Allergy and Immunology Flashcards
What is the most likely diagnosis of pt presenting with history of delay umbilical cord separation, chronic gingivitis, failure to thrive, and recurrent bacterial infections without swelling, erythema, warmth or pus?
Leukocyte Adhesion Deficiency
(due to abnormal leukocyte migration and adherence)
(dx: elevated leukocyte count)
What is the most likely diagnosis for pt presenting with fever, skin rash (urticarial like rash), joint pain, lymhpadenopathy and proteinuria after treatment with penicillin or cefaclor?
Serum sickness
(Type 3 hypersensitivity reaction)
(tx: stop offending agent, NSAIDs)
What is the mechanism of action of anaphylaxis due to antibiotics, bee sting, foods, and latex?
IgE mediated
What is the most likely diagnosis for pt presenting with diffuse erythematous maculopapular rash, facial swelling, fever, malaise, hepatic dysfunction, and cervical lymphadenopathy after taking antiseizure medication (phenytoin, phenobarbital, carbamazepine)?
DRESS syndrome
drug reaction with eosinophilia and systemic symptoms
What is the most likely diagnosis for patients with systemic lupus erythematous who has recurrent pyogenic infections?
C2 complement deficiency
What is the most likely diagnosis of pt presenting with recurrent sinopulmonary (otitis media, sinusitis, pnuemonia), GI and urogenital infections including Giardiasis?
IgA deficiency
increased risk of celiac, IBD, Hashimoto thyroiditsi
what disorder has an increased risk of anaphylaxis (SOB, angioedema, hives) after a blood transfusion?
IgA deficiency
What is the most likely diagnosis for pt presenting with erythematous macules associated with vesicular and bullous lesions some of which are necrosis and denuded skin, along with conjunctival erythema, photophobia, sloughing of less than 10% of body and hemorrhagic crusting?
Stevens-Johnson syndrome
associated with Bactrim, phenobarb, lamotrigene, NSAIDs
What is the most likely diagnosis for pt presenting with recurrent Staph abscesses, sinopulmonary infections and intense pruritic diffuse eczematous rash?
Hyper IgE syndrome
(Job syndrome)
(autosomal dominant)
What is the most likely diagnosis for pt presenting with recurrent bacterial infections with encapsulated organisms after the age of 4-6 months old? and what is the treatment?
X-linked agammaglobulinemia
(Bruton agammaglobulinemia)
IVIG
(avoid live virus vaccines)
What is Darier sign?
formation of wheals upon gentle stroking of reddish brown macules on skin
What is the most likely diagnosis for pt presenting with darier sign, small itchy bumps that are reddish brown, facial flushing, dizziness, intestinal ulcer, and GI discomfort?
Systemic mastocytosis
What is the treatment for anaphylaxis (2 organ system involvement)?
IM aqueous epinephrine
what virus is associated with DRESS syndrome?
human herpesvirus 6
HHV7, CMV, EBV
What is the most likely diagnosis for pt presenting with telangiectasias, photosensitivity, cheilitis, growth deficiency, primary hypogonadism, increased risk of neoplasm, bird like movements, high pitched voice, large protruding ears, and long limbs?
Bloom syndrome
congenital telangiectatic erythema
What is the most likely diagnosis for pt presenting with reddish brown hyperpigmented lesions with associated localized erythema and urticarial wheals following stroking/ rubbing?
Urticaria pigmentosa
due to histamine release from mast cells
what diagnosis is suggested by skin biopsy showing epidermal and subdermal edema associated with mixed inflammatory infiltrate containing eosinophils?
Papular urticaria
What is the most likely diagnosis for pt presenting with eczema, thrombocytopenia with small platelets, recurrent infections with encapsulated bacteria, history of prolonged bleeding with circumcision and bloody diarrhea?
Wiskott-Aldrich syndrome
(X-linked)
(EXIT)
What is the treatment for Red Man Syndrome?
decrease the rate of vancomycin infusion
What are the 2 major criteria that are suggestive of high risk of developing asthma?
- parent with asthma
2. child has eczema
What medication can result in a positive Darier sign?
Dextromethorphan
What is the most likely diagnosis for pt presenting with recurrent cutaneous and sinopulmonary infections, ataxia, pale/ fair skin, silvery hair and large inclusion bodies in cytoplasm of neutrophils?
Chediak-Higashi disease
What is the recommendation regarding egg allergy (anaphylaxis) and influenza vaccine?
Children with egg allergy can be given influenza vaccine without special precautions
What disorder other than HIV has an increased susceptibility to infection with pneumocystis jiroveci and have history of recurrent upper and lower respiratory tract infections?
Hyper IgM syndrome
mutated CD40 ligand on T cells
what vaccine can be transmitted to immunocompromised household members/
oral polio vaccine
What is the typical time frame between drug exposure and development of DRESS syndrome?
2-12 weeks
What is the most likely diagnosis for pt presenting with tense blisters overlying inflamed and non-inflamed skin, normal mucous membranes, rings of blister on trunk (string of pearls sign) and biopsy showing linear IgA deposition at the dermal-epidermal junction of the basement membrane?
IgA bullous dermatosis
idiopathic or drug-induced subepidermal blistering disorder
What is the treatment for IgA bullous dermatosis?
Dapsone
What location of the body do fixed drug eruptions occur? (4)
hands, trunk, genital, perioral
What is the most likely diagnosis for pt presenting with recurrent episodes of angioedema (of skin, GI, and upper airway) especially in response to stress and low C4 levels?
Hereditary angioedema
(due to C1 esterase inhibitor absence/ low presence)
(autosomal dominant)
What is a possible treatment for Hereditary angioedema?
Danazol
increased C1 esterase inhibtor
What is the most likely diagnosis of pt presenting with recurrent skin infections (especially S. aureus), pneumonias, and episodes of lymphadenitis?
Chronic granulomatosis disease
dx: dihydroorhodamine test
What lab test does the newborn screen use to look for SCID (Severe combined immunodeficiency)?
T-cell receptor excision circles
What disorder is associated with anaphylaxis in response to IVIG?
IgA deficiency
have preformed antibodies against IgA that will react to IVIG
what is the most likely diagnosis of pt with chronic pulmonary infections, unexplained bronchiectasis, recurrent Giardiasis, splenomegaly, and low IgG and IgA?
Common variable immunodeficiency (CVID)
tx: IVIG
What is the most likely diagnosis for a patient who has recurrent vaginal discomfort and swelling after protected sex and bimanual exam by physician?
Latex allergy
An infant presenting with blood streak stool but otherwise well appearing in the setting of starting cow’s milk based formula most likely suffers from….
protein induced proctitis
cow’s milk protein allergy
What are the 4 possible symptoms of which 2 need to be present to diagnosis a patient with anaphylaxis to food?
- GI symptoms
- hypotension
- respiratory symptoms (wheezing, difficulty breathing)
- urticaria/ hives
What is the most likely diagnosis of patient presenting with lower abdominal pain and bloating after eating wheat that resolves after a bowel movement?
Gluten intolerance
What is the most likely diagnosis for patient with atopy (eczema, asthma, allergic rhinitis) and dysphagia (difficulty swallowing solids)?
Eosinophilic esophagitis (dx: endoscopy)
