector for this disease

A

Onchocerca cervicalis

Culicoides, Simulium (Black fly)

215
Q

Which flies are responsible for these lesions? What disease is this?

A

Equine aural plaques

Caused by equine papillomavirus

Vectors: 1) Black fly, Simulium
2) Stable fly, Stomoxys

216
Q

Breeds predisposed to generalized demodicosis

A

*American Staffordshire terrier
*Staffordshire bull terrier
*Chinese Shar Pei
*French bulldog

217
Q

Where in the skin does Demodex gatoi live

A

Stratum corneum (like sarcoptes)

NOT hair follicle

218
Q

Which dogs are predisposed to amitraz toxicity

A

Small breeds: Pomeranians, Chihuahuas

CHIHUAHUAS ARE ON THE LABEL

219
Q

Reversal to amitraz toxicity

A

Yohimbine, atipamezole

220
Q

Which breeds are sensitive to ivermectin? Mutation?

A

Collies
Australian shepherd dogs
Shetland sheepdogs
English sheepdogs

ABCB1 gene (formerly mdr1); autosomal recessive–> nonfunctional P-glucoprotein = ATP-dependent transmembrane transporter protein, esp at the blood-brain barrier. Cannot transport drugs OUT of the CNS

221
Q

What medications should be avoided with ivermectin

A

Other substrates of P-glycoprotein efflux transporter

ALSO Spinosad products —> inhibitor of P-gp!

222
Q

Which nonpeptidergic c-fiber is most important for cAD itch

A

NP3

Inflammatory itch

Neuromediators: IL-31, IL-4/IL-13, Serotonin, Histamine, LTC4

223
Q

What are the nerve elongation factors

A

TNFa, IL-31, NGF

These are all increased in cAD skin

224
Q

What are the 4 receptors that are sensitized by G protein coupled receptors to transmit itch up the nerve

A

Ca2+ channels:
TRPV1 (vanilloid)
TRPA1 (Ankyrin)

Na+ voltage gated channels:
Na v1.7
Na v1.9

225
Q

What histamine receptors are present on sensory neurons

A

H1, H4 = ACTIVATING
H3 = INHIBITING

226
Q

Which breeds develop Acral Mutilation Syndrome

A
  • German Shorthaired pointers
  • English pointers
  • English Springer spaniels
  • French spaniels
227
Q

What induces complete remission in 100% of cats with idiopathic ulcerative dermatitis on their necks

A

Environmental enrichment

“Behavioral ulcerative dermatitis”

228
Q

Which topical flea prevention should NOT be used on rabbits

A

Fipronil

DO NOT USE ON RABBITS OR HEDGEHOGS

229
Q

Which medication should NOT be combined with ivermectin

A

Spinosad (Comfortis)

Spinosad acts as a p-glycoprotein inhibitor. Increased ivermectin in CNS –> toxicity

230
Q

Which 2 dermatophytes are in the stratum corneum ONLY (not in hair follicles)

A

1) Trichophyton mentagraphytes
2) Microsporum persicolor

231
Q

Would you find a honeycomb liver on AUS of a dog with glucogonoma-derived hepatocutaneous syndrome

A

NO. But you would see a pancreatic mass (or metastatic liver nodules)

HONEY COMB LIVER IS ABSENT IN GLUCAGONOMA HCS

232
Q

How is most T3 made in the body

A

Peripheral tissue deiodinization of T4 (from I4 to I3)

233
Q

What is the best test for hypothyroid diagnosis

A

fT4 + TSH

TSH increases the specificity of fT4

234
Q

How long prior to thyroid testing should glucocorticoids be discontinued

A

At least 4 weeks

235
Q

Effect of Sulfonamides on thyroid

A

*TT4, fT4, T3: Low
*TSH: High

TRUE HYPOTHYROIDISM –> reversible

TMS will decrease follicle function
Increase in TSH because no negative feedback from fT4

236
Q

What results of endogenous ACTH test would you expect with a pituitary tumor derived AHC

A

+ ACTH if pituitary origin

-ACTH if adrenal origin (negative feedback)

237
Q

Expected findings on ACTH stim of a dog with PDH

A

Look at 8hr first. If ABOVE 40nmol/L: consistent with HAC.

