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68 Cards in this Set
- Front
- Back
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Allergy-based skin disease is better known as...
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...Atopic dermatitis
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Which of the following are NOT true regarding atopic dermatitis?
a) an autoimmune process b) Mediated by IgM and IgG c) never happens on first exposure d) type I hypersensitivity e) shift from Th2 to Th1 cells |
a) an autoimmune process (NO)
b) Mediated by IgM and IgG (NO; IgE and IgG) e) shift from Th2 to Th1 cells (NO; shift from Th1 to Th2) |
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Which of the following is NOT true regarding atopy?
a) atopic animals have more yeast on their skin b) atopic animals have more bacteria on their skin c) dust mite is the most common allergen d) heavy pollens are commen allergens e) atopic animals do not have more bacteria or yeast on their skin, just an increased adherence which causes pathology |
d) heavy pollens are commen allergens (NO; the light pollens are)
e) atopic animals do not have more bacteria or yeast on their skin, just an increased adherence which causes pathology (NO, they DO have more bacteria/yeast AND the pathogens adhere better) |
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Which of the following are NOT true regarding atopy?
a) intense pruritus is the hallmark of atopy b) Staph and Malassezia infections are common c) usually responsive to glucocorticoid therapy if no secondary infxn d) the lesion precedes the pruritus e) signs begin at 1-3 years |
a) intense pruritus is the hallmark of atopy (NO, it is mild pruritus)
d) the lesion precedes the pruritus (nope; pruritus b4 lesions) |
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T or F:
Pruritis |
False!
its PRURITUS |
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Where on the body does atopic dermatitis generally manifest?
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Peri-ocular skin
Interdigital areas Axillae Ventral abdomen Ear pinna Perianal |
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T or F:
Most anal sac problems are due to allergies. |
True!
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How does atopic dermatitis look in cats?
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Like demodecosis! Eosinophilic plaques and miliary dermatitis
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What are the easy criteria for diagnosing atopic dermatitis?
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<3 yr onset
Indoor dog Glucocorticoid-resonsive Pruritus w/o lesions at first Affected front feet, ear pinnae NON-affected ear margins and dorso-lumbar area |
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T or F:
Atopic dermatitis is classically seasonal. |
True! But it can turn into all the time as the dog gets allergic to more stuff!
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Choose intradermal testing, serologic testing, or both:
- measure of IgE - sedation required - many false positve rxns - easy! |
BOTH - measure of IgE
Intradermal - sedation required Serologic - many false positve rxns Serologic - easy! |
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Choose intradermal testing, serologic testing, or both:
- no sedation required - many false negative rxns - pain in the ass to do - requires drug withdrawal |
Choose intradermal testing, serologic testing, or both:
Serologic - no sedation required Intradermal - many false negative rxns Intradermal - pain in the ass to do Intradermal - requires drug withdrawal |
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What is the FIRST step to controlling/treating atopic dermatitis? The next step?
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Control any secondary infection (fungal or bacterial)! Next, control pruritus!
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Which of the following topical treatments would have the GREATEST effect on pruritus?
a) Pramoxine HCl b) Diphenhydramine c) Cool water d) Hydrocortisone e) Lotion |
a) Pramoxine HCl
d) Hydrocortisone (both have a 75-80% reduction in pruritus) |
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What are some indications for using antihistamines for atopic dermatitis management? Which ones are used?
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Use 1st generation (eg: diphenhydramine) for adjunctive therapy, seasonal therapy, or for "off" steroid days
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What is the initial dose of prednisone for a 44lb atopic dog? How long and how often should this dose be given?
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22mg SID until animal responds (5-7d); after this go to the same dose every other day.
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T or F:
Dosing prednisone 2x/day every other day helps to save the pituitary-adrenal axis. |
False!
This ends up with a 36 hr interval which doesn't spare the axis! |
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What is the starting dosage for prednisone when treating atopic dermatitis?
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1.1mg/kg
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What are some side effects to pred?
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PP/PU/PD, panting, personality changes
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What are some pred alternatives? When should each be given?
