Allergy + Immunology Flashcards
Asthma symptoms occur less than twice per week
Management
Intermittent asthma
SABA prn
Asthma symptoms occur more than twice per week
Management
Mild persistent asthma
ICS + SABA prn
Daily asthma symptoms
Moderate persistent asthma
ICS + LABA + SABA prn
(Ie ICS + formeterol)
Asthma symptoms occurring multiple times per day
Severe persistent asthma
High dose ICS + LABA + leukotriene receptor antagonist + SABA prn
Signs of poor asthma control
Symptoms > 2x per week
Waking up > 2x per month
Albuterol >2x per week
Steroids >2x per year
Nasal polyps
Aspirin intolerance
Asthma
Aspirin-exacerbated respiratory disease
Allergic rhinitis
Tingling sensation in or around mouth when eating a specific food
Oral allergy syndrome
Food allergens outgrown by 5 years of age
Milk
Egg
Soy
Diagnosis anaphylaxis
Management
Involvement of more than one organ system: Derm, Respiratory, CV, GI
1) Airway
2) Epinephrine - 0.01 mg/kg (1:1000)
— 0.3mg if > 30kg
— 0.15mg if < 30kg
Disorder of phagocytic function
Deep abscess
Pneumonia
Lymphadenitis
Osteomyelitis
Staph aureus, Burkholderia, Serratia, fungi
Aspergillus
Chronic Granulomatous Disease (CGD)
NADPH oxidase defect
Diagnostic test for CGD and management
Nitroblue tetrazolium (NBT) test
(assays phagocytic oxidase acitivity)
Ppx: Bactrim and intraconazole
Defect in chemotaxis
High WBC
Abscess, omphalitis, delayed wound healing
Delayed umbilical separation
No pus
Leukocyte Adhesion Deficiency (LAD)
Diagnostic test for LAD and management
Flow cytometry
BMT and HSCT
Abnormal LYST (gene)
Giant inclusion bodies
Abnormal chemotaxis
Frequent infections (skin, lungs)
Easy bruisability
Oculicutaneos albinism
S aureus, S pyogenes, pneumococcus
Chediak-Higashi syndrome (CHS)
Autosomal recessive
diagnostic test for chediak-Higashi and management
Blood smear - giant granules in neutrophils
BMT
Most common primary immunodeficiency
Recurrent sinopulmonary infections
Not an indication for IVIG replacement
IgA deficiency
X-linked
Absent B cells
Encapsulated pyogenic bacteria
Management
Bruton’s x-linked agammaglobulinemia
IVIG
Complications of Bruton agammaglobulinema
Bronchiectasis
Chronic pulmonary insufficiency
Most common clinically significant antibody deficiency
Deficiency in B and T cells
Normal CBC
Recurrent respiratory and GI infections
Autoimmune diseases
Management
Common variable Immunodeficiency (CVID)
IVIG
Complications of CVID
Lymphoma (EBV-associated)
Disruption of B cell differentiation
Defect in CD40 (B cells will not differentiate)
Otitis
Sinopulmonary infection diarrhea
Opportunitistic infections
Lymphoid hypertrophy
Management
X-linked Hyper IgM syndrome
T cell abnormality prevents conversion of IgM to IgG
IVIG
PCP in absence of HIV
Hyper IgM syndrome
Eosinophilia
Eczema
Elevated IgE
Recurrent sinopulmonary/skin infections
Thrush
Skeletal abnormalities
Management
Job (Hyper IgE) syndrome
Antibiotics and steroids
Decreased T-helper function
Severely low IgG
Outgrow by 3-6 years
Transient hypogammaglobulinemia of Infanxy
