Allergy and Immuno Flashcards
Pathophysiology of anaphylaxis
Pt already sensitized to Ag
IgE binds mast cells releasing granules
Common causes of anaphylaxis
Bites
Meds
Foods
Latex
Characteristics of anaphylaxis
Hypotension
Tachy
SOB, wheezing, lip/tongue/face swelling
Urticaria
Rx anaphylaxis
Epi
Antihistamines
Steroids
Emergent airway protection if required
What is angioedema
Swelling of Face, Tongue, Eyes, Airway
Causes of angioedema
Hereditary angioedema
ACEI AE
Idiopathic
Defect in hereditary angioedema
Deficiency of C1 esterase inhibitor
Presentation of hereditary angioedema
Sudden facial swelling
Stridor
No Pruritis or Urticatia
What doesn’t work in hereditary angioedema
Steroids
Best initial test for hereditary angioedema
Decreased C2, C4
Deficient C1 esterase inhibitor
Acute rx hereditary angioedema
FFP
Ecallantide (works for all angioedema)
Long term management of angioedema
Androgens
What should be ensured first in angioedema
Airway protection
What is Urticaria
Sudden swelling of superficial skin layers
Physical agents causing urticaria
Pressure
Cold
Vibration
Rx urticaria
Antihistamines
LTr antagonists
What causes allergic rhinitis
IgE dependent triggering of mast cells
What can be seen on nasal smear of allergic rhinitis
Eosinophils
Dx test in allergic rhinitis
Clinical
- recurrent episodes of allergy presentation
Skin/Blood testing for Ag
Allergen-specific IgE levels
Rx allergic rhinitis
Avoid precipitant Intranasal steroids Antihistamines Intranasal anticholinergics Desensitization
Etiology of common variable immunodeficiency (CVID)
Normal B cell numbers
Decreased !gG, M, A
Presentation of CVID
Recurrent sinopulmonary infections in adults M=F
Bronchitis, PN, sinusitis, otitis media
Giardiasis, sprue-like, autoimmune diseases
Dx tests in CVID
Ig levels decreased
Decreased response to Ag stimulatino of B cells
Clue to pick CVID
Decreased output of B cells
Normal number of B cells
Normal amounts of lymphoid tissue
Rx CVID
ABX for infections
IVIG for chronic maintenance
Picture of Bruton’s
Male children w/ increased sinopulmonary infections
Abnormality in Bruton’s
B cells and lymphoid tissue dminished
Decreased/Absent tonsils, adenoids, LNs, spleen
NL T cells
Rx Bruton’s
ABX for infections
IVIG
What is the issue in SCID
Deficiency in B and T cells
B cell deficiency infections
Recurrent sinopulm starting at age 6
T cell deficiency infections
Things seen in AIDS
- PCP, varicella, candida
Curative rx in SCID
BM transplant
Unique features of IgA deficiency
Atopic diseases
Anaphylaxis to blood transfusions from non-IgA def donors
Spru-like condition
Increased risk of vitiligo, thyroiditis, RA
Rx IgA deficiency
ABX for infections
Important points about Hyper IgE
Recurrent staph skin infections
PPX w/ dicloxacillin or cephalexin
Important points about Hwiskott-aldrich
Immunodeficiency Thrombocytopenia Eczema T cells deficient BM transplant only cure
Features of CGD
LNs w/ purulent material leaking
Aphthous ulvers
Inflammation in nares
Obstruction in GI/urinary
Infections in CGD
Staph
Burkholderia
Nocardia
Aspergillus
Dx tests in CGD
Nitroblue tetrazolium
Decreased NADPH oxidase
