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OP - Yield > 9: allergy > Flashcards

9: allergy Flashcards

1
Q

behcet syndrome aka and where

A

adamantindes syndrome

oral, genital, ocular lesions

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2
Q

pathergy

A

sterile pustule after insertion of steril needle in skin

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3
Q

positive pathergy

A

behcet

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4
Q

behcet pathergy

A

positive

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5
Q

lupus pernio

A

vilocaaous indurated skin lesions in sarcoidosis

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6
Q

erythema nodosum

A

sarcoidosis

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7
Q

lofgren syndrome

A

erythema nodosum, bilateral hilar LAD, arthralgia

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8
Q

erythema nodosum, bilateral hilar LAD, arthralgia

A

lofgren syndrome

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9
Q

heertfordt syndrome

A

parotid enlargement, anterior uveitis, facial paralysis, fever

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10
Q

parotid enlargement, anterior uveitis, facial paralysis, fever

A

heertfordt syndrome

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11
Q

schaumann bodies

A

laminated calcifications (lysosomes) in sarcoid granulomas

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12
Q

laminated calcifications (lysosomes) in sarcoid granulomas

A

schaumann bodies

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13
Q

asteroid bodies in sarcoid

A

stellate inclusion (entrapped collagen) in sarcoidosis

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14
Q

stellate inclusion (entrapped collagen) in sarcoidosis

A

asteroid bodies

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15
Q

kveim test

A

sarcoid tissue injected in skin

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16
Q

sarcoid tissue injected in skin

A

kveim test

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17
Q

wegeners labs

A

c-ANCA and confirm with PR3 ELISA

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18
Q

allergic contact stomatitis aka

A

stomatitis venenata

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19
Q

quincke dz aka

A

angioedema

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20
Q

angioedema aka

A

quincke dz

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21
Q

types of angioedema (x3)

A
  • IgE hypersensitivity
  • ACE inhibitors
  • activation of complement pathway - C1 - INH problems (hereditary - type I and II; acquired - lymphoproliferative dz and autoimmune)
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22
Q

transient lingual papillities aka and 3 types

A

aka lie bumps, tongue torches

  1. localized – one or several enlarged fungirform papillae - red papule, may ulcerate, dorsal tongue
  2. generalized – large % of fungiform papillae on tip/laterl tongue dorsum
  3. diffuse (papulokeratotis): white/yellow asymptomatic papules (poss frictional keratosis)
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23
Q

recurrent aphthous ulcers underlying cellular process

A

T cell reaction - decreased CD4/CD8 ratio, increased T cell receptors, increased TNF

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24
Q

types of aphthae and alternative names

A

minor aka mikulicz
major aka sutton or periadenitis mucosa necrotica recurrens
herpetiform

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25
Q

simple and ocmplex aphthosis

A

simple: few lesions, heal 1-2 weeks, few recurrences
complex: >3 lesions, almost constant

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26
Q

silver nitrate dangers

A

used for aphthae

can cause massive necrosis and systemic argyria

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27
Q

behcet syndrome aka

A

Adamantiades syndrome

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28
Q

geography and genetics of behcet

A

middle east, japan

HLA B51

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29
Q

aphthae in behcet

A

99% of pts
commonly first sign
more numerous (>6) and dif location (soft palate and oropharynx) than sporadic aphthae
usually minor or majoe

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30
Q

genital lesions in behcet

A

less frequent, deeper, more scarring than oral

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31
Q

pathergy

A

positive in behcet

sterile pustule after insertion of sterile needle in skin

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32
Q

behcet classic histo

A

leukocytoclastic vasculitis: intramural invasion of n/ph, karyorrhexis of n/ph, RBC extravastion an dfibrinoid necrosis of vessel wall

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33
Q

diagnosis criteria for behcet

A

oral ulcers + 2 of:
- genital lesions
- eye lesions (eveitis, retinal vasculitis, cells in vitrous)
- skin lesions (erythema nodosum, pseudofolliculitis or papulopustular lesions)
or pathergy test

