Therapeutic Grab Bag Flashcards Preview

Therapeutics > Therapeutic Grab Bag > Flashcards

Flashcards in Therapeutic Grab Bag Deck (191):
1

TRUE/FALSE

Linoleic acid is an omega-6 polyunsaturated EFA

TRUE

Linoleic acid is an omega-6 polyunsaturated EFA

2

TRUE/FALSE

The canine skin has an acidic pH

FALSE

The canine skin has an acidic pH

The pH of normal canine skin has been reported to range from 4.84 to 9.95.

3

TRUE/FALSE

Lauryl ether sulfate is an anionic surfactant present in many veterinary shampoos

TRUE

Lauryl ether sulfate is an anionic surfactant present in many veterinary shampoos

4

TRUE/FALSE

Occlusive dressings enhance the percutaneous absorption of topical drugs

FALSE

Occlusive dressings enhance the percutaneous absorption of topical drugs

5

TRUE/FALSE

Miconazole has bactericidal properties - for instance, against Staphylococcus

TRUE

Miconazole has bactericidal properties - for instance, against Staphylococcus​. 

6

TRUE/FALSE
Mupirocin should not be applied to mucous membranes

TRUE

​Mupirocin should not be applied to mucous membranes

 

This precaution relates to the polyethylene glycol base and concern for nephrotoxicity.

7

TRUE/FALSE
DMSO facilitates absorption of many substances across membranes - especially corticosteroids. 

TRUE

DMSO facilitates absorption of many substances across membranes - especially corticosteroids. 

8

TRUE/FALSE

Zinc oxide and titanium dioxide are examples of chemical sunscreens

FALSE

Zinc oxide and titanium dioxide are examples of physical sunscreens

9

TRUE/FALSE

Sunflower oil contains a high percentage of linoleic acid

TRUE

Sunflower oil contains a high percentage of linoleic acid

10

TRUE/FALSE

Cryosurgery is contraindicated for mast cell tumors

TRUE

Cryosurgery is contraindicated for mast cell tumors

11

TRUE/FALSE

Melatonin is synthesized in the pineal gland from tyrosine

FALSE

Melatonin is synthesized in the pineal gland from tryptophan.

12

TRUE/FALSE


Supplementation of the diet with N-6 fatty acids can help to reduce hypersensitivity reactions

FALSE


Supplementation of the diet with N-3 fatty acids can help to reduce hypersensitivity reactions

13

TRUE/FALSE

 

Pentoxyfilline has been reported to be associated with development of erythema multiforme in dogs

TRUE

Pentoxyfilline has been reported to be associated with development of erythema multiforme in dogs

14

TRUE/FALSE

Serum levels of cyclosporine correlate well with clinical response. 

FALSE

Serum levels of cyclosporine correlate poorly with clinical response. 

 

Monitoring serum levels of cyclosporine in inflammatory skin diseases generally does not correlate with clinical response. However, there may be some value in monitoring these levels in the absence of clinical response. If levels are in the low therapeutic range, dosages can be increased in an attempt to obtain a response. 

15

TRUE/FALSE

DepoMedrol is methylprednisolone acetate

TRUE

DepoMedrol is methylprednisolone acetate

16

TRUE/FALSE

Prednisone and prednisolone have similar potency. 

Mehylprednisolone is approximately 20% more potent than either. 

FALSE

Prednisone and prednisolone have similar potency. 

Mehylprednisolone is approximately 25% more potent either. 
 

4mg of methylprednisolone = 5mg of prednisone

17

TRUE/FALSE

In a dog with hypoadrenocorticism, the replacement dosage of prednisone is as low as 0.02 mg/kg/day. 

FALSE

In a dog with hypoadrenocorticism, the replacement dosage of prednisone is as low as 0.2 mg/kg/day. 

18

TRUE/FALSE

In the cat, glucocorticoids do not cause polyuria, polydipsia and low urine density. 

TRUE

In the cat, glucocorticoids do not cause polyuria, polydipsia and low urine density. 

Cats can develop polyuria and polydipsia, but these symptoms are thought to be due to glucosuria and osmotic diuresis; most cases commonly maintain normal urine specific gravity.

19

TRUE/FALSE

Data about the impact of oral melatonin on sex hormone levels in dogs are controversial. 

TRUE

Data about the impact of oral melatonin on sex hormone levels in dogs are controversial. 

