2. MTB Step 3 - Allergic Rhinitis & Primary Immunodeficiency Syndromes Flashcards
Cards Complete:
ALLERGIC RHINITIS
PRESENTATION
Allergic Rhinitis presents with recurrent episodes of which (6) common symptoms?
- Nasal Itching
- Stuffiness
- Rhinorrhea
- Paroxysms of Sneezing
- Eye Itching
- Dermatitis
ALLERGIC RHINITIS
TREATMENT
What is the Mainstay of Therapy for patients with Extrinsic allergies?
Avoidance of Allergen
ALLERGIC RHINITIS
TREATMENT
What are some examples of Drug Therapies used for Allergic Rhinitis?
- Intranasal corticosteroids = Single Most Effective Agent
- Antihistamines (e.g., loratadine, fexofenadine, and cetirizine)
- Intranasal antihistamines (azelastine)
- Cromolyn
- Ipratropium bromide
- Leukotriene inhibitors (e.g., montelukast)
- Nasal saline spray and wash
ALLERGIC RHINITIS
BASIC SCIENCE CORRELATE
What is the Mechanism of Action (MOA) for both Cromyly and Nedocromil?
- They stabilize Mast Cells
- They prevent the degranulation of Mast Cells so that histamine & leukotrienes are not released.
- The mechanism is entirely preventive in nature:
- After exposure to the allergen has stimulated the Mast Cells, these drugs won’t work.
ALLERGIC RHINITIS
IMMUNOTHERAPY
What should be don’t for Extrinsic Allergies that can’t be avoided?
Desensitization Therapy
Beta-Blockers MUST be stopped before desensitization
ALLERGIC RHINITIS
IMMUNOTHERAPY
Under what condition should Epinephrine be used for treatment?
Anaphylaxis during Desensitization
- However, if the patient is on a Beta-Blocker it will block the effect of Epinephrine*
- The need to Stop Beta-Blockers in HIGH-YIELD*
PRIMARY IMMUNODEFICIENCY SYNDROMES
CVID
Who does Combined Variable Immunodeficiency (CVID) Syndrome present in and when in the life course?
Men & Women
in Adulthood
PRIMARY IMMUNODEFICIENCY SYNDROMES
CVID
What are (2) common Presenting Symptoms of Combined Variable Immunodeficiency (CVID)?
- Recurrent SINOPULMONARY infections (Bronchitis, Sinusitis, Pneumonia, and Pharyngitis)
- Sprue-like Abdominal disorder (Malabsorption, Steatorrhea, and Diarrhea)
+/- Lymphadenopathy and Splenomegaly
PRIMARY IMMUNODEFICIENCY SYNDROMES
CVID
What does Diagnostic Testing show for Combined Variable Immunodeficiency Syndrome (CVID)?
- The Nodes and both B-cells & T-cells are ABSENT
- ABSENT Total IgG
PRIMARY IMMUNODEFICIENCY SYNDROMES
CVID
What is the Treatment for Combined Immunodeficiency Syndrome (CVID)?
IV Immunoglobulin (Ig) Infusions
Same as for Bruton’s
PRIMARY IMMUNODEFICIENCY SYNDROMES
BRUTON’S
Who does X-Linked (Bruton’s) Agammaglobulinemia present in and when in the life course?
Male’s only
in Childhood
PRIMARY IMMUNODEFICIENCY SYNDROMES
BRUTON’S
What is (1) common Presenting Symptom of X-Linked (Bruton’s) Agammaglobulinemia?
- Recurrent SINOPULMONARY infections (Bronchitis, Sinusitis, Pneumonia, and Pharyngitis)
PRIMARY IMMUNODEFICIENCY SYNDROMES
BRUTON’S
What is the Treatment for X-Linked (Bruton’s) Agammaglobulinemia?
IV Immunoglobulin (Ig) Infusions
Same as with CVID
PRIMARY IMMUNODEFICIENCY SYNDROMES
IgA DEFICIENCY
What are (3) common Presenting Symptoms of IgA Deficiency?
- Recurrent SINOPULMONARY infections (Bronchitis, Sinusitis, Pneumonia, and Pharyngitis)
- Sprue-like Abdominal disorder (Malabsorption, Steatorrhea, and Diarrhea)
- Atopic Conditions
PRIMARY IMMUNODEFICIENCY SYNDROMES
IgA DEFICIENCY
What is a common cause of Anaphylaxis in patients with IgA Deficiency??
Receiving Blood transfusion from a donor who are NOT IgA Deficient
Must use blood from IgA Deficient donor.