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Laughing Pedi > Allergy / Imm > Flashcards

Allergy / Imm Flashcards

0
Q

anaphylactoid reactions
what are they
likely culprits

A

direct degranulation of mast cells, not IgE - can pretreat

  • vanco red man (pretreat)
  • opiod
  • radiocontrast media
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1
Q

nasal polyps… do what?

A

screen for CF!

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2
Q

epi dose for anaphylaxis

A

1:1000

IM 0.01 mg/kg up to 0.3ML q15 min

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3
Q

abdominal pain, painful swelling at sites of trauma?
Dx
Test
Tx

A

hereditary angioedema
autosomal dominant, C1 inhibitor defect.
Complement C4 is best screening test
Tx w/ anabolic steroid (danazol) or newer C1INH prep for attack

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4
Q

serum triptase used to confirm what?

A

anaphylaxis to insect

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5
Q

what is urticaria pigmentosa

tx?

A

cutaneous mastocytosis
tx w/ H1/H2 blockade
red/brown macules that urticate when stroked, need bx? vasculitis

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6
Q

chronic urticaria def

cause?

A

lasts > 6 wks

90% idiopathic

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7
Q

joint and kidney involved, with one giant urticaria and target lesions 1 week after exposure?

A

serum sickness

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8
Q

hives with exercise?

A

cholinergic urticaria

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9
Q

Dx w/ recurrent bacterial infx at 4-6 mos, paucity of lymphoid tissue
Tx?
Risk of what major bug/dz

A

X linked agammaglobulinemia
Risk of meningoenceph w/ enteroviral
Tx w/ IVIG

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10
Q

most common immunoglobulin deficiency?

A

IgA def

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11
Q

inheritance of hyper IgM?

Sx

A

x-linked

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12
Q

recurrent abscesses, high IgE levels, dental anomalies

A

Hyper IgE syndrome

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13
Q

hallmark of phagocyte def?
Test?
Tx?

A

abnormal neutrophils very high levels, adenopathy, staph infx (catalase producers), lots of ulcers and recurrent infx of many types.
Abnormal NBT test
Tx w/ interferon gamma

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14
Q

syndrome with recurrent staph infx, large granules in WBC, may have partial albinism and periph neuropathy

A

Chediak-Higashi syndrome

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15
Q

recurrent infx w/o pus, delayed umbilical cord separation?

A

leukocyte adhesion def

No abscess formation b/c no pus

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16
Q

recurrent staph, abscesses, fungal infx, osteomyelitis with aspergillus, Serratia

A

CGD def! phagocyte def

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17
Q

% of asthma with resolution by adulthood

A

60%

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18
Q

TReatment of serum sickness?

A

oral steroids

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19
Q

interstitial nephritis and antibiotics is caused by what?

A

methicillin

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20
Q

recurrent neisseria meningitis

Dx and test?

A

Complement def C6-C9: check CH50

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21
Q

pollen food oral allergy syndrome, what foods?

Ragweed vs Tree polon

A

Ragweed: watermelon, melons, banana
Tree pollen: apple, pear, cherry, plum
FRESH ONLY

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22
Q

tx of chronic allergic rhinitis w/ lots of congestion?

A

intranasal steroids for congestion

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23
Q

pyoderma gangrenosum in what disease

A

IBD

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24
Q

defect in X-linked agammaglobulinemia

Tx

A

Bruton’s tyrosine kinase gene (no B cells / Immunoglobulin)

Tx: IVIG, broad spectrum Abx

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25
Q

TReatment for T cell deficiencies?

A

Stem cell or bone marrow trp to reconstitute

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26
Q

Treatment of SCID

A

ADA def, so replace with bovine ADA

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27
Q

Tx of Digeorge immunodef?

A

Thymic transplant

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28
Q

patient with recurrent bronchospasm and bronchiectasis with transient wandering pulm infiltrates
Dx?
Lab test?

A

allergic bronchopulmonary aspergillosis (NEED dx of chronic asthma for this)
Has high Total serum IgE or IgG

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29
Q

latex food allergy cross reaction, which foods?

A

ABCs: avocado, banana, chestnut, Kiwi (cross of banana / papaya)

30
Q

recurr infx, eczema, bleeding?

A

Wiskott Aldrich Sydrome, X linked

31
Q

Top 5 food allergies?

A

milk, eggs, soy, wheat, peanuts

32
Q

most important predictor of asthma, eczema, allergic rhinitis?
Breast feeding does what?

A

parental hx: 50% if 1, 75% if two.

bf delays onset, but risk is same at age 2y

33
Q

diagnosis of allergic rhinitis?

What is the major DDX?

A

snot eos

Also found in NARES: non-allergic rhinitis with eosinophilia syndrome: but Skin test and serum IgE levels neg/normal

34
Q

Treatment and Medication for allergic rhinitis?

A

Treatment: Immunotherapy
Medication: nasal steroids

35
Q

what to do during immunotherapy if local skin reaction occurs?

A

wait 15-30, continue if no systemic rxn

36
Q

def: rhinitis medicamentosa and vasomotor rhinitis

A

medicamentosa: rebound to adrenergic nasal drops
vasomotor: drainage but no trigger / infx agent

37
Q

recurrent rhinorrhea in child less than 3y?