20

TRUE/FALSE

In the process of wound healing, platelets are the main source of TGF-b. 

TRUE

In the process of wound healing, platelets are the main source of TGF-b. 

21

Which ingredients listed below have emollient properties: 

Benzoyl peroxide

Sulfur

Urea

Glycerin

Chlorhexidine

Iodine

Which ingredients listed below have emollient properties: 

Benzoyl peroxide

Sulfur

Urea

Glycerin

Chlorhexidine

Iodine

22

Please arrange these topical glucocorticoids in decreasing order of potency: 

Dexamethasone 0.1% cream
Mometasone furoate 0.1% ointment
Fluocinolone 0.025% cream
Hydrocortisone 0.5% leave-on lotion 

Please arrange these topical glucocorticoids in decreasing order of potency: 


 1) Mometasone furoate 0.1% ointment
2) Fluocinolone 0.025% cream
3) Dexamethasone 0.1% cream
4) Hydrocortisone 0.5% leave-on lotion 

23

What is the pH of human, canine and equine skin?

HUMAN: <5

CANINE: 7-7.4

EQUINE: 7-7.4

24

What is the charge of normal hair?

Relative electric neutrality with a slight negative charge 

A image thumb
25

The most common ingredients of the diet that seem to benefit the quality of the skin and haircoat are ________ and ___________. 

The most common ingredients of the diet that seem to benefit the quality of the skin and haircoat are protein level and fatty acids

26

TRUE/FALSE

Although some breeders recommend supplementing diets with extra protein sources, the need for this has not been well documented in dogs and cats.

TRUE

Although some breeders recommend supplementing diets with extra protein sources, the need for this has not been well documented in dogs and cats.

27

These five nutrients, when added to the diet, have been shown to decrease TEWL. 

 

  1. Pantothenate
  2. Choline
  3. Nicotinamide
  4. Histidine
  5. Inositol

 

28

TRUE/FALSE

The most important fatty acids are all saturated fatty acids. 

TRUE/FALSE

The most important fatty acids are all unsaturated fatty acids. 

29

Define TEWL. 

Transepidermal water loss is a term associated with the loss of water that passes from the inside of the body through the epidermis to the surrounding atmo- sphere via diffusion and evaporation processes.
 

TEWL is also known as insensible water loss because it is a process over which there is little physiologic control.

30

TRUE/FALSE

The skin is a waterproof covering

FALSE

The skin is not a waterproof covering

It is constantly losing water to the environment by transpiration.

31

Topical application of ____________, one of the sphingoid bases naturally present at high levels in the stratum corneum of normal skin, has been shown to increase ceramide levels and improve barrier function in humans.

Topical application of phytosphingosine, one of the sphingoid bases naturally present at high levels in the stratum corneum of normal skin, has been shown to increase ceramide levels and improve barrier function in humans.

32

What is your main differential for this finding on the inguinal region of your patient?

Q image thumb

Steroid cream application 

Marked cutaneous atrophy and subepidermal bullous dermatitis

33

Can you draw this?

Q image thumb

Yes, yes you can. 

34

Steroid pathway. Know. 

Q image thumb

35

What is the difference between a corticosteroid and a glucocorticoid?

Corticosteroid = steroid hormones produced by the adrenal cortex divided into glucocorticoid and mineralocorticoids based on function

 

Glucocorticoid = steroid hormone that binds to glucocorticoid receptors and are responsible for metabolism of carbohydrates, proteins, fats and have anti-inflammatory effects 

36

Where are mineralocorticoids produced?

Zona glomerulosa of the adrenal cortex 

*Electrolyte metabolism*

37

The primary mineralocorticoid is _________. 

The primary mineralocorticoid is aldosterone

38

Melatonin affects the steroid hormone pathway in two ways. What are they?

  1. Decreases cortisol 21-hydroxylase
  2. Decreases estradiol aromatase

39

What do you think this is? What medication can cause this?

Q image thumb

Papillomatous lymphoplasmacytoid dermatitis 

Atopica/cyclosporin

40

Yikes! You just gave a lhasa apso an injection of methylprednisolone acetate - then this happened. What is it?

Q image thumb

Local atrophy or other injection site reactions. Local areas of alopecia, pigmentary changes, and epidermal and dermal atrophy are more commonly induced by SC injection. These reactions are noninflammatory and atrophic in contrast with most other injection reactions.

41

Differential for this. 

Treatment option for this. 

