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Dermatology > Dermatology Part 2 > Flashcards

Dermatology Part 2 Flashcards

1
Q

A 2 year old mixed breed dog presents to you for chronic ear infections. His rDVM has been treating bilateral ear infections since this dog is 6 months old. What underlying condition are you concerned could be causing this?

A

Atopic dermatitis (Allergies)

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2
Q

A 14 year old cat presents to you for head shaking and pawing at his ear. The owner says he has also had some ear discharge in his left ear and now his left eye is squinting. What is your first thought?

A

He has a mass or a foreign body in his ear

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3
Q

You look into an ear with an otoscope. What parts can you see?

A

The vertical and horizontal canals to the tympanic membrane

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4
Q

If you can’t see the tympanic membrane what drugs can you safely give into the ear for an infection

A

sterile water, squalene, Tris-EDTA

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5
Q

What parts of the ear do you need a CT/MRI to visualize

A

the inner ear and middle ear

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6
Q

If a cat has a middle ear infection, what part of his anatomy makes it difficult to treat

A

the bony septum that spilts the bulla into two parts

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7
Q

A human doctor recommends to you that you do a Kirby-Bauer test before you give his dog antibiotics for his ear infection. Do you agree?

A

No, because the topical antibiotics will reach much higher concentrations that what is reported in the test

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8
Q

What do you recommend using to monitor a patients ear infection to see if he is getting better

A

Frequent cytologies to monitor progress

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9
Q

Is radiology a good (sensitive) test for visualizing ear infections

A

no, CT and MRI are better

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10
Q

What are four antibiotics in medicated ear drops

A

Gentamicin, Polymyxin B, Neomycin, Amikacin

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11
Q

What seems to differ in the ears of allergic and healthy dogs?

A

There is a microbe shift and usually an overgrowth of one type of bacteria. Healthy ears are balanced with a microbiome of many types of bacteria growing all in small amounts/ controlling the growth of one another

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12
Q

Name a few predisposing factors

A

Brachycephalic, Excessive hair, pendulous pinnae, frequent ear cleanings

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13
Q

Name some primary factors

A

atopic dermatitis, parasites, foreign bodies, masses, endocrinopathies

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14
Q

Name some secondary factors

A

otitis media, bacteria, yeast, chronic pathologic changes, fibrosis, stenosis, mineralization

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15
Q

What are some signs of otitis media

A

none or fever, anorexia, pain when opening mouth, facial paralysis, Horner’s, hearing loss

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16
Q

What are some signs of otitis interna

A

hearing loss, peripheral vestibular disease, nystagmus,–> damage to vestibulochoclear nerve

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17
Q

What will you see on a histopathology of a pemphigus foliaceous case

A

acantholytic keratinocytes and no microbes

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18
Q

What is unique immunologically with pemphigus folliaceous cases in terms of auto-antibodies

A

they have IgG, IgM, IgA, NO IgE

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19
Q

What are the primary lesions with pemphigus, what about secondary?

A

Pustules–> crusts, erosions, erythema

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20
Q

A dog presents with crusts on his nose and ear flaps and has lost cobblestone appearance and pigment on his nose. He also has lesions on his footpads. What disease are you concerned about

A

Pemphigus Folliaceous

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21
Q

A dog has pustules, what are your 3 differentials

A

pemphigus, pyoderma, dermatophytosis

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22
Q

You are treating a dog with antibiotics for pustules, but he hasn’t improved in a week. You do a cytology and there are no microbes on it. What disease may he have

A

Pemphigus Folliaceous

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23
Q

What symptoms are unique to cats with Pemphigus Folliaceous

A

pustules on the nail folds

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24
Q

What animal does not have puritis when it gets pemphigus`

A

goats

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25
Q

What are two possible causes for pemphigus in dogs

A

idiopathic or drug induced

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26
Q

What is the autoantibody target pemphigus goes after

A

desmocollin 1

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27
Q

What two pemphigus varieties are most severe/ not benign. Where is a unique place these diseases have ulcers?