A

URI! Pollen needs lots of exposure over years, not seen before 3y

38
Q

treatment of chronic urticaria?

A

fexofenadine

39
Q

type of reaction of contrast media?

Tx?

A

osmolality, hypertonicity rxn triggering mast cell degranulation/basophils. NOT IgE! Prevent w/ pretreatment (benadryl/steroids)

40
Q

Treatment of child with life threatening rxn to bee sting?

A

allergist! Venom immunotherapy (98% effective for future rxns)

41
Q

IgE mediated reaction is what type?

A

Anaphylactic, A Type 1

42
Q

Ab mediated type of allergic rxn?

A

Type 2: Ab = B reaction

43
Q

Type three allergic reaction is what?

A

Immune Complex / Arthus rxn

44
Q

Type 4 allergic rxn is what?

A

Delayed hypersens: skin test PPD / Poison ivy

45
Q

sneezing, wheezing, squeezing (tight chest), teary eyes.

Dx?

A

Ragweed Respiratory rxn

46
Q

Drugs that may interfere with skin testing for allergies?

A

Antihistamine / drugs with these effects like TCAs / imipramine

47
Q

RAST vs skin testing

A

skin testing in vivo, risk of anaphylaxis, but more sensitive and cheaper.
RAST in vitro, not impacted by antihistamine tx and no anaphylaxis risk

48
Q

Rule that reassurance is okay with frequent infx?

A

about 1/month, self limited GI and resp WITHOUT growth/FTT and without RECURRENT infx of one type.

49
Q

recurrent pyogenic infx. Think what immunodef?

A

B cell Ab dysfunction

50
Q

Chronic recurrent candida infx? Type of immunodef?

A

T cell dysfunction

51
Q

No lymphoid tissue and recurrent infx/

A

SCID

52
Q

key component in adaptive immunity?

A

Antigen presenting cells

53
Q

ataxia, discolored conjunctivae, frequent sinus infx?

Dx and lab test / prognosis?

A

Ataxia telangiectasia

Incr AFP/risk for ca

54
Q

Elevated T cell count, decreased lymphoid tissue, recurrent encapsulated pyogenic bacteria: strep pneumo, pseudomonas, H flu

A

Bruton’s x-linked aggamaglobulinemia: Bcells affected so no plasma cells

55
Q

Recurrent ear infx, pna then sinusitis in older kid?

Dx, dx test / confirmation, Tx, Prognosis?

A

Bruton’s X linked agammaglobulinemia XLA
Check immunoglobulin levels, then if low check B and T cell subsets.
Tx w/ IVIG
Risk for bronchiectasis and CLD

56
Q

most common primary immunodef?
Associated with what?
Prognosis / Risk
Tx?

A

CVID
assoc w/ autoimmune dz too. Hi risk of lymphoma/EBV related
Tx w/ IVIG

57
Q

transmission of most complement def? exception?

A

autosomal recessive except X-linked properdin def

58
Q

Best treatment for DiGeorge?

A

thymic transplantation for prevention of infx

59
Q

Absence of CD40 ligand causes what?
Risk for what dz?
Tx?

A

X-linked hyper IgM syndrome: disrupts B cell differentiation (Can’t change IgM –> IgG
High risk of PCP w/o HIV
Tx w/ Ig replacement (IVIG) and bactrim for PCP prophylaxis

60
Q 
HyperE syndrome? 
Also called
Sx? Infx
Assoc features
Tx
A

Job Syndrome: Three Es: Eos, eczema, elevated IgE
Infx w/ S aureus, chronic thrush
Assoc w/ fractures, abnormal faces
Tx w/ Abx and steroids

61
Q

Lab Diagnosis of SCID

A

complete absence of T cell function, B cells may be normal

Flurometric analysis of T, B, and NK cell subsets

62
Q

Severe infx, dermatitis, diarrhea, FTT in first few months of life, DX? A specific type?
Tx

A

SCID, may be ADA deficiency

BMT

63
Q

situation in which 6 mo has lots of infections and lab has severely low IgG, slightly low IgA, and normal IgM.

A

Transient hypogammaglobulinemia of infancy due to decreased helper T cell function

64
Q

S. aureus abscesses and serratia marcescens UTIs, think of what immuno def? Tx?

A

Phagocyte issue: CGT

Tx: Abx, interferon gamma

65
Q

Dx w/ high WBC > 20,000and infx w/ perirectal abscess, indolent skin infx, omphalitis but NO PUS, delayed wound healing

A

LAD: leukocyte adhesion def

66
Q

Tx for LAD?

A

BMT can be curative

67
Q

Zidovudine type of drug

A

nucleoside analog

68
Q

nevirapine type of drug

A

reverse transcriptase inhib

69
Q

indinavir type of drug

A

protease inhib

70
Q

normal NBT test?

A

turns blue: good neutrophil ACTIVITY

71
Q

what test for ability of cells to migrate in LAD?

A

Rebuck Skin Window

72
Q

consider this dx if Ab levels are high in the first year but dysfunctional, and then later on are low?

A

HIV in infant

Laughing Pedi (24 decks)

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