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Prednisolone or methylpred (same schedule)
Triamcinolone (every 3rd day) Dexamethasone (every 4th day) |
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What are the BAD DRUGS that you NEVER use for atopic dermatitis maintenance?
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Depo-medrol
Betasone Flumethasone Dexamethasone Vetalog Genesis (triamcinolone) spray-on |
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If you have a suspected atopy case that is initially or partially responsive to glucocorticoids, what are your likely differentials?
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Scabies
Malassezia dermatitis Pyoderma Contact allergy & irritation |
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T or F:
A suspect atopy case that is non-responsive to glucorticoids is probably an adverse food reaction or a behavioral issue. |
True!
Could also be malassezia |
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Which fatty acid supplements have an effect on atopy? How does this work?
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Omega 3 and 6 fatty acids
Produce prostaglandins and leukotrienes that competitively inhibit PG2 and LT4 receptors. |
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Which immunomodulation therapy of atopy represses activation of immune cell types involved in atopic dz? What are side effects of this drug?
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Cyclosporine (Atopica)
Vomiting (50%), diarrhea, papillomatosis, gingival hyperplasia |
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Which of the following is true regarding hyposensitization?
a) Higher Th2:Th1 ratio b) Shifts IFNy to IL4 c) Forms IgG d) indicated when medical options don't work e) contraindicated with diabetes mellitus |
a) Higher Th2:Th1 ratio (NO; shifts Th2 to Th1)
b) Shifts IFNy to IL4 (NO; higher IFNy:IL4 ratio) e) contraindicated with diabetes mellitus (NO; this is an INDICATION) |
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What is the most common manifestation of feline pruritus?
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LICKING
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Which feline skin reaction pattern is associated with:
- little crusty papules - associated w/hypersensitivity - lip lesion by philtrum - frequently on rear legs or chin - associated with eosinophils |
miliary dermatitis - little crusty papules
eosinophilic plaque - associated w/hypersensitivity indolent ulcer - lip lesion by philtrum collagenolytic granuloma - frequently on rear legs or chin eosinophilic plaques @ collagenolytic granulomas - associated with eosinophils |
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Which feline skin reaction pattern is associated with:
- can be linear to serpentine - can be on belly, head, feet, mouth - mohawk cats - may resemble SCC - histiocytes, eosinophils, & necrotic collagen |
Collagenolytic granuloma - can be linear to serpentine
Eosinophilic plaque - can be on belly, head, feet, mouth Symmetrical alopecia - mohawk cats Indolent ulcer - may resemble SCC Collagenolytic granuloma - histiocytes, eosinophils, & necrotic collagen |
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T or F:
Food allergies in cats are rare. |
False! Up to 50% of derm cases are food-related!
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T or F:
Both D. cati and D. gatoi can cause ear infections in the cat. |
True!
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How can you tell if a cat is truly pruritic?
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Trichogram shows split ends!
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Who gets malassezia dermatitis more, dogs or cats?
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Dogs!
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T or F:
Cats are less affected by glucocorticoids than dogs. |
False!
They have different effects though; cats get DIABETES! |
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What must you do before putting a cat on Atopica?
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Toxo titer! If positive, OK to go ahead w/medicine. If negative, higher chance of getting Toxo (want cat to stay indoors)
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How do you know if a cat truly has psychogenic dermatosis?
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Goes after ONE SPECIFIC AREA and PULLS OUT HAIR
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How is derpatopathy diagnosis in cats different from dogs?
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Start hypoallergenic diet EARLIER
Evaluate FIV, FeLV status |
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A feline keratinization problem with secondary infections describes...
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...feline acne
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If you see a cat with big, soft, fluctulant pads, what do you think? How do you treat it?
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Plasma cell pododermatitis
Tx (doxycycline or glucocort) |
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How are feline nasopharyngeal polyps treated?
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Traction removal + abx & high dose glucocorticoids to prevent recurrence
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What causes food allergies? What type of hypersensitivity is this?
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Proteins/glycoproteins between 10K and 60KD
Type I and IV reactions |
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What are the BIG 5 offending food in canine adverse food reactions?
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Beef
Dairy Wheat Poultry Corn |
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What are the BIG 5 offending food in feline adverse food reactions?
