Allergies, Immuno + Neuro Lecture

Question 1

Asthma
Allergic rhinitis
Atopic dermatitis

IgE mediated
genetic predisposition

Answer 1

Atopy

Question 2

MC allergic disease

Frequently coexists with asthma
80% develop symptoms before 20 yo
Inhalant allergens are primarily responsible for sx

Answer 2

Allergic rhinoconjuncitivitis

Question 3

Intermittent: symptoms less than 4 days a week

Persistent: symptoms over 4 days a week for over 4 weeks

Answer 3

Allergic rhinoconjunctivitis

Question 4

Allergic salute
Nasal obstruction with mouth breathing, nasal speech, snoring
Pale blue, edematous nasal turbinates

Labs:
eosinophilia (serum IgE or smear or nasal secretions)
Skin testing

Answer 4

Allergic rhinoconjunctivitis

Question 5

Chroniclly relapsing inflammatory skin disorder, many outgrow!

Typically associated with allergies and asthma!
Presents in childhood, with onset prior to 5 yo

Answer 5

Atopic dermatitis

Question 6

Rash on face, scalp and extensor surfaces of elbows/knees

**pruritic, red papules**
secondary excoriations (can progress to plaques and lichenification)

Answer 6

Atopic dermatitis

Question 7

Tx:

Avoid irritants
hydration!!!
moisturizers (ointment!!)
topical steroids for acute flares

Answer 7

Atopic dermatitis

Question 8

Occurs when large quanitities of histamine rapidly release from mast cells and basophils after exposure to allergen

acute life threatening, medical emergency

Answer 8

Anaphylaxis

Question 9

Most common cause of anaphylaxis in:

Children/adolescents?
Middle aged adults?
Older adults?

Answer 9

Children: food

Middle aged: venom

Older: medications

Question 10

Onset within minutes after exposure

Skin-mucosal swelling
Respiratory compromise
Low systolic BP
+/- GI symptoms

Answer 10

Anaphylaxis

Question 11

Tx of anaphylaxis

Answer 11

Epinepherine

Question 12

Occurs within mins to under 2 hours after ingestion

hives, flushing, facial angioedema, mouth/throat itching

MC: cows milk, eggs, peanuts

Answer 12

Food allergies in kids

Question 13

Food specific IgE testing (immunoCAP)

Blinded food challenge (gold standard!)

Answer 13

Used in dx of food allergies

Question 14

Prolongation of “physiologic” hypogammaglobulinemia of infancy, which is normally observed during first 3-6 months

typically presents with recurrent:
URIs +/- otitis media and bronchitis

spontaneous recovery usually by 9-15 mos
IgG levels normalizing by 2-4 yo

Answer 14

Transient Hypogammaglobulinemia (THI)

Question 15

Classified based on presence/absence of T, B and NK cells

Presents with: recurrent infection, chronic diarrhea, failure to thrive

Exam:
lack of lymphoid tissue
no tonsils or lymph nodes
CXR with absent thymic shadow

*BONE MARROW TRANSPLANT MADE BY CURATIVE*

Answer 15

Severe combined immunodeficiency (SCID)

bubble boy

Question 16

After single seizure, _____% risk of recurrence

After 2 seizures, ___% risk of recurrence

Answer 16

single seizure, 50% chance

two seizures, 85% chance

Question 17

1. 3 months to 6 yo
2. fever over 38 C
3. non CNS infection/inflammation

Answer 17

criteria for febrile seizures

(>90% are generalized)

Question 19

Abnormal head size is ___ standard deviations above or below normal

Answer 19

2

Question 20

Transillumination of head is seen with…

Answer 20

Macrocephaly