Allergy and Immunology Flashcards
Difference between anaphylaxis and anaphylactoid reaction
Anaphylaxis = IgE mediated with prior sensitization to the antigen
Anaphylactoid reaction = non-IgE related, clinically identical and treated the same way, but do not need preceding sensitization to the antigen
Best initial therapy for anaphylaxis
- Epinephrine
- Antihistamines: diphenhydramine (H1-blocker) and ranitidine (H2-blocker)
- Glucocorticoids
- Emergent airway protection if needed
Although angioedema is often idiopathic, what medication should you ask about in patients presenting with sudden swelling of their face/tongue/eyes/airway?
If they recently started an ACE inhibitor
True/False
Hereditary angioedema DOES NOT respond to glucocorticoids
True
Best initial test when suspecting angioedema
Decreased levels of C2 and C4
2/2 deficiency of C1 esterase inhibitor
Treatment for angioedema
- Protect the airway
- FFP or Ecallantide
- Androgens: danazol and stanazol
Define Urticaria
Allergic reaction that causes sudden swelling of the superficial layers of the skin (considered part of anaphylaxis)
Treatment for urticaria
- Antihistamines
- Leukotriene receptor antagonists
Treatment for allergic rhinitis
- Avoidance of allergen (e.g., cover mattresses and pillows)
- Intranasal corticosteroid sprays
- Antihistamines
- Intranasal anticholinergic medications
- Desensitization
Low B cell output
Normal T cells
CVID
Low B cells
Normal T cells
Young male
X-linked (Bruton) agammaglobulinemia
Low B cells and T cells
Analogous to HIV
SCID
Atopic disorders
Anaphylaxis
IgA deficiency
Recurrent skin infections with Staph
Hyper IgE syndrome
Normal T cells
Normal B cells
Low platelets
Eczema
Wiskott-Aldrich syndrome
Infections, combined with:
Staph
Burkholderia
Nocardia
Aspergillus
CGD
Recurrent sinopulmonary infections in adults (equal gender distribution) with normal amounts of lymphoid tissue (nodes, adenoids, and tonsils)
CVID
Increased risk of lymphoma
Treatment = IVIG
Absence of tonsils, adenoids, and lymph nodes
Male children with increased sinopulmonary infections
X-linked (Bruton) Agammaglobulinemia
Treatment = IVIG
Treatment for SCID
Bone Marrow Transplant (BMT)
Anaphylaxis to blood transfusion
Think IgA deficiency
Should you give IVIG to someone with IgA deficiency
No
They will not work because the amount of IgA in the product is too insignificant to be therapeutic and the trace amounts of IgA in IVIG may provoke anaphylaxis
Treatment for Hyper IgE Syndrome
Prophylactic antibiotics (dicloxacillin or cephalexin)
Treatment for Wiskott-Aldrich Syndrome
BMT (T lymphocytes are markedly deficient in the blood and lymph nodes)
Diagnostic test for CGD
Abnormal nitroblue tetrazolium testing
Detects decrease in the respiratory burst 2/2 a decrease in NADPH oxidase
