allergies Flashcards
anaphylaxis
IgE mediated rxn: pruritis, urticaria, angioedema, flushing, N/V/D, CVsx- hypothension to shock
occur w/in 30min of exposure
tx: epi for CV and respiratory sx. systemic anti-his and corticosteroids and beta adrenergic agonist
allergic rhinitis
IgE mediated. seasonal v perennial (indoor). has sensitization.
P: allergic shiner- dark circle under eye from chronic congestion, donnie’s lines under eye from edema, allergic salute, palm to lift nose to relieve itching
lab: IgE elevated, allergen skin testing (stop anti-His 7-10d bf), nasal smear for cytology(if many leukocyte= infection)
tx: intranasal steroids. 1/2nd gen antihis. intranasal anthis. decongestant (vasoconstriction, cause insomnia, nervousness,), leukotriene R antagonist, immunotherapy (exposure to build tolerance)
atopic dermatitis define and P
chronic inflm dermitits. aka eczema. dry skin + lichenification. pruritus -scratching -
worse in winter or temp extremes. fx of it or asthma/allergic diseases.
P: all pruritis. skin (acute-erythema, weeping, crusting, 2nd bacterial or viral infection) or chronic (lichenification, dry scaly skin, pig changes)
atopic dermatitis v age
infrant: trunchal facial, scalp, extensor surfaces
early childhood: flexure + lichenification, chronic itching!
late childhood- localized/ remitting
atopic dermatitis dx
3/4 major criteria- pruritus, persona or fx of atopy, typical morphology and distribution, relapsing or chronic dermatitis
minor: xerosi (abn dryness), dermatographism, wool intol, skin infextion
atopic dermitis tx
avoid. corticosteroids, anthills, baths in tepid water
food allergies
IgE. decr by breastfeeding.
dx: RAST test to id IgE ab to food ag. double blind placebo controlled food challenge is definitive test
chronic urticaria
> 6mo. often due to underlying conditions like malig and rheum disease. many have IgG ab to IgE R
drug allergy
urticaria, angioedema(vascular run of deep dermis or subQ) associated with local edema from dilated capillaries w incr permeability- giant wheals)- analylaxis
IgA def
dx: serum IgA
Common variable immunodef
hypogammaglobulinemia. nl # B/T cell but variable T cell dysfunc.
P: respiratory infection, Gi infeaction +chronic D, AI, incr risk of malig
dx: decr Ig, decr ab function (look at amount generated to childhood immunizations)
Tx: IVIG replacement. tx infection, manage chronic D
Severe combined Immunodef disease (SCID)
inherited D - defective T/B cell func
etio: x-linked 50%, IL, AR SCID- T cell ontogeny 30%
P: incr infection in 1st few mo of life- candida, pneumocystis carinii= opportunistic organisms. chronic D, FTT
Dx: lymphopenia
ataxia telangiectasia
AR, combined immunodef, cererella ataxia, oculocutaneous telangiectasias, predisposed to malig
etio: mut on C11- gene in cell cycle ctrl/response to DNA damage
P: variable immunodef, sinopulmonary infeciton, cerebellar ataxia, telangiectasias (bulbar conjunctiva and on exposed skin and trauma areas), cafe au last, vitiligo, gray hair
dx: igE def in 85% IgA def in 75. decr t cell func
tx: tx neuro C, infection, monitor for malig, avoid ionizing rad
wiskott aldrich
C linked. immunodef, eczema, congenital thrombocytopenia with small plt
etio: mut on short arm of X
P: H influenze and S pneumonia - encapsulated org,
dx: CBC, decr igM, ab to polysaccharide ig is defective (vaccine), cellular immune fuc is defective and anergy present, have right # of T cell but don’t dev ag specific cytotoxic T cell.
tx: BM transplant. IVIG splenectomy.
X linked (burton’s) agammaglobulinemia
severe hypogammaglobulinea and decr mature B cell
