228: Fungal disease Flashcards
what does CD4 do?
communicate T cells with B cells
what is hypersensitivity pneumonitis?
heavy exposure to proteins forms an immunce complex and cell mediated hypersensitivity ( type 3 and 4)
immune cell of a type 3 hypersensitivity?
IgG
immune complexes trigger complement.
immune cells of a type 4 hypersensitivity?
Th1, Th2, cytotoxic T lymphocytes.
t lymphocytes drive macrophages ( tissue damage)
symptoms of hypersensitivity pneumonitis
dysnoea, cough, fever, flu like symptoms (4-6h after exposure)
obstructive pulmonary picture?
low FEV1
restrictive pulmonary picture?
low FVC
diagnosis of hypersensitivity pneumonitis :
restrictive lung function serum antibody precipitins high lymphocyte count in bronchiolar lavage ground glass infiltrates on CT granulomas and inflamed broncioles
treatment of hypersensitivity pneumonitis?
oral steroids initially if still not controlled add a DMARD (disease modifying anti-rheumatic drug) cyclophosphamide.
what is aspergillus?
a mould that exists as hyphae in the body.
in asthmatics/CF it can cause allergic bronchopulmonary aspergillosis.
in immune compromised it will invade blood vessels nad tissues outside the lung.
what is allergic broncho pulmonary aspergillosis?
a type 3 (immune complex) and 4 (cell mediated) hypersensitivity reactions
fever cough dyspnoea, worsening of asthma, coughing up casts.
ABPA (allergic broncho pulmonary aspergillisis) treatment?
long term antifungal therapy plus oral steroids
what is an intra-cavitary aspergilloma?
a fungus ball ( mycetoma)
the hyphae release oxalic acid and blood vessel erosion leads to haemoptysis.
treatment of an intracavity aspergilloma
antifungals are not good because its not systemic.
surgical resection
bronchial artery embolisation
what can make a person neutropaenic?
AIDS, steroids, uncontrolled DM, chemo
