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Allergy > Allergy > Flashcards

Allergy Flashcards

1
Q

Triad of aspirin-exacerbated respiratory distress

A

Asthma symptoms
chronic rhino sinusitis
Nasal polyps

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2
Q

Is aspirin-exacerbated respiratory distress triggered only by ASA?

A

NO;

other NSAIDs

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3
Q

Aspirin-exacerbated respiratory distress tx

A

Leukotriene modifying agents

Topical nasal CS

ASA desensitization

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4
Q

Allergic rhinitis Mx: do you treat with a trial of intranasal CS first or do you refer for skin testing first?

A

Trial of intranasal CS therapy

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5
Q

Atopic dermatitis triad

A

Dermatitis:
–>ACUTE: red, eczematous, crusted, papulovesicular
–>CHRONIC: lichenified and hyper pigmented
Asthma
Allergic rhinitis

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6
Q

Atopic dermatitis TX

A

Emollients
Topical GC
PO antihistamines

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7
Q

Contact dermatitis is what type of a reaction

A

Delayed Hypersensitivity reaction

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8
Q

Examples of delayed hypersensitivity reactions

A

Poison ivy
Neomycin
Preservatives
Metals

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9
Q

Gold standard diagnostic testing of Contact Dermatitis

A

Patch testing

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10
Q

Contact dermatitis TX

A

Topical GC

IF severe/extensive PO GC

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11
Q

Contact dermatitis rash

A 
Pruritic 
Red
Edematous 
Weeopy
Crusted 
Possible Vesicles or Bullae
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12
Q

Common variable immunodeficiency tx

A

Replacement of Immune Globulin

Early abx tx or prophylactic abs tx for chronic infections

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13
Q

Hypogammaglobulinemia recurrent infections consists of

A

Encapsulated bacteria

Giardia

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14
Q

Initial test for C5–C9 terminal complement deficiency

A

CH50 level if normal….

assess alternative complement pathway with AH 50

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15
Q

Terminal complement deficiency MX

A

Early abx initiation

Meningococcal vaccine

PCV 13 AND PPSV 23 vacciness

H. influenza vaccine

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16
Q

What type of immunodeficiency is present

  • invasive skin infection
  • test to diagnose
A

Granulocytes (chronic granulomatous dz)

Dihydrorhodamine (DHR) oxidation test

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17
Q

What type of immunodeficiency defect is present

  • viral, intracellular, or fungal infections
  • test to diagnose
A

Cell-mediated

CBC (lymphocyte count), CD3, CD4, CD8 - lymphocyte markers

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18
Q

What type of immunodeficiency defect is present

  • recurrent N. meningitidis meningits and Disseminated gonorrhea infections
  • test to diagnose
A

Terminal complement components

CH50–> AH 50 if CH50 is normal

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19
Q

What type of immunodeficiency defect is present

  • sinopulmonary infections, bacteremia with encapsulated orgs
  • test to diagnose
A

Immunoglobulins

Quantitative serum Ig; response to tetanus and pneumococcal vaccines

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20
Q

Hives/wheals lasting <24hrs (recurrent)

+/- Intermittent lip and tongue swelling

A

Urticaria

21
Q

MC etiologies of acute urticaria

MC etiologies of chronic urticaria (< 6wks)

A

Acute- viral, meds(B-lactams, sulfonamides, opioids, radiocontrast media)

Chronic- typically autoimmune

22
Q

Urticaria rash findings

A

Erythematous
Intensely pruritic plaques of urticaria
Dermatographism

23
Q

Urticaria Tx

A

1st line - H1 blockers (cetgirizine, loratadine)

2nd line - PO GC only if persistent and/or involves angioedema

NO ANTIHISTAMINES OR TOPICAL CS

24
Q

Do you need to order C1-esterase or C4 levels to r/o hereditary angioedema in patients with urticaria + angioedema