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Beef
Dairy Fish Poultry Corn |
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What is the common age of onset for food allergy dermatitis?
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ANY AGE
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T or F:
Food allergy dermatitis can occur with the FIRST EXPOSURE! |
False! However, non-immunologic REACTIONS (eg: food intolerance) can occur with first exposure
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What are the 3 main differences between a food allergy and atopy?
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Food allergy has
NO SEASONALITY occurs at ANY AGE and may NOT be steroid responsive |
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T or F:
Atopy is less common than food allergies in dogs. |
False! Atopy is WAY more common
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Which of the following are viable methods for food allergy diagnosis?
a) serology b) intradermal tests c) diet trials d) therapeutic response e) histopathology |
c) diet trials (DEFINITIVE)
d) therapeutic response |
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How long must diet trials be run for? What is criteria for success?
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Run for 8-12 wks
Look for >50% improvement in signs |
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What is the biggest issue with a diet trial?
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CLIENT COMPLIANCE
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Which structure is used as a landmark for otoscopy or ear swabs?
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Intertragic incisure
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Which of the following are NOT true regarding dog ear anatomy?
a) Pugs have oval ear canals b) floopy eared dogs get otitis just as often as erect eared dogs c) annular cartilage overlaps the auricular cartilage d) Noxon's fold is found where the annular cartilage begins e) annular cartilage is vertical |
c) annular cartilage overlaps the auricular cartilage (NO; auricular overlaps the annular)
e) annular cartilage is vertical (NO; the auricular is vertical) |
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T or F:
Most dog ear hair is found in simple follicles. |
True!
Except for Cocker Spaniels have compound follicles! |
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What are the 2 smallest muscles in the body and what is their function?
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Tensor tympani and Stapedius mm. contract, thus attenuating loud noises
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Choose cat, dog, or BOTH with regard to otoscopy:
- cannot see the bulla - can see the tympanic bulla - VERY thin - normally transparent |
CAT - cannot see the bulla
DOG - can see the tympanic bulla CAT - VERY thin BOTH - normally transparent |
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What is the #1 primary cause of otits in dogs? Cats?
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Dogs - atopy
Cats - ear mites |
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Which of the following commonly causes otitis?
a) Staphylococcus b) Otodectes spp. c) Malassezia spp. d) Pseudomonas |
b) Otodectes spp.
(the rest are all SECONDARY issues) |
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How is ossified ear canal treated?
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TECA
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What are sequelae to the increased temperature due to inflammation in otitis?
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Increased apocrine secretions
Dilution of antimicrobial lipid content of cerumen Incubator for bacteria/yeast |
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T or F:
Due to its accessibility, furunculosis in the ear canal can be treated by 2 weeks of antibiotics. |
False!
It requires 3-6 weeks of abx just like folliculitis/furunculosis elsewhere! |
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What are the components to cerumen?
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Sebaceous secretions
Ceruminous secretions Keratinocytes |
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What can cause keratinocyte proliferation?
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Inflammation
Propylene Glycol |
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What are some important points to the otoscopic exam?
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Goal is to visualize the tympanic membrane in both ears
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Did you read "Of Mites and Men"?
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You betcha! What a dumbass...putting cat mites in his ears 3 times!
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Which of the following are NOT true regarding ear cytology?
a) insert swab at the intertragic incisure b) Slide swab in at a 45 degree angle to ground c) should not be heat fixed (kills mites) d) should NORMALLY see low numbers of organisms e) alcohol can be used to fix the slide |
b) Slide swab in at a 45 degree angle to ground (NO; parallel to ground)
c) should not be heat fixed (kills mites) (NO; you CAN heat fix or fix in alcohol) |
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What are common topical antibiotic classes used for ear infections?
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Fluoroquinolones or aminoglycosides
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What are keys to sucess for topical treatment of otitis?
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remove obstructions (wax/hair)
Need a formulation that penetrates canal but also allows drug to penetrate Must administer at appropriate interval by volume |
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Choose aqueous or ointment...
- penetrates ear canal - delivers drug into skin |
aqueous - penetrates ear canal
ointment - delivers drug into skin |