Q image thumb

Herpes dermatitis. 

Interferon-2a (Roferon-A)

A image thumb
42

This dog has multiple sebaceous growths. What type of therapy was likely used to treat this?

Q image thumb

Laser!

43

What is the pH of canine, human and equine skin?

Canine 7-7.4

Human <5

Equine 7-7.4

44

What is the charge of normal hair?

Relative electrical neutrality with a slight negative charge

45

What is TEWL?

A term associated with the loss of water that passes from the inside of the body through the epidermis to the surrounding atmosphere via diffusion and evaporation processes.

46

What are ceramides composed of?

Sphingosine and a fatty acid

47

What is sphingomyelin?

One of the most important lipids in the lipid bilayer Made up of lipids that includes ceramides

48

What is phytosphingosine and how does it work?

One of the sphingoid bases naturally present in high levels in the stratum corneum Shown to increase ceramide levels and improve barrier function Sphingosine: Deficient in atopy; has antimicrobial properties

49

How is fipronil believed to work?

Translocates over entire body with significant levels deposited in sebum, sebaceous glands and hair follicles with the sebaceous glands acting as a reservoir Regulated by EPA

50

How does selemectin work?

High concentration in the sebaceous glands, hair follicles and epidermis but also achieves peak plasma levels 5 days after topical application Regulated by FDA

51

What are the main breeds for primary seborrhea?

Cocker spaniels Springer Irish setters Doberman pinschers

52

What are some causes of secondary seborrhea?

Atopic dermatitis Scabies Demodex Schnauzer comedy syndrome Feline acne Tail gland hyperplasia

53

What are common primary scaling disorders?

Sebaceous adenitis Vitamin-A responsive dermatosis Follicular dysplasia

54

What is an adverse event associated with topical anesthetics?

Methemoglobinemia Pramoxine is not associated with methemoglobinemia

55

Is pramoxine associated with methemoglobinemia?

No

56

What is an antiseptic?

a substance that kills or prevents growth of microbes Used with living tissue Ex: Chlorhexidene, benozoyl peroxide, ethyl lactate, iodine, miconazole

57

What is a disinfectant?

agents that prevent infection by destruction of microbes Used with inanimate objects Ex: Bleach and Accel

58

T or F: chlorhexidene is synergistic with miconazole and TrisEDTA

True

59

What is the MOA of chlorhexidene?

Membrane disruption Positively charged chlorhex is attracted to the negatively charged phospholipids in the cell wall See chlorhexidenefacts.com for fun images

60

Name 2 drugs that are synergistic with miconazole

* polymyxin b * chlorhexidene

61

What is the MOA of sodium chlorite and chloramines?

Thought to be due to the liberation of hypochlorous acid Concentration 1:10?

62

What is the mechanism of TrisEDTA?

Affects permeability of outer membrane in gram negative bacteria by removing Calcium and magnesium Chelator

63

T or F: TrizEDTA is most effective with gram positive organisms

F

64

What is the mechanism for mupirocin?

1. Binds to Leucyl-transfer RNA synthetase in bacteria 2. Interrupts bacterial protein synthesis 3. inhibits bacterial mRNA synthesis Has propylene glycol base so could be nephrotoxicity

65

What is the MOA of tacrolimus?

Calcineruin inhibition Inhibits antigen-presenting T-cells and various cytokine production from T cells, as well as keratinocytes and Langerhans cells Similar in action to cyclosporine

66

What is the MOA of Imiquimod?

Toll -like receptor 7 agonist Results in cytokine secretion from monocytes and macrophages (IFN-alpha, IL-12 and TNF-alpha) Locally generated immune-response leads to a TH-1 response to treat viral infections, neoplasia and actinic keratosis ,Equine sarcoids, SCC in situ

67

_________ is keratolytic, keratoplastic and parasidicidal (D. gatoi), antifungal, antibacterial

Sulfur

68

Which feline demodex mite responds to lime sulfur?

D. gate

69

What 2 topical agents lower pH?

Benzoyl peroxide and ethyl lactate

70

Compare and contract between physical and chemical sunscreens:

Chemical - absorb Physical- reflect

71

What are some examples of chemical sunscreen? MOA? Benefit?

In chemical sunscreens aminobenzoic acid or benzophenone derivatives act to absorb UV rays. Clear, cosmetically acceptable lotions or gels

72

What are some examples of physical sunscreen? MOA? 

