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Allergy Flashcards

1
Q

increase symptoms at night suggest

A

Bedroom Allergens

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2
Q

Weekend remissions suggest

A

School place allergens

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3
Q

Eosinophil level suggestive of allergy

A

> 700/mm3 in blood
5 ~ 10 % in cells

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4
Q

IgE is considered……

A

good negative (sensitive not specific)

لو لقيته واطي اوي هقدر ا exclude atopy
بس لو لقيته عالي مش هقدر اعتمد عليه لوحده في التشخيص عشان بيبقى عالي في حاجات تانية

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5
Q

skin prick test is considered +ve when…..

A

a wheal of ≥ 3mm appears

indicates that IgE Ab is present on mast cells
doesn’t indicate that pateint will have symptoms on exposure of allergen

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6
Q

Provocation test vs skin prick

A

Provocation is more accurate but riskier

should only be done in hospitals

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7
Q

M/I line of ttt of allergy

A

Avoidance of allergen

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8
Q

SCIT

A

not approved before 5 years

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9
Q

SLIT

A

not available for food allergy

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10
Q

Atopy and breastfeeding

A

continue breastfeeding

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11
Q

m/c chronic inflammatory skin disorder

A

atopic dermatitis

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12
Q

Define JIA

A

arthritis of unknown etiology
begins before the 16th birthday
persists for at least 6 weeks
with other known conditions excluded

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13
Q

type of fever in Systemic JIA

A

Quotidian = intermittent

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14
Q

criteria of Systemic JIA

A

arthritis in ≥ 1 joint with history of 2 weeks fever that is quotidian for at least 3 days+ one of the following:
- Serositis ( eg. Pericardial effusion)
- Hepatomegaly or splenomegaly
- Generalized lymphadenopathy
- Evanescent erythematous rash

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15
Q

Criteria of psoriatic JIA

A

Arthritis + psoriasis or Arthritis + ≥ 1 of:
- Dactylitis
- Nail pitting / onycholysis
- 1st degree relative has psoriasis

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16
Q

criteria of enthesitis related JIA

A

arthritis + enthesitis or Arthritis / enthesitis + ≥ 2 of:
- Sacroiliac tenderness / inflammatory lumbosacral pain
- onset in male > 6 years old
- HLA-B27 +ve
- Acute anterior uveitis
- +ve FH

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17
Q

character of pain in JIA

A

Aching or streching
occurs on active or passive movement

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18
Q

joint stiffness improves by

A

activity or application of heat to the affected area

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19
Q

arthritis in the knee is characterized by

A

atrophy of Vastus Medialis

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20
Q

peak age of Systemic JIA

A

1 ~ 5 years (both genders are equally affected)

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21
Q

at which part of the day does fever occur

A

any time of the day but is characteristically present in the late afternoon to evening in conjunction with the rash

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22
Q

M/C location of skin rash in JIA

A

Trunk and proximal extremities
** NON PURITIC**
- elicited by Scratching / Hot bath / Psychological stress

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23
Q

M/C joints involved in systemic JIA

A
  • wrists
  • Knees
  • Ankles
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24
Q