A

NO

25
Q

Hereditary angioedema testing

A

C1-esterase or C4 levels

26
Q

2 different etiologies of Hereditary angioedema

A
  1. mast cell mediated

2. bradykinin mediated

27
Q

3 types of bradykinin mediated angioedema

A

Hereditary - Low C4 and low or dysfunctional C1- inh

ACE inh - Normal C4 and C1-inh levels

Acquired C1 inh deficiency
- older age onset

28
Q

Acute hereditary angioedema tx

A 
Kallikrein inh (ecallantide)
Bradykinin R Ag (icatibant)
29
Q

Hereditary angioedema prophylactic tx

A

Kallikrein inh ( lanadelumab)

30
Q

Testing and prevention for Hymenoptera sting allergy anaphylaxis and diffuse cutaneous symptoms

A

Referral to an allergist for immunotherapy and Venom skin testing***

31
Q

Food allergy is mediated by

A

IgE

32
Q

Negative skin testing could be

Positive skin testing could be

A

Negative

False

33
Q

Serum sickness is what type of allergic reaction ?

Example?***

A

Type III immune complex deposition

Antivenom injection + snake venom

34
Q

Maculopapular rash is what type of allergic reaction

A

Type IV (T cell-mediated )

35
Q

What is Jarisch-Herxheimer reaction?

What do you do?

A

Acute febrile rxn occurring within 24 hrs of starting antibiotic therapy for syphilis -
ALLERGIC MIMIC reaction
DON’T STOP PNC

36
Q

Initial cutaneous manifestation of acute graft vs host dz

A

Maculopapular rash

37
Q

Graft vs host dz is commonly seen in

A

Allogenic HCT

38
Q

Graft vs host dz syptoms

A

Maculopapular rash
Abd cramps and Diarrhea
Hyperbilirubinemia

39
Q

ACUTE Graft vs host dz prevented and treated by

A

Nonspecific - prednisone and methotrexate

Specific T cell suppressor - cyclosporin, tacrolimus

40
Q

CHRONIC Graft vs host syptoms

A
  • -Lichen Plans, lichen sclerosis, or scleroderma-like skin rxn
  • -dry oral mucosa
  • -GI tract sclerosis
  • -hyperbilirubinemia
41
Q
  1. Difference between Skin testing vs serum allergen specific IgE testing
  2. Does antihistamine use affect skin testing or IgE testing
A
  1. skin testing evaluates broader range of allergic response mechanisms.
  2. Antihistamine can affect skin testing but not IgE testing
42
Q

For unclear reasons Spina bifida is associated with

A

Latex allergies

43
Q

2 types of acquired Angioedema (low C1 esterase inhibitor + low C1q)

A

Type 1- myeloproliferative + lymphoproliferative dz like LYMPHOMA ***

Type 2- autoAbs to C1 esterase inhibitor

44
Q

What differentiates hereditary angioedema from acquired angioedema

A

Age (hereditary occurs <40yo)

C1q (normal in hereditary and low in acquired )

45
Q

Rare autosomal recessive d/o of chrome 11

  • neurodegeneration (loss of muscle coordination –> wheelchair)
  • progressive cerebellar ataxia and telangiectasias
  • immunodeficiency (depressed Ig levels)
  • predisposition to cancer
A

Ataxia-telangiectasia

46
Q

Rare autosomal recessive disorder

  • progressive limb and gait ataxia
  • sensory loss
  • weakness
  • dysarthria
  • NO IMMUNE DYSFXN
A

Friedreich ataxia

47
Q

Difference between Friedreich ataxia and Ataxia-telangiectasia

A

NO immune dysfxn seen in Friedreich ataxia

48
Q

Spelenctomy patients are at increased risk for which bacterias (4)

A

Strep pneumoniae
H. influenzae
N. meningitidis
Klebsiella pneumoniae

49
Q

Class I HLA is present on

A

ALL nucleated cells

Allergy (1 decks)

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