In physical sunscreens, ingredients include zinc oxide and titanium dioxide Works by reflecting and scattering light by forming an opaque barrier Efficiency is rated by SPF (sun-protective factor)

73

Which are the EFAs in dogs and cats that need to be supplemented?

Dog: linoleic acid (18:2N-6) and alpha-linolenic acid (18:3N-3) Cats: arachidonic acid (20:4N-6) in addition to canine needs

74

FA nomenclature

Number of carbon atoms, number of double bonds and then location of the first double bond from the methyl group.Number of carbon atoms, number of double bonds and then location of the first double bond from the methyl group.

75

What species does not have Delta-6-desaturase?

Cats Atopic humans

76

What does Delta-6-desaturase do and why is it important?

Insert double bonds If deficient in desaturase enzymes, then linoleic acid, gamma-linlenic acid or DGLA accumulate locally and therefore cannot be metabolized to arachidonic acid locally

77

MOA of EPA and DHA ?

Work by inhibiting LeukotrieneB4 (which is a proinflammatory cytokine).

78

Possible side effect of fatty acids?

Cutaneous xanthomas Pancreatitis/GI

79

What is pentoxyfylline and what is the MOA?

Methylzanthine derivative Immune-modulatory and rheologic effects includes increased leukocyte deformability and chemotaxis, decrease platelet aggragation, decrease leukocyte responsiveness to IL-1 and TNF-alpha, decreased production of TNF-alpha from macrophages, decreased produciton of IL-1, IL-4 and IL-12, inhibition of T and B cell lymphocyte activation, and decreased natural killer cell activity. Inhibits T-cell adherence to keratinocytes

80

What is the MOA of cyclosporine?

Calcineurin inhibitor Blocks IL-2 transcription and T-cell responsiveness to IL-2 Leads to impaired T-helper and T-cytotoxic lymphocytes Directly inhibits histamine release from dog mast cells Inhibits mononuclear cell function, antigen presentation, mast cell and eosinophil production, prostaglandin release from mast cells, neutrophil adherence, NK cell activity, and growth and differentation of B-cells

81

What other drugs inhibit cytochrome P450?

1. Ketoconazole (and other azaleas 2. Specific enzyme P450(CYP) 3A12 3. Erythromycin 4. Furosemide 5. Calcium channel blockers (Diltiazem) 6. Metoclopramide 7. Methylprednisolone 8. Doxycycline 9. Allopurinol 10. Also flavanoids from grapefruit juice)

82

Cyclosporine is to be used with caution with avermectins. Why?

cyclosporine can inhibit p-glycoprotein pump

83

What are the mechanisms and actions of glucocorticoids?

GC increase the production of lipocortin 1 lipomodulin , which is thought to cause a reduction in the action of PLA2 on cell membranes, which results in inhibition of the arachidonic acid pathway

84

Why do animals with low albumin at increased risk for toxicity for glucocorticoids?

* Less protein for steroid to bind, so more free glucocorticoid * Usually bind globulins, but when that capacity is exceeded albumin is the second choice

85

Why do cats require higher glucocorticoid doses than dogs?

Have decreased number of glucocorticoid receptors and lower affinity of those GC receptors with their ligands

86

What is the mechanism of PU/PD with glucocorticoids in the dog?

* In the dog: due to interference of GC with ADH resulting in a decreased USG * This MOA does not occur in the cat (PUPD in the cat thought to be a different mechanism)

87

Describe type 1 interferons:

* Antiviral * Alpha, beta, omega, lower-case delta, tau, sigma, epsilon, kappa * Alpha and beta are the most important * Produced by Plasmacytoid dendritic cells

88

Describe type 2 interferons : 

* IFN-gamma * Activate macrophages * Amplify TH1 response

89

Describe Type 3 interferons:

* IFN lambda 1,2,3 * Action similar to type 1

90

Where is melatonin synthesized and from what?

* In the pineal gland from L-tryptophan * Greatest production in the dark hours * Secreted highest in the winter when sunlight is shorter

91

How does melatonin effect sex hormones?

* Inhibition of adrenal 21 hydroxylase and aromatase enzymes * Leads to reduced estradiol levels

92

T or F: melatonin can be used to treat hyperprogesteronism

False. Only works with estradiol.

93

What is the wavelength of the CO2 laser?

