Derm1- Diagnostics

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  1. What is the most common type of testing that is used in almost every patient?
    screening tests
  2. What are types of screening tests used in dermatology? (5)
    scrape, cytology, culture, trichography, diascopy
  3. With vasculitis, what will the results of diascopy be?
    no blanche b/c there is leakage out of the vessels
  4. What is the purpose of a superficial skin scrape?
    identification of surface mites- Sarcoptes, Notoedres cati, Demodex gatoi, Cheyletiella, Otodectes, Trombicula, Lynxacarus
  5. What is unique about Demodex gatoi?
    the only species of Demodex that lives on the skin surface, instead of within the follicle
  6. What are the key points to performing a superficial skin scrape? (4)
    cover a large surface area, search entire slide on low power, lower condenser, negative does NOT rule out disease
  7. What is the indication for a deep skin scrape?
    identification of follicular parasites- Demodex (except gatoi)
  8. What are the key points to performing a deep skin scrape? (3)
    small focal areas (as opposed to superficial, in which you must cover a large area), induce capillary bleeding, negative usually rules out disease [except when hyperplastic tissue is seen--> can't get down to follicle]
  9. What is the most used procedure by dermatologists?
    surface cytology
  10. What are indications for surface cytology?
    identify presence of microorganisms, assess inflammatory cell types, acantholytic cells, or neoplastic cells
  11. What are the methods of surface cytology? (4)
    #10 blade prep, acetate tape prep, cotton swab (ears only), impression smears
  12. What are indications for impression smear surface cytology? (5)
    [moist exudate] pustules, erosions, ulcers, draining lesions, cut surface of a nodule
  13. What are the indications for fine needle aspirate cytology?
    plaque, nodule, tumor- identify cell type and organisms
  14. What are the 2 main types of culture for derm?
    bacterial and fungal (DTM- dermatophyte test medium)
  15. What do you usually do for bacterial culture? When might you add other cultures?
    aerobic for routine pyoderma and otitis; add anaerobic and atypical mycobacterial plus fungal for deep infections
  16. What are the indications for bacterial culture? [4 criteria]
    poor response to antimicrobial therapy, all chronic deep infections (>2 weeks, cellulitis, draining tracts, nodules), rule out infectious organism if suspect autoimmune, rods found on cytology
  17. What are the key points to performing deep skin cultures? (3)
    sterile punch biopsy (surgical scrub before), sterile instrument pack, do not biopsy ulcerated areas (they have secondary contamination)
  18. What is a positive result on DTM?
    culture turns red within 7-10 days (not after)
  19. What are indications for therapeutic trials?
    insecticidal trials (to rule in/out fleas, Demodex gatoi, Sarcoptes), food allergy dietary trial, antibacterial therapy (rule in sterile disease- not much anymore b/c of antimicrobial resistance)
  20. What are some advanced testing techniques? (3)
    histopathology, allergy tests, immunostaining techniques
  21. What are the reasons for performing skin biopsy? (2)
    for histopathology, for culture
  22. What is the reason for performing histopathology?
    to determine pattern of inflammation
  23. What are indications for histopathology? (7)
    suspect neoplasia, ulcerative disease, mucosal lesions, footpad lesions, nodular lesions, unknown disease after work0up, rule out diseases
  24. What are the key points for performing biopsy for histopathology? (2)
    DO NOT prep/scrub/disturb lesions, handle atraumatically (grasping epidermis will damage structures and make impossible to interpret)
  25. What are the different biopsy techniques for histopathology? (3)
    punch biopsy, wedge biopsy, amputation of third phalanx
  26. When can you wedge biopsy for histopathology? (4)
    solitary lesion, large lesion, deep lesion, ear pinna
  27. What is important for biopsy for histopathology?
    biopsy acute/new lesions (pustules, papules, vesicles, petechiae, erythematous macules), include all layers of skin, get entire lesion if possible (papule, vesicle, etc)
  28. What lesions should you NOT biopsy? (4)
    secondary lesions (ulcers), secondary infection, chronic lesions, large areas of normal skin
  29. What biopsy sites should the animal be under general anesthesia for? (4)
    face, claws, footpad, and distal legs [because they bleed a lot]
  30. What are indications for tests of non-cutaneous organs? (4)
    breed or cross known to have adverse drug rxns, suspect genodermatosis, suspect systemic or endocrine disease, pre-treatment screening
  31. What are some tests of non-cutaneous organs that are often helpful in dermatology? (7)
    CBC/Chem, UA, endocrine assays, PCR, genetic screening, imaging, serology
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Derm1- Diagnostics
2016-01-25 16:50:24
vetmed derm1

vetmed derm1
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