Most devastating complication if JIA

A

Macrophage activation syndrome

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25
MAS is characterized clinically by the rapid development of:
- Unremitting fever - Hepatosplenomegaly and lymphadenopathy - Hepatic dysfunction (and even liver failure) - Encephalopathy - Purpura, bruising, and mucosal bleeding - Severe cases rapidly progress to multiorgan involvement , hypotension and shock.
26
peak age of oligoarticular JIA
2-4 years with female predominance.
27
Most common Joint involved in oligoarticular JIA
Knee
28
If oligoarticular JIA + +ve ANA
search for chronic uveitis
29
peak age of Polyarticular JIA
Rh-negative: 2-4 and 10-14 years Rh-positive: 9-12 years Female predominance
30
Most common joint affected in polyarticular JIA
small joints of the hands, feet, ankles, wrists, and knees
31
TMJ arthritis leads to
Micrognathia
32
Rheumatoid nodules are present in
severe Rh-positive polyarthritis
33
Peak age of Enthesitis Related arthritis
9 ~ 12 years male predominance
34
character of The peripheral arthritis in ERA
oligoarticular, asymmetrical and mainly involves the lower extremities.
35
Most common joint affected in ERA
Hip
36
Peak age of psoriatic JIA
2~4 and 9 ~ 11 female predominance
37
Most common X-ray finding in Arthritis
periarticular osteopenia,
38
Drug-induced Lupus
- Anticonvulsants - Antiarrhythmics - Sulfa ** No major organ Involvement**
39
Maternal Ab in neonatal Lupus
- Anti Ro = Anti SSA - Anti La = Antia SSB - Anti RNP
40
the most common inflammatory myositis in children
Juvenile dermatomyositis (JDM)
41
Peak age at onset of Juvenile dermatomyositis (JDM)
4 ~ 10 years Femal predominance
42
Shawl sign
Photosensitive erythematous skin rash in sun-exposed area; over upper chest and neck
43
heliotrope rash
blue-violet discoloration of the eyelids that may be associated with periorbital edema.
44
Gottron papules
bright-pink or pale, shiny, thickened or atrophic plaques over the proximal interphalangeal joints and distal interphalangeal joints and occasionally on the knees, elbows
45
character of fever in Kawasaki Disease
high spiking (≥38.3°C ) unremitting unresponsive to antipyretics The duration of fever without treatment is generally 1-2 wk but may be as short as 5 days or may persist for 3-4 wk
46
Criteria of Kawasaki disease
(1) bilateral nonexudative conjunctival injection with limbal sparing (2) erythema of the oral and pharyngeal mucosa with strawberry tongue and red, cracked lips (3) edema (induration) and erythema of the hands and feet (4) rash of various forms (maculopapular, erythema multiforme, scarlatiniform or less often psoriatic-like, urticarial or micropustular), and (5) nonsuppurative cervical lymphadenopathy, usually unilateral, with node size >1.5 cm.
47
duration of Acute phase of KD
1 ~ 2 weeks Perineal desquamation is common
48
duration of Subacute phase of KD
3 Weeks associated with desquamation, thrombocytosis, development of CAA **High risk of sudden death**
49
duration of Convalescent phase of KD
6 ~ 8 weeks after onset continues until ESR is back to normal
50
diagnosing KD requires
the presence of fever for at least 4 days and at least 4 of 5 of the other principal characteristics of the illness
51
diagnosing KD should be done within
7 ~ 10 days to improve coronary artery outcomes
52
CBC in KD
1. ↑ TLC (Neutrophils predominant) 2. Normocytic Normochromic anemia 3. Platelets normal in 1st week rapidly increasing in 2nd and 3rd week
53
TTT of KD
- 2 g/kg of IVIG as a single infusion, administered over 10-12 hrs ASAP when diagnosis is established - Aspirin
54
Aspirin in KD
1. Moderate to High dose until patient is afebrile 2. Lowered from anti-inflammatory to antithrombotic dose when afebrile for 48 h 3. discontinued after 6 ~ 8 weeks of disease onset
55
Most common vasculitis in childhood
Henoch-Schönlein purpura
56
duration of rash in HSP
3 ~ 10 days recur after 4 months
57
cause of FMF
AR mutations in MEFV gene Homozygosity for the M694V mutation with earlier onset
58
The hallmark cutaneous finding in FMF
erysipeloid erythematous rash that overlies the ankle or dorsum of the foot
59
most common cause of acquired Heart disease in developed countries
Kawasaki disease
60
Most significant ccc of Kawasaki disease
Coronary artery aneurysm
61
When to suspect SCID
ALC< 3000x103/uL at birth ❑2800x103/uL during infancy
62

Pediatrics (9 decks)

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