* 10,600 nm * Longest wavelength

94

What is the MOA of the CO2 laser?

when energy is applied, atoms move to a higher energy state and when they go back to their ground state, energy is liberated in the form of a photon. The photons then resonate in the laser chamber and stimulate other molecules or atoms. As momentum escalates, mirrors cause the photons to travel in parallel which creates a concentrated beam of light

95

What are the phases of wound healing?

Stage 1: Coagulation and inflammation Clot formation, platelet aggregation, neutrophil involvement At the end, macrophages come Stage 2: Tissue formation Fibroblasts, clot lysis, and keratinocyte migration Neovascularization Stage 3: Scar tissue formation and tissue remodeling Wound contraction Tissue remodeling/scar tissue formation

96

Key players in wound healing:

* TGF-β1 * Colony-stimulating factors

97

MOA of micronized silver

Silver ions prevent bacterial adhesion and can destabilize binding sites of bacteria to proteins.

98

Colchicine

Unique anti-inflammatory Inhibits neutrophil migration Shar-pei fever (or amyloidosis) Occasionally hepatic cirrhosis/fibrosis VERY toxic. Experimental. Teratogenic, reduces spermatogenesis

99

Lab. considerations with Colchicine

can increase ALKP May interfere with 17-hydroxycorticosteroid May cause false-positive resutls when testing for erythrocytes or hemoglobin in urine

100

Weird ocular side effect reported with ketoconazole

Cataracts

101

Weird ocular side effect of pentoxifylline

Tearing

102

What main receptor does Imiquimod act on?

Toll-like receptor 7 (TLR 7) - Agonist 

103

What is the name of the receptor that binds to cyclosporine? (and not tacrolimus)

Cyclophyllin

104

Tacrolimus has a direct effect on T lymphocytes to inhibit ______ transcription

IL-2

105

Tacrolimus was formerly known as?

FK506

106

Too little of _____ (<5% of dry matter) and ____ (<1% dry matter) results in dry scaly skin or poor hair coat

Total fat and linoleic acid

107

Optimal ratio of N6 and N3 fatty acids to minimise of the inflammatory mediator LTB4 is?

Between 5:1 and 10:1

108

Common sources of linoleic acid

Sunflower and safflower oil

109

What is stud tail?

Trouble with the large supracaudal organ on the dorsal surface of the tail (mass of hyperactive sebaceous glands)

110

What is Burow solution?

Aluminium acetate solution

111

Toxicity/risk of topical anaesthetics ("-caines") 

Methemoglobinemia

112

What concentration of isopropyl alcohol is the most effective and bactericidal?

70-90%

113

Phenols and cresols are contraindicated?

In cats

114

Chlorhexidine is highly effective against most bacteria except:

Some Pseudomonas and Serratia strains

115

Name some of the properties of benzoyl peroxide

Antibacterial, keratolytic, keratoplastic, antipruritic, degreasing, follicular flushing

116

What is Nisin?

Nisin is an antimicrobial peptide produce by Lactococcus lactis - marketed as teat wipes for prevention of bovine mastitis - control common bacterial pathogens such as some methicillin-resistant Staph spp

117

True/False Benzalkonium chloride is a broad-spectrum antibacterial agent effective against Pseudomonas spp

False - not effective against Pseudomonas spp

118

What is EDTA tris?

Ethylene diamine tetra acetic acid tris - chelating agent - potent disinfectant - alkalinizing solution - antibiotic potentiating agent

119

How does EDTA-tris exert its antibacterial effect?

Affect permeability of the outer membrane in Gram-negative bacteria by removing Ca2+ and Mg2+

120

What is mupirocin?

An antibiotic derived from fermentation of Pseudomonas fluorescens that specifically and reversibly binds to isoleucyl transfer RNA synthetase in bacteria

121

What toxicity is associated with mupirocin?

Nephrotoxicity due to the polyethylene glycol base if ingested

122

Q image thumb

Prolonged use of topical glucocorticoids can results in atrophy or pinnal curling

123

A subepidermal bullous dermatosis has been reported from topical application of?

Triamcinolone acetonide, fluocinoline acetonide and betamethasone valerate

124

What is tacrolimus?

A 23-member macrolide similar in action to CsA and results in calcineurin inhibition

125

What cells does tacrolimus affect?