A

P. vulgaris and Paraneoplastic pemphigus and they have oral ulcers

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28
Q

Which pemphigus does not have suprabasilar pustules/clefts and what does it attack in the skin

A

P. erythematosus and it attaches the subcorneal space with lichenoid interface dermatitis

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29
Q

Which pemphigus is described as a crossover between pemphigus and discoid lupus

A

P. erythematosus

30
Q

which pemphigus can have wart-like proliferations

A

P. vegetans

31
Q

What disease targets hemidesmosomes on haired skin

A

Bullous pemphigoid

32
Q

What disease causes subepidermal vesicles in the oral cavity and paramucosal body areas and German shepherds are overrepresented in it? Is it a death sentence?

A

Mucous Membrane Pemphigoid and no it is benign

33
Q

What causes subepidermal vesicles in the oral cavity, pinna, and groin and causes foot pad sloughing and fever, anorexia, and depression

A

Epidermolysis Bulbosa Aquisita

34
Q

A 4 month old dog presents for oral lesions and footpad sloughing, what disease are you concerned about and why

A

Epidermolysis bullosa because it is a genetic disease (why he has it so young)

35
Q

What disease is antibody mediated? Which one is not (uses cytotoxic T cells)

A

Pemphigus complex, Lupus group

36
Q

What is the pathogenesis of Systemic lupus erythematous

A

T cell dysfunction, polyclonal-cell activation (autoantibody formation), abnormal cytokine profiles

37
Q

What disease often has Antinuclear autoantibodies elevated?

A

SLE- systemic lupus

38
Q

What is the prognosis for SLE

A

guarded, very unpredictable disease that can wax and wane

39
Q

What disease types has an abnormal immune response to self antigens and which one has an abnormal response to antigens/foreign proteins

A

autoimmune and immune-mediated

40
Q

A Gordon Setter presents with multiple toenails falling off of several feet. What disease are you suspicious of?

A

Systemic lupoid onychitis

41
Q

Other than affecting the nails are there any other signs of Systemic lupoid onychitis and what type of disease is this? What is the treatment?

A

No other signs, it is immune-mediated disease, treat with Glucocorticoids initially and then essential fatty acids

42
Q

What disease is characterized as a reaction to any drug. It also has 2 forms what are they?

A

Cutaneous adverse drug reaction, has predictable form that is dose dependent and a idiosyncratic form that is dose independent

43
Q

What are 2 drugs that cause a dose dependent cutaneous adverse drug reaction and what lesions do they present as

A

Doxorubicin- alopecia
Cyclosporine- gingival hyperplasia, lymphoplasmacytic dermal plaques

44
Q

What makes cutaneous adverse drug reactions difficult to diagnose

A

It can mimic any other skin disease, has no specific blood work changes and histopathology isn’t very helpful

45
Q

What immune-mediated disease causes interface dermatitis (cell-rich cutaneous inflammatory reaction) and single keratinocyte death/apoptosis

A

Erthyema multiforme

46
Q

Which one is more severe Stevens-Johnson-Syndrome or Toxic Epidermal Necrolysis. What do they cause at a cellular level and what is unique on histopathology

A

Toxic Epidermal Necrolysis is more severe but they both cause massive keratinocyte apoptosis with minimal inflammation upon histopathology

47
Q

What drugs are high risk to cause Stevens-Johnson-Syndrome and Toxic Epidermal Necrolysis

A

Trimethoprim-sulfa, cephalosporins, penicillins

48
Q

Do you target the lesions for treatment of Erythema Multiforme of humans and dogs?

A

You target them in humans but only sometimes in dogs

49
Q

A dog presents with ulcers all over his body after being given penicillin a month ago. He also is painful upon touch and when you put pressure near an ulcer the skin starts to form a bulla (positive nikolsky sign). The owners said this recently occurred. What diseases could this be and what is the prognosis?

A

Stevens-Johnson-Syndrome or Toxic Epidermal Necrolysis. The prognosis is not good and it will be life-threatening with rapid progression

50
Q

What syndrome (not disease) can be associated with infection, drug reactions, vaccination, other immune-mediated reactions and causes pitting edema, necrosis, purpura, vesicles, and ulcers and affects the ear tips, lips, pressure points, tail, paws. The distribution may have a “checkerboard pattern” and how do you treat it?