Then we need to know if PDH or uncertain origin:

PDH confirmed if:
* 4-hr: <40 nmol/L (in normal range)
* 8-hr: >40 nmol/L BUT >50% reduction from baseline

238
Q

How does TMS affect thyroid levels

A

Inhibits thyroid peroxidase (which adds iodine to tyrosine). Results in true, reversible hypothyroidism

Low TT4, fT4
High TSH

May result in a goiter

239
Q

How does euthyroid sick syndrome affect thyroid levels

A

1) Inhibits 5’/3’ deiodinase, which converts T4 to T3 in the peripheral tissue
2) Decreased TSH secretion
3) Decreased thyroid protein binding

Low TT4, fT4
Normal to low TSH

240
Q

Treatment for cutaneous plasmacytosis (only dogs get this! Like MM)

A

Chemotherapy: Melphalan!

241
Q

What is a risk factor for BISC, especially on haired, pigmented skin in cats?

A

FcaPV2

242
Q

Treatment for perianal gland adenoma

A

Neuter resolves perianal gland adenoma in 95% of cases

243
Q

Gene, mode of inheritance for Dermoid Cysts

A

FGF 3, 4, 19
Autosomal recessive

Dorsal midline

244
Q

Which virus is associated with SCC in cats, horses

A

FcaPV2 (cats)
EcPV2 (horses)

245
Q

Which ceramides contain linoleic acid

A

Ceramides 1, 4, 9

246
Q

Papilloma oncogene that binds pRb (TSP)

A

E7

247
Q

IHC markers for histiocytoma

A

CD1a, CD11c/CD18, E-cadherin, IBA-1

E-cadherin are specific for histiocytoma

248
Q

How can you tell if a mass is cutaneous reactive histiocytosis vs histiocytoma

A

Histiocytoma (LC): Top heavy, E-cadherin +

Cutaneous reactive histiocytosis (DC): Bottom heavy, E-cadherin -

249
Q

MOA of selegiline hydrochloride

A

IRREVERSIBLE inhibitor of monoamine oxidase (MAO)
-Increase in dopamine
-Downregulate ACTH secretion

-Best in dogs with pars intermedia tumor

DOES NOT WORK FOR HAC. But owners like it bc selegiline is metabolized to amphetamine –> increased alertness

250
Q

Why do cats need to ingest arachidonic acid

A

No delta-6-desaturase

251
Q

Which parasiticide is TOXIC TO BIRDS

A

Imidacloprid (Advantage)

252
Q

Which parasiticide should NOT be given to finches

A

Ivermectin

253
Q

Which parasiticide should NOT be given to chelonians (turtles)

A

Ivermectin

254
Q

Treatment for mites and lice in guinea pigs

A

Ivermectin SQ ONLY!!!

PO has poor GI absorption in guinea pigs

255
Q

Which species develops cutaneous lymphoma most commonly

A

Hamsters

256
Q

Why are rabbit abscesses more inspisated than dogs/cats

A

Rabbit heterophils are myeloperoxidase- deficient

257
Q

Which hormones ARE elevated in Ferret Cushings?

A
  • Androgens (andostenedione, 17-alphahydroxyprogesterone, DHEAS)
  • Estradiol

Cortisol NOT elevated

258
Q

Which receptor is present on ferret adrenal tissue in both health and HAC animals

A

LH receptors

Activation of pre-existing LH receptor proteins with HAC!

*Confirmed with GnRH stimulation test

GnRH tells pituitary to release LH –> binds to LH receptors on adrenal glands –> Adrenal glands make estradiol, androgens

259
Q

Life-threatening sequela of ferret adrenocortical disease

A

Cystic urogenital anomalies –> URINARY BLOCKAGE

Prostatic most common (but also in females)
Stranguria, dysuria

260
Q

Medical treatment of adrenocortical disease in ferrets

A

Deslorelin acetate (Suprelorelin) implant

GnRH analog: downregulates GnRH receptors in pituitary gland –> inhibits LH, FSH production

AFTER an initial stimulation (esp in males)

261
Q

Which cytokines are elevated in culicoides hypersensitivity

A

IL-4
IL-5
IL-13
IL-31

Th1 is unaffected or decreased. Th1 is PROTECTIVE against CH

262
Q

3 risk factors for sarcoids

A

1) Exposure to BPV (but also in healthy skin!)
2) Local cutaneous trauma (allows viral activation)
3) Genetic predilection (certain MHC profiles, QH, Ap, Arabian, TB, WB)

263
Q

Which virus is commonly found in ocular and genital SCC in horses

A

EcPV-2

(in 100% in one study!)

Necessary but not sufficient to induce SCC

264
Q

Which goat parasite can cause pruritus due to nerve pain

A

Parelaphostrongylus tenius

Neuro exam, CSF
Tx: Fenbendazole

265
Q

Causative agent of herpes mammillitis in cows

A

BHV-2

Direct contact, insect vectors

EV ACVD Study (52 decks)

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