Allergy and Immunology Flashcards
Signs of impaired phagocytes?
Chronic or early infections of the skin, mucous membranes, lungs, bone or liver.
10 warning signs for immunodeficiency
- 4 or more new ear infections in 1 year
- 2 or more serious sinus infections within 1 year
- 2 or more months on antibiotics with little effect
- 2 or more pneumonias within 1 year
- Failure of an infant to gain weight/grow normally
- Recurrent, deep skin or organ abscesses
- Persistent thrush in mouth or skin fungal infection
- IV abx needed to clear infections
- 2 or more deep seated infections including septicemia
- FmHx of primary immunodeficiency
Risk factors for allergic rhinitis (6)
- FmHx of atopy
- mothers who smoke heavily
- serum IgE >100 IU/mL before age 6
- heavy exposure to indoor allergens
- C/S delivery
- 2 or more episodes of rhinorrhea in the first year of life
What can be done to reduce the risk of developing allergic rhinitis?
- exposure to cat/dog dander early in childhood
- prolonged breastfeeding
- early introduction to wheat, rye, oats, barley, fish, eggs
What are some complications of allergic rhinitis?
- chronic sinusitis
- persistent cough
- eustachian tube obstruction and middle ear effusion
- tonsillar/adenoid hypertrophy
- OSA
- daytime fatigue
What are the diagnostic criteria for anaphylactic shock?
- acute onset of illness with involvement of the skin and/or mucous membranes along with either a) respiratory compromise or b) reduced BP or signs of end-organ dysfunction
- 2 or more of the following signs rapidly following exposure to a likely allergen: skin/mucosal involvement, respiratory compromise, reduced BP, persistent GI symptoms
- reduced BP after exposure to a known allergen
What advice should be given to a child with numbness and tingling after oral ingestion of apples or plums?
- advise the child that they likely have oral allergy syndrome
- will need further testing for confirmation
- may be able to tolerate cooked or processed forms of that food, but should carry and EpiPen and avoid completely if systemic reaction occurs
What is the dose of Epinephrine that must be given in the event of anaphylactic shock?
Epinephrine 1:1000 0.01 mg/kg IM into anterolateral thigh
Mother brings her 6 month old baby boy to your office. He has had two episodes of AOM since birth. He also has eczema and some bloody stool. He also had prolonged bleeding after his circumcision. What is the likely diagnosis?
Wiskott-Aldrich Syndrome (X-linked recessive)
What is the curative treatment for WAS?
bone marrow or cord blood transplantation
Recurrent/multiple skin/lung/bone/GU infections with aspergillus, staph aureus, serratia and salmonella is concerning for what condition?
Chronic granulomatous disease
What test should be done to diagnose Chronic granulomatous disease?
- NiroBlue Tetrazolium test
- neutrophil oxidative burst index
What steps should be taken to treat children with CGD?
- antibacterial and antifungal prophylaxis
- aggressive treatment of infections when present
- bone marrow transplantation
What are the distinguishing features of Job’s Syndrome?
- cold abscesses in the skin/lungs
- coarse facies
- high Ig E count and eosinophilia
- poor antibody response to vaccines
- delayed shedding of teeth
- eczema
What condition should be considered in the event of delayed cord separation? What other features are present?
Leukocyte adhesion defect
will also see:
- lack of pus (as neutrophils are unable to leave blood vessel lumen)
- large chronic ulcers