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PEDIATRIC BRS > allergy/immuno > Flashcards

allergy/immuno Flashcards

1
Q

anaphylaxis

A

acute systemic IgE mediated reaction

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2
Q

what does anaphylaxis effect?

A

vascular tone and bronchial reactivity

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3
Q

mechanism of of anaphylaxis

A

antigen binding to IgE on the surface of mast cells and basophils results int eh release of potent mediators that affect vascular tone and bronchial activity

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4
Q

what are the cardiovascular symptoms relating to anaphylaxis?

A

ranges from mild hypotension to shock

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5
Q

what is the treatment for acture respiratory and cardiovascular complications of anaphylaxis?

A

epinephrine

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6
Q

this is an IgE mediated inflammatory response int he nasal mucosa to inhaled antigens

A

allergic rhinitis

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7
Q

pathophysiology behind allergic rhinitis

A

mast cells degranulate and release histamine, leukotrienes, kinins, and prostaglandins

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8
Q

these are dark circles under the eyes caused by VENOUS CONGESTION

A

allergic shinders

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9
Q

these are creases under the eyes as a result of CHRONIC EDEMA

A

Dennie’s lines

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10
Q

what is the lab eval of allergic rhinitis?

A

total IgE concentration may be elevated, allergen skin testing

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11
Q

what is critical to do before an allergy skin test?

A

discontinue antihistamines 4-7 days before skin testing

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12
Q

how can you differentiate allergic rhinitis from other disorders

A

more than 10% eosinophils suggests allergic rhinitis

more POLYMORPHIC LEUKOCYTES SUGGESTS AN INFECTION CAUSE

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13
Q

what is the most effective class of drugs for controlling rhinitis symptoms?

A

intranasal steroids

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14
Q

what are the 2 benefits of intranassal steroids

A

minimal systemic absorption, and the hypothalamic pituitary adrenal axis is not affected at recommended doses

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15
Q

diphenhydramine is a ____ generation antihistamine that may cause _____ and can impair academic performance

A

first generation antihistamine

sedation

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16
Q

cetirizine, fexofenadine, loratidine are all what class of drugs

A

second generation antihistamines that are safer and better tolerated

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17
Q

how does cromolyn sodium work?

A

prevents max cell degranulation

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18
Q

these relieve vasoconstriction and relieve nasal congestion but can cause insomnia, nervousness and rebound rhinitis?

A

decongestants (pseudoephedrine)

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19
Q

repeated injections of allergens with time lead to ?

A

better tolerance of the allergen by the patient

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20
Q

chronic inflamm dermatitis

A

atopic dermatitis (eczema)

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21
Q

characteristics of eczema

A

dry skin and lichenification

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22
Q

when is atopic dermatitis worse?

A

in extremes of temperature

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23
Q

is atopic dermatitis familial?

A

yes

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24
Q

acute or chronic? erythema, weeping and crusting and secondary staph aureus, hsv infection?

A

ACUTE

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25
Q

acute or chronic? lichenification, dry scaly skin and pigmentary changes?

A

chronic

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26
Q

truncal and facial area, scalp and EXTENSOR SURFACES are affected

A

infantile form of atopic dermatitis

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27
Q

FLexural serfeces, lichenifcation ?

A

early childhood form of atopic dermatitis

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28
Q

what are the 4 major criteria of eczema?

A

pruritus
personal/familial history of atopy
typical morphologic distribution
relapsing or chronic dermatitis

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29
Q

management of eczema

A

avoid known triggers
low to medium potency corticosteroid cream except on face
antihisamines
baths

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30
Q

this is an igE mediated response to food antigens?

A

food allergy

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31
Q

what are most allergic reactions caused by?

A

egg, milk, peanut, soy wheat and fish

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32
Q

true or false, exclusive breastfeeding for 6 months may decrease food allergies and atopic dermatitis in the infant?

A

true

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33
Q

what are the 2 tests for food allergies?

A

skin tests and radioallergosorbent tests

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34
Q

what its he definitive test for food allergy?

A

double blind placebo controlled food challenge test

35
Q

what can local skin reactions be treated with for insect bites?

A

cold compresses, analgesics and antihistamines

36
Q

diffuse urticartia tx

A

antihistamines and systemic steroids

37
Q

this is a circumscribes, raised vanishing areas of edema that are always pruritic? they are are also symmetric and migratory

A

urticaria

38
Q

these 2 groups of ppl are at higher risk for acute urticaria due to latex allergy

A

MYELOMENINGOCELE

health care workers

39
Q

this is urticaria that last >6 months

A

chronic urticaria

40
Q

what is chronic urticaria usually associated with?

A

malignancy and rheumatologic disease

41
Q

those with chronic urticaria generally have an Ig___ antibody to the Ig____ receptor

A

IgG antibody to the IgE receptor

42
Q

these are common drugs that cause drug allergies

A

penicillin, sulfonamides, cephalosporins, aspirin and other non steroidal antiinflam drugs and narcotics

43
Q

phagocytic cells, nK cells, toll-like receptors, mannose binding protein and alternative complement pathway are all what type of response?

A

innate response ( first defense)

44
Q

T cells, B cells and immunoglobulin molecules are all what type of response?

A

adaptive responses

45
Q

serum igA concentrations

A

IgA deficiency ( most common deficiency)

46
Q

a patient comes in with recurrent sinusitis, pneumonia, otitis media and bronchitis along w/ chronic diarrhea and foul smelling fatty droplet diarrhea w/ SLE and JVA will most likely have what?

