Module 2 MiniModule 1: Pruritus - Introduction, Approach, and Feline Pruritus

Question 1

Mediators of pruritus:
Histamine, serotonin, platelet-activating factor

Answer 1

Vaso-active amines

Question 2

Mediators of pruritus:
Prostaglandin, leukotrienes

Answer 2

Eicosanoids

Question 3

Mediators of pruritus:
Cathepsin, trypsin, fibrinolysin

Answer 3

Proteases

Question 4

Mediators of pruritus:
Neuropeptides, bradykinin

Answer 4

Peptides

Question 5

Mediators of pruritus:
IL-31

Answer 5

Cytokines

Question 6

Role of Cutaneous Neurons in Skin:
Mediators of pruritus are released in close proximity to what nerves?

Answer 6

Primary Afferent Nerves

Question 7

Role of Cutaneous Neurons in Skin: Fill in the blanks
The signals travel along nerve fibers, received by the _____(1)____ root ganglia and the _____(2)____ horn of the spinal cord to the brain

Answer 7

1. Dorsal
2. Dorsal

Question 8

Puritus:
What is the threshold phenomenon and summation effect?

Answer 8

Allergic animals can tolerate certain degrees of stimuli that are involved in their pruritus, but each one has a variable threshold

Question 9

Hypersensitivities defined:
A pruritic skin disease that is a result of IgE-mediated hypersensitivity to environmental allergens

Answer 9

Atopic Dermatitis (AD)

Question 10

Hypersensitivities defined:
- Food allergy
- Immunologically mediated adverse response to food
- Food intolerance
- Abnormal physiologic response to a food
- Toxic, pharmacologic, metabolic

Answer 10

Cutaneous adverse food reactions (CAFR)

Question 11

List the most common causes of pruritis:

Answer 11

• Allergic disease
  
  • FAD, CAFR, AD
• Infections
  
  • Pyoderma, Malassezia (yeast) dermatitis
• Parasites
  
  • Sarcoptes, Notoedres
  • Demodex gatoi
  • Cheyletiella

Question 12

Seasonality:
Relating to or characteristic of a particular season of the year

Answer 12

Seasonal

Question 13

Seasonality:
No varying with the seasons; constant, permanent

Answer 13

Nonseasonal

Question 14

Seasonality:
Year-round itching, but at certain times during the year the pruritus escalates

Answer 14

“Seasonally nonseasonal”

Question 15

• Flea allergy dermatitis
• Atopic dermatitis
• Insect hypersensitivity
  What seasonality are these?

Answer 15

Seasonal -> Nonseasonal

Question 16

• Cutaneous adverse food reaction
• Sarcoptic mange
• Infections
  What seasonality are these?

Answer 16

Nonseasonal
- these are strictly nonseasonal

Question 17

(T/F) The clinician rates the pruritus of the animal

Answer 17

False, the owner rates the pruritus (scale of 1-10). Reference point needed to monitor changes.

Question 18

List the disease with the most intense pruritus:

Answer 18

• Sarcoptic mange
• Flea allergy dermatitis
• CAFR

Question 19

Age of Onset:
Ectoparasites, FAD, CAFR

Answer 19

< 6 months old

Question 20

Age of Onset:
Atopic Dermatitis/CAFR

Answer 20

1 to 3 years of age

Question 21

Age of Onset:
CAFR

Answer 21

> 7 years of age

Question 22

List some human/animal pruritus:

Answer 22

• Sarcoptic mange, Notoedres
• Dermatophytosis +/- (it can be pruritic but sometimes it isn’t)
• Demodex gatoi (only cat to cat)

Question 23

Diagnostic procedures:
- Demodicosis

Answer 23

Deep skin scraping

Question 24

Diagnostic procedures:
- Sarcoptes, Cheyletiella, Notoedres

Answer 24

Superficial skin scraping

Question 25

Diagnostic procedures: - Bacteria, yeast

Answer 25

Surface cytology

Question 26

Diagnostic procedures: Fleas, flea feces

Answer 26

Flea comb

Question 27

List some cat skin lesions differences:

Answer 27

- Non-inflammatory alopecia, miliary dermatitis, eosinophilic granuloma complex - Rare excoriations, lichenification, hyperpigmentation

Question 28

You identify 10-20 yeast organisms/oil immersion field microscopically from the paws. You want to prescribe a topical product for the owner to use daily on the paws. What active ingredient should the topical product contain?

Answer 28

- Miconazole - Climbazole (Azoles are a god choice for topical therapy for yeast)

Question 29

If you are unsure if a cat is pruritic and the cat has hair loss, what diagnostic test should be performed?

Answer 29

Trichogram - If the tips of the hairs are *blunted*, the cat is pruritic; if the tips are pointed, the hairs are falling out and the cat is not pruritic

Question 30

The least common cause of feline self-induced feline symmetric alopecia is:

Answer 30

Psychogenic

Question 31

If a cat is pruritic in the "pants" region, what is the most likely cause?

Answer 31

- FAD - CAFR - FASS

Question 32

List skin lesions that are less common to see on a cat:

Answer 32

- Excoriations, lichenification, hyperpigmentation - Secondary infections, OE

Question 33

Definition: - Papulocrustous cutaneous reaction pattern - *NOT* an etiologic diagnosis - Common - Secondary alopecia, erythema, excoriation - Localized or generalized

Answer 33

Miliary Dermatitis

Question 34

Eosinophilic Granuloma Complex: - Upper lip - Well-circumscribed - Disc-shaped - Uni- or Bilateral

Answer 34

Indolent Ulcer

Question 35

Eosinophilic Granuloma Complex: - Linear granuloma - Pharyngeal granuloma - Chin/lip form - Pawpad

Answer 35

Collagenolytic Granuloma

Question 36

Eosinophilic Granuloma Complex: - Raised lesion - Can be anywhere, but mostly seen in the ventral abdomen

Answer 36

Eosinophilic Plaque

Question 37

Eosinophilic Granuloma Complex: - Mimics dogs - Very severe - Multiple crusts on the lesion - Mimics autoimmune disease

Answer 37

Head and neck pruritus

Question 38

Non-Self-Induced Alopecia (Rare): Endocrine

Answer 38

- Hyperthyroidism - Diabetes mellitus - *Hyperadrenocorticism* (skin tear)

Question 39

Non-Self-Induced Alopecia (Rare): Paraneoplastic - Shinny

Answer 39

- Feline paraneoplastic alopecia - Pancreatic AC - Biliary carcinoma