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
Ataxia
Conjunctival discoloration
Frequent sinus infections
Developmental regression
Ataxia Telangiectasia
Autosomal recessive
Conotruncal cardiac anomalies and VSD
Abnormal facies
Thymic aplasia and hypoplasia
Tetany
Cleft palate
Hypoparathyroidism
22q11 deletion syndrome
Best therapeutic approach for DiGeorge
Thymic transplantation
Complete absence of B and T cell function
FTT
Chronic diarrhea
Recurrent opportunistic infection
Low WBC
Management
Severe Combined Immunodeficiency (SCID)
T cell receptor excision circles
Supportive. BMT
Eczema
Thrombocytopenia/unusual bleeding
Cellular immunodeficiency
Recurrent sinopulmonary infections
Small platelets
Encapsulated bacteria
Opportunistic infection
Wiskott-Aldrich t
Management and complications of wiskott-aldrich
Supportive
BMT. HSCT.
Lymphoma (most common cause of death)
C1-C4 deficiency
Recurrent sinopulmonary infection due to encapsulated bacteria
C5-C9 deficiency
Recurrent Neisseria infection
Increased risk of meningitis
Blood streaks in poop
Growing well
Non-IgE mediated
Protein-induced proctitis
Reduced C1 inhibitor and C4 levels
Hereditary angioedema
Congenital telangiectatic erythema
Long face
Large protruding ears
Bloom syndrome
Drug association with IgA bullous dermatosis
Vancomycin