Inhibits antigen-presenting T cells

126

Imiquimod's antiviral and antitumor effects are due to activation of ____

TLR-7 - resulting in cytokine secretion from monocyte/macrophages (IFN-α, IL-12, TNF-α)

127

Indications of imiquimod in vet derm (2)

Feline SCC in situ and equine sarcoids

128

At low concentrations, sulfur is ___ At high concentrations, ____

Keratoplastic, keratolytic

129

Indication of topical sulfur

Inhibit Microsporum canis growth from infected cat hairs

130

Topical vitamin A acid properties (4)

- Increases epidermal turnover time - reduces the cohesiveness of keratinocytes - normalizes maturation of follicular epithelium - Comedolytic

131

Topical Zinc gluconate properties

Antiseborrheic properties Down regulated sebum production

132

What is DMSO?

Dimethyl sulfoxide Hygroscopic organic solvent

133

Potential uses of DMSO (9)

Topical application to cutaneous ulcers, burns, insect bites, interdigital granulomas, open wounds, skin grafts, reduction of exuberant granulation tissue (decreases fibroplasia), tx calcinosis cutis and acral lick dermatitis

134

Melaleuca oil (tea tree oil) toxicosis (5)

Hypersalivation, incoordination, weakness, hypothermia, and hepatic injury

135

Solar-induced neoplasias (3)

SCC, hemangioma, HSC

136

Indications for photochemotherapy

Malignant melanoma, fibrosarcoma, MCT, squamous cell carcinoma (superficial)

137

Formula for linoleic acid

18:2N-6

138

The EFAs most important in cutaneous homeostasis in the dog (2)

Linoleic acid (18:2N-6) and α-linolenic acid (18:3N-3)

139

The EFA in a cat

Aracadonic acid (20:4N-6)

140

DGLA and EPA can be synthesized from ___ and ___ in animals respectively

Linoleic acid and α-linolenic acid

141

Arachadonic acid is stored in cells in an unavailable form until it is released by the action of ____

Phospholipase A2

142

Effects of prostaglandins on the skin (4)

- alteration of vascular permeability - potentiation of vasoactive substances such as histamine - modulation of lymphocyte function - potentiation of pain and pruritus

143

Effects of leukotrienes on the skin (4)

- alter vascular permeability - activate neutrophils - modify lymphocyte function - cause potent neutrophil and eosinophil chemotaxis

144

Pentoxifylline has 2 major effects

Immunomodulatory and rheologic effects

145

7 effects of pentoxifylline

- increased leukocyte deformability and chemotaxis - decreased platelet aggregation - decreased leukocyte responsiveness to IL-1 and TNF- α - decreased production of TNF- α from macrophages - decreased production of IL-1, IL-4 and IL-12 - inhibition of T- and B-lymphocyte activation - decreased natural killer cell activity - inhibit T-cell adherence to keratinocytes - wound healing: increase production of collagenase and decreased production of collagen, fibronectin, glycoasaminoglycans

146

What is naturally occurring vitamin A

An alcohol, all-trans retinol

147

Vit A is oxidized in the body to?

Retinal and retinoic acid

148

How do retinoids enhance wound healing?

By stimulating fibroblasts to produce various chemicals such as TGF

149

MOA of cyclosporin

- blocks IL-2 transcription - impair T-helper and T-cytotoxic lymphocytes - inhibits IFN-α transcription - impair cytokines (IL-3, IL-4, IL-5, TNF α and IFN α) - inhibit mononuclear cell function, antigen presentation, mast cell and eosinophil production, histamine and prostaglandin release from mast cells, neutrophil adherence, NK cell activity, growth and differentiation of B cells

150

What drugs may potentiate CsA toxicity?

Drugs that inhibit cytochrome P450 microsomal enzyme (ie. keto, itraconazole, fluconazole, Ca channel blockers etc)

151

What enzyme does ketoconazole inhibit that affects CsA?

Hepatic microsomal cytochrome P450 (CYP) 3A12 enzyme

152

CsA can also inhibit ____ pump, caution should be used in treating animals with CsA and _____ concurrently

P-glycoprotein pump Avermectins

153

How does CsA work in the treatment of AD?

Inhibition of mast cell degranullation by affecting the interaction between mast cells and nerves CsA also directly inhibits histamine release from dog mast cells

154

Explain the cause of leukocytosis in glucocorticoid administration

Glucocorticoids inhibit expression of adhesion molecules on endothelial cells (particularly ELAM-1 and ICAM-1) --> interefere with movement of leukocytes from the vasculature into inflamed tissues

155

Explain mature neutrophilia in exogenous glucocorticoid treatment

- increased release of mature neutrophils from BM - decreased margination - decreased migration of neutrophils out of the blood vessels (--> prolonged circulatory half-life)

156

How does glucocorticoid cause lymphopenia?