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34
Q

sarcoidosis ethnic and age

A

10-17x more in black

<50yo

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35
Q

predominant sites for sarcoid

A

lungs, LN, skin, eyes, salivary glands

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36
Q

chroni violaceous indurated skin lesions in sarcoid

A

lupus pernio

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37
Q

erythema nodosum

A

scattered nonspecific tender erythematous nodules on lower legs
e.g., sarcoid

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38
Q

lofgren syndrome

A

erythema nodosum, bilateral hilar LAD, arthralgia

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39
Q

erythema nodosum, bilateral hilar LAD, arthralgia

A

lofgren syndrome

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40
Q

heerfordt syndrome aka

A

uveoparotid fever

parotid enlargement, anterior uveitis, facial paralysis, fever

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41
Q

parotid enlargement, anterior uveitis, facial paralysis, fever

A

heerfordt syndrome aka uveoparotid fever

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42
Q

schaumann bodies

A

laminated calcifications, degenerated lysosomes

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43
Q

asteroid bodies

A

stellate inclusion, entrapped fragment of collagen

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44
Q

laminated calcifications, degenerated lysosomes

A

schaumann bodies

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45
Q

stellate inclusion, entrapped fragment of collagen

A

asteroid bodies

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46
Q

hamazaki weisenberg bodies

A

small yellow brown structures (large lymphocytes) in LN in sarcoid

47
Q

labs in sarcoid

A

elevated ACE

48
Q

sarcoid prognosis and mortality

A

60% resolve within 2y
observe 3-12 months
if needed, steroids
4-10% mortality

49
Q

kveim test

A

injection of sterile sarcoid

50
Q

non tender persistent swelling of one or both lips

A

orofacial granulomatosis

51
Q

what to rule out for orofacial granulomatosis

A

melkerson rosenthal syndrome, Chron’s, sarcoid, TB, leprosy, foreign body

52
Q

orofacial granulomatosis involving only lip

A

cheilitis granulomatosa (of Miescher)

53
Q

granulomatous inflammation on gingiva only: what to rule out

A

foreign material

54
Q

wegeners granulomatosis locations

A

granulomatous lesions of respiratory tract, glomerulonephritis, systemic vasulitis

55
Q

types of wegeneres (3)

A

classic: upper and lower resp tract + rapid renal lesions (aka generalized)
limited: respiratory without renal
superficial (skin and mucosal only, slowly develops systemic)

56
Q

wegeners and nose

A

saddle nose deformity – destroys nasal septum

57
Q

oral wegeners

A

strawberry gingivitis (hyperplastic gingiva with hemorrhagic bulbous projections)

58
Q

strawberry gingivitis

A

hyperplastic gingiva with hemorrhagic bulbous projections

oral wegeners

59
Q

hyperplastic gingiva with hemorrhagic bulbous projections

A

strawberry gingivitis

oral wegeners

60
Q

non strawberry oral wegeners

A

ulcerations, facial paralysis, labial mucosa nodules, sinusitis related toothache, TMJ arthralgia, jaw claudication, palatal ulceration, oral-antral fistula, poorly healing extraction

61
Q

histo wegeners

A

RBC extravastaion close to surgace

sinonasls: necrosis, vasculitis, granulomatous inflammation

62
Q

wegeners labs

A

c-ANCA (also for monitoring)

confirm with PR3 Elisa

63
Q

wegeners tx

A

prednisons + cyclophosphamide

64
Q

c=ANCA

65
Q

risk of adverse drug rxns with 2, 5, 8+ drigs

A

6% with 2
50% with 5
100% with 8+

66
Q

patterns of stomatitis medicamentosa

A

anaphylactic, fixed drug eription, lichenoid, lupus like, pemphigus like, nonspecific vesiculo-ulcerative/aphthous like

67
Q

which drug can prompt PV-like lesions

A

penicillamine

68
Q

string of pearls on IIF

A

IgG along basal cell layer – stomatitis medicametosa

69
Q

circulating antibody in stomatitis medicamentosa

A

basal cell cytoplasmic antibody

70
Q

stomatitis medicamentosa on IIF

A

IgG string of pearls

71
Q

allergic contact stomatitis aka

A

stomatitis venenata

72
Q

contact cinnamon stomatitis histo

A

mixed infiltrate that obscures connective tissue/epith interface and perivascular inflammation

73
Q

gingiva and allergy

A

plasma cell gingivitis

74
Q

amalgam allergy

A

lichenoid contact stomatitis
usually old amalgams
–> erosion and relase of ions

75
Q

lichenoid stomatitis vs lichen planus

A

no migration, directly relates to dental material, improves upon removal, patch test to dental material positive

76
Q

koebner phenomenon

A

pts w contact stomatitis but negative patch test

77
Q

pts w contact stomatitis but negative patch test

A

koebner phenomenon

78
Q

angioedema aka

A

Quincke’s dz

79
Q

mechanisms of angioedema (5)

