Allergy Flashcards

1
Q

CVID diagnosis

A

hypogammaglobulinemia

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2
Q

complement deficiency clinical features

A

Recurrent neisseria (meningococcal meningitis)

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3
Q

Management of refractory asthma

A

IF elevated IgE or sensitivity to allergies: omalizumab (binds IgE)
IF increased eosinophils: mepolizumab

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4
Q

Other biologic approved for uncontrolled asthma

A

Dupilumab

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5
Q

step up from albuterol in asthma

A

Daily low-dose ICS

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6
Q

step up from daily low dose ICS

A

ICS-formoterol

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7
Q

Safe

A

Budesonide

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8
Q

long term SE to know of from chronic beta agonist (eg albuterol) overuse

A

tachyphylaxis (patients become refractory)

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9
Q

Triad of aspirin-exacerbated respiratory disease

A

nasal polyps, asthma, aspirin sensitivity

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10
Q

Allergic bronchopulmonary aspergillosis

A

asthma +

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11
Q

Treatment of allergic bronchopulmonary aspergillosis

A
  • steroids

- antifungals

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12
Q

Person comes in with bee sting and diffuse hives management

A

do nothing

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13
Q

Person comes in with bee sting and severe systemic reaction

A
  • refer to AI + epi pen

- obtain baseline serum tryptase

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14
Q

Fire ant clinical features

A

Sterile pustule 24 hours after sting

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15
Q

potency of topical steroids

A
low = hydrocortisone
mid = triamcinolone
high = fluocinonide
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16
Q

Treatment of refractory eczema

A
  • topical calcineurin inhibitors

- dupilumab

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17
Q

contact dermatitis treatment

A
  • avoidance
  • topical steroids
    IF severe – systemic steroids
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18
Q

allergen in poison ivy

A

urushiol

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19
Q

cause of hereditary angioedema

A

C1 esterase inhibitor deficiency

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20
Q

management of ACEi angioedema

A

After 6 weeks, trial ARB

21
Q

chronic spontaneous urticaria and angioedema clinical features

A
  • recurrent urticaria and or angiodedema without identifiable trigger
22
Q

Management of chronic spontaneous urticaria

A
  • high dose antihistamines

- no lab workup

23
Q

Type 1 drug allergy

A
  • IgE mediated

- anaphylaxis

24
Q

Type 2 drug allergy

A
  • antibody mediated

- hemolysis

25
Q

Type 3 drug allergy

A

..

26
Q

Management of anaphylaxis if persistent after first epi shot

A

Repeat epi

27
Q

Fixed drug eruption clinical features

A
  • pink/purple dusty plaque that occurs in the same spot the culprit med is taken
28
Q

Treatment of fixed drug eruption

A
  • self limiting, no need to treat
29
Q

Acute generalized exanthematous pustulosis clinical features

A

pustular rash + fever

30
Q

Acute generalized exanthematous pustulosis clinical features

A

pustular rash + fever

31
Q

treatment of hypereosinophilia syndrome

A
  • steroids

- imatinib

32
Q

treatment of eosinophilic esophagitis

A
  • avoid culprit food

- swallowed budesonide or flonase

33
Q

how to differentiate allergic from acei/bradykinin induced angioedema

A

no urticaria, bronchospasm, or other symptoms of allergic reactions.

34
Q

workup of acromegaly

A

Serum IGF-1

35
Q

acromegaly clinical features

A

coarsening of facial features + macroglossa + increased hand and foot size

36
Q

acromegaly treatment

A

pituitary adenoma resection (typically caused by pituitary adenoma)

37
Q

CGD diagnosis

A

Abnormal neutrophil oxidative burst

38
Q

C1 esterase inhibitor deficiency presentation

A

Alexia with a sombrero on: her face is really edematous + she’s grabbing her stomach in agony + she’s choking and gasping for air/presentation = hereditary bradykinin-associated angioedema + recurrent episodes of abdominal pain + life-threatening laryngeal edema + pyogenic infections.

39
Q

Late or terminal complement (C5-C9) deficiency presentation

A

Hailing + Alexia hoola-hooping in middle: Serra’s from AK hanging from the ceiling topless/terminal complement deficiency increases susceptibility to recurrent Neisseria bacteremia (you can’t form MAC attack complex).

40
Q

Presentation of allergic contact dermatitis of the nails

A
  • exposure to artificial nails

- edema or eczema + nail dystrophy + periungual hyperkeratosis + paresthesias + fingertip dermatitis

41
Q

Clinical features of psoriasis of the nail

A
  • pittting + onycholysis (separation of the nail plate from the underlying nail bed)
42
Q

herpetic whitlow clinical features

A
  • vesicular rash + paresthesias
43
Q

Initial management of parapneumonic effusion

A

IF less than 10 mm – observe (likely to resolve with abx)

IF greater than 10 mm – US to confirm, then thora

44
Q

Next step after US of parapneumonic effusion

A

IF high risk features (loculated, over half hemithorax, or thickened pleura –> chest tube for drainage
IF no high risk features –> diagnostic thora

45
Q

Indications for chest tube following diagnostic thoracentesis

A

Complicated effusion
(positive gram stain or culture
OR pH less than 7.2)

46
Q

Management of mild anaphylaxis

A

*anaphylaxis can present with relatively mild manifestations initially so anyone with dyspnea + skin findings + hypotension + GI symptoms after exposure to an allergen should get IM epinephrine

47
Q

Initial treatment of chronic urticaria

A
  • second generation antihistamines
48
Q

what are the second generation antihistamines?

A
  • loratadine (claritin)
  • fexofenadine (allegra)
  • cetirizine (zyrtec)
49
Q

what is ranitidine?

A

H2 receptor blocker