Redistribution of circulating lymphocytes to nonvascular lymphatic compartments such as LNs

157

How does glucocorticoid inhibit the arachidonic acid cycle?

Glucocorticoid increase the production of lipocortin 1 lipomodulin , which is thought to cause a reduction in the action of phospholipase A2 on cell membranes --> inhibit AA cycle

158

True/False High doses of glucocorticoids may suppress antibody production

True Some allergic dogs, it may suppress IgE production

159

True/False Only free glucocorticoid is metabolically active

True

160

What is the specific glycoprotein that binds glucocorticoids?

Corticosteroid-binding globulin (when its capacity is exceeded, albumin becomes used for binding)

161

IM or SC preferred for glucocorticoid injections? Why?

Q image thumb

IM - local reactions (alopecia, pigmentary changes, epidermal and dermal atrophy) are more commonly induced by SC inj

162

What breeds may be predisposed to SC injection reactions?

Yorkshire, Silky terrier, lhasa apsos, poodles and Shih Tzu

163

What is the glucocorticoid of choice for intralesional therapy? (acral lick dermatitis, histiocytomas, sterile granulomas, proliferative otitis etc)

Triamcinolone acetonide

164

What is it called when a patient previously responded well to a glucocorticoid then loses its effectiveness?

Steroid tachyphylaxis

165

What is the daily cortisol production in dogs?

0.2-1 mg/kg/day

166

What is the difference between dogs and cats with pu/pd from glucocorticoids?

Dogs - due to interference of glucocorticoids with antidiuretic hormone --> decrease USG Cats - due to glucosuria and osmotic diuresis - most maintain normal USG

167

Type __ interferons are important in antiviral immunity

Type 1

168

Type II IFNs primarily include IFN- γ produced by : (3)

NK cells, CD4+ helper T cells, and CD8+ cytotoxic cells

169

Interferon has been used to treat what conditions

Pigmented epidermal plaques Canine pyoderma Feline herpes

170

Where is melatonin synthesized?

Pineal gland from L-tryptophan

171

Melatonin secretion is tied to the photoperiod, with the greatest production during dark/light hours

Dark

172

True/False There is an inverse relationship between circulating prolactin levels and secretion of melanocyte-stimulating hormone

True

173

True/False In dogs, melatonin can decrease sex hormone levels

True

174

What is the proposed mechanism on how melatonin affects sex hormones?

Inhibition of adrenal 21-hydroxylase and aromatase enzymes which could results in reduction in estradiol levels

175

True/False Cryosurgery is contraindicated for mast cell tumors

True

176

What are the 3 recognized phases of wound healing?

Coagulation/inflammation Tissue formation Scar tissue formation and tissue remodelling

177

What cell is the most important storage for TBF-β1?

Platelets

178

Within ____ of wounding, monocytes replace neutrophils as the predominant inflammatory cell in the wound

24-48 hours

179

Formation of the fibrin clot and platelet activation is triggered by exposure to ____ and ____

Thrombin and fibrillar collagen

180

Collagen ___ is around vessels and in vascular hypetrophic scars

Collagen V

181

Collagen ___ appears early in wound healing, then collagen __ appears as wound stabilizes (scar tissue)

Collagen III appears early Collagen I as wound stabilizes

182

Formation of granulation tissue and subsequent recollagenation of the dermal matrix

Fibroplasia

183

What cytokine from local mast cells is a potent stimulator of collagen production by fibroblasts?

IL-4

184

Type VI collagen is produced by what cell in wound healing?

Keratinocytes

185

Where is K5 and K14 produced?

Basal layer

186

Where is K6 and K16 produced?

Proliferating spinous layer

187

Collagens in BMZ (2)

Type IV and VII

188

Collagens in the dermis (4)

Types I, III, V and VI

189

What is the most important growth factor during the inflammatory phase of wound healing?

bFGF released by macrophages - when exposed to bFGF, endothelial cells release plasminogen activator and procollagenase to activate collagenases to degrade the BM of the vessel

190

What are the stages of wound healing?

Inflammatory Proliferative Remodelling

191

The functional outcome of the scar typically only reaches what % of the original tissue strength?

70%