A

1- mast cell degranulation (histamine and IgE mediated/allergic)
2 - ACEi and ARB
3 - complement pathway, deficiency of C1-INH activity
4 = high Ab-Ag complexes (lupus, viral/bacterial infx)
5 - elevated peripheral blood eosinophils

80
Q

deficient C1-INH activity

A

angioedema

hereditary - type I (less C1-INH) and type II (normal levels but dysfunctional C1-INH)
acquired - lymphoprilferative dz (autoAB consumes C1-INH) or autoimmune (autoABbinds to and reduces C1-INH fx)

81
Q

tx for angioedema

A

allergic - histamine
ACE and hereditary/acquired - C1-INH concentrate
autoimmune - steroids

82
Q

transient lingual papillitis which papillae

83
Q

periadenitis mucosa necrotica recurrens

A

major aphthae (aka sutton)

84
Q

sweet syndrome

A 
Febrile neutrophilic dermatosis
 High fever
 Leukocytosis
 Red plaques
 Neutrophilia
85
Q

Febrile neutrophilic dermatosis

A 
sweet syndrome
 High fever
 Leukocytosis
 Red plaques
 Neutrophilia
86
Q

classic triad of reactive arthritis

A

1-nongonococcal urethritis
2-conjuctivits
3-arthritis

87
Q

reiter syndrome

A

reactive arthritis + mucocutaneous component

88
Q

1-nongonococcal urethritis
2-conjuctivits
3-arthritis

A

reactive arthritis

89
Q

1-nongonococcal urethritis
2-conjuctivits
3-arthritis
4-mucocutaneous component

A

reiter syndrome

90
Q

behcet HLA

91
Q

violaceous indurated plaques ddx

A 
lupus pernio (sarcoid)
lupus vulgaris (TB)
92
Q

scattered erythematous nodules on lower leg

A

erythema nodosum - consider sarcoi

93
Q

degenerated lysosomes in granulomata

A

schaumann - consider sarcoid

94
Q

entrapped collagen in granulomata

A

asteroid bodies - consider sarcoid

95
Q

intradermal injection of human sarcoid tissue

A

kveim test

96
Q

melkersson rosenthal components

A
  1. Facial paralysis
  2. Fissured tongue
  3. Swelling of lip
97
Q

cheilitis granulomatosa eponym

98
Q

types of wegeners

A

Limited: respiratory system
Superficial: Skin and mucosa
Generalized: respiratory and renal and small arteries (vasculitis)

99
Q

strawberry gingivitis

100
Q

4 criteria for wegeners

A

4 Criteria:

  1. Granulomatous inflammation
  2. Oral ulcerations
  3. Abnormal urinary sediment
  4. Cavities on chest wall
101
Q

immunofluorescne in wegeners

A

Indirect immunofluorescence or serum AB against Anti neutrophilic cytoplasm antibodies
(ANCA)

102
Q

best AB for wegeners diagnosis

A

1- PR3-ANCA; c-ANCA : proteinase-3 / part of neutrophilic azurophilic cytoplasmic granules

103
Q

proteinase 3

A

ELISA and PR3-ANCA indirect immunofluorescence for wegeners

104
Q

MPO-ANCA

A

vasculitides other than wegeners (low specificity)

MPO-ANCA; p-ANCA: Myeloperoxidase neutrophil lysosomal granules

105
Q

c-ANCA new name

106
Q

p-ANCA new name

107
Q

allergic contact stomatitis sex

108
Q

circumoral vs perioral dermatitis

A

Persistent erythematous papules involving the skin surrounding the vermilion border
there is spared skin ( vs circumoral dermatitis)

109
Q

gold standard tx for perioral dermatitis

A

oral tetracycline

110
Q

Persistent erythematous papules involving the skin surrounding the vermilion border
there is spared skin

A

perioral/periorificial dermatitis

111
Q

angioedema vs emphysema

A

Cervicofacial emphysema:
Air pocket in facial spaces
CREPITUS

112
Q

ethnic angioedema

A

3-4x more in black ppl

113
Q

poss reasons for angioedema

A

hypersensitivity (IgE and mast cells)
ACEi *-pril
herediratary (C1-INH – type 1 *85% less of it, type 2 doesn’t work)
acquired - lymphoproliferative dzz and autoimmune

lupus and infections – higher AG-AB complexes in principle
also w high peripheral eosinophils

OP - Yield (19 decks)

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