A

Vasculitis, treat with glucocorticoids after eliminating the underlying cause

51
Q

What are the three (four?) stages of therapy for immune- mediated disease

A

Induction- fast acting glucocorticoids
Transition- taper with attempt to eliminate glucocorticoids and start on long-use non-steroidal immunotherapies
Maintenance- taper drugs and adjust doses to individual animal
Cure?

52
Q

What drug can cause calcinosis cutis and what statement should you keep in mind that this side effect demonstrates

A

Long-term glucocorticoid treatment, you should keep in mind that the side effects of a treatment should never be worse than the actual disease

53
Q

What is the best way to take a skin biopsy

A

Take bigger specimens, multiple pieces, store in formaldehyde, take them dirty, and rotate the blade in one direction to limit shearing effect

54
Q

What is the difference between furunculosis and follicilitis

A

Furniculosis involves the hair follicle and it is not intact, the dermis responds to the keratin and bacteria and inflammatory cells breaking through the follicle and into the dermis with severe inflammation and hemorrhage

55
Q

What are the three etiologies for folliculitis

A

Staphylococcal infection, dermatophyte infection, demodex mite infestation

56
Q

What is the recommended treatment for furunculosis (broad description)

A

Topical and long term systemic antibiotics

57
Q

What is also known feline acne and what is a common primary factor that makes cats more susceptible to it

A

Chin furunculosis and concurrent atopic dermatitis

58
Q

Is the cause of canine acral lick dermatitis easy to determine the cause of?

A

No, it can have a very complex etiology ranging from allergies to infections to ortho or neuro disorders or can be anxiety based

59
Q

An indoor/outdoor cat presents with a nodular lesion on his abdomen with draining tracts. The owner claims there has been no response to antibiotics and it is slowly getting worse and now has fibrosis. What are you concerned about? How should you treat it?

A

The cat received a wound that has been infected with atypical mycobacteria (from the earth). Need antibiotics and radical surgical resection

60
Q

What is mucormycosis caused by and what does it look like

A

Caused by saprophytic fungi living in organic matter and skin trauma is required for infection, will cause nodular lesions

61
Q

What causes swamp cancer

A

Pythian insidiosum, also known as pythiosis. Caused by motile zoospores in the water that get in via a pre-existing wounds

62
Q

What is the challenge of treating pythiosis

A

It has cellulose in the cell wall, unlike fungi which has chitin so antifungals don’t work. Requires radical surgical resection (like amputation, if possible)

63
Q

How do you diagnose Pythian insidiosum

A

It requires a tissue culture and/or PCR, histology cannot provide a final diagnosis

64
Q

What is the pathogenesis of summer sores

A

The habronema and draschia species of nematodes are deposited in mucoid areas by flies (IH- they eat poop containing the immature nematodes and develop into larvae that are deposited on the horse)

65
Q

What are four causes of sterile inflammation

A

Eosinophilic granulomas, juvenile cellulitis, sterile panniculitis, and sterile granulomas

66
Q

What are the clinical signs of puppy strangles

A

Rapid (overnight) onset causing cellulitis around nose and eyes with possible fever, anorexia, and depression

67
Q

What is the best therapy for canine juvenile cellulitis

A

Glucocorticoids (topically)

68
Q

A dog presents with a mass with small wounds on it and other deep wounds on his back. He also has very red conjunctiva. On histopath there are neutrophils and macrophages and no signs of organisms. What disease are you suspicious of?

A

Sterile pyogranulomatous panniculitis/ Idiopathic nodular panniculitis

69
Q

A cat presents with non-puritic ventral alopecia. The skin looks shiny and the owner states the cat looks like she has been losing weight and is more tired. What disease and underlying cause are you concerned about?

A

Feline Paraneoplastic Alopecia which is caused by and underlying neoplasia

70
Q

What are the three autoimmune diseases that cause blisters and how does that differ from the other pemphigus diseases in terms of lesions?

A

Mucous membrane pemphigoid, Bullosa pemphigoid, epidermolysis bullosa aquisita. The other pemphigus diseases cause pustules or oral ulcers

71
Q

Which pemphigus disease cause pustules and which cause oral ulcers

A

Pemphigus foliaceus (in dogs), Pemphigus erythamatosus, and pemphigus vegetans cause pustules. Pemphigus vulgaris and paraneoplastic pemphigus cause oral ulcers

Dermatology (1 decks)

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