A

igA deficiency

47
Q

how is igA deficiency diagnosed?

A

quantitative measurement of serum immunoglobulin

48
Q

true or false IVIG is indicated in IgA deficiency?

A

false, IVIG is not indicated b/c IgA cannot be replaces, IVIG is not indicated because it contains almost all IgG

49
Q

normal numbers of B and T cells but variable degrees of T - cell dysfunction?

A

common variable immunodeficiency w/ HYPOGAMMAGLOBULINEMIA

50
Q

a fully immunized boy comes in but his titers still show low antibodies? what does he most probably have?

A

diminished antibody function due to common variable immunodeficiency

51
Q

3 treatments for common variable immunodeficiency?

A

monthly IVIG replacement
aggressive management of infections w/ antibiotics
chronic diarrhea management w/ nutritional support

52
Q

deficiency of the common gamma chain of receptor for cytokines IL 2,4,7,9 and 15?

A

x linked SCID

53
Q

caused by T- cell ontogeny defect and adenosine deaminiase def?

A

Autosomal recessive SCID

54
Q

what 2 opportunistic organisms will cause infection within the first few months of life in a baby w/ SCIDS?

A

candida and pneumocystis carinii

55
Q

how will a patient w/ acids present in CBC? flow cytometry? ogg? t cell response?

A
  1. perisient lymphopenia
56
Q

treatments for SCIDS

A
  1. supportive care
  2. blood prudcts be irradiated to prevent draft vs. host disease
  3. monthly IVIG replacement
  4. TMPSMX prophylaxis for P. Carinii
57
Q

combined immunodeficiency, cerebellar ataxia, oculocutaneous telangiectasias, and predisposition to malignancy?

mutation of a gene on the long arm of CHROMOSOME 11

A

ataxia telangiectasia

58
Q

true or false? most patients diagnosed w/ ataxia telangiectasia will need wheel chair assistance by early adolescence?

A

true

59
Q

what are most patients w/ ataxia telengectasia deficient in?

A

IgE and IgA

60
Q

what should those w/ ataxia telangiectasia avoid?

A

avoid ionizing radiation which exacerbates DNA breakage and repair thus increasing risk for malignancy

61
Q

cardiac defects, abnormal facies, thymic hypoplasia, cleft palate and hypocalcemia?

A

digeorges syndrome

62
Q

what chromosome is involved w/ digeorges syndrome?

A

22q11

63
Q

x linked disoder characterized by combined immunodeficiency, eczema, congenital thrombocytopenia w/ small platelets?

A

wiskott aldrich syndrome

64
Q

what gene product is lost in wiskott aldrich syndrome?

A

t - cell receptor signaling and cyto skeletal organization

65
Q

what will those w/ wiskott aldrich syndrome generally present w/

A
  • infection w/ encapsulated organism such as h. influenza and s. pneumo
  • thromboycytopenia w/ small defective platelets ( frequent bleeding episodes)
  • eczema
66
Q

those with wiskott aldrich syndrome will have decreased Ig_____

A

IgM

67
Q

what is the therapy of choice for wiskott aldriche syndrome?

A

HLA matched bone transplantation

68
Q

what will cure the thromboycytopenia in wiskott aldrich?

A

splenectomy

69
Q

severe hypogammaglobulinemia w/ a paucity of mature B cels in peripheral blood w/ normal t- cell number and function?

A

Brutons Agammaglobulinemia

70
Q

this gene is critical to normal B-cell ontogeny and mutations lead to a block in the development from Pre-b Cellt o B cell?

A

BTK

71
Q

what is preserved in britons a gammaglobulinemia?

A

t - cells are present and cell mediated functions are preserved, IVIG replacement to prevent infection

72
Q

defective NADPH results in what?

A

chronic granulomatous disease

73
Q

does chronic grandulomatous disease affect catalase positive or negative bacteria?

A

catalase positive

74
Q

what are 3 disorders of granulocytes?

A

CGD, schwachman diamond syndrome, chediak higashi sydrome

75
Q

what is characteristic of CGD?

A

abscess formation

76
Q

what is the diagnostic test for CGD?

A

nitroblue tetrazolium test

77
Q

what 3 things are given prophylactically to CGD patients?

A

TMP SMX, itraconazole for aspergillus, interferon gamma

78
Q

patients with disease present with recurrent soft tissue infection, chronic diarrhea and failure to thrive

A

schachman diamond syndrome

79
Q

patients with those infections generally have s. aureus infections, neutropenia, thrombocytopenia, and partial albinism

A

chediak higashi syndrome

80
Q

composed of plasma proteins and cellular receptors functioning in an integrated series to prevent infection

A

complement systom

81
Q

how can you differentiate between early component deficiency vs. late component?

A

early - autoimmune

late - increased meningococcal and gonococcal infections

82
Q

this type of complement deficiency will cause heretarary angioedema and episodic swelling ov arious body parts including hands and feet and bowel

A

C1 esterase deficiency

83
Q

how can you diagnose complementt system disorders

A

CH50

84
Q

management of complement deficiency

A
  1. tx bacterial infect
  2. manage autoimmune disease
  3. fibrinolysis inhibitiors and attenuated androgens (DANAZOL) for hereditary angioedema

PEDIATRIC BRS (9 decks)

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